Clinical Pharmacology of N,N‐Bis(phenylcarbamoylmethyl)dimethylammonium Chloride (QX‐572), A New Antiarrhythmic Agent

Schwartz, Mortimer L.; Stapleton, Michelle; Covino, Benjamín G.

doi:10.1002/j.1552-4604.1967.tb00065.x

Cited by 8 publications

(5 citation statements)

References 5 publications

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“…The lack of a significant decrease in systemic vascular resistance does not preclude this statement since, according to the protocol, cardiac output and vascular resistance were not measured at the point of maxinal hypotension. One of the most constant and striking effects of a QX-572 infusion is the increase in heart rate (Katz, I965;Schwartz et al, I967;Ryden et al, 1974a) which was also obvious in ..ir has a positive inotropic action was not confirmed by the present study. When discussing the lack of agreement in results, methodological aspects must be considered first of all.…”

Section: Resultscontrasting

confidence: 48%

Haemodynamic effects of the antiarrhythmic quaternary ammonium compound QX-572 in man.

Rydén¹,

Hjalmarson²,

Kvasnička³

et al. 1975

Heart

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The haemodynamic effects of N, N-bis(phenyl-carbamoylmethyl) dimethylammonium chloride (QX-572) in man were studied. A controlled study was performed to rule out a possible influence of the catheterization procedure as such on the results. Ten patients with mild to moderate aortic regurgitation were studied: based on clinical data the patients were divided into 2 groups of 5. Randomly it was decided that one group should constitute a control group receiving saline while the second group received QX-572 , MG/KG BODY WEIGHT. In both groups the administration was performed as a slow intravenous infusion during 30 minutes. Heart rate, pressures in brachial artery and right atrium, cardiac output, stroke volume, and systemic vascular resistance were determined before, during, and up to 30 minutes after completion of placebo or QX-572. These variable remained stable in the control group while QX-572 produced an increase in heart rate most pronounced at the end of the infusion period. A transient decrease in systolic and mean brachial artery pressure during the infusion, and during the same period a decrease in right atrial pressure. Cardiac output and systemic vascular resistance were unchanged by QX-572 but they were not measured during the infusion when the changes in pressures were most pronounced. QX-572 was thought to act as a peripheral vasodilator during the infusion. Left ventricular contractility was studied by means of pressure curves obtained from a catheter tip manometer placed in the left ventricle. The first derivative of the isovolumic left ventricular pressure at the highest level (45mmHg) common to all patients was used (dp/dt-45). No significant difference could be observed when comparing mean changes of dp/dt-45 for the two groups. In the control group there was a slight but significant increase in dp/dt-45 during the time of observation. In the QX-572 group the results varied between individuals. Two of the patients differed from all other patients in the control and QX-572 groups showing a decrease in dp/dt-45 which, when most pronounced at the end of the infusion period, was -31 and -28 per cent of the preinfusion levels, respectively. This decrease probably reflects reduction of contractility. It was concluded that QX-572 in a dose of 8 mg/kg body weight did not have any major haemodynamic drawbacks.

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Section: Resultscontrasting

confidence: 48%

Haemodynamic effects of the antiarrhythmic quaternary ammonium compound QX-572 in man.

Rydén¹,

Hjalmarson²,

Kvasnička³

et al. 1975

Heart

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“…The major problem during our comparative study was the adverse effects of QX-572. This drug has previously been found to produce an initial vasodilatation and also an increased sympathetic tone (25). The early BP fall and the later tachycardia and hypertension recorded in this study probably reflect these pharmacological effects.…”

Section: Discussionsupporting

confidence: 68%

“…The quarternary ammonium compound N,N-bis (phenylcarbamoylmethyl) dimethylammonium chloride (QX-572, Astra, Sweden) has been shown to prevent and abolish ventricular arrhythmias in animals (4,5, 12,17,25) and man (1 1, 22,23). After an uncontrolled study Rydtn et al (23) reported the drug to be very effective in patients with ventricular arrhythmias refractory to other treatments.…”

mentioning

confidence: 99%

Lidocaine and the Quarternary Ammonium Compound QX‐572 in Acute Myocardial Infarction

Bergdahl

Karlsson

et al. 1978

Journal of Internal Medicine

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ABSTRACT. Patients with suspected or proven acute myocardial infarction complicated by ventricular arrhythmias not corrected by lidocaine therapy (bolus dose 100 mg followed by infusion 2 mg/min) were treated either with an increased dose of lidocaine (bolus dose 50 mg followed by infusion 3 mg/min) or with 600 mg N,N‐bis dimethylammonium chloride (QX‐572, Astra, Sweden) as an i.v. infusion during 30 min (3 patients) or 60 min (13 patients). In the lidocaine group the arrhythmias were controlled in 6 out of 15 patients, in the QX‐572 group in 12 out of 16, a difference that is not statistically significant. However, the frequency of side‐effects was significantly higher (p<0.001) in the QX‐572 group (15 out of 16 patients) than in the lidocaine group (4 out of 15 patients). They were also more severe, including pronounced tachycardia and hypertension. It is concluded that despite the high antiarrhythmic effect of QX‐572, an increase of the lidocaine dose would be safer and preferable in the clinical situation studied.

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“…It has been shown to possess antiarrhythrnic properties both in animals (Covino 1962;Katz 1964) and in man (Rydin 1974). However, in human studies some investigators (Katz 1965;Schwartz et at. 1967;Rydin et al 1974Rydin et al , 1975aRydin et al .…”

mentioning

confidence: 99%

Haemodynamic Effects of the Quaternary Ammonium Compound QX 572 in Anaesthetized Cats. I. Cardiac Chronotropic Effects

Åberg¹,

Köpp²,

Rydén³

1979

Acta Pharmacologica et Toxicologica

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The haemodynamic effects of the antiarrhythmic compound, QX 572, have been studied in anaesthetized cats. I t was found that QX 572 increased the heart rate and decreased the blood pressure of the cats during the infusion of the drug. A slight increase in blood pressure was seen after the infusion was terminated. The same results have been obtained in patients. Experiments on cats pretreated with propranolol or reserpine showed that infusions of QX 572 caused an increase in heart rate by increasing the sympatheticactivity in the cats. It is also shown that changes in vagal tone may contribute to the effects of QX 572 on the heart rate.Key-word.~ Antiarrhythmic compoundquaternary ammonium compoundhaemodynamic effectchronotropic effectanaesthetized cats.

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Clinical Pharmacology of N,N‐Bis(phenylcarbamoylmethyl)dimethylammonium Chloride (QX‐572), A New Antiarrhythmic Agent

Cited by 8 publications

References 5 publications

Haemodynamic effects of the antiarrhythmic quaternary ammonium compound QX-572 in man.

Haemodynamic effects of the antiarrhythmic quaternary ammonium compound QX-572 in man.

Lidocaine and the Quarternary Ammonium Compound QX‐572 in Acute Myocardial Infarction

Haemodynamic Effects of the Quaternary Ammonium Compound QX 572 in Anaesthetized Cats. I. Cardiac Chronotropic Effects

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