Comparative haemodynamic effects of lidocaine, mexiletine, and disopyramide

J Cardiovasc Pharmacol. 1984 May-Jun;6(3):483-90.

Abstract

The effect of intravenous boluses of lidocaine (5 mg/kg), mexiletine (3.5 mg/kg), and disopyramide (5 mg/kg) on mean arterial pressure (MAP), heart rate (HR), cardiac output (CO), total peripheral resistance, left ventricular end-diastolic pressure, and peak rate of change of left ventricular pressure (peak LV dP/dt) were assessed in the conscious rabbit. Plasma levels for the three drugs corresponded to the human therapeutic range 3 min after administration. All three drugs had negative inotropic effects and reduced HR. Lidocaine reduced peak LV dP/dt by 26%, mexiletine by 41%, and disopyramide by 53%. The three drugs had quite different effects on CO as a result of differences in their actions on peripheral blood vessels: disopyramide caused a 21% fall in CO, associated with a significant vasoconstriction; mexiletine did not lower CO, as it caused a substantial vasodilation; and lidocaine did not produce any substantial change in either CO or vascular resistance. Cardiac autonomic blockade did not alter these changes. These results confirm that disopyramide has a marked cardiodepressant effect, and demonstrate that, although lidocaine depresses myocardial contractility in the conscious rabbit, it has little effect on other haemodynamic parameters. The experiments also show that mexiletine is a more profound negative inotrope than lidocaine, but that, as it produces a significant fall in MAP and thus a reduction in afterload, the CO is maintained.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Pressure / drug effects
  • Cardiac Output / drug effects
  • Disopyramide / blood
  • Disopyramide / pharmacology*
  • Female
  • Heart Rate / drug effects
  • Hemodynamics / drug effects*
  • Lidocaine / blood
  • Lidocaine / pharmacology*
  • Male
  • Mexiletine / blood
  • Mexiletine / pharmacology*
  • Propylamines / pharmacology*
  • Rabbits
  • Vascular Resistance / drug effects

Substances

  • Propylamines
  • Mexiletine
  • Lidocaine
  • Disopyramide