chapter  111
Cardiac Drug Adverse Effects and Interactions
Pages 18

Antiarrhythmic agents ■ Disopyramide Worsening LV dysfunction,

anticholinergic (avoid in prostatic hypertrophy, glaucoma, myasthenia gravis)

■ Flecainide Arrhythmia risk in structural heart disease (avoid in heart failure or post myocardial infarction)

■ Lidocaine/ Seizures, CNS depression mexiletine

■ Procainamide Torsades de pointes, hypotension (IV), lupus-like syndrome with long-term therapy

■ Propafenone Bronchospasm, arrhythmia risk in structural heart disease

■ Quinidine Anticholinergic effects (prostatic hypertrophy, glaucoma,

Fig. 4. A drug, given as a solid, encounters several barriers and sites of loss in its sequential movement during gastrointestinal absorption. Dissolution, a prerequisite to movement across the gut wall, is the first step. Incomplete dissolution or metabolism in the gut lumen or by enzymes in the gut wall is a cause of poor absorption. Removal of drug as it first passes through the liver further reduces absorption.