Indecainide

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Indecainide

Chemical structure of Indecainide

Indecainide is a pharmaceutical compound that was developed as an antiarrhythmic agent. It belongs to the class of drugs known as Class I antiarrhythmic agents, which work by blocking sodium channels in the heart, thereby affecting the cardiac action potential and stabilizing the cardiac rhythm.

Mechanism of Action

Indecainide functions primarily by inhibiting the fast sodium channels in the cardiac myocytes. This action results in a decrease in the rate of depolarization during phase 0 of the cardiac action potential. By slowing down the conduction velocity, Indecainide can help to correct abnormal heart rhythms, such as ventricular tachycardia and atrial fibrillation.

Pharmacokinetics

Indecainide is administered orally and is absorbed through the gastrointestinal tract. It undergoes hepatic metabolism and is excreted primarily through the kidneys. The drug has a relatively short half-life, which necessitates frequent dosing to maintain therapeutic levels in the bloodstream.

Clinical Use

Indecainide was primarily used in the treatment of life-threatening ventricular arrhythmias. However, due to the development of newer antiarrhythmic agents with better safety profiles, its use has declined. It is important to monitor patients for potential side effects, including proarrhythmic effects, which can exacerbate existing arrhythmias or create new ones.

Side Effects

Common side effects of Indecainide include dizziness, nausea, and headache. More serious side effects can include proarrhythmia, hypotension, and heart failure. Due to these potential adverse effects, careful monitoring of patients is required during treatment.

History

Indecainide was developed in the late 20th century as part of a broader effort to find effective treatments for cardiac arrhythmias. While it showed promise in early trials, its use was eventually overshadowed by other medications with improved efficacy and safety profiles.

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Contributors: Prab R. Tumpati, MD