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Pharmacology: Pharmacodynamics: Flecainide is a Class 1 anti-arrhythmic (local anaesthetic) agents. Flecainide slows conduction through the heart, having its greatest effect on His bundle conduction. It also acts selectively to increase anterograde and particularly retrograde accessory pathway refractoriness.
Its actions may be reflected in the ECG by prolongation of the PR interval and widening of the QRS complex. The effect on the JT interval is insignificant.
Pharmacokinetics: Oral administration of Flecainide results in extensive absorption, with bioavailability approaching 90 to 95%. Flecainide does not appear to undergo significant hepatic first-pass metabolism. In patients, 200 to 500 mg Flecainide daily produced plasma concentrations within the therapeutic range of 200-1000 μg/L. Protein binding of flecainide is within the range of 32 to 58%.
Recovery of unchanged flecainide in urine of healthy subjects was approximately 42% of a 200mg oral dose, whilst the two major metabolites (Meta-O-Dealkylated lactam Metabolites) accounted for a further 14% each. The elimination half-life was 12 to 27 hours.
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