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Cardiovascular Drugs during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Tocainide is a lidocaine-related amide antiarrhythmic agent. The drug was not associated with an increased frequency of congenital anomalies at doses several times the usual adult dose, but the number of pregnancy losses was increased. There are no human studies during pregnancy, but it is closely related to lidocaine and its data may be extrapolated to tocainide. It is an FDA category C drug under the old system.
Drugs That Can Precipitate Seizures
Published in Stanley R. Resor, Henn Kutt, The Medical Treatment of Epilepsy, 2020
Brian K. Alldredge, Roger P. Simon
Tocainide is an antiarrhythmic agent structurally related to lidocaine which has also been reported to cause seizures in man (185). A case report of one patient who experienced a tonic-clonic seizure during concomitant treatment with lidocaine and tocainide highlights the potential for enhanced toxicity with these related antiarrhthmic agents (186). Tocainide and mexiletine have both been reported to cause seizures after overdose (187,188).
Antidysrhythmic Drugs in Pediatrics
Published in Sam Kacew, Drug Toxicity and Metabolism in Pediatrics, 1990
Howard C. Mofenson, Thomas R. Caraccio, Kathleen Mimnagh, Peter Bruzzo
A search for an orally available lidocaine analog for the long-term treatment of ventricular dysrrythmias led to the development of tocainide. Tocainide, an amine analog of lidocaine first marketed in November 1984, avoids first-pass hepatic metabolism and is almost 100% bioavailable.155,156 An oral dose of 600 to 2000 mg/d, given in two or three divided doses, has resulted in a 75% or greater suppression of premature ventricular contractions (PVCs) in 50 to 75% of adult patients.159,160 However, in patients with sustained ventricular tachycardia induced by programmed ventricular stimulation, tocainide has a fairly low response rate of 10 to 37%.161,165 In 24 h post-MI, tocainide has resulted in a 75% suppression of PVCs in 56% of patients.166 Its effect on mortality post-MI has not been evaluated in a large-scale controlled study. It is a reasonably safe and effective antiarrhythmic agent with little hemodynamic effect. Long-term use has a number of side effects.
Mexiletine (NaMuscla) for the treatment of myotonia in non-dystrophic myotonic disorders
Published in Expert Opinion on Orphan Drugs, 2020
Karen J. Suetterlin, Dipa Raja Rayan, Emma Matthews, Michael G Hanna
In terms of drugs in development, ranolazine has preclinical evidence of its efficacy and has undergone two recent open-label studies providing class IV evidence of its efficacy for the treatment of NDM [24,25]. In the PMC study, ranolazine significantly improved all subjective measures of muscle stiffness, weakness, and pain [25] while for the MC study significant improvement was limited to muscle stiffness only [24]. Tocainide is known to be a very effective anti-myotonic agent [18] but its use is precluded by reports of fatal agranulocytosis [26]. Therefore, research has looked at developing Tocainide analogues [27]. The leading compound, To042, is 100 times more potent than mexiletine at reducing muscle stiffness in a rat model of myotonia [27]. Additional preclinical studies are now needed to progress To042 to human studies [19].
Efficacy and Safety of Lidocaine Patch 5% Supplementation to Intra-articular Bupivacaine Dexmedetomidine after Knee Arthroscopy under General Anesthesia: A Randomized Controlled Study
Published in Egyptian Journal of Anaesthesia, 2021
Ahmed R. Elsayed, Mohamed A. Elharty, Ahmed S. Elgebaly
Exclusion criteria were patient refusal, pregnancy, lactation, cardiac, renal, or hepatic diseases, hypertension treated with α methyldopa or beta-adrenergic blockers, opioid use within the previous 24 h, receiving class I antiarrhythmic drugs (such as tocainide and mexiletine), and known history of sensitivity to amide local anesthetics or to any other component of the LP5.