116 results on '"Antazoline"'
Search Results
2. Antazoline in Comparison to Propafenone in Pharmacological Cardioversion of Atrial Fibrillation. (AnProAF)
- Author
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Jarosław Karwowski, Principal Investigator
- Published
- 2023
3. Comparison of efficacy of pharmacological cardioversion with antazoline and propafenone versus electrical cardioversion in atrial fibrillation during cryoablation.
- Author
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Klocek, Konrad, Tworek, Michał, Klimek, Katarzyna, Zabochnicki, Mateusz, Mazur, Marta, Milewski, Krzysztof, Kaźmierczak, Paweł, and Janas, Adam
- Subjects
- *
CRYOSURGERY , *ATRIAL fibrillation , *ELECTRIC countershock , *RIGHT heart atrium , *PROPAFENONE , *LEFT heart atrium - Abstract
Introduction: Antazoline with propafenone may be an alternative to electrical cardioversion (ECV) in restoring sinus rhythm in patients with atrial fibrillation (AF), including during balloon cryoablation. Aim: To compare the efficacy of antazoline with propafenone and ECV in restoring and maintaining sinus rhythm at discharge in patients with AF during cryoablation with special regard to type of AF. Material and methods: The study retrospectively analyzed 196 patients who underwent elective cryoablation. Eighty-nine patients who developed AF in the perioperative period were selected as the study group (32 women and 57 men). The study group was divided into two groups – 46 (51.7%) patients were given pharmacological cardioversion with 70 mg of propafenone and 100 or 200 mg of antazoline, whereas the other 43 (48.3%) patients underwent ECV. Results: There were no statistically significant differences between the groups regarding: left atrial area, left atrium diameter, right atrial area and right atrium diameter. In the overall population, ECV was more effective than antazoline with propafenone therapy (31 [72.1%] vs. 20 [43.5%]; p = 0.01). A similar relationship was demonstrated in patients with persistent AF (13 [59.1%] vs. 3 [12.5%]; p = 0.002). There was no significant difference in the group of patients with paroxysmal AF (18 (85.6%) vs. 17 (77.3%); p = 0.7). Conclusions: In AF during the cryoablation procedure ECV appears to be more effective in restoring and maintaining sinus rhythm at discharge than antazoline with propafenone in the general AF patient population, especially in patients with persistent AF. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
4. Systematic review of the safety and efficacy of antazoline in the treatment of atrial fibrillation.
- Author
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Raghad Aldulaymi and Ahmad Z. Al Meslamani
- Subjects
antazoline ,efficacy ,pharmacological cardioversion ,recent-onset atrial fibrillation ,safety ,Therapeutics. Pharmacology ,RM1-950 ,Pharmacy and materia medica ,RS1-441 - Abstract
Context: In the emergency department, patients with recent-onset atrial fibrillation are typically managed with intravenous antiarrhythmic agents. However, the currently used agents have a low efficacy and safety profile. Antazoline is an antihistaminic agent that has been shown to have a strong antiarrhythmic effect when administered intravenously, facilitating rapid conversion to normal sinus rhythm. Aims: To systematically review the literature on the safety and efficacy of antazoline in the treatment of recent-onset short-duration atrial fibrillation and to compare the clinical efficacy of antazoline to that of other antiarrhythmic agents listed in clinical guidelines. Methods: The study was written in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol. A comprehensive search of databases (PubMed, Scopus, ScienceDirect, Web of Sciences, Google Scholar, Clinical trial.gov) for relevant studies in English from inception to 2021 using keywords involving “antazoline” AND other terms such as “antiarrhythmic”, “atrial fibrillation”, and “arrhythmia”. Results: Of the 478 studies identified, 446 were screened, and 7 were included, one of which was a randomized control trial, and the others were observational studies. The majority of studies indicated that antazoline resulted in rapid cardioversion to sinus rhythm. When compared to other pharmacological cardioversion options, antazoline achieved higher cardioversion rates than amiodarone or propafenone and was generally a safer option. Conclusions: Antazoline appears to be an effective pharmacological agent for the rapid cardioversion of short-term atrial fibrillation. More randomized clinical trials, however, should be conducted to strengthen the evidence.
- Published
- 2022
5. Novel Stability-Indicating TLC-Densitometric Method for Quantification of Antazoline and Tetryzoline; Application to Pharmaceutical Formulation
- Author
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Ola G. Hussein, Mohamed Abdelkawy, Mamdouh R. Rezk, Dina A. Ahmed, and Yasmin Rostom
- Subjects
Antazoline ,Hydrolysis ,Mass spectrometry ,Oxidation ,Tetryzoline ,Chemistry ,QD1-999 - Abstract
Ophthalmic pharmaceutical preparation containing antazoline hydrochloride (ANT) and tetryzoline hydrochloride (TET) is prescribed widely as an over the counter (OTC) medication to treatment allergic conjunctivitis and their determination in presence of their degradation products is a major challenge. A novel sensitive, selective, and precise thin-layer chromatographic method established to determination both ANT and TET in both bulk drugs, formulation, and in presence of their degradation products with the elucidation of degradate's structures. Upon using silica gel plates and means of a developing system using ethyl acetate: ethanol: ammonia (8: 2: 0.1, by volume) the studied drugs separation was achieved, and scanning was carried out at 220.0 nm for the separated bands with a 0.2–18.0 µg/band concentration range for each of ANT and TET. Optimum separation was achieved with values Rf of 0.42 and 0.69, for TET and ANT, respectively. Additionally, the studied drugs' stock solutions were imperiled to different stress conditions. Both drugs were found to be vulnerable to alkaline hydrolysis as well as oxidative degradation showing well resolved degradation products' peaks. While they held out against acidic, thermal and photo degradation. Mass spectrometry was employed to elucidate the degradates' structures. Validity was applied for the proposed method with respect to all validation parameters. Effectively the method was applied to estimate the cited drugs' in marketed ophthalmic formulation.
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- 2023
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- View/download PDF
6. Development and Performance Verification of the PBPK Model for Antazoline and Its Metabolite and Its Utilization for Pharmacological Hypotheses Formulating.
- Author
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Wiśniowska, Barbara, Giebułtowicz, Joanna, Piotrowski, Roman, Kułakowski, Piotr, and Polak, Sebastian
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ATRIAL fibrillation , *DRUG interactions , *GENERATION gap , *PHARMACOKINETICS , *HYPOTHESIS - Abstract
Antazoline is an antihistaminic drug that is effective in the termination of paroxysmal atrial fibrillation. Despite its long presence in the market, antazoline's ADME parameters and pharmacokinetic effects in humans are poorly characterized. The objective of this study was to fill this gap by generation of in vitro and in vivo data and the development of a physiologically based pharmacokinetic model describing antazoline and its main metabolite disposition. A set of ADME parameters for the antazoline and its hydroxy metabolite is provided based on literature data, QSAR predictions, in vitro binding and metabolic stability assays. These can be used to feed PBPK models. In our current work, the developed PBPK model simulating simultaneously the pharmacokinetic profile of antazoline and its metabolite was successfully verified against the available clinical data and the presented capability to account for the clinically observed variability. When used to feed the PD model (e.g., simulating ECG), concentration-time profiles predicted by the model enable the assessment of antazoline's effect in various clinical scenarios with the possibility to account for population differences or CP mediated drug-drug interactions. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
7. Antazoline in Rapid Cardioversion of Paroxysmal Atrial Fibrillation (AnPAF)
- Published
- 2015
8. Development and Performance Verification of the PBPK Model for Antazoline and Its Metabolite and Its Utilization for Pharmacological Hypotheses Formulating
- Author
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Barbara Wiśniowska, Joanna Giebułtowicz, Roman Piotrowski, Piotr Kułakowski, and Sebastian Polak
- Subjects
atrial fibrillation ,antazoline ,PBPK modelling ,IVIVE ,Medicine ,Pharmacy and materia medica ,RS1-441 - Abstract
Antazoline is an antihistaminic drug that is effective in the termination of paroxysmal atrial fibrillation. Despite its long presence in the market, antazoline’s ADME parameters and pharmacokinetic effects in humans are poorly characterized. The objective of this study was to fill this gap by generation of in vitro and in vivo data and the development of a physiologically based pharmacokinetic model describing antazoline and its main metabolite disposition. A set of ADME parameters for the antazoline and its hydroxy metabolite is provided based on literature data, QSAR predictions, in vitro binding and metabolic stability assays. These can be used to feed PBPK models. In our current work, the developed PBPK model simulating simultaneously the pharmacokinetic profile of antazoline and its metabolite was successfully verified against the available clinical data and the presented capability to account for the clinically observed variability. When used to feed the PD model (e.g., simulating ECG), concentration-time profiles predicted by the model enable the assessment of antazoline’s effect in various clinical scenarios with the possibility to account for population differences or CP mediated drug-drug interactions.
- Published
- 2022
- Full Text
- View/download PDF
9. ANTAZOLINE RENAISSANCE IN THE TREATMENT OF CARDIAC ARRHYTHMIA: A REVIEW.
- Author
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PALIMONKA, KRZYSZTOF and PAŚKO, PAWEŁ
- Subjects
ARRHYTHMIA treatment ,ATRIAL fibrillation ,IMMUNOSUPPRESSIVE agents ,MYOCARDIAL depressants ,ANTIHISTAMINES - Abstract
Antazoline is an antihistaminic, immunosuppressive, antiarrhythmic agent. Antazoline can be administered orally, intravenously, intramuscularly or via the ophthalmic route. Antazoline has a limited application as an antiarrhythmic drug. This review was undertaken with the aim to combine the old and the new results of different types of studies (clinical, retrospective, or pharmacokinetic) and sum up the positive and negative effects of antazoline in cardiology and emergency medicine. A literature queries were performed in the following databases: PubMed, Embase, Google Scholar, and Web of Science (all from their inception date till June 2019). The queries covered antazoline in combinations with such terms as antiarrhythmic activity, arrhythmia, electrocardiography, emergency medicine, and cardiology. Additional publications were found by checking all the reference lists. The newest research shows that antazoline may have the highest success rate of pharmacological cardioversion among all drugs used in the contemporary treatment of cardiac arrhythmia (up to 85.3%). The rate of cardioversion with antazoline alone was higher than the combined amiodarone and/or propafenone. Most of the studies which were reviewed indicated that paroxysmal atrial fibrillation, compared to chronic atrial fibrillation, responded more satisfactorily to antazoline treatment. Most patients tolerated antazoline well and conversion was safe, effective, and smooth. Some research proves that antazoline use may also reduce the rate of hospitalization due to the adverse effects. Antazoline has a definite place in the therapeutic repertoire for several cardiac arrhythmias. It should not be neglected as an old drug, and ought to be reconsidered in emergency medicine treatment recommendations. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
- View/download PDF
10. Intravenous antazoline, a first‐generation antihistaminic drug with antiarrhythmic properties, is a suitable agent for pharmacological cardioversion of atrial fibrillation induced during pulmonary vein isolation due to the lack of influence on atrio‐venous conduction and high clinical effectiveness (AntaEP Study)
- Author
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Farkowski, Michal M., Maciag, Aleksander, Kowalik, Ilona, Konka, Marek, Szwed, Hanna, and Pytkowski, Mariusz
- Subjects
- *
PULMONARY veins , *ELECTRIC countershock , *EYE drops , *ATRIAL fibrillation , *INTRAVENOUS therapy , *LONGITUDINAL method , *DRUG utilization - Abstract
Aims: Antazoline is a first‐generation antihistaminic drug used primarily in eye drop formulations. When administered intravenously, antazoline displays antiarrhythmic properties resulting in a rapid conversion of recent‐onset atrial fibrillation (AF) to sinus rhythm (SR). The aim of the study was to assess the influence of antazoline on atrio‐venous conduction and other electrophysiological parameters in patients undergoing AF ablation. Methods: An experimental prospective study. Patients scheduled for the first‐time AF ablation, in SR and not on amiodarone were enrolled. Atrio‐venous conduction assessment and invasive electrophysiological study (EPS) were performed before and after intravenous administration of 250 mg of antazoline. In case of AF induction during EPS, antazoline was administered until conversion to SR or a cumulative dose of 300 mg. Results: We enrolled 14 patients: 13 (93%) men, mean age 63.4 (59.9–66.8) years, mean CHA2DS2‐VASc score 1.6 (1.0–2.2). Antazoline was administered in a mean dose 257.1 (246.7–267.6) mg. Pulmonary vein potentials and atrial capture during pulmonary vein stimulation were present before and after the administration of antazoline. Wenckebach point and atrial conduction times did not change significantly, but atrio‐ventricular node effective refractory period improved—324.7 (275.9–373.5) ms vs 284.3 (256.2–312.4) ms, P = 0.02. Antazoline was effective in all 5 (100%) cases of AF induction during EPS. There were no serious adverse events. Conclusion: Due to the lack of influence on atrio‐venous conduction and high clinical effectiveness, antazoline may be suitable for pharmacological cardioversion of AF occurring during AF ablation. [ABSTRACT FROM AUTHOR]
- Published
- 2019
- Full Text
- View/download PDF
11. Pharmacological Cardioversion With Antazoline in Atrial Fibrillation: The Results of the CANT Study
- Author
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Maciej T. Wybraniec, Wojciech Wróbel, Katarzyna Wilkosz, Karolina Wrona, Karolina Bula, and Katarzyna Mizia‐Stec
- Subjects
amiodarone ,antazoline ,atrial fibrillation ,pharmacological cardioversion ,propafenone ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background Antazoline mesylate represents an antihistamine capable of rapid and safe cardioversion of atrial fibrillation, yet evidence concerning its efficacy in comparison to other medications is insufficient. The study aimed to evaluate the success rate and safety of pharmacological cardioversion of atrial fibrillation with intravenous antazoline (CANT [Cardioversion With Antazoline Mesylate] study) in the setting of the emergency department. Methods and Results After reviewing 1984 medical records, 450 eligible patients (22.7%) with short‐duration atrial fibrillation subject to pharmacological cardioversion were enrolled in a retrospective observational analysis. The choice of antiarrhythmic drug was left to the discretion of the attending physician. The primary end point was successful cardioversion in the emergency department. The safety end point comprised bradycardia
- Published
- 2018
- Full Text
- View/download PDF
12. Antiarrhythmic effect of antazoline in experimental models of acquired short- and long-QT-syndromes.
- Author
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Ellermann, Christian, Sterneberg, Magdalena, Kochhäuser, Simon, Dechering, Dirk G, Fehr, Michael, Eckardt, Lars, and Frommeyer, Gerrit
- Subjects
ACTION potentials ,ADRENERGIC beta blockers ,ANIMALS ,ANTIBIOTICS ,ANTIHISTAMINES ,ARRHYTHMIA ,BIOLOGICAL models ,ERYTHROMYCIN ,IMIDAZOLES ,MEMBRANE proteins ,MENTAL health surveys ,MYOCARDIAL depressants ,NEURAL conduction ,ORGANIC compounds ,RABBITS ,VENTRICULAR fibrillation ,VENTRICULAR tachycardia ,LONG QT syndrome ,ARTHRITIS Impact Measurement Scales ,PHARMACODYNAMICS - Abstract
Aims: Antazoline is a first-generation antihistamine with antiarrhythmic properties. This study examines potential electrophysiological effects of antazoline in short-QT-syndrome (SQTS) and long-QT-syndrome (LQTS).Methods and results: Sixty-five rabbit hearts were Langendorff-perfused. Action potential duration at 90% of repolarization (APD90), QT-interval, spatial dispersion (DISP), and effective refractory period (ERP) were measured. The IK, ATP-opener pinacidil (1 µM, n = 14) reduced APD90 (-14 ms, P < 0.01), QT-interval (-14 ms, P < 0.01), and ERP (-11 ms, P < 0.01), thus simulating acquired SQTS. Additional infusion of 20 µM antazoline prolonged repolarization. Under baseline conditions, ventricular fibrillation (VF) was inducible in 5 of 14 hearts (10 episodes) and in 5 of 14 pinacidil-treated hearts (21 episodes, P = ns). Antazoline significantly reduced induction of VF (0 episodes, P < 0.05 each). Further 17 hearts were perfused with 100 µM sotalol and 17 hearts with 300 µM erythromycin to induce acquired LQTS2. In both groups, prolongation of APD90, QT-interval, and ERP was observed. Spatial dispersion was increased (sotalol: +26 ms, P < 0.01; erythromycin: +31 ms, P < 0.01). Additional infusion of antazoline reduced DISP (sotalol: -22 ms, P < 0.01; erythromycin: -26 ms, P < 0.01). Torsade de pointes (TdP) occurred in 6 of 17 sotalol-treated (22 episodes, P < 0.05 each) and in 8 of 17 erythromycin-treated hearts (96 episodes P < 0.05 each). Additional infusion of antazoline completely suppressed TdP in both groups (P < 0.05 each). Acquired LQTS3 was induced by veratridine (0.5 µM, n = 17) and similar results were obtained (APD90: +24 ms, P < 0.01, QT-interval: +58 ms, P < 0.01, DISP: +38 ms, P < 0.01). Torsade de pointes occurred in 10 of 17 hearts (41 episodes, P < 0.05 each). Antazoline significantly reduced TdP (2 of 17 hearts, 4 episodes, P < 0.05 each).Conclusion: Antazoline significantly reduced induction of VF in an experimental model of acquired SQTS. In three experimental models of acquired LQTS, antazoline effectively suppressed TdP. [ABSTRACT FROM AUTHOR]- Published
- 2018
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13. Antazoline:the Lazarus of antiarrhythmic drugs?
- Author
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Peter, Calvert, Dhiraj, Gupta, and Gregory Y H, Lip
- Subjects
Atrial Fibrillation/drug therapy ,Atrial Fibrillation ,Internal Medicine ,Antazoline ,Anti-Arrhythmia Agents/adverse effects ,Humans ,Anti-Arrhythmia Agents - Published
- 2022
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14. Efficacy and safety of antazoline in the rapid cardioversion of paroxysmal atrial fibrillation (the AnPAF Study).
- Author
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Maciag, Aleksander, Farkowski, Michal M., Chwyczko, Tomasz, Beckowski, Maciej, Syska, Pawel, Kowalik, Ilona, Pytkowski, Mariusz, Wozniak, Jacek, Dabrowski, Rafal, and Szwed, Hanna
- Subjects
ATRIAL fibrillation diagnosis ,ACTION potentials ,ANTIHISTAMINES ,ATRIAL fibrillation ,COMPARATIVE studies ,ELECTROCARDIOGRAPHY ,HEART beat ,HEART conduction system ,IMIDAZOLES ,INTRAVENOUS therapy ,RESEARCH methodology ,MEDICAL cooperation ,MYOCARDIAL depressants ,RESEARCH ,TIME ,EVALUATION research ,RANDOMIZED controlled trials ,TREATMENT effectiveness ,BLIND experiment - Abstract
Aims: The aim of the study was to assess the clinical efficacy of antazoline, a first-generation anti-histaminic agent, in the rapid conversion of paroxysmal non-valvular atrial fibrillation (AF) to sinus rhythm in patients without heart failure.Methods and Results: This study was a single center, randomized, double blind, placebo-controlled, superiority clinical trial. We enrolled patients with an AF episode lasting less than 43 h, in stable cardiopulmonary condition. Subjects who fulfilled the selection criteria were randomly assigned to receive intravenously either a placebo or up to 250 mg of antazoline. The primary end point was the conversion of AF to sinus rhythm confirmed in electrocardiogram (ECG). We enrolled 74 patients: 36 (48.6%) in the antazoline group and 38 (51.4%) in the control group. The mean age was 68 ± 12 years (range 31-90 years), 39 (53.3%) patients were male. The successful conversion of AF to sinus rhythm during the observation period was achieved in 26 (72.2%) patients treated with antazoline and 4 (10.5%) in the control group: RR 6.86 (95% CI: 2.66-17.72, P < 0.0001). Median time to conversion was 16.0 min in antazoline and 72.5 min in the control group (P = 0.0246). There were no cases of atrial tachycardia/flutter in the antazoline group.Conclusion: Intravenous antazoline was effective and safe in the rapid conversion of non-valvular paroxysmal atrial fibrillation to sinus rhythm in patients without heart failure. Clinical Trial Registration number: NCT01527279. [ABSTRACT FROM AUTHOR]- Published
- 2017
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15. Antazoline-insights into drug-induced electrocardiographic and hemodynamic effects: Results of the ELEPHANT II substudy.
- Author
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Piotrowski, Roman, Giebułtowicz, Joanna, Baran, Jakub, Sikorska, Agnieszka, Gralak‐Łachowska, Dagmara, Soszyńska, Małgorzata, Wroczyński, Piotr, Kułakowski, Piotr, Giebułtowicz, Joanna, Gralak-Łachowska, Dagmara, Soszyńska, Małgorzata, Wroczyński, Piotr, and Kułakowski, Piotr
- Abstract
Background: Antazoline is an old antihistaminic and new antiarrhythmic agent with unknown mechanisms of action which recently has been shown to effectively terminate atrial fibrillation. The aim of study was to examine the effects of antazoline on hemodynamic and ECG parameters.Methods: Antazoline was given intravenously in three 100 mg boluses to 10 healthy volunteers (four males, mean age 40 + 11 years). Hemodynamic and ECG parameters were measured using impedance cardiography [systolic (sBP), diastolic (dBP), mean (mBP) blood pressure, stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR) and heart rate (HR), P wave, PR interval, QRS complex, QT and corrected QT (QTcF) interval]. Plasma concentration of antazoline was also measured.Results: Antazoline caused significant prolongation of P wave, QRS as well as QT and QTcF (101 ± 10 vs 110 ± 16 ms, p < .05, and 101 ± 12 vs 107 ± 12 ms, p < .05, 399 ± 27 vs 444 ± 23 ms, p < .05, and 403 ± 21 vs 448 ± 27 ms, p < .05, respectively). Also, a significant decrease in SV was noted (94.9 ± 21.8 vs 82.4 ± 19.6 ml, p < .05). A significant correlation between changes in plasma drug concentration and changes in CO, HR, and dBP was found.Conclusions: Antazoline impairs slightly hemodynamics, significantly reducing SV. Significant prolongation of P wave and QRS duration corresponds to drug-induced prolongation of conduction, whereas QT prolongation represents drug-induced prolongation of repolarization. [ABSTRACT FROM AUTHOR]- Published
- 2017
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16. Stability Indicating UHPLC-PDA Assay for Simultaneous Determination of Antazoline Hydrochloride and Naphazoline Hydrochloride in Ophthalmic Formulations.
- Author
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Ali, Amir, Farooq, Umar, Ahmed, Mahmood, Athar, Muhammad Makshoof, Nadeem, Kashif, and Murtaza, Ghulam
- Subjects
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OPHTHALMIC drugs , *OCULAR pharmacology , *OPHTHALMOLOGY , *LIQUID chromatography , *TRIETHYLAMINE - Abstract
In the μresent study, a newly develoμed method based on ultrahigh μerformance liquid chromatograμhy (UHPLC) was oμtimized for the simultaneous determination of antazoline hydrochloride (ANZ) and naμhazoline hydrochloride (NFZ) in oμhthalmic formulations. Isocratic seμaration of ANZ and NFZ was μerformed at 40 °C with an ACE Excel 2 Cl8-PFP column (2 μm, 2.1 x 100 mm) at a flow rate of 0.6 mL min-1 whereas the mobile μhase consisted of acetonitri-le/μhosμhate buffer (60:40, v/v, μH 3.0) containing 0.5% triethylamine. Both analytes were detected at a wavelength of 285 nm and the injection volume was 1.0 μL. The overall run time μer samμle was 4.5 min with retention time of 0.92 and 1.86 min for NFZ and ANZ, resμectively. The calibration curve was linear from 0.500-100 μg mL-1 for ANZ and NFZ with a correlation coefficient ≥ 0.9981 while reμeatability and reμroducibility (exμressed as relative standard deviation) were lower than 1.28 and 2.14%, resμectively. In comμarison with high-μerformance liquid chromatograμhy (HPLC), the develoμed UHPLC method had remarkable advantages over HPLC as the run time was significantly reduced by 3.4-fold with a 5-fold decreased solvent consumμtion. Forced degradation studies indicated a comμlete seμaration of the analytes in the μresence of their degradation μroducts μroviding high degree of method sμecificity. The μroμosed UHPLC method was demonstrated to be simμle and raμid for the determination of ANZ and NFZ in commer-cially available oμhthalmic formulations μroviding recoveries between 99.6 and 100.4%. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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17. Repurposing of Antazoline Hydrochloride as an Inhibitor of Hepatitis B Virus DNA Secretion
- Author
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Xue Hu, Yu Guo, Xinwen Chen, Canyu Liu, Yifei Yuan, Yangyang Hu, Rongjuan Pei, Yuan Zhou, Yinan Zhao, Yun Wang, Jing Li, Chunchen Wu, and Qiqi Han
- Subjects
0301 basic medicine ,Drug ,Hepatitis B virus ,medicine.medical_specialty ,Hydrochloride ,medicine.medical_treatment ,media_common.quotation_subject ,030106 microbiology ,Immunology ,Pharmacology ,Virus Replication ,medicine.disease_cause ,Antiviral Agents ,03 medical and health sciences ,chemistry.chemical_compound ,Hepatitis B, Chronic ,Medical microbiology ,Virology ,Humans ,Medicine ,media_common ,biology ,business.industry ,Antazoline ,Drug Repositioning ,DNA ,Hepatitis B ,biology.organism_classification ,In vitro ,Chronic infection ,030104 developmental biology ,Hepadnaviridae ,chemistry ,DNA, Viral ,Molecular Medicine ,Antihistamine ,business ,Research Article - Abstract
Hepatitis B virus (HBV) belongs to Hepadnaviridae family and mainly infects hepatocytes, which can cause acute or chronic hepatitis. Currently, two types of antiviral drugs are approved for chronic infection clinically: interferons and nucleos(t)ide analogues. However, the clinical cure for chronic infection is still rare, and it is a huge challenge for all researchers to develop high-efficiency, safe, non-tolerant, and low-toxicity anti-HBV drugs. Antazoline hydrochloride is a first-generation antihistamine with anticholinergic properties, and it is commonly used to relieve nasal congestion and in eye drops. Recently, an in vitro high-throughput evaluation system was constructed to screen nearly 800 compounds from the Food and Drug Administration (FDA)-approved Drug Library. We found that arbidol hydrochloride and antazoline hydrochloride can effectively reduce HBV DNA in the extracellular supernatant in a dose-dependent manner, with EC(50) of 4.321 μmol/L and 2.910 μmol/L in HepAD38 cells, respectively. Moreover, the antiviral effects and potential mechanism of action of antazoline hydrochloride were studied in different HBV replication systems. The results indicate that antazoline hydrochloride also has a significant inhibitory effect on HBV DNA in the extracellular supernatant of Huh7 cells, with an EC(50) of 2.349 μmol/L. These findings provide new ideas for screening and research related to HBV agents.
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- 2020
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18. ANTAZOLINE RENAISSANCE IN THE TREATMENT OF CARDIAC ARRHYTHMIA: A REVIEW
- Author
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Mariusz Szuta, Joanna Sowizdraniuk, Paweł Paśko, and Krzysztof Palimonka
- Subjects
Pharmacology ,medicine.medical_specialty ,business.industry ,Pharmaceutical Science ,The Renaissance ,Cardiac arrhythmia ,cardiac arrhythmia ,Internal medicine ,antazoline ,medicine ,Antazoline ,Cardiology ,arrhythmia pharmacological treatment ,atrial fibrillation ,business ,medicine.drug - Abstract
Antazoline is an antihistaminic, immunosuppressive, antiarrhythmic agent. Antazoline can be administered orally, intravenously, intramuscularly or via the ophthalmic route. Antazoline has a limited application as an antiarrhythmic drug. This review was undertaken with the aim to combine the old and the new results of different types of studies (clinical, retrospective, or pharmacokinetic) and sum up the positive and negative effects of antazoline in cardiology and emergency medicine. A literature queries were performed in the following databases: PubMed, Embase, Google Scholar, and Web of Science (all from their inception date till June 2019). The queries covered antazoline in combinations with such terms as antiarrhythmic activity, arrhythmia, electrocardiography, emergency medicine, and cardiology. Additional publications were found by checking all the reference lists. The newest research shows that antazoline may have the highest success rate of pharmacological cardioversion among all drugs used in the contemporary treatment of cardiac arrhythmia (up to 85.3%). The rate of cardioversion with antazoline alone was higher than the combined amiodarone and/or propafenone. Most of the studies which were reviewed indicated that paroxysmal atrial fibrillation, compared to chronic atrial fibrillation, responded more satisfactorily to antazoline treatment. Most patients tolerated antazoline well and conversion was safe, effective, and smooth. Some research proves that antazoline use may also reduce the rate of hospitalization due to the adverse effects. Antazoline has a definite place in the therapeutic repertoire for several cardiac arrhythmias. It should not be neglected as an old drug, and ought to be reconsidered in emergency medicine treatment recommendations.
- Published
- 2020
- Full Text
- View/download PDF
19. Pharmacological Cardioversion in Patients with Recent-Onset Atrial Fibrillation and Chronic Kidney Disease Subanalysis of the CANT II Study
- Author
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Beata Ceynowa-Sielawko, Maciej T. Wybraniec, Aleksandra Topp-Zielińska, Aleksander Maciąg, Dawid Miśkowiec, Paweł Balsam, Maciej Wójcik, Wojciech Wróbel, Michał M. Farkowski, Edyta Ćwiek-Rębowska, Krzysztof Ozierański, Robert Błaszczyk, Karolina Bula, Tomasz Dembowski, Michał Peller, Bartosz Krzowski, Wojciech Wańha, Marek Koziński, Jarosław D. Kasprzak, Hanna Szwed, Katarzyna Mizia-Stec, and Marek Szołkiewicz
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Male ,Health, Toxicology and Mutagenesis ,Antazoline ,Electric Countershock ,Public Health, Environmental and Occupational Health ,Amiodarone ,atrial fibrillation ,pharmacological cardioversion ,chronic kidney disease ,antazoline ,propafenone ,amiodarone ,Treatment Outcome ,Propafenone ,Atrial Fibrillation ,Humans ,Female ,Renal Insufficiency, Chronic ,Anti-Arrhythmia Agents - Abstract
Pharmacological cardioversion (PCV) is commonly a primary option for termination of recent-onset atrial fibrillation (AF) in emergency departments (ED). This is a subanalysis of the CANT II study, evaluating the effectiveness and safety of antazoline in patients (n = 777) at three stages of chronic kidney disease (CKD): Group I > 60 mL/min (n = 531), Group II 45–59 mL/min (n = 149), and Group III < 45 mL/min (n = 97). Patients in Group III were older and with a higher prevalence of co-morbidities; however, we did not find statistically significant differences in the overall effectiveness of PCV in comparison with the other groups. In patients receiving amiodarone, the PCV success rate was similar in all the studied groups, but along with a renal function decline, it decreased in patients receiving antazoline (79.1 vs. 35%; p < 0.001), and it increased almost significantly in patients receiving propafenone (69.9 vs. 100%; p = 0.067). In patients in Group I, antazoline restored a sinus rhythm as effectively as propafenone and amiodarone; however, in patients in Group III, both antazoline and amiodarone became less effective in restoring a sinus rhythm than propafenone (p = 0.002 and p = 0.034, respectively). The rate of safety endpoint was the highest in patients in Group III (eGFR < 45 mL/min), and it was significantly higher than in patients in Groups I and II (p = 0.008 and p = 0.036, respectively). We did not observe antazoline-related adverse events in any of the studied groups of patients. This real-world registry analysis revealed a different influence of CKD on the effectiveness of individual drugs, and while propafenone and amiodarone maintained their AF termination efficacy, antazoline became significantly less effective in restoring sinus rhythm.
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- 2022
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20. Efficacy and safety of antazoline for cardioversion of atrial fibrillation: propensity score matching analysis of multicenter registry (CANT II Study)
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Maciej T. Wybraniec, Aleksander Maciąg, Dawid Miśkowiec, Beata Ceynowa-Sielawko, Paweł Balsam, Maciej Wójcik, Wojciech Wróbel, Michał Farkowski, Edyta Ćwiek-Rębowska, Marek Szołkiewicz, Krzysztof Ozierański, Robert Błaszczyk, Karolina Bula, Tomasz Dembowski, Michał Peller, Bartosz Krzowski, Wojciech Wańha, Marek Koziński, Jarosław D. Kasprzak, Hanna Szwed, and Katarzyna Mizia-Stec
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Male ,Antazoline ,Electric Countershock ,Amiodarone ,Treatment Outcome ,Propafenone ,Atrial Fibrillation ,Internal Medicine ,Humans ,Female ,Registries ,Propensity Score ,Anti-Arrhythmia Agents ,Aged ,Retrospective Studies - Abstract
Due to safety concerns about available antiarrhythmic drugs (AADs), reliable agents for termination of atrial fibrillation (AF) are requisite.The aim of the study was to evaluate the efficacy and safety of antazoline, a first‑generation antihistamine, for cardioversion of recent‑onset AF in the setting of an emergency department.This multicenter, retrospective registry covered 1365 patients (median [interquartile range] age, 69.0 [61.0-76.0] years, 53.1% men) with new‑onset AF submitted to urgent pharmacological cardioversion. AAD allocation was performed by the attending physician: antazoline alone was utilized in 600 patients (44%), amiodarone in 287 (21%), propafenone in 150 (11%), and ≥2 AADs in 328 patients (24%). Antazoline in monotherapy or combination was administered to 897 patients (65.7%). Matched antazoline and nonantazoline groups were identified using propensity score matching (PSM, n = 330). The primary end point was return to sinus rhythm within 12 hours after initiation of the treatment.Before PSM, antazoline alone was superior to amiodarone (78.3% vs 66.9%; relative risk [RR], 1.17; 95% CI, 1.07-1.28; P0.001) and comparable to propafenone (78.3% vs 72.7%; RR, 1.08; 95% CI, 0.97-1.20; P = 0.14) in terms of rhythm conversion rate. In the post‑PSM population, the rhythm conversion rate was higher among patients receiving antazoline alone than in the nonantazoline group (84.2% vs 66.7%; RR, 1.26; 95% CI, 1.11-1.43; P0.001), and the risk of adverse events was comparable (P = 0.2).Antazoline appears to be an efficacious agent for termination of AF in real‑world setting. Randomized controlled trials are required to evaluate its safety in specific patient populations.
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- 2022
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21. Rapid pharmacological cardioversion of recent-onset atrial fibrillation using antazoline in elderly patients
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Ilona Kowalik, Michał M. Farkowski, Mariusz Pytkowski, Piotr Gardziejczyk, Aleksander Maciąg, Karol Kołakowski, Małgorzata Żurawska, and Hanna Szwed
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business.industry ,Medical record ,Antazoline ,Electric Countershock ,Atrial fibrillation ,Emergency department ,medicine.disease ,Treatment Outcome ,Anesthesia ,Atrial Fibrillation ,Internal Medicine ,medicine ,Pharmacological cardioversion ,Humans ,In patient ,Adverse effect ,business ,Recent onset ,Anti-Arrhythmia Agents ,medicine.drug ,Aged ,Retrospective Studies - Abstract
INTRODUCTION Little is known about the safety and effectiveness of pharmacological cardioversion of recent-onset atrial fibrillation (AF) in the elderly. Antazoline has already been shown to be effective and safe in a wide variety of patients. OBJECTIVES To compare clinical effectiveness and safety of iv antazoline administered for pharmacological cardioversion of recent-onset AF in patients aged ≥75 years and younger. PATIENTS AND METHODS This retrospective analysis was conducted using data derived from emergency room medical records of patients qualified for pharmacological cardioversion due to symptomatic AF lasting less than 48 hours. For the purpose of the analysis the threshold for old age was set at 75 years. Conversion to sinus was considered a primary effectiveness outcome. The primary safety outcome was defined as any adverse event (AE) leading to hospitalization. RESULTS Out of 334 patients, 110 patients ≥75 years old comprised the study group. Successful CV was achieved using smaller doses of antazoline in the study group than in the control group: 151 (59) mg vs. 168 (58) mg (P = 0.039). The effectiveness and safety of antazoline was similar in patients aged ≥75 and
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- 2021
22. The reinvented old player – an antazoline is effective in pharmacological cardioversion of atrial fibrillation
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J.D. Kasprzak, Błażej Michalski, D Miskowiec, E Cwiek-Rebowska, Haval D Qawoq, P. Zycinski, Karolina Kupczyńska, and T Dembowski
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medicine.medical_specialty ,business.industry ,Internal medicine ,medicine ,Antazoline ,Cardiology ,Pharmacological cardioversion ,Atrial fibrillation ,Cardiology and Cardiovascular Medicine ,medicine.disease ,business ,medicine.drug - Abstract
Introduction Antazoline (ANT) is an old antihistaminic medication with antiarrhythmic properties. After intravenous administration ANT exerts rapid antiarrhythmic effect often resulting in conversion of atrial fibrillation (AF) to sinus rhythm (SR) and is widely used in Poland for this purpose in the last years. However, published data on its effectiveness, safety and clinical utility for rapid AF termination are limited and ANT is not recognized as a cardioversion drug. Aim To assess the real-world efficacy of ANT for pharmacological cardioversion of paroxysmal and persistent non-valvular AF. Methods Our single center, retrospective, observational study included patients (pts) with history paroxysmal or persistent AF episode lasting less than 6 months, in stable cardiopulmonary condition who were qualified for elective pharmacological cardioversion with intravenous ANT. The primary end-point was the conversion of AF to SR confirmed in electrocardiography (ECG) during the 6-hours observation. Results A total of 176 pts (mean age 68.4±12.0 years, 49% male) were enrolled into the study. In 93 patients (52%) AF duration was shorter than 48 hours and median AF duration time was 24 (7–432) hours. The overall success rate of pharmacological cardioversion of AF with intravenous ANT was 45.5% (80/176 pts). The mean used dose of ANT was 250.9±65.4mg. The subgroup analysis, regarding the AF duration, suggested the effectiveness of ANT mainly in in short-lasting AF (effectiveness of antazoline based cardioversion for AF lasting Conclusions Antazoline is effective and safe in rapid pharmacological cardioversion of paroxysmal AF, especially in the short-lasting AF ( Funding Acknowledgement Type of funding sources: None. Figure 1. ROC curve analysis
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- 2021
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23. Intravenous antazoline, a first‐generation antihistaminic drug with antiarrhythmic properties, is a suitable agent for pharmacological cardioversion of atrial fibrillation induced during pulmonary vein isolation due to the lack of influence on atrio‐venous conduction and high clinical effectiveness (AntaEP Study)
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Hanna Szwed, Ilona Kowalik, Michał M. Farkowski, Aleksander Maciag, Marek Konka, and Mariusz Pytkowski
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Male ,medicine.medical_specialty ,Amiodarone ,Cryosurgery ,030226 pharmacology & pharmacy ,Pulmonary vein ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,medicine ,Antazoline ,Humans ,Pharmacology (medical) ,Sinus rhythm ,Prospective Studies ,030212 general & internal medicine ,Adverse effect ,Aged ,Pharmacology ,Cumulative dose ,business.industry ,Effective refractory period ,Atrial fibrillation ,Original Articles ,Middle Aged ,medicine.disease ,Pulmonary Veins ,Histamine H1 Antagonists ,Cardiology ,Administration, Intravenous ,Female ,business ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Aims Antazoline is a first-generation antihistaminic drug used primarily in eye drop formulations. When administered intravenously, antazoline displays antiarrhythmic properties resulting in a rapid conversion of recent-onset atrial fibrillation (AF) to sinus rhythm (SR). The aim of the study was to assess the influence of antazoline on atrio-venous conduction and other electrophysiological parameters in patients undergoing AF ablation. Methods An experimental prospective study. Patients scheduled for the first-time AF ablation, in SR and not on amiodarone were enrolled. Atrio-venous conduction assessment and invasive electrophysiological study (EPS) were performed before and after intravenous administration of 250 mg of antazoline. In case of AF induction during EPS, antazoline was administered until conversion to SR or a cumulative dose of 300 mg. Results We enrolled 14 patients: 13 (93%) men, mean age 63.4 (59.9-66.8) years, mean CHA2 DS2 -VASc score 1.6 (1.0-2.2). Antazoline was administered in a mean dose 257.1 (246.7-267.6) mg. Pulmonary vein potentials and atrial capture during pulmonary vein stimulation were present before and after the administration of antazoline. Wenckebach point and atrial conduction times did not change significantly, but atrio-ventricular node effective refractory period improved-324.7 (275.9-373.5) ms vs 284.3 (256.2-312.4) ms, P = 0.02. Antazoline was effective in all 5 (100%) cases of AF induction during EPS. There were no serious adverse events. Conclusion Due to the lack of influence on atrio-venous conduction and high clinical effectiveness, antazoline may be suitable for pharmacological cardioversion of AF occurring during AF ablation.
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- 2019
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24. Cinderella drug: an antazoline is effective in pharmacological cardioversion of atrial fibrillation - Single center experience
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P. Zycinski, D Miskowiec, Haval D Qawoq, Karolina Kupczyńska, Błażej Michalski, E Cwiek-Rebowska, J.D. Kasprzak, and T Dembowski
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Drug ,Bradycardia ,medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Left atrium ,Atrial fibrillation ,Single Center ,medicine.disease ,medicine.anatomical_structure ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,Antazoline ,Pharmacological cardioversion ,Sinus rhythm ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,media_common ,medicine.drug - Abstract
Funding Acknowledgements Type of funding sources: None. Introduction Antazoline (ANT) is an old antihistaminic medication with antiarrhythmic properties. After intravenous administration ANT exerts rapid antiarrhythmic effect often resulting in conversion of persistent atrial fibrillation (AF) to sinus rhythm (SR). However, published data on its effectiveness, safety and clinical utility for rapid AF termination are limited and ANT is not recognized as a cardioversion drug. Aim To assess the real-world efficacy of ANT for pharmacological cardioversion of paroxysmal and persistent non-valvular AF. Methods We conducted a single center, retrospective, observational study including patients (pts) with history paroxysmal or persistent AF episode lasting less than 6 months, in stable cardiopulmonary condition who were qualified for elective pharmacological cardioversion with intravenous ANT. The primary end-point was the conversion of AF to SR confirmed in electrocardiography (ECG) during the 6-hours observation. Results A total of 176 pts (mean age 68.4 ± 12.0 years, 49% male) were enrolled into the study. In 93 patients (52%) AF duration was shorter than 48 hours and median AF duration time was 24 (7 – 432) hours. The overall success rate of pharmacological cardioversion of AF with intravenous ANT was 45.5% (80/176 pts). The mean used dose of ANT was 250.9 ± 65.4mg. The subgroup analysis, regarding the AF duration, suggested the effectiveness of ANT mainly in in short-lasting AF (effectiveness of antazoline based cardioversion for AF lasting Conclusions Intravenous antazoline administration is effective and safe in rapid pharmacological cardioversion of paroxysmal AF, especially in the short-lasting AF (
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- 2021
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25. Antazoline for pharmacological cardioversion of atrial fibrillation: the results of the high-volume multicenter CANT study
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M Szolkiewicz, Bartosz Krzowski, Cant Study Investigators, Paweł Balsam, Wojciech Wróbel, J.D. Kasprzak, Katarzyna Mizia-Stec, Hanna Szwed, D Miskowiec, Krzysztof Ozierański, B Ceynowa-Sielawko, Aleksander Maciag, M.M. Farkowski, E Cwiek-Rebowska, M Kozinski, and Maciej T. Wybraniec
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Bradycardia ,medicine.medical_specialty ,business.industry ,Sotalol ,Atrial fibrillation ,Propafenone ,Cant (architecture) ,medicine.disease ,Amiodarone ,Internal medicine ,medicine ,Antazoline ,Cardiology ,Pharmacological cardioversion ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Background Antazoline mesylate represents a first generation antihistamine with quinidine-like antiarrhythmic properties, which allows for rapid and effective termination of atrial fibrillation (AF). Despite its widespread use in Polish emergency departments, paucity of data exists concerning safety and efficacy of antazoline in comparison to other antiarrhythmic agents. Purpose This study aimed to evaluate the pooled hitherto data on effectiveness and safety of pharmacological Cardioversion with intravenous ANTazoline (CANT Study) in short-duration atrial fibrillation. Methods This retrospective observational study was performed in 5 medical centers and comprised 1300 patients with paroxysmal or persistent AF who underwent emergent pharmacological cardioversion in the real-world setting of emergency or cardiology department. The choice of antiarrhythmic drug was left to the discretion of attending physician. The exclusion criteria involved permanent AF, other supraventricular arrhythmias, including atrial flutter, chronic antiarrhythmic therapy or preemptive electrical cardioversion. The primary endpoint was restoration of sinus rhythm up to 12 hours after antiarrhythmic drug infusion. The combined safety endpoint was bradycardia Results The mean age of study population was 67.7±11.6 years and the majority of patients were men (52.9%). The median AF episode duration was 10 (4; 24) hours, while median CHA2DS2-VASc score was 3 (2; 4) pts. Antazoline alone was administered in 45.6% of patients (n=593); amiodarone in 22.1% (n=287); propafenone in 11.5% (n=150); sotalol in 0.5% (n=6), while 20.3% (n=264) received overlapping antiarrhythmic therapy. Antazoline had the highest rhythm conversion rate (Figure), which was comparable to propafenone (78.2% vs 72.7%; RR 1.08; 95% CI:0.97–1.20; P=0.175) and superior to amiodarone (vs 66.9%; RR 1.17, 95% CI:1.07–1.28; P=0.0008) and collective amiodarone/propafenone/sotalol treatment (vs 68.6%; RR 1.14; 95% CI:1.06–1.23; P=0.0006). The rate of combined safety endpoint was comparable in patients treated with antazoline and other antiarrhythmic drugs (5.2% vs 3.9%; P=0.297). Among patients treated with antazoline, 29 exhibited bradycardia Conclusion Antazoline appears to be an effective antiarrhythmic drug for cardioversion of atrial fibrillation, which is associated with low rate of relatively benign adverse events. Figure 1 Funding Acknowledgement Type of funding source: None
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- 2020
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26. Characterization of In Vitro and In Vivo Metabolism of Antazoline Using Liquid Chromatography-Tandem Mass Spectrometry
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Ewa Szymańska, Gniewomir Latacz, Joanna Giebułtowicz, Roman Piotrowski, Piotr Kułakowski, Natalia Korytowska, Sebastian Polak, and Barbara Wiśniowska
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Metabolite ,Glucuronidation ,030204 cardiovascular system & hematology ,In Vitro Techniques ,Tandem mass spectrometry ,Catalysis ,Article ,lcsh:Chemistry ,Inorganic Chemistry ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Pharmacokinetics ,Liquid chromatography–mass spectrometry ,Tandem Mass Spectrometry ,Antazoline ,medicine ,Humans ,atrial fibrillation ,030212 general & internal medicine ,Physical and Theoretical Chemistry ,lcsh:QH301-705.5 ,Molecular Biology ,Spectroscopy ,reproductive and urinary physiology ,liquid chromatography coupled with tandem mass spectrometry ,biology ,Chemistry ,Organic Chemistry ,fungi ,Cytochrome P450 ,food and beverages ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,ANT ,Healthy Volunteers ,Computer Science Applications ,cytochrome P450 isoform ,lcsh:Biology (General) ,lcsh:QD1-999 ,Biochemistry ,antazoline ,biology.protein ,behavior and behavior mechanisms ,Hepatocytes ,metabolism ,medicine.drug ,Chromatography, Liquid - Abstract
Antazoline (ANT) was recently shown to be an effective and safe antiarrhythmic drug in the termination of atrial fibrillation. However, the drug is still not listed in clinical guidelines. No data on ANT metabolism in humans is available. We used liquid chromatography coupled with tandem mass spectrometry to identify and characterize metabolites of ANT. We analyzed plasma of volunteers following a single intravenous administration of 100 mg of ANT mesylate and in in vitro cultures of human hepatocytes. We revealed that ANT was transformed into at least 15 metabolites and we investigated the role of cytochrome P450 isoforms. CYP2D6 was the main one involved in the fast metabolism of ANT. The biotransformation of ANT by CYP2C19 was much slower. The main Phase I metabolite was M1 formed by the removal of phenyl and metabolite M2 with hydroxyl in the para position of phenyl. Glucuronidation was the leading Phase II metabolism. Further study on pharmacokinetics of the metabolites would allow us to better understand the activity profile of ANT and to predict its potential clinical applications. Ultimately, further investigation of the activity profile of the new hydroxylated M2 metabolite of ANT might result in an active substance with a different pharmacological profile than the parent molecule, and potentially a new drug candidate.
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- 2020
27. Clinical efficacy of antazoline in rapid cardioversion of paroxysmal atrial fibrillation - a protocol of a single center, randomized, doubleblind, placebo-controlled study (the AnPAF Study).
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Farkowski, Michal M, Maciag, Aleksander, Dabrowski, Rafal, Pytkowski, Mariusz, Kowalik, Ilona, and Szwed, Hanna
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ATRIAL fibrillation , *ATRIAL arrhythmias , *MEDICAL research , *RANDOMIZED controlled trials , *HEART failure - Abstract
Background: Rapid conversion of atrial fibrillation (AF) to sinus rhythm may be achieved by the administration of class IA, IC and III antiarrhythmic drugs or vernakalant hydrochloride. However, that treatment may be related to potential pro-arrhythmia, lack of efficacy or the exceptionally high cost of a compound used. Antazoline is a first generation antihistaminic agent with chinidin-like properties. When administered intravenously, antazoline exerts a strong antiarrhythmic effect on supraventricular arrhythmia, especially on AF, facilitating rapid conversion to sinus rhythm. Despite a relative lack of published data antazoline has been marketed in Poland and widely used in cardiology wards and emergency rooms for many years due to its efficacy, safety and rapid onset of action within minutes of administration. Methods/design: A randomized, double blind, placebo-controlled, superiority clinical trial was designed to assess clinical efficacy of antazoline in rapid conversion of AF to sinus rhythm. Eligible patients will present AF lasting less than 43 hours, will be in stable cardio-pulmonary condition and will have no prior history of advanced heart failure or significant valvular disease. Long-term antiarrhythmic therapy is not considered an exclusion criterion. Subjects who fulfill selection criteria will be randomly assigned to receive intravenously either antazoline or placebo in divided doses and observed for 1.5 hours after conversion to sinus rhythm or after the last i.v. bolus. Primary end point will be the conversion of AF to sinus rhythm confirmed in an electrocardiogram (ECG) during the observation period. Secondary end points will be comprised of time to conversion and return of AF during the observation period. Special consideration will be given to the observation of any adverse events. A sample size of 80 patients was calculated based on the following assumptions: two-tailed test, a type I error of 0.01, a power of 90%, efficacy of placebo 5%, efficacy of antazoline 50% and 20% drop-out rate to fulfill the criteria of intention-to-treat analysis. Due to the presumed lack of statistical power, the secondary end points and safety endpoints will be considered exploratory. [ABSTRACT FROM AUTHOR]
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- 2012
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28. Application of Ratio Derivative Spectrophotometry for Simultaneous Determination of Naphazoline and Antazoline in Eye Drops.
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Hajian, R., Shams, N., and Kaedi, I.
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SPECTROPHOTOMETRY , *ANALYTICAL chemistry , *SPECTRUM analysis , *EYE care , *ABSORPTION spectra , *ABSORBANCE scale (Spectroscopy) - Abstract
Ratio derivative spectrophotometrie method has been developed for the simultaneous determination of naphazoline (NAP) and antazoline (ANT) at micromolar levels in Britton Robinson buffer (pH 9) medium. In this method the overlapping spectra of naphazoline and antazoline were well resolved by making use of the first-derivative of the ratios of their direct absorption spectra. The derivative ratio absorbances of naphazoline and antazoline were measured at 227.2 and 235 nm, respectively for their quantification. The method is simple, fast and does not require separation of naphazoline and antazoline. Another salient feature of the method is that simultaneous standard additions of both analytes permitted to resolve matrix effect and quantification at a unique standard addition plot. Naphazoline and antazoline were determined in the concentration range of 10-150 μmol L-1 (NAP/ANT ratio varying from about 10 to 150) in the same aliquot with a precision and accuracy of about 1.7% and 1.8%, respectively. The recommended procedure was successfully applied for analysis of naphazoline and antazoline in eye drops. [ABSTRACT FROM AUTHOR]
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- 2010
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29. P1907Propensity score matched analysis of antazoline mesylate vs. amiodarone or propafenone for pharmacological cardioversion of short-duration atrial fibrillation
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Wojciech Wróbel, Jarosław Kolasa, Katarzyna Wilkosz, Maciej T. Wybraniec, Karolina Wrona, Karolina Bula, and Katarzyna Mizia-Stec
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medicine.medical_specialty ,ANTAZOLINE MESYLATE ,business.industry ,Atrial fibrillation ,Propafenone ,Amiodarone ,medicine.disease ,Internal medicine ,medicine ,Cardiology ,Antazoline ,Pharmacological cardioversion ,Cardiology and Cardiovascular Medicine ,business ,Short duration ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Background Former studies corroborated promising quinidine-like properties of antazoline mesylate facilitating rapid cardioversion atrial fibrillation (AF). Still, paucity of data exists concerning direct comparison of antazoline to other antiarrhythmic agents. Purpose The study aimed to verify the hypothesis that intravenous antazoline is non-inferior to amiodarone and/or propafenone in terms of rhythm conversion rate and safety among patients with AF. Methods After reviewing 2344 consecutive medical records with I48 code of international classification of diseases (ICD), 505 eligible patients (21.5%) with paroxysmal or persistent AF who underwent emergent pharmacological cardioversion in the real-world setting of emergency department were enrolled in retrospective observational analysis. The choice of antiarrhythmic drug was left to the discretion of attending physician. Antazoline group was separately matched with corresponding amiodarone (n=218) and propafenone (n=90) cohort using propensity score matching (PSM) with nearest neighbor algorithm (ratio 1:1), adjusting for age, sex, arterial hypertension, diabetes, depressed left ventricular ejection fraction, coronary artery disease, history of stroke, AF ablation, CHA2DS2-VASc score, chronic kidney disease and duration of AF episode. The primary endpoint was restoration of sinus rhythm in the emergency department. Results The study population (mean age of 67 (59; 74) years; 53.7% females) was characterized by median AF episode duration of 10.5 (5; 24) hours. Antazoline alone was administered in 23.4% of patients (n=118); amiodarone in 47.5% (n=240); propafenone in 9.9% (n=50); while 19.2% (n=97) received ≥2 antiarrhythmic drugs. Before PSM adjustment, antazoline had comparable rhythm conversion rate to propafenone (85.6% vs. 80.0%; P=0.367) and higher than amiodarone treatment (vs. 66.7%, P=0.0002), and greater than combined amiodarone/propafenone group (68.6%; RR 1.25; 95% CI: 1.12–1.39, P=0.0001). After PSM, the use of antazoline was associated with the efficacy similar to propafenone (82.2% vs. 80.0%, RR 1.03; 95% CI: 0.84–1.25, P=0.788) and superior to amiodarone (85.3% vs. 67.0%, RR 1.27, 95% CI: 1.09–1.48, P=0.0019, number needed to treat 5.5; Figure). No major adverse actions were reported in the antazoline group. Conclusion Antazoline appears to be an efficacious and safe drug for pharmacological cardioversion of AF in real-life setting, which is at least non-inferior to existing antiarrhythmic drugs. Acknowledgement/Funding None
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- 2019
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30. Antazoline: the Lazarus of antiarrhythmic drugs?
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Calvert P, Gupta D, and Lip GYH
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- Anti-Arrhythmia Agents adverse effects, Humans, Antazoline, Atrial Fibrillation drug therapy
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- 2022
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31. Magnetic Core–Shell Molecularly Imprinted Nano-Conjugates for Extraction of Antazoline and Hydroxyantazoline from Human Plasma—Material Characterization, Theoretical Analysis and Pharmacokinetics
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Monika Sobiech, Joanna Giebułtowicz, Roman Piotrowski, Piotr Kułakowski, Barbara Wiśniowska, Piotr Luliński, Natalia Korytowska, and Sebastian Polak
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Adult ,Male ,biomedical applications ,magnetic molecularly imprinted polymers ,particle characterization ,Sorbent ,hydroxyantazoline ,Metabolite ,dispersive solid phase extraction ,Nanoconjugates ,030204 cardiovascular system & hematology ,Mass spectrometry ,01 natural sciences ,Article ,Catalysis ,lcsh:Chemistry ,Inorganic Chemistry ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Adsorption ,Molecularly Imprinted Polymers ,Antazoline ,medicine ,Humans ,atrial fibrillation ,Solid phase extraction ,Physical and Theoretical Chemistry ,lcsh:QH301-705.5 ,Molecular Biology ,Spectroscopy ,mass spectrometry ,Chromatography ,Chemistry ,Solid Phase Extraction ,010401 analytical chemistry ,Organic Chemistry ,Extraction (chemistry) ,General Medicine ,Healthy Volunteers ,0104 chemical sciences ,Computer Science Applications ,lcsh:Biology (General) ,lcsh:QD1-999 ,antazoline ,core–shell nanostructures ,Conjugate ,medicine.drug - Abstract
The aim of this study was to develop magnetic molecularly imprinted nano-conjugate sorbent for effective dispersive solid phase extraction of antazoline (ANT) and its metabolite, hydroxyantazoline (ANT-OH) in analytical method employing liquid chromatography coupled with mass spectrometry method. The core–shell material was characterized in terms of adsorption properties, morphology and structure. The heterogeneous population of adsorption sites towards ANT-OH was characterized by two Kd and two Bmax values: Kd (1) = 0.319 µg L−1 and Bmax (1) = 0.240 μg g−1, and Kd (2) = 34.6 µg L−1 and Bmax (2) = 5.82 μg g−1. The elemental composition of magnetic sorbent was as follows: 17.55, 37.33, 9.14, 34.94 wt% for Si, C, Fe and O, respectively. The extraction protocol was optimized, and the obtained results were explained using theoretical analysis. Finally, the analytical method was validated prior to application to pharmacokinetic study in which the ANT was administrated intravenously to three healthy volunteers. The results prove that the novel sorbent could be useful in extraction of ANT and ANT-OH from human plasma and that the analytical strategy could be a versatile tool to explain a potential and pharmacological activity of ANT and ANT-OH.
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- 2021
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32. Pharmacological Cardioversion in Patients with Recent-Onset Atrial Fibrillation and Chronic Kidney Disease Subanalysis of the CANT II Study.
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Ceynowa-Sielawko B, Wybraniec MT, Topp-Zielińska A, Maciąg A, Miśkowiec D, Balsam P, Wójcik M, Wróbel W, Farkowski MM, Ćwiek-Rębowska E, Ozierański K, Błaszczyk R, Bula K, Dembowski T, Peller M, Krzowski B, Wańha W, Koziński M, Kasprzak JD, Szwed H, Mizia-Stec K, and Szołkiewicz M
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- Anti-Arrhythmia Agents therapeutic use, Electric Countershock, Female, Humans, Male, Propafenone adverse effects, Treatment Outcome, Amiodarone therapeutic use, Antazoline adverse effects, Atrial Fibrillation chemically induced, Atrial Fibrillation drug therapy, Atrial Fibrillation epidemiology, Renal Insufficiency, Chronic chemically induced, Renal Insufficiency, Chronic drug therapy, Renal Insufficiency, Chronic epidemiology
- Abstract
Pharmacological cardioversion (PCV) is commonly a primary option for termination of recent-onset atrial fibrillation (AF) in emergency departments (ED). This is a subanalysis of the CANT II study, evaluating the effectiveness and safety of antazoline in patients (n = 777) at three stages of chronic kidney disease (CKD): Group I > 60 mL/min (n = 531), Group II 45−59 mL/min (n = 149), and Group III < 45 mL/min (n = 97). Patients in Group III were older and with a higher prevalence of co-morbidities; however, we did not find statistically significant differences in the overall effectiveness of PCV in comparison with the other groups. In patients receiving amiodarone, the PCV success rate was similar in all the studied groups, but along with a renal function decline, it decreased in patients receiving antazoline (79.1 vs. 35%; p < 0.001), and it increased almost significantly in patients receiving propafenone (69.9 vs. 100%; p = 0.067). In patients in Group I, antazoline restored a sinus rhythm as effectively as propafenone and amiodarone; however, in patients in Group III, both antazoline and amiodarone became less effective in restoring a sinus rhythm than propafenone (p = 0.002 and p = 0.034, respectively). The rate of safety endpoint was the highest in patients in Group III (eGFR < 45 mL/min), and it was significantly higher than in patients in Groups I and II (p = 0.008 and p = 0.036, respectively). We did not observe antazoline-related adverse events in any of the studied groups of patients. This real-world registry analysis revealed a different influence of CKD on the effectiveness of individual drugs, and while propafenone and amiodarone maintained their AF termination efficacy, antazoline became significantly less effective in restoring sinus rhythm.
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- 2022
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33. Comparative effectiveness and safety of antazoline‑based and propafenone‑based strategies for pharmacological cardioversion of short‑duration atrial fibrillation in the emergency department
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Małgorzata Żurawska, Mariusz Pytkowski, Ilona Kowalik, Michał M. Farkowski, Hanna Szwed, Jacek Woźniak, Aleksander Maciąg, and Maciej Sterliński
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Male ,0301 basic medicine ,medicine.medical_specialty ,medicine.medical_treatment ,Propafenone ,030204 cardiovascular system & hematology ,Cardioversion ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Atrial Fibrillation ,Internal Medicine ,Clinical endpoint ,medicine ,Antazoline ,Humans ,Adverse effect ,Aged ,Retrospective Studies ,Aged, 80 and over ,Fibrillation ,business.industry ,Atrial fibrillation ,Emergency department ,Middle Aged ,medicine.disease ,Treatment Outcome ,030104 developmental biology ,Anesthesia ,Cardiology ,Female ,Patient Safety ,medicine.symptom ,Emergency Service, Hospital ,business ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
INTRODUCTION Numerous studies described the effectiveness and safety of antazoline in pharmacological cardioversion of short‑duration atrial fibrillation (AF). However, there are no data on the comparison of antazoline and antiarrhythmic drugs listed in clinical guidelines. OBJECTIVES The aim of the study was to assess the comparative effectiveness and safety of antazoline‑based and propafenone‑based strategies in pharmacological cardioversion of short‑duration AF performed in our emergency department. PATIENTS AND METHODS We conducted a retrospective case‑control study based on the analysis of medical records of patients undergoing pharmacological cardioversion of short‑duration AF with intravenous antazoline or propafenone at our department in the years 2008-2012. The primary endpoint was the successful cardioversion of AF. The primary safety endpoint was hospitalization due to the adverse effects of the treatment. RESULTS We analyzed 432 cases of cardioversion. The mean age of patients was 68.9 ±9.8 years; 65% of the patients were male; 90% of the patients had a history of AF. Antazoline was administered 334 times and propafenone-98 times. The mean dose of antazoline was 172 ±65 mg, while all patients in the propafenone group received the drug at a fixed dose of 70 mg (1 vial). Cardioversion with antazoline was successful in 239 cases (71.6%) and with propafenone-in 54 patients (55.1%) (relative risk [RR], 1.30; 95% confidence interval [CI], 1.07-1.57). The rate of hospitalization due to the adverse effects of the treatment were low and similar between the study groups: 10 (3.0%) for antazoline and 4 (4.1%) for propafenone (RR, 0.73; 95% CI, 0.23-2.27). CONCLUSIONS The antazoline‑based strategy was more effective and safer in comparison with propafenone‑based strategy in the pharmacological cardioversion of short‑duration AF in our emergency department.
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- 2016
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34. Effect of Antazoline on Electrophysiological Properties of Atrial Muscle and Conduction System of the Heart
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Andrzej Lubiński, Bartłomiej Jacek Bińkowski, Marcin Makowski, and Paweł Kubiński
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Adult ,Male ,medicine.medical_specialty ,Refractory period ,Action Potentials ,030204 cardiovascular system & hematology ,QT interval ,03 medical and health sciences ,QRS complex ,Young Adult ,0302 clinical medicine ,Heart Conduction System ,Heart Rate ,Internal medicine ,medicine ,Antazoline ,Humans ,Tachycardia, Atrioventricular Nodal Reentry ,Pharmacology (medical) ,Sinus rhythm ,030212 general & internal medicine ,cardiovascular diseases ,Heart Atria ,Aged ,Pharmacology ,Supraventricular arrhythmia ,Dose-Response Relationship, Drug ,business.industry ,General Medicine ,Middle Aged ,Papillary Muscles ,Atrioventricular node ,medicine.anatomical_structure ,Treatment Outcome ,Antiarrhythmic drug ,Atrial Flutter ,Cardiology ,Catheter Ablation ,Female ,Original Article ,Electrophysiological study ,Electrical conduction system of the heart ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Purpose Antazoline is a first-generation antihistaminic agent with additional anticholinergic properties and antiarrhythmic potential. Recent data shows its high effectiveness in sinus rhythm restoration among patients with paroxysmal atrial fibrillation. The effect of antazoline on electrophysiological parameters of the heart in vivo has not yet been examined. The aim of this study was to evaluate changes in electrophysiological parameters of the heart muscle and conduction system as a response to increasing doses of antazoline. Methods After successful ablation of supraventricular arrhythmias, the electrophysiological parameters: sinus rhythm cycle length (SRCL), AH, HV, QRS, QT, QTc intervals, Wenckebach point (WP), sinus node recovery period (SNRT), intra- (hRA-CSos) and interatrial conduction time (hRA-CSd), right and left atrium refractory period (RA-; LA-ERP), and atrioventricular node refractory period (AVN-ERP) were assessed initially and after 100, 200, and 300 mg of antazoline given intravenously. Results Fifteen patients (8 males, 19–72 years old) undergoing EPS and RF ablation were enrolled. After 100 mg bolus, a significant reduction in SRCL was noticed. After antazoline administration, significant prolongation of HV, QRS, QTc, hRA-CSos, hRA-CSd intervals, RA– and LA-ERP and reduction of SRCL were observed. After a total dose of 300 mg, QT interval prolonged significantly. Increasing the dose of antazoline had no impact on AH, Wenckebach point, AVN-ERP, and SNRT. Conclusion Antazoline has an effect on electrophysiological parameters of the atrial muscle and has rapid onset of action. No negative effect on sinus node function and atrioventricular conduction in a unique property among antiarrhythmic drugs.
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- 2018
35. Magnetic Core–Shell Molecularly Imprinted Nano-Conjugates for Extraction of Antazoline and Hydroxyantazoline from Human Plasma—Material Characterization, Theoretical Analysis and Pharmacokinetics.
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Giebułtowicz, Joanna, Korytowska, Natalia, Sobiech, Monika, Polak, Sebastian, Wiśniowska, Barbara, Piotrowski, Roman, Kułakowski, Piotr, Luliński, Piotr, and Jarzębski, Maciej
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- *
SOLID phase extraction , *LIQUID-liquid extraction , *PHARMACOKINETICS , *MASS spectrometry , *LIQUID chromatography - Abstract
The aim of this study was to develop magnetic molecularly imprinted nano-conjugate sorbent for effective dispersive solid phase extraction of antazoline (ANT) and its metabolite, hydroxyantazoline (ANT-OH) in analytical method employing liquid chromatography coupled with mass spectrometry method. The core–shell material was characterized in terms of adsorption properties, morphology and structure. The heterogeneous population of adsorption sites towards ANT-OH was characterized by two Kd and two Bmax values: Kd (1) = 0.319 µg L−1 and Bmax (1) = 0.240 μg g−1, and Kd (2) = 34.6 µg L−1 and Bmax (2) = 5.82 μg g−1. The elemental composition of magnetic sorbent was as follows: 17.55, 37.33, 9.14, 34.94 wt% for Si, C, Fe and O, respectively. The extraction protocol was optimized, and the obtained results were explained using theoretical analysis. Finally, the analytical method was validated prior to application to pharmacokinetic study in which the ANT was administrated intravenously to three healthy volunteers. The results prove that the novel sorbent could be useful in extraction of ANT and ANT-OH from human plasma and that the analytical strategy could be a versatile tool to explain a potential and pharmacological activity of ANT and ANT-OH. [ABSTRACT FROM AUTHOR]
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- 2021
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36. The influence of pH on the stability of antazoline: kinetic analysis
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Ilze Grante, Andris Actiņš, Kārlis Bērziņš, and Ilva Nakurte
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Aqueous solution ,Chemistry ,General Chemical Engineering ,Kinetic analysis ,Inorganic chemistry ,Analytical chemistry ,General Chemistry ,Kinetic energy ,High-performance liquid chromatography ,chemistry.chemical_compound ,Hydrolysis ,Antazoline ,medicine ,Spectral data ,Acetamide ,medicine.drug - Abstract
Degradation of the drug antazoline was studied in aqueous solutions by means of pH-rate profiling (pH 0–7.4). The novel approach of Runge–Kutta numerical integration in combination with multi-parameter optimisation was applied to UV-Vis spectral data to determine a valid kinetic model and kinetic parameters of the degradation process. The overall degradation mechanism was found to be dependent on the environmental pH. In the pH range of 3.0–7.4, the formation of the antazoline hydrolysis product (N-(2-aminoethyl)-2-(N-benzylanilino)acetamide) through three different pathways (acidic, non-catalysed, and semi-alkaline hydrolysis) was observed. In highly acidic media (pH 0–2), the degradation mechanism was found to be more complex. Although the same primary degradation product formed, a colourful (dark blue/violet) intermediate was also observed and further investigated by HPLC/TOF-MS.
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- 2015
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37. Antiarrhythmic effect of antazoline in experimental models of acquired short- and long-QT-syndromes
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Gerrit Frommeyer, Christian Ellermann, Michael Fehr, Dirk G. Dechering, Simon Kochhäuser, Magdalena Sterneberg, and Lars Eckardt
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medicine.medical_specialty ,Refractory Period, Electrophysiological ,Refractory period ,Long QT syndrome ,Adrenergic beta-Antagonists ,Action Potentials ,Torsades de pointes ,030204 cardiovascular system & hematology ,QT interval ,03 medical and health sciences ,0302 clinical medicine ,Torsades de Pointes ,Physiology (medical) ,Internal medicine ,Membrane Transport Modulators ,Antazoline ,medicine ,Repolarization ,Animals ,030212 general & internal medicine ,business.industry ,Pinacidil ,Sotalol ,Effective refractory period ,Arrhythmias, Cardiac ,Isolated Heart Preparation ,medicine.disease ,Anti-Bacterial Agents ,Erythromycin ,Disease Models, Animal ,Long QT Syndrome ,Ventricular Fibrillation ,Cardiology ,Histamine H1 Antagonists ,Rabbits ,Cardiology and Cardiovascular Medicine ,business ,medicine.drug - Abstract
Aims Antazoline is a first-generation antihistamine with antiarrhythmic properties. This study examines potential electrophysiological effects of antazoline in short-QT-syndrome (SQTS) and long-QT-syndrome (LQTS). Methods and results Sixty-five rabbit hearts were Langendorff-perfused. Action potential duration at 90% of repolarization (APD90), QT-interval, spatial dispersion (DISP), and effective refractory period (ERP) were measured. The IK, ATP-opener pinacidil (1 µM, n = 14) reduced APD90 (-14 ms, P
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- 2017
38. P2697Utility of antazoline for cardioversion of recent onset atrial fibrillation in patients with a history of myocardial infarction
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Aleksander Maciag, I. Kowalik, Mariusz Pytkowski, Hanna Szwed, M. Zurawska, and M.M. Farkowski
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,Cardioversion ,medicine.disease ,Internal medicine ,Antazoline ,medicine ,Cardiology ,In patient ,Myocardial infarction ,Cardiology and Cardiovascular Medicine ,business ,Recent onset ,medicine.drug - Published
- 2017
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39. Antazoline for rapid termination of atrial fibrillation during ablation of accessory pathways
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Jakub Baran, Roman Piotrowski, Sebastian Stec, Piotr Futyma, Piotr Kułakowski, and Tomasz Kryński
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Adult ,Male ,Tachycardia ,medicine.medical_specialty ,medicine.medical_treatment ,Catheter ablation ,Electrocardiography ,Heart Rate ,Internal medicine ,Atrial Fibrillation ,Heart rate ,medicine ,Antazoline ,Humans ,Sinus rhythm ,Heart Atria ,Intraoperative Complications ,Dose-Response Relationship, Drug ,medicine.diagnostic_test ,business.industry ,Atrial fibrillation ,General Medicine ,medicine.disease ,Accessory Atrioventricular Bundle ,Anesthesia ,Injections, Intravenous ,Catheter Ablation ,Histamine H1 Antagonists ,Cardiology ,Female ,Wolff-Parkinson-White Syndrome ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Atrial flutter ,Follow-Up Studies ,medicine.drug - Abstract
Background and aim: To assess safety and efficacy of antazoline for termination of atrial fibrillation (AF) occurring during ablation of accessory pathways (AP). Methods: We analyzed electrophysiological mechanism of antazoline (changes in A-A interval) and the percentage of pre-excited QRS complexes before and after antazoline administration. The total dose administered and the time from the start of injection to sinus rhythm restoration were also measured. Results: Out of consecutive 290 patients with Wolff-Parkinson-White syndrome undergoing radiofrequency (RF) ablation, 12 (4.1%) (4 females, mean age 36 ± 20 years) developed sustained AF which did not stop spontaneously within 10 min, and antazoline in 100 mg repeated boluses was administered. In all 12 patients the drug restored sinus rhythm after a mean of 425 ± 365 s (range 43–1245 s) using a mean cumulative dose of 176 ± 114 mg (range 25–400 mg). The drug slightly prolonged R-R intervals during AF (from 383 ± 106 to 410 ± 70 ms) and reduced the percentage of fully pre-excited QRS complexes (from 35% to 26%). Intracardiac recordings showed gradual increase in A-A intervals, as well as regularization and decreasing fractionation of atrial activity following drug injection (mean A-A interval of 162 ± 30 ms at baseline vs. 226 ± 26 ms shortly before sinus rhythm restoration, p < 0.001). AP was not completely blocked in any patient which enabled continuation of ablation. Conclusions: Antazoline safely and rapidly converts AF into sinus rhythm during ablation of AP. The drug does not block AP completely, enabling continuation of ablation. The drug converting AF into more organized atrial activity (atrial flutter/tachycardia) before sinus rhythm resumption.
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- 2014
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40. Characterization of In Vitro and In Vivo Metabolism of Antazoline Using Liquid Chromatography-Tandem Mass Spectrometry.
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Giebułtowicz, Joanna, Korytowska, Natalia, Piotrowski, Roman, Kułakowski, Piotr, Latacz, Gniewomir, Szymańska, Ewa, Wiśniowska, Barbara, and Polak, Sebastian
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- *
DRUG metabolism , *TANDEM mass spectrometry , *CYTOCHROME P-450 , *ATRIAL fibrillation - Abstract
Antazoline (ANT) was recently shown to be an effective and safe antiarrhythmic drug in the termination of atrial fibrillation. However, the drug is still not listed in clinical guidelines. No data on ANT metabolism in humans is available. We used liquid chromatography coupled with tandem mass spectrometry to identify and characterize metabolites of ANT. We analyzed plasma of volunteers following a single intravenous administration of 100 mg of ANT mesylate and in in vitro cultures of human hepatocytes. We revealed that ANT was transformed into at least 15 metabolites and we investigated the role of cytochrome P450 isoforms. CYP2D6 was the main one involved in the fast metabolism of ANT. The biotransformation of ANT by CYP2C19 was much slower. The main Phase I metabolite was M1 formed by the removal of phenyl and metabolite M2 with hydroxyl in the para position of phenyl. Glucuronidation was the leading Phase II metabolism. Further study on pharmacokinetics of the metabolites would allow us to better understand the activity profile of ANT and to predict its potential clinical applications. Ultimately, further investigation of the activity profile of the new hydroxylated M2 metabolite of ANT might result in an active substance with a different pharmacological profile than the parent molecule, and potentially a new drug candidate. [ABSTRACT FROM AUTHOR]
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- 2020
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41. Effective suppression of atrial fibrillation by the antihistaminic agent antazoline: First experimental insights into a novel antiarrhythmic agent
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Gerrit Frommeyer, Dirk G. Dechering, Lars Eckardt, Michael Fehr, Magdalena Sterneberg, Harilaos Bogossian, Sven Kaese, Peter Milberg, Christian Pott, and Nils Bögeholz
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medicine.medical_specialty ,Atrial action potential ,Time Factors ,Refractory Period, Electrophysiological ,Refractory period ,medicine.medical_treatment ,Action Potentials ,030204 cardiovascular system & hematology ,Antiarrhythmic agent ,03 medical and health sciences ,Electrocardiography ,0302 clinical medicine ,Heart Rate ,Internal medicine ,Atrial Fibrillation ,Drug Discovery ,medicine ,Antazoline ,Animals ,Pharmacology (medical) ,030212 general & internal medicine ,Flecainide ,Pharmacology ,Dose-Response Relationship, Drug ,business.industry ,Cardiac Pacing, Artificial ,Isoproterenol ,Atrial fibrillation ,Isolated Heart Preparation ,General Medicine ,medicine.disease ,ANT ,Acetylcholine ,Cardiology ,Histamine H1 Antagonists ,Rabbits ,Cardiology and Cardiovascular Medicine ,business ,Electrophysiologic Techniques, Cardiac ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Introduction The antihistaminic antazoline (ANT) was reported to be highly effective and safe for rapid conversion of atrial fibrillation (AF). We therefore analyzed underlying mechanisms in an experimental whole-heart model. Methods and Results Isolated and retrogradely perfused rabbit hearts underwent a standardized protocol employing atrial burst pacing induced AF in 5 of 20 hearts under baseline conditions (7 episodes). Thereafter, a combination of acetylcholine and isoproterenol was employed to enhance AF occurrence. Two monophasic action potential recordings on the left- and two on the right atrial epicardium showed a decrease of atrial action potential duration (aAPD, -25ms, p
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- 2017
42. Study and Development of Reversed-Phase HPLC Systems for the Determination of 2-Imidazolines in the Presence of Preservatives in Pharmaceutical Preparations
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Catherine K. Markopoulou, John E. Koundourellis, Constantinos G. Antoniou, and Maria G. Kouskoura
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Pharmacology ,Chromatography ,Correlation coefficient ,Reversed-phase chromatography ,Naphazoline ,Tramazoline ,High-performance liquid chromatography ,Analytical Chemistry ,Benzalkonium chloride ,chemistry.chemical_compound ,chemistry ,Antazoline ,medicine ,Environmental Chemistry ,Ammonium ,Agronomy and Crop Science ,Food Science ,medicine.drug - Abstract
Different HPLC chromatographic systems were investigated on a C18ACE 5 μm, 150 × 4.6 mm id column for the determination of tymazoline, tramazoline, and antazoline, with either naphazoline or xylometazoline, in commercial preparations. For the development and optimization of the systems, a Response Surface Method (r = 0.925–0.980) was used to illustrate the changes in k as a function of pH values and different salt concentrations. The simultaneous separation of 2-imidazolines was accomplished at 40°C with 0.01 M ammonium acetate–methanol (50 + 50, v/v, pH 6.0) mobile phase at a flow rate of 1.2 mL/min. In order to deal with the usual coexistence of 2-imidazolines with benzethonium and benzalkonium chloride preservatives, it was necessary to use another chromatographic system, 0.01 M ammonium acetate–methanol (50 + 50, v/v) mobile phase on a cyano ACE 5 μm, 150 × 4.6 mm id column. As part of a more thorough theoretical investigation, a partial least-squares (PLS) technique was used for modeling the RP-HPLC retention data. The model was based on molecular structure descriptors of the analytes' X variables and on their retention time (Log K) Y. The goodness of fit was estimated by the PLS correlation coefficient (r2) and root mean square error of estimation values, which were 0.994 and 0.0479, respectively.
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- 2011
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43. Modulation of metabolic activity of phagocytes by antihistamines
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Ondřej Vašíček, Tomáš Perečko, Katarína Drábiková, Radomír Nosáľ, Tatiana Mačičková, Gabriela Ambrožová, Michaela Pekarova, Jana Moravcová, Milan Číž, Lukáš Kubala, Jana Pečivová, Antonín Lojek, and Viera Jančinová
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Pharmacology ,chemistry.chemical_classification ,reactive oxygen species ,Reactive oxygen species ,antihistamines ,Chemistry ,Superoxide ,Health, Toxicology and Mutagenesis ,Toxicology ,Brompheniramine ,Nitric oxide ,Respiratory burst ,chemistry.chemical_compound ,Chlorcyclizine ,nitric oxide ,Clemastine ,Immunology ,medicine ,Antazoline ,phagocytes ,Original Article ,oxidative burst ,medicine.drug - Abstract
Modulation of metabolic activity of phagocytes by antihistaminesThe purpose of the study was to investigate the effects of H1-antihistamines of the 1stgeneration (antazoline, bromadryl, brompheniramine, dithiaden, cyclizine, chlorcyclizine, chlorpheniramine, clemastine) and the 2ndgeneration (acrivastine, ketotifen, and loratadine) on the respiratory burst of phagocytes. Reactive oxygen species generation in neutrophils isolated from rat blood was measured using luminol-enhanced chemiluminescence. Changes in nitrite formation and iNOS protein expression by RAW 264.7 macrophages were analysed using Griess reaction and Western blotting. The antioxidative properties of drugs in cell-free systems were detected spectrophotometrically, luminometrically, fluorimetrically, and amperometrically. The majority of the H1-antihistamines tested (bromadryl, brompheniramine, chlorcyclizine, chlorpheniramine, clemastine, dithiaden, and ketotifen) exhibited a significant inhibitory effect on the chemiluminescence activity of phagocytes. H1-antihistamines did not show significant scavenging properties against superoxide anion and hydroxyl radical, thus this could not contribute to the inhibition of chemiluminescence. H1-antihistamines had a different ability to modulate nitric oxide production by LPS-stimulated macrophages. Bromadryl, clemastine, and dithiaden were the most effective since they inhibited iNOS expression, which was followed by a significant reduction in nitrite levels. H1-antihistamines had no scavenging activity against nitric oxide. It can be concluded that the effects observed in the H1-antihistamines tested are not mediated exclusively via H1-receptor pathway or by direct antioxidative properties. Based on our results, antihistamines not interfering with the microbicidal mechanisms of leukocytes (antazoline, acrivastine and cyclizine) could be used preferentially in infections. Other antihistamines should be used, under pathological conditions accompanied by the overproduction of reactive oxygen species.
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- 2011
44. Clinical effectiveness and safety of antazoline‐based therapy in patients with stable coronary artery disease undergoing pharmacological cardioversion of short‐duration atrial fibrillation in the emergency department
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Ilona Kowalik, Michał M. Farkowski, Malgorzata Zurawska, Hanna Szwed, Mariusz Pytkowski, and Aleksander Maciag
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Male ,medicine.medical_specialty ,Time Factors ,medicine.medical_treatment ,Comorbidity ,Coronary Artery Disease ,030204 cardiovascular system & hematology ,Cardioversion ,Amiodarone ,Medical Records ,Coronary artery disease ,Vernakalant ,03 medical and health sciences ,chemistry.chemical_compound ,Patient Admission ,0302 clinical medicine ,Heart Conduction System ,Heart Rate ,Risk Factors ,Internal medicine ,Atrial Fibrillation ,medicine ,Antazoline ,Humans ,Pharmacology (medical) ,Sinus rhythm ,030212 general & internal medicine ,Myocardial infarction ,Aged ,Retrospective Studies ,Pharmacology ,business.industry ,Atrial fibrillation ,General Medicine ,Middle Aged ,medicine.disease ,Treatment Outcome ,chemistry ,Cardiology ,Female ,Emergency Service, Hospital ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Introduction Options for a pharmacological cardioversion (CV) of short-duration atrial fibrillation (AF) in patients with a stable coronary artery disease (CAD) are limited to amiodarone or vernakalant. Antazoline has been reported to achieve high rates of AF conversion to sinus rhythm, but data on its effectiveness and, more importantly, safety in stable CAD patients, have been sparse. Aims To assess the effectiveness and safety of antazoline-based therapy in patients with a stable CAD undergoing pharmacological CV of short-duration AF in the emergency department (ED). Results A retrospective case-control study. We conducted an analysis of medical records of patients with a stable CAD undergoing CV of short duration (≤48 hours) AF in the ED using intravenous antazoline. The main endpoints of the study were successful cardioversion of AF and hospitalization due to the adverse effects (AE) of the treatment. Between 2008 and 2012, out of 548 CVs, antazoline was administered 334 times: 138 in CAD and 196 in the control group. Patients in the CAD group were older and had more comorbidities than controls; 65 patients had had a history of myocardial infarction (MI). In CAD group, the effectiveness was higher (82.6% vs 63.8%, RB: 1.30 [95% CI: 1.14-1.48], P = 0.0002) and the hospitalization rate due to AE was similar (1.4% vs 4.1%, RR: 0.36 [95% CI: 0.08-1.65], P = 0.2054) to the control group. Among patients with CAD, a history of MI did not influence the effectiveness or safety of the CV (P = 0.2252 and P = 1.0000, respectively). Conclusions In selected patients with a stable CAD, even with a history of MI, antazoline-based CV of short-duration AF may be an effective and safe therapeutic option.
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- 2018
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45. Application of Ratio Derivative Spectrophotometry for Simultaneous Determination of Naphazoline and Antazoline in Eye Drops
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I. Kaedi, Nafiseh Shams, and Reza Hajian
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Accuracy and precision ,Analyte ,Chromatography ,medicine.diagnostic_test ,Chemistry ,Analytical chemistry ,General Chemistry ,Derivative ,Naphazoline ,Britton-Robinson buffer ,lcsh:Chemistry ,lcsh:QD1-999 ,Spectrophotometry ,Standard addition ,Antazoline ,medicine ,medicine.drug - Abstract
Ratio derivative spectrophotometrie method has been developed for the simultaneous determination of naphazoline (NAP) and antazoline (ANT) at micromolar levels in Britton Robinson buffer (pH 9) medium. In this method the overlapping spectra of naphazoline and antazoline were well resolved by making use of the first-derivative of the ratios of their direct absorption spectra. The derivative ratio absorbances of naphazoline and antazoline were measured at 227.2 and 235 nm, respectively for their quantification. The method is simple, fast and does not require separation of naphazoline and antazoline. Another salient feature of the method is that simultaneous standard additions of both analytes permitted to resolve matrix effect and quantification at a unique standard addition plot. Naphazoline and antazoline were determined in the concentration range of 10-150 μmol L-1(NAP/ANT ratio varying from about 10 to 150) in the same aliquot with a precision and accuracy of about 1.7% and 1.8%, respectively. The recommended procedure was successfully applied for analysis of naphazoline and antazoline in eye drops.
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- 2010
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46. A Rapid Derivative Spectrophotometric Method for Simultaneous Determination of Naphazoline and Antazoline in Eye Drops
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Effat Souri, Alma Afshari, Massoud Amanlou, and Hassan Farsam
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Derivative ,Spectrophotometry ,Anti-Allergic Agents ,Drug Discovery ,Antazoline ,medicine ,Antazoline Phosphate ,Reference standards ,Chromatography ,medicine.diagnostic_test ,Chemistry ,Reproducibility of Results ,Naphazoline Hydrochloride ,General Chemistry ,General Medicine ,Naphazoline ,Reference Standards ,Calibration ,Indicators and Reagents ,Spectrophotometry, Ultraviolet ,Ophthalmic Solutions ,Linear correlation ,Adrenergic alpha-Agonists ,medicine.drug - Abstract
A zero-crossing first-derivative spectrophotometric method is applied for the simultaneous determination of naphazoline hydrochloride and antazoline phosphate in eye drops. The measurements were carried out at wavelengths of 225 and 252 nm for naphazoline hydrochloride and antazoline phosphate, respectively. The method was found to be linear (r2>0.999) in the range of 0.2-1 microg/ml for naphazoline hydrochloride in the presence of 5 microg/ml antazoline phosphate at 225 nm. The same linear correlation (r2>0.999) was obtained in the range of 1-10 microg/ml of antazoline phosphate in the presence of 0.5 microg/ml of naphazoline hydrochloride at 252 nm. The limit of determination was 0.2 microg/ml and 1 microg/ml for naphazoline hydrochloride and antazoline phosphate, respectively. The method was successfully used for simultaneous analysis of naphazoline hydrochloride and antazoline phosphate in eye drops without any interference from excipients and prior separation before analysis.
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- 2006
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47. P298Intravenous antazoline for cardioversion of recent onset atrial fibrillation in patients with stable coronary artery disease
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M. Zurawska, Aleksander Maciag, Ilona Kowalik, Mariusz Pytkowski, Hanna Szwed, and Mm. Farkowski
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medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Atrial fibrillation ,Cardioversion ,medicine.disease ,Coronary artery disease ,Physiology (medical) ,Internal medicine ,Antazoline ,medicine ,Cardiology ,In patient ,Cardiology and Cardiovascular Medicine ,business ,Recent onset ,medicine.drug - Published
- 2017
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48. Antazoline-insights into drug-induced electrocardiographic and hemodynamic effects: Results of the ELEPHANT II substudy
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Dagmara Gralak-Łachowska, Joanna Giebułtowicz, Piotr Kułakowski, Małgorzata Soszyńska, Roman Piotrowski, Jakub Baran, Piotr Wroczyński, and Agnieszka Sikorska
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Adult ,Male ,Cardiac output ,medicine.medical_specialty ,medicine.medical_treatment ,Hemodynamics ,Blood Pressure ,030204 cardiovascular system & hematology ,Antiarrhythmic agent ,QT interval ,Electrocardiography ,03 medical and health sciences ,QRS complex ,0302 clinical medicine ,Heart Rate ,Reference Values ,Physiology (medical) ,Internal medicine ,medicine ,Antazoline ,Humans ,030212 general & internal medicine ,PR interval ,medicine.diagnostic_test ,business.industry ,Stroke Volume ,Original Articles ,General Medicine ,Impedance cardiography ,Anesthesia ,Histamine H1 Antagonists ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,business ,Anti-Arrhythmia Agents ,medicine.drug - Abstract
Background Antazoline is an old antihistaminic and new antiarrhythmic agent with unknown mechanisms of action which recently has been shown to effectively terminate atrial fibrillation. The aim of study was to examine the effects of antazoline on hemodynamic and ECG parameters. Methods Antazoline was given intravenously in three 100 mg boluses to 10 healthy volunteers (four males, mean age 40 + 11 years). Hemodynamic and ECG parameters were measured using impedance cardiography [systolic (sBP), diastolic (dBP), mean (mBP) blood pressure, stroke volume (SV), cardiac output (CO), total peripheral resistance (TPR) and heart rate (HR), P wave, PR interval, QRS complex, QT and corrected QT (QTcF) interval]. Plasma concentration of antazoline was also measured. Results Antazoline caused significant prolongation of P wave, QRS as well as QT and QTcF (101 ± 10 vs 110 ± 16 ms, p
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- 2017
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49. Simultaneous determination of antazoline and naphazoline by the net analyte signal standard addition method and spectrophotometric technique
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Karim Asadpour-Zeynali, Raoof Ghavami, Payam Soheili-Azad, and Roghayeh Esfandiari
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Analyte ,Analytical chemistry ,Signal ,Analytical Chemistry ,Spectrophotometry ,Anti-Allergic Agents ,Antazoline ,medicine ,Calibration ,Environmental Chemistry ,Figure of merit ,Pharmacology ,Chromatography ,medicine.diagnostic_test ,Chemistry ,Naphazoline ,Hydrogen-Ion Concentration ,Solutions ,Drug Combinations ,Standard addition ,Indicators and Reagents ,Spectrophotometry, Ultraviolet ,Ophthalmic Solutions ,Agronomy and Crop Science ,Adrenergic alpha-Agonists ,Algorithms ,Food Science ,medicine.drug - Abstract
A novel net analyte signal standard addition method (NASSAM) was used for simultaneous determination of the drugs anthazoline and naphazoline. The NASSAM can be applied for determination of analytes in the presence of known interferents. The proposed method is used to eliminate the calibration and prediction steps of multivariate calibration methods; the determination is carried out in a single step for each analyte. The accuracy of the predictions against the H-point standard addition method is independent of the shape of the analyte and interferent spectra. The net analyte signal concept was also used to calculate multivariate analytical figures of merit, such as LOD, selectivity, and sensitivity. The method was successfully applied to the simultaneous determination of anthazoline and naphazoline in a commercial eye drop sample.
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- 2011
50. Antagonism of levcromakalim by imidazoline- and guanidine-derivatives in rat portal vein: involvement of the delayed rectifier
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Timothy Ibbotson, Arthur H. Weston, and Gillian Edwards
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Male ,Cromakalim ,medicine.medical_specialty ,Potassium Channels ,Receptors, Drug ,Voltage clamp ,Imidazoline receptor ,Clonidine ,Rats, Sprague-Dawley ,chemistry.chemical_compound ,Phentolamine ,Internal medicine ,Glyburide ,medicine ,Antazoline ,Animals ,Benzopyrans ,Pyrroles ,Pharmacology ,Guanabenz ,Portal Vein ,Cirazoline ,Potassium channel ,Rats ,Endocrinology ,chemistry ,Imidazoline Receptors ,Research Article ,medicine.drug - Abstract
1. In rat whole portal veins, guanabenz (100 nM to 10 microM) and antazoline (100 nM to 100 microM) each increased the amplitude, frequency and duration of spontaneous contractions. In addition, guanabenz (30 microM) and antazoline (30 microM) each antagonized the ability of levcromakalim (3 nM to 10 microM) to inhibit the spontaneous contractions of this tissue. 2. Whole-cell voltage-clamp recordings were made from freshly-isolated rat portal vein cells dispersed by a collagenase/pronase enzyme treatment. The ability of several agents (antazoline, cirazoline, clonidine, guanabenz and phentolamine, each containing an imidazoline or guanidine moiety), to modulate potassium (K) currents and to inhibit the actions of levcromakalim was investigated. 3. Antazoline, cirazoline, clonidine, guanabenz and phentolamine (each at a concentration of 30 microM) had little effect on control non-inactivating currents but inhibited the delayed-rectifier current, IK(V). 4. Levcromakalim (1 microM) induced a non-inactivating current, IK(ATP), and also inhibited the delayed rectifier current, IK(V). 5. Glibenclamide (1 microM) had no effect on control delayed rectifier or non-inactivating currents, but it inhibited the simultaneous induction of IK(ATP) and reduction of IK(V) produced by levcromakalim (1 microM). 6. Antazoline, cirazoline, clonidine and guanabenz (each at a concentration of 30 microM) prevented the induction of IK(ATP) by levcromakalim (1 microM). Phentolamine (30 microM) and clonidine (30 microM) each inhibited the IK(ATP) generated by levcromakalim (1 microM). 7. It is concluded that a variety of agents which possess either an imidazoline (antazoline, cirazoline, clonidine and phentolamine) or a guanidine (guanabenz) moiety within their structure inhibit the delayed rectifier current, IK(V). This action may thus be mediated via a so-called non-adrenoceptor imidazoline binding site. Furthermore, the ability of these ligands to inhibit IK(V) and to antagonize both the induction of IK(ATP) and the vasorelaxation produced by levcromakalim is consistent with the view that the channel (KATP) which underlies IK(ATP) is a voltage-insensitive state of the delayed rectifier K-channel (Kv).
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- 1993
- Full Text
- View/download PDF
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