雙異丙吡胺磷酸鹽
Disopyramide Phosphate
Disopyramide phosphate
別名: Norpace CR · Dicorantil · Dirythmin · Dirytmin · DisoDuriles · Disomet · Disonorm · Durbis · Isomide · Isorythm · Ritmodan · Ritmoforine · Rythmical · Rythmodan · Rythmodul · disopyramidi phosphas · SC-13957
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
各物種劑量
🌎 NA — North America🌍 EU — Europe
狗
| 適應症 | 劑量 | 途徑 | 頻次 | 療程 | 地區 |
|---|---|---|---|---|---|
| Antiarrhythmic (almost never used) | 7-30 mg/kg PO q4h | PO | q4h | — | 🌎 NA |
- Antiarrhythmic (almost never used): Considered a 2nd or 3rd line agent.
劑量為持牌獸醫專業人員的臨床參考。請務必對照最新藥品說明書及個別病患確認。
概覽
雙異丙吡胺磷酸鹽 (Disopyramide phosphate) 是一種 Ia 類（膜穩定）抗心律不整藥物，結構上與奎尼丁 (quinidine) 和普魯卡因胺 (procainamide) 不同，但藥理作用相似。
- 臨床應用：在獸醫學中極少使用（主要被視為犬的二線或三線藥物），因為其半衰期短且具有強烈的負性肌力作用。
- 主要特徵：它能降低心肌興奮性和傳導速度。值得注意的是，它具有顯著的抗膽鹼（迷走神經抑制）活性（150 mg 的雙異丙吡胺約等於 0.09 mg 的阿托品），這極大地影響了其副作用和禁忌症。
- 心血管影響：雖然它通常對靜息心率或血壓影響極小，但可使全身外周阻力增加高達 20%，並顯著抑制心肌收縮力。
作用機制
- Blocks fast inward sodium (Na⁺) channels → decreases the rate of phase 0 depolarization → slows conduction velocity through the atria and ventricles.
- Inhibits potassium (K⁺) channels → prolongs the action potential duration and increases atrial and ventricular refractory times.
- Decreases automaticity of ectopic atrial or ventricular pacemakers and shortens sinus node recovery time.
- Exerts a direct negative inotropic effect on the myocardium, reducing cardiac contractility.
- Possesses significant anticholinergic (vagolytic) activity, which can alter autonomic tone to the heart.
安全性與警告
禁忌症
- Hypersensitivity to the drug
- 2nd or 3rd degree AV block (unless a pacemaker is inserted)
- Cardiogenic shock
- Severe uncompensated or poorly compensated cardiac failure
- Hypotension
- Glaucoma (closed-angle)
- Urinary retention
- Myasthenia gravis
不良反應
- Dry mouth, eyes, or nose
- Constipation
- Urinary hesitancy or retention
- Urinary frequency and urgency
- Edema
- Hypotension
- Dyspnea
- Syncope
- Conduction disturbances (e.g., AV block)
- Vomiting and diarrhea
- Intrahepatic cholestasis
- Hypoglycemia
- Fatigue and headache
- Muscle weakness and pain
- Prolonged QT interval (at 15 mg/kg q8h in dogs)
- Widened QRS complex (at doses >30 mg/kg in dogs)
注意事項
Use with extreme caution in patients with sick sinus syndrome, bundle branch block, or Wolff-Parkinson-White (WPW) syndrome. Patients with atrial fibrillation or flutter must be digitalized before disopyramide therapy to negate increased ventricular response. Use with caution (and possibly at a reduced dosage) in patients with hepatic or renal disease. Use with caution in nursing animals as the drug is excreted in milk.
藥物相互作用
Additive anticholinergic effects may be encountered.
Additional prolongation of the QT interval.
Increased disopyramide levels; prolongation of QT interval may occur.
May increase disopyramide's metabolism and reduce serum levels.
May be used concurrently, but widening of QRS and prolongation of QT interval may occur.
May increase disopyramide levels; disopyramide may decrease quinidine levels.
May increase disopyramide's metabolism and reduce serum levels.
Because of additional negative inotropic effects, use of disopyramide within 48 hours of using verapamil is not recommended.
May cause additive negative inotropic effects.
監測
- ECG (monitor for QT prolongation and QRS widening)
- Blood pressure
- Clinical signs of adverse effects (anticholinergic and cardiovascular)
- Liver function tests (if on chronic therapy)
- Serum drug levels (Therapeutic: 2-7 mcg/mL; Toxic: >9 mcg/mL)
藥物動力學
半衰期
吸收
Rapidly absorbed following oral administration. Oral bioavailability in dogs is about 70%.
分佈
Distributed throughout the body in extracellular water and is not extensively bound to tissues. Plasma protein binding is variable and concentration-dependent (approximately 50-65% at therapeutic levels in humans). Crosses the placenta and enters milk.
代謝
Metabolized in the liver.
排除
40-65% is excreted unchanged in the urine. Dosage adjustments may be needed in renal disease to prevent accumulation.
過量
Clinical signs of toxicity: Anticholinergic effects, apnea, loss of consciousness, hypotension, cardiac conduction disturbances and arrhythmias, widening of the QRS complex and QT interval, bradycardia, congestive heart failure, seizures, asystole, and death.
Treatment:
- Initially consists of prompt gastric emptying, activated charcoal, and cathartics.
- Follow with vigorous symptomatic therapy using cardiac glycosides, vasopressors, sympathomimetics, diuretics, mechanically assisted respiration, and endocardial pacing if necessary.
- Disopyramide can be removed with hemodialysis.
可用產品
劑型
- Extended-release capsules
- Oral suspension (compounded)
人用標示
- Disopyramide Phosphate Capsules: 100 mg & 150 mg; Norpace® (Pharmacia); generic
- Disopyramide Phosphate Capsules Extended-Release: 100 mg & 150 mg; Norpace CR® (Pharmacia); generic
各地核准狀態
暫無法規資料: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Capsules should be stored at room temperature (15-30°C) in well-closed containers. An extemporaneously prepared suspension of 1-10 mg/mL of disopyramide (from capsules) in cherry syrup has been shown to be stable for one month if stored in amber bottles and refrigerated (2-8°C).
飼主須知
重要提示：由於此藥物在狗狗體內代謝非常快，必須嚴格按照時間表給藥。請勿漏服或在漏服後服用雙倍劑量。
- 注意副作用：由於此藥物的作用機制，它可能會引起「乾燥」效應。如果您的寵物出現口乾、眼乾、便秘或排尿困難，請聯繫您的獸醫。
- 監測呼吸和活力：如果您的寵物變得異常嗜睡、抑鬱或呼吸困難，請立即尋求獸醫協助，因為這可能表明心臟泵血能力或血壓受到了不良影響。
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