Use of lignocaine in treatment of cardiac arrhythmias.

Abstract

Oral Lichen Planus-awson MWDi 'ICSoui 89 In 30 patients with oral lichen planus regarded as severe enough to justify treatment, use of betamethasone (Betnovate) pellets 0.1 mg. was followed by substantial improvement or complete clearance of oral lesions in 20. Seven patients showed gradual or incomplete improvement.Only 2 out of 30 patients failed to show any response to betamethasone, but treatment was not continued for more than one month in these cases. Of two patients with mucous membrane pemphigoid the use of betamethasone pellets was followed by complete clearance of oral lesions. A third patient showed substantial improvement until he ceased to attend.The only side-effect of treatment was development of thrusb in four patients.The assistance of Messrs. Glaxo in their generous supply of tablets and for other help for this trial is gratefully acknowledged.

Effect of lidocaine on the electrophysiological properties of ventricular muscle and Purkinje fibers

“…For instance, lidocaine, at therapeutic levels, seems to have less effect on excitability and intraventricular conduction than procaine amide or quinidine (14). Lidocaine is more effective against arrhythmias induced by digitalis (7,(15)(16)(17) and less effective against atrial arrhythmias such as atrial fibrillation or flutter than procaine amide or quinidine (6)(7)(8)(9). These observations are sufficient to question the hypothesis that the electroThe Journal of Clinical Investigation Volume 49 1970 physiological properties of lidocaine are identical with or very similar to those of procaine amide or quinidine.…”

“…This assumption is not unreasonable when one considers the similarity of structure and of local anesthetic properties shared by these two drugs. Indeed, the strongest arguments made for the clinical use of lidocaine in the treatment of arrhythmias rather than procaine amide or quinidine usually have been related to either the pronounced differences in its mode and rate of metabolism (4)(5)(6)(7)(8) or to differences between the effects of lidocaine and these two drugs on blood pressure, cardiac output, and myocardial contractility (9)(10)(11)(12). Differences in electrophysiological properties or antiarrhythmic spectrum usually have been neglected in such discussions.…”

“…Lidocaine hydrochloride has been used sporadically as a cardiac antiarrhythmic drug since 1950 (1) and in the past few years, has been frequently used to treat ventricular arrhythmias which occur during and after cardiac surgery (2)(3)(4)(5) and myocardial infarction (6)(7)(8)(9). The antiarrhythmic and electrophysiological properties of lidocaine were assumed to be similar to those of procaine amide.…”

Cardiac Pharmacology

“…Its effectiveness in ventricular arrhythmias con trasts with its slight value in atrial arrhythmias, including atrial flutter and atrial fi brillation (63,65,67). It is of questionable usefulness in treatment of supraventricular ectopic beats (65,67) and virtually ineffective in cases with supraventricular tachycardia with or without A-V block (63,65,67).…”

Effect of Lidocaine on Action Potentials, Currents and Contractions in the Absence and Presence of Ouabain in Guinea‐pig Ventricular Cells

“…If the antiarrhythmic action of lidocaine occurred primarily in Purkinje fibres then it would tend to inhibit those ventricular arrhythmias arising from abnormal activity in the Purkinje fibres. This could also explain the greater effectiveness of lidocaine in ventricular rather than in atrial arrhythmias (Spracklen, Kimerling, Besterman & Litchfield, 1968;Jewitt, Kishon & Thomas, 1968 …”