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Volume 08
Clinical Pharmacology & Biopharmaceutics
ISSN: 2167-065X
Pharmacology 2019
World Heart Congress 2019
August 19-20, 2019
JOINT EVENT
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August 19-20, 2019 Vienna, Austria
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7
th
World Heart Congress
24
th
World Congress on
Pharmacology
Effectiveness of combine therapyusingAllapininandcardiac glycosides for suppressionof supraventricular
paroxysmal tachyarrhythmias in patients with ischemic heart disease
Kapustnyk Yurii
Ukrainian Medical Stomatological Academy, Ukraine
P
aroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia can be treated using several
preparations. Author of this abstract has developed the newmethod of treatment for paroxysmal supraventricular
tachyarrhythmia’s including such disorder of cardiac rhythm in patients with severe heart failure. In accordance with
this method combination of preparations with antiarrhythmic action (allapinin + cardiac glycosides) is used.
Allapinin is the alkaloid of bromhydrate lappaconitine. This alkaloid was extracted from the perennial plant. It can
be extracted from the wild plant of the aconite, which belongs to the group of buttercup plants. It is produced in
tablets at 50 mg and in solution for intravenous or intramuscular administration: 1% solution in ampoules at 2 ml.
Allapinin occupies the special place among antiarrhythmic agents of the 1st class according to Vaughan-Williams
classification. It differs from agents of IA and IB subclass. Being different from quinidine, procainamide, gilurytmal
and others agents of the 1st class of antiarrhythmic drugs allapinin in effective antiarrhythmic doses has small
influence on the width of ventricular QRS complex, P-Q interval and Q-T interval. Allapinin in doses, which provide
denominated antiarrhythmic effect, unlike the other antiarrhythmic drugs, does not lead to reduction of the system
arterial pressure and to negative inotropic action in myocardium fibers.
In accordance with the new method of treatment of paroxysmal supraventricular tachyarrhythmias a cardiac
glycoside – digoxin (lanoxin) in dose 0,25 mg or strophantin in dose 0,25 mg is administered intravenously. Then in
20-30 minutes after administration of cardiac glycoside allapinin is used intravenously in dose 30-40 mg
In case of suppression of paroxysmal tachyarrhythmia prophylactic treatment must be administered using the
above preparations. Allapinin is administered orally in daily dose 75 mg (25 mg 3 times daily). In combination with
allapinin digoxin is used orally in dose 0,25 mg (1 tab) 1-2 times daily. In case of positive result of therapy the daily
dose of allapinin can be reduced to 50 mg (1 tablet 2 times a day) and digoxin - to the minimum effective one, which
is 0,25 mg (1 tablet) once a day.
The criterion of such positive result of therapy is occurrence of the periods without paroxysms of tachyarrhythmia,
which are greater than 1,5-2 periods. Such periods occurred earlier between paroxysms of tachyarrhythmia. Thus,
this therapy provides prophylactic effect in respect to occurrence of tachyarrhythmia attack.
The significant advantage of this method is the possibility of using it for the patients with severe heart failure. Unlike
the majority of other antiarrhythmic drugs of synthetic origin allapinin does not have any negative inotropic action
in effective antiarrhythmic doses. For the patients with cardiac failure this cardiac glycoside leads to improving of
metabolism in myocardial cells. Such improvement of myocardium metabolism contributes to the elimination of
paroxysmal tachyarrhythmias.
The most expressive effect of combined therapy is observed in case of intravenous administration of allapinin in
single dose 30-40 mg and cardiac glycoside in 20-30 minutes after using allapinin. Such combination of these agents
is conditioned by their pharmacodynamics. The beginning of antiarrhythmic effect occurred only in 10-15 minutes
after its intravenous administration. The maximal effect of allapinin is achieved in 20-40 minutes after using this
antiarrhythmic drug. This property of allapinin is conditioned by the time of intravenous administration of cardiac
Kapustnyk Yurii, Clin Pharmacol Biopharm, Volume 08