Antiarrhythmic effects of optical isomers of disopyramide on canine ventricular arrhythmias.
Disopyramide is an effective class I antiarrhythmic drug and widely used for the treatment of arrhythmias, but it has anticholinergic side effects. In vitro studies demonstrated that dextrorotatory (D-) disopyramide has a stronger anticholinergic action, whereas the levorotatory (L-) isomer has a stronger Na channel blocking action. Because the antiarrhythmic mechanism of disopyramide suppressing digitalis- and two-stage coronary ligation-induced canine ventricular arrhythmias is the drug-induced Na channel block, we examined the antiarrhythmic efficacy of D- and L-disopyramide on two arrhythmia models. On ouabain-induced ventricular tachycardia (VT), L-disopyramide 3 mg/kg decreased the arrhythmic ratio (number of ectopic beats/total heart rate), whereas the same dose of the D-isomer was ineffective and a higher dose (5 mg/kg) was needed to suppress the arrhythmia. The effective plasma concentrations (IC50) decreasing the arrhythmic ratio to 50% of the control were 5.3 and 11.3 mu g/ml for L- and D-disopyramide, respectively. We obtained similar results using 24-h two-stage coronary ligation VT. The IC50 were 8.9 and 22.2 mu g/ml for the L- and D-isomers, respectively. Our results indicate that L-disopyramide is about twice as strong an antiarrhythmic drug as the D-isomer.
Nakamura
M
M
Department of Pharmacology, Yamanashi Medical University, Japan.
Xue
Y
Y
Eto
K
K
Hashimoto
K
K
D000200:Action Potentials / Q000187:drug effects; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D003327:Coronary Disease / Q000150:complications; D004070:Digitalis; D004206:Disopyramide / Q000494:pharmacology* / Q000627:therapeutic use; D004285:Dogs; D004562:Electrocardiography; D005260:Female; D008297:Male; D010946:Plants, Medicinal; D010947:Plants, Toxic; D013237:Stereoisomerism
D000889:Anti-Arrhythmia Agents; D004206:Disopyramide