New antiarrhythmic drugs: tocainide, mexiletine, flecainide, encainide, and amiodarone

Mayo Clin Proc. 1987 Nov;62(11):1033-50. doi: 10.1016/s0025-6196(12)65077-0.

Abstract

Tocainide, mexiletine, flecainide, encainide, and amiodarone are antiarrhythmic agents that have recently been approved by the Food and Drug Administration for general use in the treatment of ventricular arrhythmias. All five agents are effective in the treatment of patients with ventricular arrhythmias, whereas encainide, flecainide, and amiodarone are also useful in patients with supraventricular arrhythmias and the Wolff-Parkinson-White syndrome (although not yet approved for these indications). Tocainide and mexiletine are similar to lidocaine and are as effective as quinidine in patients with ventricular arrhythmias. Encainide and flecainide are superior to quinidine for the control of ventricular ectopic beats and as effective as quinidine for patients with ventricular tachycardia. Amiodarone is the most effective agent available for treating patients with ventricular tachycardia, but it is also the most toxic antiarrhythmic agent and should be used only when other antiarrhythmic drugs have not been effective or tolerated.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Amiodarone / adverse effects
  • Amiodarone / pharmacology
  • Anilides / adverse effects
  • Anilides / pharmacology
  • Anti-Arrhythmia Agents*
  • Drug Interactions
  • Encainide
  • Flecainide / adverse effects
  • Flecainide / pharmacology
  • Heart Conduction System / drug effects
  • Humans
  • Lidocaine / adverse effects
  • Lidocaine / analogs & derivatives
  • Lidocaine / pharmacology
  • Mexiletine / adverse effects
  • Mexiletine / pharmacology
  • Tachycardia / drug therapy
  • Tocainide

Substances

  • Anilides
  • Anti-Arrhythmia Agents
  • Mexiletine
  • Tocainide
  • Lidocaine
  • Flecainide
  • Amiodarone
  • Encainide