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最容易引起心律失常的药物是抗心律失常药物本身。因此,在选用此类药物时,应掌握好适应症,熟悉其副作用、药物的相互作用以及患者的情况。例如碘胺酮用于低血钾者易引起尖端扭转型室速(Tdp);与洋地黄合用亦易致心律失常。奎尼丁与洋地黄合用(尤其是房颤者)易发生Tdp和多形性室速,甚者可因室颤而死亡。前几年,我们合用奎尼丁与洋地黄纠正房颤,结果有几例在较小剂量(维持量)时发生室颤。
The drug most likely to cause arrhythmia is the antiarrhythmic drug itself. Therefore, the choice of such drugs, should have good indications, familiar with its side effects, drug interactions and the patient’s condition. For example, the use of amiodarone in hypokalemia can cause torsades de pointes (Tdp); combined with digitalis also prone to arrhythmia. Quinidine combined with digitalis (especially those with atrial fibrillation) prone to Tdp and pleomorphic ventricular tachycardia, or even death due to ventricular fibrillation. A few years ago, we combined quinidine and digitalis to correct atrial fibrillation, the results of a few cases in the smaller dose (maintenance dose) occurs when the ventricular fibrillation.