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一、血中浓度测定的必要性最近,临床开始重视抗心律不齐药物的血中浓度测定。这是因为尽管按照使用说明书的用量投与抗心律不齐药物,还是常常出现副作用而几乎没有效果。例如:急性心肌梗塞伴室性期前收缩时给与利多卡因1～4mg/分静脉滴注,通常有效,且无副作用。然而有时却出现错乱、嗜睡等较强的神经系统作用。其副作用的发生机理,是滴注的利多卡因大部分由肝脏排泄。即在急性心肌梗塞合并心功能不全时,肝脏淤血,利多卡因的排泄发生障碍,血中浓度高出预计值,出现副作用。可是,实际上在临床上预测能否出现这样的副作用是非常困难的。在这种情况下,如果能够迅速测定利多卡因的血中浓度,可以说对于临床第一线的医师是极其有用的。另一方面,在药物无效时,有尽管达到了有效血中浓度也仍然无效(真正无效)和因体重过多或投与方法不当达不到血中有效浓度而无效两种情况。实际上,其鉴别如不测定血中浓度是非常困难的。以上治疗上的原因,提示抗心律不齐药物血中浓度测定的重要性。另外,对心律不齐的发生机理和抗
First, the need for determination of blood concentration Recently, the clinical began to attach importance to anti-arrhythmic drugs blood concentration determination. This is because despite administration of anti-arrhythmic drugs in accordance with the instructions for use, there are often side effects with little if any effect. For example: Acute myocardial infarction with ventricular premature ventricular contractions given lidocaine 1 ~ 4mg / min intravenous infusion, usually effective, and no side effects. However, sometimes there is disorder, lethargy and other strong nervous system. The mechanism of its side effects, most of the drip lidocaine excreted by the liver. That acute myocardial infarction with cardiac insufficiency, liver congestion, lidocaine excretion obstacles occur, blood levels higher than expected, the side effects. However, it is actually very difficult to predict clinically whether such side effects occur. In this case, the rapid determination of the lidocaine blood concentration can be said to be extremely useful for the first-line clinicians. On the other hand, when the drug is ineffective, there are two cases of ineffective (real ineffectiveness) despite reaching an effective blood concentration and ineffectiveness of not reaching the effective concentration of blood due to overweight or improper administration. In fact, its identification, if not measured in blood concentrations is very difficult. The above treatment causes suggest the importance of measuring the concentration of antiarrhythmic drugs in blood. In addition, the mechanism and anti-arrhythmia