499 lines
No EOL
83 KiB
HTML
499 lines
No EOL
83 KiB
HTML
<?xml version="1.0" encoding="utf-8"?>
|
|
<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
|
|
<html xmlns="http://www.w3.org/1999/xhtml" xml:lang="en" lang="en">
|
|
|
|
<head><meta http-equiv="Content-Type" content="text/html; charset=utf-8" />
|
|
<!-- AppResources meta begin -->
|
|
<meta name="paf-app-resources" content="" />
|
|
<script type="text/javascript">var ncbi_startTime = new Date();</script>
|
|
|
|
<!-- AppResources meta end -->
|
|
|
|
<!-- TemplateResources meta begin -->
|
|
<meta name="paf_template" content="" />
|
|
|
|
<!-- TemplateResources meta end -->
|
|
|
|
<!-- Logger begin -->
|
|
<meta name="ncbi_db" content="books" /><meta name="ncbi_pdid" content="book-part" /><meta name="ncbi_acc" content="NBK548693" /><meta name="ncbi_domain" content="livertox" /><meta name="ncbi_report" content="record" /><meta name="ncbi_type" content="fulltext" /><meta name="ncbi_objectid" content="" /><meta name="ncbi_pcid" content="/NBK548693/" /><meta name="ncbi_pagename" content="Disopyramide - LiverTox - NCBI Bookshelf" /><meta name="ncbi_bookparttype" content="chapter" /><meta name="ncbi_app" content="bookshelf" />
|
|
<!-- Logger end -->
|
|
|
|
<title>Disopyramide - LiverTox - NCBI Bookshelf</title>
|
|
|
|
<!-- AppResources external_resources begin -->
|
|
<link rel="stylesheet" href="/core/jig/1.15.2/css/jig.min.css" /><script type="text/javascript" src="/core/jig/1.15.2/js/jig.min.js"></script>
|
|
|
|
<!-- AppResources external_resources end -->
|
|
|
|
<!-- Page meta begin -->
|
|
<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]" /><meta name="citation_title" content="Disopyramide" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="citation_date" content="2018/01/04" /><meta name="citation_pmid" content="31644003" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK548693/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Disopyramide" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="DC.Date" content="2018/01/04" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK548693/" /><meta name="description" content="Disopyramide is an oral antiarrhythmic agent that has been in wide use for several decades. Long term disopyramide therapy is associated with a low rate of serum enzyme elevations and is a rare cause of clinically apparent acute liver injury." /><meta name="og:title" content="Disopyramide" /><meta name="og:type" content="book" /><meta name="og:description" content="Disopyramide is an oral antiarrhythmic agent that has been in wide use for several decades. Long term disopyramide therapy is associated with a low rate of serum enzyme elevations and is a rare cause of clinically apparent acute liver injury." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK548693/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/livertox/Disopyramide/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK548693/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
|
|
|
|
<!-- Page meta end -->
|
|
<link rel="shortcut icon" href="//www.ncbi.nlm.nih.gov/favicon.ico" /><meta name="ncbi_phid" content="CE8E173E7C8D75B10000000000AF0094.m_13" />
|
|
<meta name='referrer' content='origin-when-cross-origin'/><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3852956/3985586/3808861/4121862/3974050/3917732/251717/4216701/14534/45193/4113719/3849091/3984811/3751656/4033350/3840896/3577051/3852958/4008682/4207974/4206132/4062871/12930/3964959/3854974/36029/4128070/9685/3549676/3609192/3609193/3609213/3395586.css" /><link type="text/css" rel="stylesheet" href="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/css/3411343/3882866.css" media="print" /></head>
|
|
<body class="book-part">
|
|
<div class="grid">
|
|
<div class="col twelve_col nomargin shadow">
|
|
<!-- System messages like service outage or JS required; this is handled by the TemplateResources portlet -->
|
|
<div class="sysmessages">
|
|
<noscript>
|
|
<p class="nojs">
|
|
<strong>Warning:</strong>
|
|
The NCBI web site requires JavaScript to function.
|
|
<a href="/guide/browsers/#enablejs" title="Learn how to enable JavaScript" target="_blank">more...</a>
|
|
</p>
|
|
</noscript>
|
|
</div>
|
|
<!--/.sysmessage-->
|
|
<div class="wrap">
|
|
<div class="page">
|
|
<div class="top">
|
|
<div id="universal_header">
|
|
<section class="usa-banner">
|
|
<div class="usa-accordion">
|
|
<header class="usa-banner-header">
|
|
<div class="usa-grid usa-banner-inner">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/favicons/favicon-57.png" alt="U.S. flag" />
|
|
<p>An official website of the United States government</p>
|
|
<button class="non-usa-accordion-button usa-banner-button" aria-expanded="false" aria-controls="gov-banner-top" type="button">
|
|
<span class="usa-banner-button-text">Here's how you know</span>
|
|
</button>
|
|
</div>
|
|
</header>
|
|
<div class="usa-banner-content usa-grid usa-accordion-content" id="gov-banner-top" aria-hidden="true">
|
|
<div class="usa-banner-guidance-gov usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-dot-gov.svg" alt="Dot gov" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The .gov means it's official.</strong>
|
|
<br />
|
|
Federal government websites often end in .gov or .mil. Before
|
|
sharing sensitive information, make sure you're on a federal
|
|
government site.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
<div class="usa-banner-guidance-ssl usa-width-one-half">
|
|
<img class="usa-banner-icon usa-media_block-img" src="https://www.ncbi.nlm.nih.gov/coreutils/uswds/img/icon-https.svg" alt="Https" />
|
|
<div class="usa-media_block-body">
|
|
<p>
|
|
<strong>The site is secure.</strong>
|
|
<br />
|
|
The <strong>https://</strong> ensures that you are connecting to the
|
|
official website and that any information you provide is encrypted
|
|
and transmitted securely.
|
|
</p>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<div class="usa-overlay"></div>
|
|
<header class="ncbi-header" role="banner" data-section="Header">
|
|
|
|
<div class="usa-grid">
|
|
<div class="usa-width-one-whole">
|
|
|
|
<div class="ncbi-header__logo">
|
|
<a href="/" class="logo" aria-label="NCBI Logo" data-ga-action="click_image" data-ga-label="NIH NLM Logo">
|
|
<img src="https://www.ncbi.nlm.nih.gov/coreutils/nwds/img/logos/AgencyLogo.svg" alt="NIH NLM Logo" />
|
|
</a>
|
|
</div>
|
|
|
|
<div class="ncbi-header__account">
|
|
<a id="account_login" href="https://account.ncbi.nlm.nih.gov" class="usa-button header-button" style="display:none" data-ga-action="open_menu" data-ga-label="account_menu">Log in</a>
|
|
<button id="account_info" class="header-button" style="display:none" aria-controls="account_popup" type="button">
|
|
<span class="fa fa-user" aria-hidden="true">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 24 24" width="20px" height="20px">
|
|
<g style="fill: #fff">
|
|
<ellipse cx="12" cy="8" rx="5" ry="6"></ellipse>
|
|
<path d="M21.8,19.1c-0.9-1.8-2.6-3.3-4.8-4.2c-0.6-0.2-1.3-0.2-1.8,0.1c-1,0.6-2,0.9-3.2,0.9s-2.2-0.3-3.2-0.9 C8.3,14.8,7.6,14.7,7,15c-2.2,0.9-3.9,2.4-4.8,4.2C1.5,20.5,2.6,22,4.1,22h15.8C21.4,22,22.5,20.5,21.8,19.1z"></path>
|
|
</g>
|
|
</svg>
|
|
</span>
|
|
<span class="username desktop-only" aria-hidden="true" id="uname_short"></span>
|
|
<span class="sr-only">Show account info</span>
|
|
</button>
|
|
</div>
|
|
|
|
<div class="ncbi-popup-anchor">
|
|
<div class="ncbi-popup account-popup" id="account_popup" aria-hidden="true">
|
|
<div class="ncbi-popup-head">
|
|
<button class="ncbi-close-button" data-ga-action="close_menu" data-ga-label="account_menu" type="button">
|
|
<span class="fa fa-times">
|
|
<svg xmlns="http://www.w3.org/2000/svg" viewBox="0 0 48 48" width="24px" height="24px">
|
|
<path d="M38 12.83l-2.83-2.83-11.17 11.17-11.17-11.17-2.83 2.83 11.17 11.17-11.17 11.17 2.83 2.83 11.17-11.17 11.17 11.17 2.83-2.83-11.17-11.17z"></path>
|
|
</svg>
|
|
</span>
|
|
<span class="usa-sr-only">Close</span></button>
|
|
<h4>Account</h4>
|
|
</div>
|
|
<div class="account-user-info">
|
|
Logged in as:<br />
|
|
<b><span class="username" id="uname_long">username</span></b>
|
|
</div>
|
|
<div class="account-links">
|
|
<ul class="usa-unstyled-list">
|
|
<li><a id="account_myncbi" href="/myncbi/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_myncbi">Dashboard</a></li>
|
|
<li><a id="account_pubs" href="/myncbi/collections/bibliography/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_pubs">Publications</a></li>
|
|
<li><a id="account_settings" href="/account/settings/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_settings">Account settings</a></li>
|
|
<li><a id="account_logout" href="/account/signout/" class="set-base-url" data-ga-action="click_menu_item" data-ga-label="account_logout">Log out</a></li>
|
|
</ul>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
</div>
|
|
</div>
|
|
</header>
|
|
<div role="navigation" aria-label="access keys">
|
|
<a id="nws_header_accesskey_0" href="https://www.ncbi.nlm.nih.gov/guide/browsers/#ncbi_accesskeys" class="usa-sr-only" accesskey="0" tabindex="-1">Access keys</a>
|
|
<a id="nws_header_accesskey_1" href="https://www.ncbi.nlm.nih.gov" class="usa-sr-only" accesskey="1" tabindex="-1">NCBI Homepage</a>
|
|
<a id="nws_header_accesskey_2" href="/myncbi/" class="set-base-url usa-sr-only" accesskey="2" tabindex="-1">MyNCBI Homepage</a>
|
|
<a id="nws_header_accesskey_3" href="#maincontent" class="usa-sr-only" accesskey="3" tabindex="-1">Main Content</a>
|
|
<a id="nws_header_accesskey_4" href="#" class="usa-sr-only" accesskey="4" tabindex="-1">Main Navigation</a>
|
|
</div>
|
|
<section data-section="Alerts">
|
|
<div class="ncbi-alerts-placeholder"></div>
|
|
</section>
|
|
</div>
|
|
<div class="header">
|
|
<div class="res_logo"><h1 class="res_name"><a href="/books/" title="Bookshelf home">Bookshelf</a></h1><h2 class="res_tagline"></h2></div>
|
|
<div class="search"><form method="get" action="/books/"><div class="search_form"><label for="database" class="offscreen_noflow">Search database</label><select id="database"><optgroup label="Recent"><option value="books" selected="selected" data-ac_dict="bookshelf-search">Books</option><option value="pubmed">PubMed</option><option value="clinvar">ClinVar</option><option value="gquery" class="last">All Databases</option></optgroup><optgroup label="All"><option value="gquery">All Databases</option><option value="assembly">Assembly</option><option value="biocollections">Biocollections</option><option value="bioproject">BioProject</option><option value="biosample">BioSample</option><option value="books" data-ac_dict="bookshelf-search">Books</option><option value="clinvar">ClinVar</option><option value="cdd">Conserved Domains</option><option value="gap">dbGaP</option><option value="dbvar">dbVar</option><option value="gene">Gene</option><option value="genome">Genome</option><option value="gds">GEO DataSets</option><option value="geoprofiles">GEO Profiles</option><option value="gtr">GTR</option><option value="ipg">Identical Protein Groups</option><option value="medgen">MedGen</option><option value="mesh">MeSH</option><option value="nlmcatalog">NLM Catalog</option><option value="nuccore">Nucleotide</option><option value="omim">OMIM</option><option value="pmc">PMC</option><option value="protein">Protein</option><option value="proteinclusters">Protein Clusters</option><option value="protfam">Protein Family Models</option><option value="pcassay">PubChem BioAssay</option><option value="pccompound">PubChem Compound</option><option value="pcsubstance">PubChem Substance</option><option value="pubmed">PubMed</option><option value="snp">SNP</option><option value="sra">SRA</option><option value="structure">Structure</option><option value="taxonomy">Taxonomy</option><option value="toolkit">ToolKit</option><option value="toolkitall">ToolKitAll</option><option value="toolkitbookgh">ToolKitBookgh</option></optgroup></select><div class="nowrap"><label for="term" class="offscreen_noflow" accesskey="/">Search term</label><div class="nowrap"><input type="text" name="term" id="term" title="Search Books. Use up and down arrows to choose an item from the autocomplete." value="" class="jig-ncbiclearbutton jig-ncbiautocomplete" data-jigconfig="dictionary:'bookshelf-search',disableUrl:'NcbiSearchBarAutoComplCtrl'" autocomplete="off" data-sbconfig="ds:'no',pjs:'no',afs:'no'" /></div><button id="search" type="submit" class="button_search nowrap" cmd="go">Search</button></div></div></form><ul class="searchlinks inline_list"><li>
|
|
<a href="/books/browse/">Browse Titles</a>
|
|
</li><li>
|
|
<a href="/books/advanced/">Advanced</a>
|
|
</li><li class="help">
|
|
<a href="/books/NBK3833/">Help</a>
|
|
</li><li class="disclaimer">
|
|
<a target="_blank" data-ga-category="literature_resources" data-ga-action="link_click" data-ga-label="disclaimer_link" href="https://www.ncbi.nlm.nih.gov/books/about/disclaimer/">Disclaimer</a>
|
|
</li></ul></div>
|
|
</div>
|
|
|
|
|
|
|
|
<!--<component id="Page" label="headcontent"/>-->
|
|
|
|
</div>
|
|
<div class="content">
|
|
<!-- site messages -->
|
|
<!-- Custom content 1 -->
|
|
<div class="col1">
|
|
|
|
</div>
|
|
|
|
<div class="container">
|
|
<div id="maincontent" class="content eight_col col">
|
|
<!-- Custom content in the left column above book nav -->
|
|
<div class="col2">
|
|
|
|
</div>
|
|
|
|
<!-- Book content -->
|
|
|
|
|
|
<!-- Custom content between navigation and content -->
|
|
<div class="col3">
|
|
|
|
</div>
|
|
|
|
<div class="document">
|
|
<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK548693_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK548693_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Dipyridamole/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/Disulfiram/" title="Next page in this title">Next ></a></div></div></div></div></div>
|
|
<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK548693_"><span class="title" itemprop="name">Disopyramide</span></h1><p class="small">Last Update: <span itemprop="dateModified">January 4, 2018</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Disopyramide.OVERVIEW"><h2 id="_Disopyramide_OVERVIEW_">OVERVIEW</h2><div id="Disopyramide.Introduction"><h3>Introduction</h3><p>Disopyramide is an oral antiarrhythmic agent that has been in wide use for several decades. Long term disopyramide therapy is associated with a low rate of serum enzyme elevations and is a rare cause of clinically apparent acute liver injury.</p></div><div id="Disopyramide.Background"><h3>Background</h3><p>Disopyramide (dye" soe pir' a mide) is a pyridine derivative and has electrophysiological effects that resemble quinidine (antiarrhythmic Class IA). Disopyramide decreases cardiac automaticity, increases refractory periods and slows conduction. Disopyramide is considered a myocardial depressant and can depress contractility. It also has anticholinergic effects. Disopyramide was approved for use in the United States in 1977, and current indications include suppression of symptomatic premature ventricular contractions and life threatening ventricular tachycardia. It is also effective in conversion as well as maintenance of normal sinus rhythm in patients with atrial fibrillation or flutter, but is not approved for this indication in the United States. Disopyramide is available in capsules of 100 and 150 mg generically and under the brand name Norpace. Extended release formulations are also available. The usual maintenance dose in adults is 400 to 800 mg daily in 2 to 4 divided doses. The most common side effects include dry mouth, urinary hesitancy, fatigue, headache, dizziness and anxiety.</p></div><div id="Disopyramide.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>In clinical trials, disopyramide was associated with a low rate of serum aminotransferase and alkaline phosphatase elevations. Despite wide scale use, disopyramide has only rarely been linked to cases of clinically apparent liver injury. Two types of hepatic injury have been described. The first is an acute hepatocellular injury that arises within 1 to 3 days of starting disopyramide and resembles acute hepatic ischemia with marked early rises in serum aminotransferase levels (and LDH), with minimal increase in alkaline phosphatase and subsequent rise in serum bilirubin. The prothrombin time may be abnormal initially. The injury resolves rapidly and may relate to sudden worsening of congestive heart failure due to the myocardial depressant effects of disopyramide.</p><p>The second type of injury is a cholestatic hepatitis that arises after 1 to 3 weeks of therapy and is characterized by jaundice and pruritus, with prominent elevations in serum alkaline phosphatase and mild-to-moderate increases in serum aminotransferase levels (Case 1). This injury may be prolonged, but reported cases have been self limited. Immunoallergic and autoimmune features are rare.</p><p><a class="def" href="/books/n/livertox/glossary/def-item/glossary.likelihood-score/">Likelihood score</a>: B (rare but likely cause of clinically apparent liver injury).</p></div><div id="Disopyramide.Mechanism_of_Injury"><h3>Mechanism of Injury</h3><p>The mechanism by which disopyramide causes liver injury is not clear but the early, acute hepatocellular injury is probably caused by ischemia due to sudden worsening of heart failure. The more delayed cholestatic hepatitis attributed to disopyramide is an idiosyncratic reaction and may relate to hypersensitivity to a product of its metabolism by the cytochrome P450 system (CYP 3A4).</p></div><div id="Disopyramide.Outcome_and_Management"><h3>Outcome and Management</h3><p>The hepatic injury caused by disopyramide ranges from asymptomatic and transient serum enzyme elevations, to acute hepatic necrosis to cholestatic hepatitis. Disopyramide has not been linked to cases of acute liver failure, chronic hepatitis or vanishing bile duct syndrome. Following the cholestatic, idiosyncratic hepatic injury due to disopyramide, recurrence with reexposure is typical and should be avoided. Withdrawal of disopyramide therapy may be associated with relapse in the arrhythmia for which it is used and is often done in the hospital under careful monitoring. There is no evidence that there is cross sensitivity to hepatic injury between disopyramide and other oral antiarrhythmic agents.</p><p>Drug Class: <a href="/books/n/livertox/AntiarrhythmicAgents/">Antiarrhythmic Agents</a></p></div></div><div id="Disopyramide.CASE_REPORT"><h2 id="_Disopyramide_CASE_REPORT_">CASE REPORT</h2><div id="Disopyramide.Case_1._Mild_cholestatic_he"><h3>Case 1. Mild cholestatic hepatitis due to disopyramide.</h3><p>[Modified from: Edmonds ME, Hayler AM. A case of intra-hepatic cholestasis after disopyramide therapy. Eur J Clin Pharmacol 1980; 18: 285-6. <a href="https://www.ncbi.nlm.nih.gov/pubmed/7439249" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">PubMed Citation</a>]</p><p>A 74 year old woman developed jaundice 13 days after starting disopyramide (100 mg daily) for difficult-to-control atrial fibrillation. She gave no history of liver disease, alcohol abuse or risk factors for viral hepatitis. However, she had a complex medical history which included chronic obstructive pulmonary disease, right heart failure, gout and diverticulitis. Six weeks before the onset of jaundice, she had undergone an emergency colostomy for large bowel obstruction after perforation of a sigmoid diverticulum. The surgery was carried out under general anesthesia with thiopentone, fentanyl and nitrous oxide. Postoperatively, she received several antibiotics including ampicillin, metronidazole and cefuroxime. The medications that she took chronically were digoxin (0.125 mg), furosemide (240 mg), prednisolone (3 mg/day), and allopurinol (300 mg/day). On examination, she was jaundiced but had no fever, rash or clinical evidence of heart failure. Laboratory tests showed a serum bilirubin of 2.2 mg/dL, <a class="def" href="/books/n/livertox/glossary/def-item/glossary.aspartate-aminotransferase-ast-/">AST</a> 30 U/L, alkaline phosphatase 840 U/L and <a class="def" href="/books/n/livertox/glossary/def-item/glossary.gamma-glutamyl-transpeptidase-ggt-/">GGT</a> 840 U/L (normal 4-18 U/L). These tests had been normal earlier during her prolonged hospital admission (Table). Tests for hepatitis B and serum autoantibodies were negative. Plasma levels of disopyramide had been in the normal therapeutic range. Disopyramide and the antibiotics were discontinued. Her serum bilirubin improved over the next week, but alkaline phosphatase levels rose to above 2000 U/L and then began to fall slowly. Six weeks after stopping disopyramide, all liver tests were normal.</p><div id="Disopyramide.Key_Points"><h4>Key Points</h4><div id="Disopyramide.T1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548693/table/Disopyramide.T1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Disopyramide.T1_lrgtbl__"><table><tbody><tr><td rowspan="1" colspan="1" style="vertical-align:top;">Medication:</td><td rowspan="1" colspan="1" style="vertical-align:top;">Disopyramide (100 mg daily)</td></tr><tr><th id="hd_b_Disopyramide.T1_1_1_2_1" rowspan="1" colspan="1" style="vertical-align:top;">Pattern:</th><td headers="hd_b_Disopyramide.T1_1_1_2_1" rowspan="1" colspan="1" style="vertical-align:top;">Cholestatic (R=0.2)</td></tr><tr><th id="hd_b_Disopyramide.T1_1_1_3_1" rowspan="1" colspan="1" style="vertical-align:top;">Severity:</th><td headers="hd_b_Disopyramide.T1_1_1_3_1" rowspan="1" colspan="1" style="vertical-align:top;">3+ (jaundice, hospitalization)</td></tr><tr><th id="hd_b_Disopyramide.T1_1_1_4_1" rowspan="1" colspan="1" style="vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.latency/">Latency</a>:</th><td headers="hd_b_Disopyramide.T1_1_1_4_1" rowspan="1" colspan="1" style="vertical-align:top;">2 weeks</td></tr><tr><th id="hd_b_Disopyramide.T1_1_1_5_1" rowspan="1" colspan="1" style="vertical-align:top;">Recovery:</th><td headers="hd_b_Disopyramide.T1_1_1_5_1" rowspan="1" colspan="1" style="vertical-align:top;">6 weeks</td></tr><tr><th id="hd_b_Disopyramide.T1_1_1_6_1" rowspan="1" colspan="1" style="vertical-align:top;">Other medications:</th><td headers="hd_b_Disopyramide.T1_1_1_6_1" rowspan="1" colspan="1" style="vertical-align:top;">Ampicillin, metronidazole, cefuroxime, allopurinol, furosemide, digoxin, prednisolone, diazepam</td></tr></tbody></table></div></div></div><div id="Disopyramide.Laboratory_Values"><h4>Laboratory Values</h4><div id="Disopyramide.T2" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548693/table/Disopyramide.T2/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Disopyramide.T2_lrgtbl__"><table><thead><tr><th id="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">Time After Starting</th><th id="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">Time After Stopping</th><th id="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.aspartate-aminotransferase-ast-/">AST</a> (U/L)</th><th id="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">Alk P* (U/L)</th><th id="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;"><a class="def" href="/books/n/livertox/glossary/def-item/glossary.bilirubin/">Bilirubin</a>* (mg/dL)</th><th id="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;">Comment</th></tr></thead><tbody><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">Pre</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">70</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">0.6</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">1.5 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">250</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">1.3</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">2 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">0</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">30</td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">840</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">2.2</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;">Disopyramide stopped</td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">3 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">1 week</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">2000</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">1.3</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">4 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">2 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">900</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">1.0</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">5 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">3 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">250</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">0.8</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">8 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">6 weeks</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;"></td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">80</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">1.0</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr><tr><td headers="hd_h_Disopyramide.T2_1_1_1_1 hd_h_Disopyramide.T2_1_1_1_2" colspan="2" rowspan="1" style="vertical-align:top;">
|
|
<b>Normal Values</b>
|
|
</td><td headers="hd_h_Disopyramide.T2_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">
|
|
<b><20</b>
|
|
</td><td headers="hd_h_Disopyramide.T2_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">
|
|
<b><100</b>
|
|
</td><td headers="hd_h_Disopyramide.T2_1_1_1_5" rowspan="1" colspan="1" style="vertical-align:top;">
|
|
<b><1.2</b>
|
|
</td><td headers="hd_h_Disopyramide.T2_1_1_1_6" rowspan="1" colspan="1" style="vertical-align:top;"></td></tr></tbody></table></div></div><p>* Values estimated from Figure 1.</p></div><div id="Disopyramide.Comment"><h4>Comment</h4><p>Despite the complexity of the medical history and exposure to multiple medications, the mild cholestatic hepatitis was entirely compatible with disopyramide induced liver injury which typically arises within 1-3 weeks of starting the medication and is characterized by a mild cholestatic course. Most of the other medications (except for ampicillin and metronidazole) were continued or restarted without recurrence of jaundice or liver test abnormalities.</p></div></div></div><div id="Disopyramide.PRODUCT_INFORMATION"><h2 id="_Disopyramide_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><div id="Disopyramide.BPI" class="box"><p>
|
|
<b>REPRESENTATIVE TRADE NAMES</b>
|
|
</p><p>Disopyramide – Generic, Norpace®</p><p>
|
|
<b>DRUG CLASS</b>
|
|
</p><p>Antiarrhythmic Agents</p><p>
|
|
<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Disopyramide" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
|
|
</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div></div><div id="Disopyramide.CHEMICAL_FORMULA_AND_STRUCT"><h2 id="_Disopyramide_CHEMICAL_FORMULA_AND_STRUCT_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="Disopyramide.T3" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548693/table/Disopyramide.T3/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Disopyramide.T3_lrgtbl__"><table><thead><tr><th id="hd_h_Disopyramide.T3_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">DRUG</th><th id="hd_h_Disopyramide.T3_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">CAS REGISTRY NUMBER</th><th id="hd_h_Disopyramide.T3_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Disopyramide.T3_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Disopyramide.T3_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">Disopyramide</td><td headers="hd_h_Disopyramide.T3_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">
|
|
<a href="https://pubchem.ncbi.nlm.nih.gov/substance/134985964" ref="pagearea=body&targetsite=entrez&targetcat=link&targettype=pubchem">3737-09-5</a>
|
|
</td><td headers="hd_h_Disopyramide.T3_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">C21-H29-N3-O</td><td headers="hd_h_Disopyramide.T3_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">
|
|
<div class="graphic"><img src="/books/NBK548693/bin/Disopyramide_Structure.jpg" alt="Chemical Structure for Disopyramide" /></div>
|
|
</td></tr></tbody></table></div></div></div><div id="Disopyramide.ANNOTATED_BIBLIOGRAPHY"><h2 id="_Disopyramide_ANNOTATED_BIBLIOGRAPHY_">ANNOTATED BIBLIOGRAPHY</h2><p>References updated: 04 January 2018</p><ul class="first-line-outdent"><li><div class="bk_ref" id="Disopyramide.R1">Zimmerman HJ. Antiarrhythmics. Drugs used in cardiovascular disease. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 642-4.<div><i>(Expert review of hepatotoxicity published in 1999 mentions that disopyramide has been linked to at least 10 cases of drug-induced liver disease).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R2">De Marzio DH, Navarro VJ. Hepatotoxicity of cardiovascular and antidiabetic drugs. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 524.<div><i>(Review of hepatotoxicity of cadriovascular drugs including antiarrhythmics; disopyramide is not discussed).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R3">Sampson KJ, Kass RS. Antiarrhythmic drugs. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman’s the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 815-60.<div><i>(Textbook of pharmacology and therapeutics).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R4">Riccioni N, Bozzi L, Susini N, Roni P. Disopyramide-induced intrahepatic cholestasis. Lancet 1977; 2: 1362-3. [<a href="https://pubmed.ncbi.nlm.nih.gov/74773" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 74773</span></a>]<div><i>(61 year old man developed pruritus 10 days after starting disopyramide followed by jaundice [3.0 mg/dL, ALT 410 U/L, Alk P 171 U/L, 55% eosinophils], resolving several months after stopping).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R5">Meinertz T, Langer KH, Kasper W, Just H. Disopyramide-induced intrahepatic cholestasis. Lancet 1977; 2: 828-9. [<a href="https://pubmed.ncbi.nlm.nih.gov/71640" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 71640</span></a>]<div><i>(38 year old woman with recurrent atrial fibrillation developed nausea within 3 days of starting disopyramide followed by jaundice [bilirubin 5.7 mg/dL, ALT 242 U/L, Alk P 1381 U/L], resolving several months later).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R6">Koch-Weser J. Disopyramide. N Engl J Med 1979; 300: 957-62. [<a href="https://pubmed.ncbi.nlm.nih.gov/431563" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 431563</span></a>]<div><i>(Review of disopyramide; mechanism of action is unclear, myocardial depressant and has anticholinergic activity which accounts for side effects of urinary retention, visual blurring, constipation and nausea; acute psychoses, cholestatic jaundice, hypoglycemia and agranulocytosis have occurred in rare patients).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R7">Tonkin AM, Joel SE, Reynolds JL. Unusual hepatocellular and cardiovascular complications of disopyramide. Chest 1980; 77:125. [<a href="https://pubmed.ncbi.nlm.nih.gov/7351137" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7351137</span></a>]<div><i>(74 year old male with ventricular arrhythmia developed abnormal liver enzymes 3 days after starting disopyramide [ALT 6200 U/L, Alk P 125 U/L, bilirubin 4.0 mg/dL, INR 2.6], resolving in 2 weeks).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R8">Craxi A, Gatto G, Maringhini A, Orsini S, Pinzello G, Pagliaro L. Disopyramide and cholestasis. Ann Intern Med 1980; 93: 150-1. [<a href="https://pubmed.ncbi.nlm.nih.gov/7396302" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7396302</span></a>]<div><i>(2 men and 1 woman, ages 60-79 years, developed cholestatic hepatitis 10 to 15 days after starting disopyramide [bilirubin 0.9, 14.6 and 16.9 mg/dL, ALT peak 65-120 U/L, Alk P 280-300 U/L], all resolving, but two had jaundice that lasted 4 and 7 months).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R9">Edmonds ME, Hayler AM. A case of intra-hepatic cholestasis after disopyramide therapy. Eur J Clin Pharmacol 1980; 18: 285-6. [<a href="https://pubmed.ncbi.nlm.nih.gov/7439249" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7439249</span></a>]<div><i>(74 year old woman developed jaundice 13 days after starting disopyramide [bilirubin 2.3 mg/dL, Alk P 840 rising to 2000 U/L, AST 30 U/L], resolving 6 weeks after stopping: Case 1).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R10">Scheinman SJ, Poll DS, Wolfson S. Acute cardiac failure and hepatic ischemia induced by disopyramide phosphate. Yale J Biol Med 1980; 53: 361-6. [<a href="/pmc/articles/PMC2595921/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC2595921</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/7222741" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7222741</span></a>]<div><i>(2 men, ages 61 and 62 years, developed heart failure and raised serum enzymes within 1-2 days of starting disopyramide [AST 4780 and 1495 U/L, bilirubin peak 2.1 mg/dL, Alk P normal], resolving within 7-8 days).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R11">Doody PT. Disopyramide hepatotoxicity and disseminated intravascular coagulation. South Med J 1982; 75: 496-8. [<a href="https://pubmed.ncbi.nlm.nih.gov/7071649" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 7071649</span></a>]<div><i>(55 year old woman developed nausea and cyanosis within 24 hours of starting disopyramide followed by confusion by day 4, ALT rising from 28 to 3090 U/L, Alk P 92 to 138 U/L, direct bilirubin to 1.6 mg/dL, protime to 40 seconds, with recovery in 10 days).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R12">Strathman I, Schubert EN, Cohen A, Nitzberg DM. Hypoglycemia in patients receiving disopyramide phosphate. Drug Intell Clin Pharm 1983; 17: 635-8. [<a href="https://pubmed.ncbi.nlm.nih.gov/6413187" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6413187</span></a>]<div><i>(Analysis of 32 reports of hypoglycemia in patients on disopyramide, 14 had liver disease; studies of glucose metabolism done in volunteers demonstrated a glucose lowering effect of disopyramide).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R13">Bakris GL, Cross PD, Hammarsten JE. Disopyramide-associated liver dysfunction. Mayo Clin Proc 1983; 58: 265-7. [<a href="https://pubmed.ncbi.nlm.nih.gov/6834895" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6834895</span></a>]<div><i>(61 year old man developed jaundice 21 days after starting disopyramide [bilirubin 7.7 mg/dL, Alk P 2274, ALT not given], resolving within next 3 months).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R14">Arif M, Laidlaw JC, Oshrain C, Willis PW 3rd, Nissen CH, McDermott DJ, Smith WS, et al. A randomized, double-blind, parallel group comparison of disopyramide phosphate and quinidine in patients with cardiac arrhythmias. Angiology 1983; 34: 393-400. [<a href="https://pubmed.ncbi.nlm.nih.gov/6408949" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6408949</span></a>]<div><i>(124 patients with ventricular arrhythmias received disopyramide or quinidine for 8 weeks; AST elevations occurred in 3 on quinidine and 1 on disopyramide but none had symptoms or jaundice).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R15">Antonelli D, Koltun B, Barzilay J. Acute hepatotoxic effect of disopyramide. Chest 1984; 86: 274. [<a href="https://pubmed.ncbi.nlm.nih.gov/6744970" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 6744970</span></a>]<div><i>(46 year old developed abdominal pain 1 day after starting disopyramide [ALT 770 U/L, normal bilirubin and Alk P], resolving in 2 weeks).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R16">Bauman JL, Gallastegui J, Strasberg B, Swiryn S, Hoff J, Welch WJ, Bauernfeind RA. Long-term therapy with disopyramide phosphate: side effects and effectiveness. Am Heart J 1986; 111: 654-60. [<a href="https://pubmed.ncbi.nlm.nih.gov/3082173" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3082173</span></a>]<div><i>(Among 40 patients with arrhythmias treated with disopyramide long term, most common side effects were xerostomia, constipation, blurred vision and urinary hesitancy; no mention of liver injury or ALT elevations).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R17">Libersa C, Caron J, Pladys A, Beuscart R, Kacet S, Wajman A, Connell C, et al. Propafenone versus disopyramide: a double-blind randomized crossover trial in patients presenting chronic ventricular arrhythmias. Clin Cardiol 1987; 10: 405-10. [<a href="https://pubmed.ncbi.nlm.nih.gov/2440632" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 2440632</span></a>]<div><i>(Ten patients with ventricular arrhythmias were treated with disopyramide vs propafenone vs placebo in a crossover study for 6 days each; no change in chemical parameters).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R18">Jonason T, Ringqvist I, Bandh S, Nilsson G, Nilsson H, Lidell C, Bjerle P, et al. Propafenone versus disopyramide for treatment of chronic symptomatic ventricular arrhythmias. A multicenter study. Acta Med Scand 1988; 223: 515-23. [<a href="https://pubmed.ncbi.nlm.nih.gov/3291557" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 3291557</span></a>]<div><i>(38 patients with symptomatic ventricular arrhythmias were treated with either propafenone or disopyramide for 28 days; propafenone had fewer side effects; no mention of liver injury or ALT elevations).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R19">Roden DM. Antiarrhythmic drugs: from mechanisms to clinical practice. Heart 2000; 84: 339-46. [<a href="/pmc/articles/PMC1760959/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC1760959</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/10956304" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 10956304</span></a>]<div><i>(Overview of antiarrhythmic drugs which are separated in four classes based upon molecular target: I being sodium channel blockers; II beta blockers; III potassium channel blockers; and, IV calcium channel blockers; some agents having multiple targets).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R20">McNamara RL, Tamariz LJ, Segal JB, Bass EB. Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Ann Intern Med 2003; 139: 1018-33. [<a href="https://pubmed.ncbi.nlm.nih.gov/14678922" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 14678922</span></a>]<div><i>(Systematic review of literature on efficacy of antiarrhythmic agents for different forms of arrhythmia; disopyramide has shown efficacy for maintenance of sinus rhythm after conversion from atrial fibrillation: hepatic side effects are not discussed).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R21">Drugs for cardiac arrhythmias. Treat Guidel Med Lett 2007; 5: 51-8. [<a href="https://pubmed.ncbi.nlm.nih.gov/17505408" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 17505408</span></a>]<div><i>(Concise review of drugs for arrhythmias; disopyramide can aggravate heart failure and anticholinergic effects are often prominent; no mention of adverse effects on the liver). </i></div></div></li><li><div class="bk_ref" id="Disopyramide.R22">Chalasani N, Fontana RJ, Bonkovsky HL, Watkins PB, Davern T, Serrano J, Yang H, Rochon J; Drug Induced Liver Injury Network (DILIN). Causes, clinical features, and outcomes from a prospective study of drug-induced liver injury in the United States. Gastroenterology 2008; 135: 1924-34. [<a href="/pmc/articles/PMC3654244/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC3654244</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/18955056" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 18955056</span></a>]<div><i> (Among 300 cases of drug induced liver disease collected between 2004 and 2008 in the US, none were attributed to disopyramide).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R23">Treatment of atrial fibrillation. Treat Guidel Med Lett 2010; 8 (97): 65-70. [<a href="https://pubmed.ncbi.nlm.nih.gov/20733547" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 20733547</span></a>]<div><i> (Concise review of efficacy and safety of drugs for atrial fibrillation; disopyramide is effective in maintaining sinus rhythm after cardioversion; side effects resemble those of anticholinergic drugs; no mention of hepatotoxicity or ALT elevations).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R24">Camm J. Antiarrhythmic drugs for the maintenance of sinus rhythm: risks and benefits. Int J Cardiol 2012; 155: 362-71. [<a href="https://pubmed.ncbi.nlm.nih.gov/21708411" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 21708411</span></a>]<div><i>(Review of the safety and efficacy of antiarrhythmic drugs used to maintain normal sinus rhythm; no discussion of hepatotoxicity).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R25">Hernández N, Bessone F, Sánchez A, di Pace M, Brahm J, Zapata R, A Chirino R, et al. Profile of idiosyncratic drug induced liver injury in Latin America. An analysis of published reports. Ann Hepatol 2014; 13: 231-9. [<a href="https://pubmed.ncbi.nlm.nih.gov/24552865" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 24552865</span></a>]<div><i>(Systematic review of literature of drug induced liver injury from Latin American countries published between 1996 and 2012 identified 176 cases, but none attributed to disopyramide).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R26">Chalasani N, Bonkovsky HL, Fontana R, Lee W, Stolz A, Talwalkar J, Reddy KR, et al.; United States Drug Induced Liver Injury Network. Features and outcomes of 899 patients with drug-induced liver injury: The DILIN Prospective Study. Gastroenterology 2015; 148: 1340-52.e7. [<a href="/pmc/articles/PMC4446235/" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pmc">PMC free article<span class="bk_prnt">: PMC4446235</span></a>] [<a href="https://pubmed.ncbi.nlm.nih.gov/25754159" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 25754159</span></a>]<div><i>(Among 899 cases of drug induced liver injury enrolled in a US prospective study between 2004 and 2013, none were attributed to disopyramide).</i></div></div></li><li><div class="bk_ref" id="Disopyramide.R27">Verlinden NJ, Coons JC. Disopyramide for hypertrophic cardiomyopathy: a pragmatic reappraisal of an old drug. Pharmacotherapy 2015; 35: 1164-72. [<a href="https://pubmed.ncbi.nlm.nih.gov/26684556" ref="pagearea=cite-ref&targetsite=entrez&targetcat=link&targettype=pubmed">PubMed<span class="bk_prnt">: 26684556</span></a>]<div><i>(Review of the potential role of chronic disopyramide therapy for hypertrophic cardiomyopathy based upon analyses of 3 retrospective studies in 372 patients mentions common side effects including dry mouth, urinary retention and blurred vision due to the anitcholinergic effects of disopyramide, and cardiac arrhythmias attributed to drug induced prolongation of the QTc interval; no mention of ALT elevations or hepatotoxicity).</i></div></div></li></ul></div><div id="bk_toc_contnr"></div></div></div>
|
|
<div class="post-content"><div><div class="half_rhythm"><a href="/books/about/copyright/">Copyright Notice</a></div><div class="small"><span class="label">Bookshelf ID: NBK548693</span><span class="label">PMID: <a href="https://pubmed.ncbi.nlm.nih.gov/31644003" title="PubMed record of this page" ref="pagearea=meta&targetsite=entrez&targetcat=link&targettype=pubmed">31644003</a></span></div><div style="margin-top:2em" class="bk_noprnt"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Dipyridamole/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/Disulfiram/" title="Next page in this title">Next ></a></div></div></div></div>
|
|
|
|
</div>
|
|
|
|
<!-- Custom content below content -->
|
|
<div class="col4">
|
|
|
|
</div>
|
|
|
|
|
|
<!-- Book content -->
|
|
|
|
<!-- Custom contetnt below bottom nav -->
|
|
<div class="col5">
|
|
|
|
</div>
|
|
</div>
|
|
|
|
<div id="rightcolumn" class="four_col col last">
|
|
<!-- Custom content above discovery portlets -->
|
|
<div class="col6">
|
|
<div id="ncbi_share_book"><a href="#" class="ncbi_share" data-ncbi_share_config="popup:false,shorten:true" ref="id=NBK548693&db=books">Share</a></div>
|
|
|
|
</div>
|
|
<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK548693/?report=reader">PubReader</a></li><li><a href="/books/NBK548693/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK548693" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK548693" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Disopyramide. [Updated 2018 Jan 4].<span class="bk_cite_avail"></span></div></div></li><li><a href="/books/NBK548693/pdf/Bookshelf_NBK548693.pdf">PDF version of this page</a> (126K)</li><li><a href="#" class="toggle-glossary-link" title="Enable/disable links to the glossary">Disable Glossary Links</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>New and Updated</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="https://pubmed.ncbi.nlm.nih.gov/?term=%22LiverTox%22+AND+pmcbook&sort=date&size=200" ref="pagearea=source-links&targetsite=external&targetcat=link&targettype=uri">In PubMed</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Bulk Download</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="https://ftp.ncbi.nlm.nih.gov/pub/litarch/29/31/" ref="pagearea=source-links&targetsite=external&targetcat=link&targettype=uri">Bulk download LiverTox data from FTP</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Overviews</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/livertox/intro/">Introduction</a></li><li><a href="/books/n/livertox/ClinicalCourse/">Clinical Course</a></li><li><a href="/books/n/livertox/ClinicalOutcome/">Clinical Outcomes</a></li><li><a href="/books/n/livertox/ImmuneFeatures/">Immune Features</a></li><li><a href="/books/n/livertox/Phenotypes_intro/">Phenotypes</a></li><li><a href="/books/n/livertox/Causality/">Causality</a></li><li><a href="/books/n/livertox/DrugCategory/">Likelihood Scale</a></li><li><a href="/books/n/livertox/Severity/">Severity Grading</a></li><li><a href="/books/n/livertox/CaseReport/">Writing a Case Report</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Support Links</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="source-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/n/livertox/">LiverTox Homepage</a></li><li><a href="/books/n/livertox/masterlistintro/">Master List of LiverTox Drugs [with Metadata]</a></li><li><a href="/books/n/livertox/drugliverinjury/">LiverTox Drugs by Drug Class</a></li><li><a href="/books/n/livertox/aboutus/">About LiverTox</a></li><li><a href="/books/n/livertox/editorsandreviewers/">Editors and Review Committee</a></li><li><a href="/books/n/livertox/alert/">Meetings and News</a></li><li><a href="/books/n/livertox/abbreviation/">Abbreviations Used</a></li><li><a href="/books/n/livertox/glossary/">Glossary</a></li><li><a href="/books/n/livertox/resource/">Information Resources</a></li><li><a href="/books/n/livertox/disclaimer/">User/Medical Advice Disclaimer</a></li><li><a href="/books/n/livertox/Contactus/">Contact Us</a></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>OTHER REFERENCE LINKS</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="document-links" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li>
|
|
<a href="https://www.ncbi.nlm.nih.gov/sites/entrez?cmd=search&db=pubmed&pubmedfilters=true&term=(Disopyramide/AE)+AND+Human%5BMH%5D+AND+(drug+induced+liver+injury+OR+jaundice/CI+OR+bile+duct+diseases/CI+OR+liver/DE+OR+liver+diseases/CI)+AND+(%221900/1/1%22%5BEDat%5D%3A%222999/12/31%22%5BEDat%5D)" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Recent References on Disopyramide: from PubMed.gov</a>
|
|
</li><li>
|
|
<a href="https://clinicaltrials.gov/ct2/results?term=Disopyramide" ref="pagearea=document-links&targetsite=external&targetcat=link&targettype=uri">Trials on Disopyramide: from ClinicalTrials.gov</a>
|
|
</li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Related information</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="discovery_db_links" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pmc&DbFrom=books&Cmd=Link&LinkName=books_pmc_refs&IdsFromResult=4863500" ref="log$=recordlinks">PMC</a><div class="brieflinkpop offscreen_noflow">PubMed Central citations</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pcsubstance&DbFrom=books&Cmd=Link&LinkName=books_pcsubstance&IdsFromResult=4863500" ref="log$=recordlinks">PubChem Substance</a><div class="brieflinkpop offscreen_noflow">Related PubChem Substances</div></li><li class="brieflinkpopper"><a class="brieflinkpopperctrl" href="/books/?Db=pubmed&DbFrom=books&Cmd=Link&LinkName=books_pubmed_refs&IdsFromResult=4863500" ref="log$=recordlinks">PubMed</a><div class="brieflinkpop offscreen_noflow">Links to PubMed</div></li></ul></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Similar articles in PubMed</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PBooksDiscovery_RA" id="Shutter"></a></div><div class="portlet_content"><ul><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31643355" ref="ordinalpos=1&linkpos=1&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Flecainide.</a><span class="source">[LiverTox: Clinical and Researc...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Flecainide.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2012</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31483500" ref="ordinalpos=1&linkpos=2&log$=relatedarticles&logdbfrom=pubmed">Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.</a><span class="source">[Cochrane Database Syst Rev. 2019]</span><div class="brieflinkpop offscreen_noflow">Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Valembois L, Audureau E, Takeda A, Jarzebowski W, Belmin J, Lafuente-Lafuente C. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Cochrane Database Syst Rev. 2019 Sep 4; 9(9):CD005049. Epub 2019 Sep 4.</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/31643962" ref="ordinalpos=1&linkpos=3&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Mexiletine.</a><span class="source">[LiverTox: Clinical and Researc...]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Mexiletine.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. 2012</em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/2285495" ref="ordinalpos=1&linkpos=4&log$=relatedreviews&logdbfrom=pubmed"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Poisoning due to class IA antiarrhythmic drugs. Quinidine, procainamide and disopyramide.</a><span class="source">[Drug Saf. 1990]</span><div class="brieflinkpop offscreen_noflow"><span xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="invert">Review</span> Poisoning due to class IA antiarrhythmic drugs. Quinidine, procainamide and disopyramide.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Kim SY, Benowitz NL. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">Drug Saf. 1990 Nov-Dec; 5(6):393-420. </em></div></div></li><li class="brieflinkpopper two_line"><a class="brieflinkpopperctrl" href="/pubmed/2437392" ref="ordinalpos=1&linkpos=5&log$=relatedarticles&logdbfrom=pubmed">Effects of diet-induced hypokalaemia on the antiarrhythmic and electrophysiological actions of prolonged oral treatment with either amiodarone or disopyramide in the anaesthetised rat.</a><span class="source">[J Cardiovasc Pharmacol. 1987]</span><div class="brieflinkpop offscreen_noflow">Effects of diet-induced hypokalaemia on the antiarrhythmic and electrophysiological actions of prolonged oral treatment with either amiodarone or disopyramide in the anaesthetised rat.<div class="brieflinkpopdesc"><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="author">Winslow E, Marshall RJ, Hope FG. </em><em xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="cit">J Cardiovasc Pharmacol. 1987 Mar; 9(3):267-75. </em></div></div></li></ul><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed_reviews&uid=31644003" ref="ordinalpos=1&log$=relatedreviews_seeall&logdbfrom=pubmed">See reviews...</a><a class="seemore" href="/sites/entrez?db=pubmed&cmd=link&linkname=pubmed_pubmed&uid=31644003" ref="ordinalpos=1&log$=relatedarticles_seeall&logdbfrom=pubmed">See all...</a></div></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Recent Activity</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="recent_activity" id="Shutter"></a></div><div class="portlet_content"><div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" id="HTDisplay" class=""><div class="action"><a href="javascript:historyDisplayState('ClearHT')">Clear</a><a href="javascript:historyDisplayState('HTOff')" class="HTOn">Turn Off</a><a href="javascript:historyDisplayState('HTOn')" class="HTOff">Turn On</a></div><ul id="activity"><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=1" href="/portal/utils/pageresolver.fcgi?recordid=67c8df01f4a390645e296f07">Disopyramide - LiverTox</a><div class="ralinkpop offscreen_noflow">Disopyramide - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=2" href="/portal/utils/pageresolver.fcgi?recordid=67c8df00f4a390645e296b38">Dipyridamole - LiverTox</a><div class="ralinkpop offscreen_noflow">Dipyridamole - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=3" href="/portal/utils/pageresolver.fcgi?recordid=67c8deffb15b832ebc077462">Diphenoxylate - LiverTox</a><div class="ralinkpop offscreen_noflow">Diphenoxylate - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=4" href="/portal/utils/pageresolver.fcgi?recordid=67c8defea68b6b5afc6c966c">Diphenhydramine - LiverTox</a><div class="ralinkpop offscreen_noflow">Diphenhydramine - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li><li class="ra_rcd ralinkpopper two_line"><a class="htb ralinkpopperctrl" ref="log$=activity&linkpos=5" href="/portal/utils/pageresolver.fcgi?recordid=67c8defdb15b832ebc076e5d">Dipeptidyl Peptidase-4 Inhibitors - LiverTox</a><div class="ralinkpop offscreen_noflow">Dipeptidyl Peptidase-4 Inhibitors - LiverTox<div class="brieflinkpopdesc"></div></div><div class="tertiary"></div></li></ul><p class="HTOn">Your browsing activity is empty.</p><p class="HTOff">Activity recording is turned off.</p><p id="turnOn" class="HTOff"><a href="javascript:historyDisplayState('HTOn')">Turn recording back on</a></p><a class="seemore" href="/sites/myncbi/recentactivity">See more...</a></div></div></div>
|
|
|
|
<!-- Custom content below discovery portlets -->
|
|
<div class="col7">
|
|
|
|
</div>
|
|
</div>
|
|
</div>
|
|
|
|
<!-- Custom content after all -->
|
|
<div class="col8">
|
|
|
|
</div>
|
|
<div class="col9">
|
|
|
|
</div>
|
|
|
|
<script type="text/javascript" src="/corehtml/pmc/js/jquery.scrollTo-1.4.2.js"></script>
|
|
<script type="text/javascript">
|
|
(function($){
|
|
$('.skiplink').each(function(i, item){
|
|
var href = $($(item).attr('href'));
|
|
href.attr('tabindex', '-1').addClass('skiptarget'); // ensure the target can receive focus
|
|
$(item).on('click', function(event){
|
|
event.preventDefault();
|
|
$.scrollTo(href, 0, {
|
|
onAfter: function(){
|
|
href.focus();
|
|
}
|
|
});
|
|
});
|
|
});
|
|
})(jQuery);
|
|
</script>
|
|
</div>
|
|
<div class="bottom">
|
|
|
|
<div id="NCBIFooter_dynamic">
|
|
<!--<component id="Breadcrumbs" label="breadcrumbs"/>
|
|
<component id="Breadcrumbs" label="helpdesk"/>-->
|
|
|
|
</div>
|
|
|
|
<div class="footer" id="footer">
|
|
<section class="icon-section">
|
|
<div id="icon-section-header" class="icon-section_header">Follow NCBI</div>
|
|
<div class="grid-container container">
|
|
<div class="icon-section_container">
|
|
<a class="footer-icon" id="footer_twitter" href="https://twitter.com/ncbi" aria-label="Twitter"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11 {
|
|
fill: #737373;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>Twitter</title>
|
|
<path class="cls-11" d="M250.11,105.48c-7,3.14-13,3.25-19.27.14,8.12-4.86,8.49-8.27,11.43-17.46a78.8,78.8,0,0,1-25,9.55,39.35,39.35,0,0,0-67,35.85,111.6,111.6,0,0,1-81-41.08A39.37,39.37,0,0,0,81.47,145a39.08,39.08,0,0,1-17.8-4.92c0,.17,0,.33,0,.5a39.32,39.32,0,0,0,31.53,38.54,39.26,39.26,0,0,1-17.75.68,39.37,39.37,0,0,0,36.72,27.3A79.07,79.07,0,0,1,56,223.34,111.31,111.31,0,0,0,116.22,241c72.3,0,111.83-59.9,111.83-111.84,0-1.71,0-3.4-.1-5.09C235.62,118.54,244.84,113.37,250.11,105.48Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_facebook" href="https://www.facebook.com/ncbi.nlm" aria-label="Facebook"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>Facebook</title>
|
|
<path class="cls-11" d="M210.5,115.12H171.74V97.82c0-8.14,5.39-10,9.19-10h27.14V52l-39.32-.12c-35.66,0-42.42,26.68-42.42,43.77v19.48H99.09v36.32h27.24v109h45.41v-109h35Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_linkedin" href="https://www.linkedin.com/company/ncbinlm" aria-label="LinkedIn"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<title>LinkedIn</title>
|
|
<path class="cls-11" d="M101.64,243.37H57.79v-114h43.85Zm-22-131.54h-.26c-13.25,0-21.82-10.36-21.82-21.76,0-11.65,8.84-21.15,22.33-21.15S101.7,78.72,102,90.38C102,101.77,93.4,111.83,79.63,111.83Zm100.93,52.61A17.54,17.54,0,0,0,163,182v61.39H119.18s.51-105.23,0-114H163v13a54.33,54.33,0,0,1,34.54-12.66c26,0,44.39,18.8,44.39,55.29v58.35H198.1V182A17.54,17.54,0,0,0,180.56,164.44Z">
|
|
</path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_github" href="https://github.com/ncbi" aria-label="GitHub"><svg xmlns="http://www.w3.org/2000/svg" data-name="Layer 1" viewBox="0 0 300 300">
|
|
<defs>
|
|
<style>
|
|
.cls-11,
|
|
.cls-12 {
|
|
fill: #737373;
|
|
}
|
|
|
|
.cls-11 {
|
|
fill-rule: evenodd;
|
|
}
|
|
</style>
|
|
</defs>
|
|
<title>GitHub</title>
|
|
<path class="cls-11" d="M151.36,47.28a105.76,105.76,0,0,0-33.43,206.1c5.28,1,7.22-2.3,7.22-5.09,0-2.52-.09-10.85-.14-19.69-29.42,6.4-35.63-12.48-35.63-12.48-4.81-12.22-11.74-15.47-11.74-15.47-9.59-6.56.73-6.43.73-6.43,10.61.75,16.21,10.9,16.21,10.9,9.43,16.17,24.73,11.49,30.77,8.79,1-6.83,3.69-11.5,6.71-14.14C108.57,197.1,83.88,188,83.88,147.51a40.92,40.92,0,0,1,10.9-28.39c-1.1-2.66-4.72-13.42,1-28,0,0,8.88-2.84,29.09,10.84a100.26,100.26,0,0,1,53,0C198,88.3,206.9,91.14,206.9,91.14c5.76,14.56,2.14,25.32,1,28a40.87,40.87,0,0,1,10.89,28.39c0,40.62-24.74,49.56-48.29,52.18,3.79,3.28,7.17,9.71,7.17,19.58,0,14.15-.12,25.54-.12,29,0,2.82,1.9,6.11,7.26,5.07A105.76,105.76,0,0,0,151.36,47.28Z">
|
|
</path>
|
|
<path class="cls-12" d="M85.66,199.12c-.23.52-1.06.68-1.81.32s-1.2-1.06-.95-1.59,1.06-.69,1.82-.33,1.21,1.07.94,1.6Zm-1.3-1">
|
|
</path>
|
|
<path class="cls-12" d="M90,203.89c-.51.47-1.49.25-2.16-.49a1.61,1.61,0,0,1-.31-2.19c.52-.47,1.47-.25,2.17.49s.82,1.72.3,2.19Zm-1-1.08">
|
|
</path>
|
|
<path class="cls-12" d="M94.12,210c-.65.46-1.71,0-2.37-.91s-.64-2.07,0-2.52,1.7,0,2.36.89.65,2.08,0,2.54Zm0,0"></path>
|
|
<path class="cls-12" d="M99.83,215.87c-.58.64-1.82.47-2.72-.41s-1.18-2.06-.6-2.7,1.83-.46,2.74.41,1.2,2.07.58,2.7Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M107.71,219.29c-.26.82-1.45,1.2-2.64.85s-2-1.34-1.74-2.17,1.44-1.23,2.65-.85,2,1.32,1.73,2.17Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M116.36,219.92c0,.87-1,1.59-2.24,1.61s-2.29-.68-2.3-1.54,1-1.59,2.26-1.61,2.28.67,2.28,1.54Zm0,0">
|
|
</path>
|
|
<path class="cls-12" d="M124.42,218.55c.15.85-.73,1.72-2,1.95s-2.37-.3-2.52-1.14.73-1.75,2-2,2.37.29,2.53,1.16Zm0,0"></path>
|
|
</svg></a>
|
|
<a class="footer-icon" id="footer_blog" href="https://ncbiinsights.ncbi.nlm.nih.gov/" aria-label="Blog">
|
|
<svg xmlns="http://www.w3.org/2000/svg" id="Layer_1" data-name="Layer 1" viewBox="0 0 40 40">
|
|
<defs><style>.cls-1{fill:#737373;}</style></defs>
|
|
<title>NCBI Insights Blog</title>
|
|
<path class="cls-1" d="M14,30a4,4,0,1,1-4-4,4,4,0,0,1,4,4Zm11,3A19,19,0,0,0,7.05,15a1,1,0,0,0-1,1v3a1,1,0,0,0,.93,1A14,14,0,0,1,20,33.07,1,1,0,0,0,21,34h3a1,1,0,0,0,1-1Zm9,0A28,28,0,0,0,7,6,1,1,0,0,0,6,7v3a1,1,0,0,0,1,1A23,23,0,0,1,29,33a1,1,0,0,0,1,1h3A1,1,0,0,0,34,33Z"></path>
|
|
</svg>
|
|
</a>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
|
|
<section class="container-fluid bg-primary">
|
|
<div class="container pt-5">
|
|
<div class="row mt-3">
|
|
<div class="col-lg-3 col-12">
|
|
<p><a class="text-white" href="https://www.nlm.nih.gov/socialmedia/index.html">Connect with NLM</a></p>
|
|
<ul class="list-inline social_media">
|
|
<li class="list-inline-item"><a href="https://twitter.com/NLM_NIH" aria-label="Twitter" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st20 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st30 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Twitter</title>
|
|
<g>
|
|
<g>
|
|
<g>
|
|
<path class="st20" d="M192.9,88.1c-5,2.2-9.2,2.3-13.6,0.1c5.7-3.4,6-5.8,8.1-12.3c-5.4,3.2-11.4,5.5-17.6,6.7 c-10.5-11.2-28.1-11.7-39.2-1.2c-7.2,6.8-10.2,16.9-8,26.5c-22.3-1.1-43.1-11.7-57.2-29C58,91.6,61.8,107.9,74,116 c-4.4-0.1-8.7-1.3-12.6-3.4c0,0.1,0,0.2,0,0.4c0,13.2,9.3,24.6,22.3,27.2c-4.1,1.1-8.4,1.3-12.5,0.5c3.6,11.3,14,19,25.9,19.3 c-11.6,9.1-26.4,13.2-41.1,11.5c12.7,8.1,27.4,12.5,42.5,12.5c51,0,78.9-42.2,78.9-78.9c0-1.2,0-2.4-0.1-3.6 C182.7,97.4,189.2,93.7,192.9,88.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st30" cx="124.4" cy="128.8" r="108.2"></circle>
|
|
</g>
|
|
</svg></a></li>
|
|
<li class="list-inline-item"><a href="https://www.facebook.com/nationallibraryofmedicine" aria-label="Facebook" rel="noopener noreferrer" target="_blank">
|
|
<svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<style type="text/css">
|
|
.st10 {
|
|
fill: #FFFFFF;
|
|
}
|
|
|
|
.st110 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
</style>
|
|
<title>Facebook</title>
|
|
<g>
|
|
<g>
|
|
<path class="st10" d="M159,99.1h-24V88.4c0-5,3.3-6.2,5.7-6.2h16.8V60l-24.4-0.1c-22.1,0-26.2,16.5-26.2,27.1v12.1H90v22.5h16.9 v67.5H135v-67.5h21.7L159,99.1z"></path>
|
|
</g>
|
|
</g>
|
|
<circle class="st110" cx="123.6" cy="123.2" r="108.2"></circle>
|
|
</svg>
|
|
</a></li>
|
|
<li class="list-inline-item"><a href="https://www.youtube.com/user/NLMNIH" aria-label="Youtube" target="_blank" rel="noopener noreferrer"><svg xmlns="http://www.w3.org/2000/svg" xmlns:xlink="http://www.w3.org/1999/xlink" version="1.1" x="0px" y="0px" viewBox="0 0 249 249" style="enable-background:new 0 0 249 249;" xml:space="preserve">
|
|
<title>Youtube</title>
|
|
<style type="text/css">
|
|
.st4 {
|
|
fill: none;
|
|
stroke: #FFFFFF;
|
|
stroke-width: 8;
|
|
stroke-miterlimit: 10;
|
|
}
|
|
|
|
.st5 {
|
|
fill: #FFFFFF;
|
|
}
|
|
</style>
|
|
<circle class="st4" cx="124.2" cy="123.4" r="108.2"></circle>
|
|
<g transform="translate(0,-952.36218)">
|
|
<path class="st5" d="M88.4,1037.4c-10.4,0-18.7,8.3-18.7,18.7v40.1c0,10.4,8.3,18.7,18.7,18.7h72.1c10.4,0,18.7-8.3,18.7-18.7 v-40.1c0-10.4-8.3-18.7-18.7-18.7H88.4z M115.2,1058.8l29.4,17.4l-29.4,17.4V1058.8z"></path>
|
|
</g>
|
|
</svg></a></li>
|
|
</ul>
|
|
</div>
|
|
<div class="col-lg-3 col-12">
|
|
<p class="address_footer text-white">National Library of Medicine<br />
|
|
<a href="https://www.google.com/maps/place/8600+Rockville+Pike,+Bethesda,+MD+20894/@38.9959508,-77.101021,17z/data=!3m1!4b1!4m5!3m4!1s0x89b7c95e25765ddb:0x19156f88b27635b8!8m2!3d38.9959508!4d-77.0988323" class="text-white" target="_blank" rel="noopener noreferrer">8600 Rockville Pike<br />
|
|
Bethesda, MD 20894</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a href="https://www.nlm.nih.gov/web_policies.html" class="text-white">Web Policies</a><br />
|
|
<a href="https://www.nih.gov/institutes-nih/nih-office-director/office-communications-public-liaison/freedom-information-act-office" class="text-white">FOIA</a><br />
|
|
<a href="https://www.hhs.gov/vulnerability-disclosure-policy/index.html" class="text-white" id="vdp">HHS Vulnerability Disclosure</a></p>
|
|
</div>
|
|
<div class="col-lg-3 col-12 centered-lg">
|
|
<p><a class="supportLink text-white" href="https://support.nlm.nih.gov/">Help</a><br />
|
|
<a href="https://www.nlm.nih.gov/accessibility.html" class="text-white">Accessibility</a><br />
|
|
<a href="https://www.nlm.nih.gov/careers/careers.html" class="text-white">Careers</a></p>
|
|
</div>
|
|
</div>
|
|
<div class="row">
|
|
<div class="col-lg-12 centered-lg">
|
|
<nav class="bottom-links">
|
|
<ul class="mt-3">
|
|
<li>
|
|
<a class="text-white" href="//www.nlm.nih.gov/">NLM</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.nih.gov/">NIH</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.hhs.gov/">HHS</a>
|
|
</li>
|
|
<li>
|
|
<a class="text-white" href="https://www.usa.gov/">USA.gov</a>
|
|
</li>
|
|
</ul>
|
|
</nav>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
</section>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/rlib/js/InstrumentOmnitureBaseJS/InstrumentNCBIConfigJS/InstrumentNCBIBaseJS/InstrumentPageStarterJS.js?v=1"> </script>
|
|
<script type="text/javascript" src="/portal/portal3rc.fcgi/static/js/hfjs2.js"> </script>
|
|
</div>
|
|
</div>
|
|
</div>
|
|
<!--/.page-->
|
|
</div>
|
|
<!--/.wrap-->
|
|
</div><!-- /.twelve_col -->
|
|
</div>
|
|
<!-- /.grid -->
|
|
|
|
<span class="PAFAppResources"></span>
|
|
|
|
<!-- BESelector tab -->
|
|
|
|
|
|
|
|
<noscript><img alt="statistics" src="/stat?jsdisabled=true&ncbi_db=books&ncbi_pdid=book-part&ncbi_acc=NBK548693&ncbi_domain=livertox&ncbi_report=record&ncbi_type=fulltext&ncbi_objectid=&ncbi_pcid=/NBK548693/&ncbi_pagename=Disopyramide - LiverTox - NCBI Bookshelf&ncbi_bookparttype=chapter&ncbi_app=bookshelf" /></noscript>
|
|
|
|
|
|
<!-- usually for JS scripts at page bottom -->
|
|
<!--<component id="PageFixtures" label="styles"></component>-->
|
|
|
|
|
|
<!-- CE8B5AF87C7FFCB1_0191SID /projects/books/PBooks@9.11 portal107 v4.1.r689238 Tue, Oct 22 2024 16:10:51 -->
|
|
<span id="portal-csrf-token" style="display:none" data-token="CE8B5AF87C7FFCB1_0191SID"></span>
|
|
|
|
<script type="text/javascript" src="//static.pubmed.gov/portal/portal3rc.fcgi/4216699/js/3879255/4121861/3501987/4008961/3893018/3821238/4062932/4209313/4212053/4076480/3921943/3400083/3426610.js" snapshot="books"></script></body>
|
|
</html> |