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Ibutilide is currently indicated for the rapid pharmacologic conversion of atrial fibrillation and atrial flutter, although it may be more efficacious for the latter. It can be given intravenously and has a fast onset.
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It prolongs repolarization by increasing the slow inward sodium current and by blocking the late rectifier current. Ibutilide is one of the more recently released intravenous class III antiarrhythmic drugs. DiNardo, in A Practice of Anesthesia for Infants and Children (Sixth Edition), 2019 Ibutilide (Corvert ) AV nodal blocking drugs may also be used but are often difficult to titrate because of the relatively slow cycle length and fixed conduction ratios often seen in IART.Īnnette Y. The frequent occurrence of thrombosis in adult patients with CHD and atrial tachycardia suggests that warfarin or other potent anticoagulant therapy is indicated in most of these patients. Novel antiarrhythmic drugs with pure class III activity have not been widely used in IART and may prove useful. However, proarrhythmia and adverse effects on ventricular and nodal function may limit their value. Experimental models of atrial reentry have given us a good understanding of the potential salutary effects of New York Heart Association class IC and class III drugs, and symptomatic arrhythmias can sometimes be suppressed in individual patients using these agents.
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Walsh, in Diagnosis and Management of Adult Congenital Heart Disease (Second Edition), 2011 Drug therapyĪlthough some small studies have suggested otherwise, clinical experience generally suggests that antiarrhythmic drug therapy is unlikely to suppress recurrences of IART. Currently, DDS are developed using the modern techniques for augmenting their absorption into the systemic circulation using the transdermal route ( Kintzing and Cochran, 2016). Besides, absorption enhancers can be employed to enhance the permeability of these molecules. Delivery of exogenous proteins may cause obstruction while interacting with the endogenous proteins and affect the normal physiology and functioning of endogenous protein. These properties are crucial for the designing an apt DDS for their delivery as per the therapeutic requirements.
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Physiochemical properties of therapeutic proteins like protein folding and/or instability is vital for calculating their pharmacokinetic parameters. Patients receiving protein and peptide injections often experience discomfort and pain, which has resulted in peptide delivery not being considered in the last decades to have constituted the desired breakthrough. Therefore, most of the protein and peptide drugs in the market today are administered parenterally as injections. Furthermore, poor stability and short plasma half-life are major drawbacks. Most pharmaceutical proteins and peptides are considered to be BCS Class III drugs, thus having a good solubility but poor permeability, which leads to an overall poor bioavailability. Tekade, in Dosage Form Design Considerations, 2018 12.4.2.5 Biopharmaceutical Aspects
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