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21. Antiarrhythmic Efficacy of Desipramine.

Author

Fenster, Paul E., Bressler, Rubin, and Kipps, Julie

Abstract

The effect of desipramine on chronic ventricular ectopic depolarizations (VEDs) was studied in 10 patients with at least 30 VEDs per hour. A single-blind, placebo-controlled, dose-ranging protocol was followed. Efficacy was defined as a decrease in VED frequency of at least 75%, based on three 24 hour ambulatory ECGs obtained on each dose. Among seven patients with analyzable data, one responded to 75 mg daily, and three others responded to 150 mg daily. Six of the seven patients demonstrated decreases in VED frequency with increases in desipramine serum concentration. Among five patients with episodes of nonsustained ventricular tachycardia, desipramine completely abolished the episodes in two, and reduced the frequency of episodes by at least 90% in two others. Adverse reactions were common, and necessitated drug discontinuation or dose reduction in five patients. Desipramine has an antiarrhythmic effect in patients with chronic ventricular ectopy, but its clinical utility is limited by adverse effects. [ABSTRACT FROM AUTHOR]

Published
1989
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22. Suppression of Atrial Ectopy with Intravenous Metoprolol in Chronic Obstructive Pulmonary Disease Patients.

Author

QUAN, STUART F., FENSTER, PAUL E., HANSON, CHRISTINE D., COAKER, LLOYD A., and BASISTA, MICHAEL P.

Abstract

To determine the efficacy of a cardioselective beta blocker in the treatment of atrial ectopy in patients with chronic obstructive pulmonary disease (COPD), we administered intravenous metoprolol (0.2 mg/kg) to six patients with atrial ectopic depolarizations (AEDs) and chronic partially reversible airflow limitation (FEV1 = 1.24 ± 0.21 liter, mean ± S.E.). Metoprolol reduced the mean frequency of AEDs from 713 ± 237 per hour to 218 ± 127 per hour. Furthermore, three of six patients experienced an 85 per cent or greater decrease in AEDs. No changes were observed in FEV1, FVC, or FEF25-75 over the course of the study. These data suggest that intravenous metoprolol is effective in reducing the frequency of AEDs and that it can be administered to patients with COPD without causing an increase in airflow limitation. [ABSTRACT FROM AUTHOR]

Published
1983
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25. Pharmacokinetic evaluation of the digoxin-amiodarone interaction

Author

Fenster, Paul E., White, Neal W., and Hanson, Christine D.

Abstract

Amiodarone is known to raise serum digoxin levels. This study was designed to evaluate the pharmacokinetic basis of this interaction in 10 normal subjects. The pharmacokinetic variables for digoxin were determined after a 1.0 mg intravenous dose of digoxin in each subject, before and after oral amiodarone, 400 mg daily for 3 weeks. During amiodarone administration, systemic clearance of digoxin was reduced from 234 ± 72 ml/min (mean ± standard deviation) to 172 ± 33 ml/min (p < 0.01). This was due to reductions in both renal clearance (from 105 ± 39 to 84 ± 15 ml/min) (p < 0.05) and nonrenal clearance (from 130 ± 38 to 88 ± 20 ml/min) (p < 0.01). Digoxin half-life of elimination was prolonged from 34 ± 13 to 40 ± 16 hours (p < 0.05). Digoxin volume of distribution was not significantly changed. Amiodarone caused a three- to fivefold increase in serum reverse triiodothyronine levels, but changes in thyroid function were not quantitatively related to the changes in digoxin pharmacokinetics.

Published
1985
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29. Career Development of the Academic Cardiologist

Author

Kronenberg, Marvin W., primary, Rubin, Stanley A., additional, Atkins, Floyd, additional, Fenster, Paul E., additional, Marsh, James D., additional, Pine, Michael B., additional, and Kronenberg, Marvin W., additional

Published
1982
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33. Ethmozine for ventricular premature complexes

Author

Gear, Kathleen, primary, Marcus, Frank I., additional, Huang, Shoei K., additional, Fenster, Paul E., additional, Appleton, Christopher, additional, Moeller, Virginia, additional, Renaud, Gerri, additional, and Serokman, Ruth, additional

Published
1986
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