AJMALINUM (Ajmalinum; Arytmal, Cardiorythmine, Gilurytmal, Rauwolfin, Ritmos, Tachmalin; joint venture. B) — antiarrhythmic means. The alkaloid emitted from Rauwolfia (Rauwolfia serpentina Benth.). Treats indole derivatives:
White crystal powder, we will well dissolve in chloroform, it is almost water-insoluble. Hydrochloric salt of AJMALINUM of a rastvorim in water. And. it is well soaked up from went. - kish. a path, it is inactivated in a liver, does not kumulirutsya, removed with urine within several hours. In an experiment on animals And. stops or warns the ectopic arrhythmias (premature ventricular contraction, ventricular tachycardia, atrial fibrillation, fibrillation of ventricles) caused by various aritmogenny means (aconitine, adrenaline, acetylcholine, cardiac glycosides, calcium chloride, etc.) or disturbance of blood supply of a myocardium. And. treats hinidinopodobny substances. Its antiarrhythmic action is explained by stabilization of cellular membranes of a myocardium and braking of passive transport of cations. The partial inactivation of «transport» system of sodium causes reduction of speed of slow and bystry depolarization of membranes therefore activity of the ectopic centers of formation of impulses is suppressed. Besides, And., extending duration of action potential, increases the effective refractory period and thus lowers excitability of a myocardium and slows down spread of activation on the carrying-out system of heart. Unlike Reserpinum, And. does not cause antipsychotic effect, moderately and quickly lowers arterial pressure. And. has negative inotropic effect on heart, a cut, however, it is considerably less expressed, than at quinidine and propranolol (inderal). Coronary blood stream under influence And. significantly does not change.
AJMALINUM apply at Bouveret's supraventricular and ventricular disease, including and at a myocardial infarction; at paroxysmal atrial fibrillation, atrial and ventricular premature ventricular contraction of various genesis, and also for prevention of ventricular arrhythmias at a myocardial infarction, catheterization and heart operations. At a resistant ciliary arrhythmia and an atrial flutter And. is less effective. Drug is appointed intravenously, intramusculary and inside. For stopping of paroxysmal arrhythmia AJMALINUM is entered intravenously in a dose of 0,05 g (50 mg): 2 ml of 2,5% of solution dissolve in 10 ml of isotonic solution of sodium chloride or 5% of solution of glucose and pour within 3 — 5 min. (under control of an ECG); intramusculary it is possible to enter 0,1 — 0,15 g (100 — 150 mg) during the day. Inside appoint 0,05 — 0,1 g (50 — 100 mg) 3 — 4 times a day within 1 — 3 weeks. And. it is well transferred by patients. Side effects (short-term feeling of heat, lengthening of an interval of PQ and broadening of the QRS complex) are generally observed at bystry intravenous administration.
AJMALINUM it is contraindicated at severe defeat of the carrying-out system of heart; at the expressed heart failure and hypotonia drug should be used with care.
Forms of release: 2,5% solution in ampoules on 2 ml and drazhirovanny tablets on 0,05 g. Keep in the place protected from light.
See also Antiarrhythmic means .
Bibliography: Apostles of L., etc. Three years' experience of treatment of some arrhythmias Rithmosum (Ajmalinum), Cardiology, t. 8, No. 11, page 82, 1968, bibliogr.; Gendenstein E. I. Influence of some alkaloids of Rauwolfia and derivative EDTA on experimental cardiac arrhythmias, Cor et vasa (Praha), t. 8, No. 4, page 283, 1966, bibliogr.; Gendenstein E. I. and Davidovsky N. M. Pharmacological properties and a therapeutic effectiveness of Ajmalinum — new antiarrhythmic means, Cardiology, t. 5, No. 6, page 71, 1965, bibliogr.; Doshchitsin V. L. Treatment of disturbances of a cordial rhythm gilurytmal (Ajmalinum), in the same place, t. 8, No. 2, page 109, 1968, bibliogr.; Bazika V. Ajmalin, alkaloid Rauwolfia serpentina, Vnitřni Lek., s. 662, 1969; Forster G. Holzmann M. Zur Ajmalintherapie von Herzrhythmusstörungen, Schweiz. med. Wsehr., S. 216, 1967, Bibliogr.
E. I. Gendenstein.