This is A potent anti-arrhythmia agent, effective in a wide range of ventricular and atrial arrhythmias and tachycardias, This PPT covers: Introduction, Generic Name/Trade name, Mechanism of Action, Pharmacological class, Pharmacodynamics, Metabolism, therapeutic uses, Dosage, Adverse Effect, Precautions & Drug interaction and Contraindication This PPT Under supervisors Drs in FUE Pharmacy Written By a Pharmacy Student Ahmed Yehia Abu El-Naga

2. CONTENT Introduction
 Generic Name/Trade name
 Mechanism of Action
 Pharmacological class
 Pharmacodynamics
 Metabolism
 therapeutic uses
 Dosage
 Adverse Effect
 Precautions & Drug interaction
 Contraindication
 References

3. INTRODUCTION
A potent anti-arrhythmia agent, effective in a wide range of ventricular and
atrial arrhythmias and tachycardias. Paradoxically, however, in myocardial
infarct patients with either symptomatic or asymptomatic arrhythmia,
flecainide exacerbates the arrhythmia and is not recommended for use in
these patients.

4. Generic Name : Flecainide
Common Brand Name : Tambocor/ Almarytm / Apocard
IUPAC Name: N-(piperidin-2-ylmethyl)-2,5-bis(2,2,2-trifluoroethoxy)benzamide

5. MECHANISM OF ACTION
Flecainide acts on sodium channels on the neuronal cell membrane, limiting the spread of
seizure activity and reducing seizure propagation. The antiarrhythmic actions are
mediated through effects on sodium channels in Purkinje fibers. Flecainide is a sodium
channel blocker, binding to voltage gated sodium channels. It stabilizes the neuronal
membrane by inhibiting the ionic fluxes required for the initiation and conduction of
impulses. Ventricular excitability is depressed and the stimulation threshold of the
ventricle is increased during diastole.

6. Flecainide is a class group IC antiarrhythmic Flecainide systemic as such, it
is used for the prevention of paroxysmal supraventricular tachycardias
(PSVT), including atrioventricular nodal reentrant tachycardia,
atrioventricular reentrant
Pharmacodynamics:
Flecainide has local anesthetic activity and belongs to the membrane
stabilizing (Class 1) group of antiarrhythmic agents; it has electrophysiologic
effects characteristic of the IC class of antiarrhythmic
PHARMACOLOGICAL CLASS

7. METABOLISM
Hepatic. Flecainide does not undergo any consequential presystemic
biotransformation. The two major urinary metabolites are meta-O-
dealkylated flecainide (active, but about one-fifth as potent) and the meta-
O-dealkylated lactam of flecainide (non-active metabolite).
Absorption: Nearly complete following oral administration.

8. THERAPEUTIC USES
Group 1 antiarrhythmic Flecainide Systemic is used in treatment:
• Anti Fibrillation
• Arterial Flutter
• Paroxysmal Supraventricular Tachycardia
• Supraventricular Tachycardia
• Ventricular Tachycardia
• Wolff-Parkinson-White Syndrome
What are Group I antiarrhythmic?
 Group 1 antiarrhythmic: Sodium-channel blockers, which block the fast sodium
channels, thereby slowing electrical conduction in the heart

9. DOSAGE
Usual Adult Dose for Ventricular Tachycardia
Initial dose: 100 mg orally every 12 hours.
Maintenance dose: May be increased in increments of 50 mg bid every 4 days until efficacy is achieved.
Usual Adult Dose for Atrial Flutter , Wolff-Parkinson-White Syndrome , for Atrial Fibrillation ,
Paroxysmal Supraventricular Tachycardia
Initial dose: 50 mg orally every 12 hours.
Maintenance dose: May be increased in increments of 50 mg bid every 4 days until efficacy is achieved.
Usual Pediatric Dose for Supraventricular Tachycardia
less than 1 month:
Supraventricular tachycardia: Limited data available: Initial: 2 mg/kg/day orally divided every 12 hours;
1 month or older:
Initial: 1 to 3 mg/kg/day orally , up to 8 mg/kg/day, the average effective dose to be 4 mg/kg/day
.

10. ADVERSE EFFECTS
 Dizziness
 vision problems (such as blurred vision, problems focusing, seeing spots)
 shortness of breath
 Headache
 nausea
 shaking
 tiredness or weakness
 Flecainide has been shown to have teratogenic effects

11. PRECAUTIONS & DRUG INTERACTION
Many drugs besides flecainide may affect the heart rhythm (QT prolongation),
including amiodarone, dofetilide, pimozide, procainamide, quinidine, sotalol, and
macrolide antibiotics(such as erythromycin).
Flecainide has been administered to patients receiving digitalis preparations or beta-
adrenergic blocking agents without adverse effects. During administration of multiple
oral doses of Flecainide to healthy subjects stabilized on a maintenance dose of digoxin, a
13% to 19% increase in plasma digoxin levels occurred at six hours postdose

12. CONTRAINDICATIONS
Flecainide is contraindicated in patients with preexisting second- or third
degree AV block, or with right bundle branch block when associated with
a left hemiblock (bifascicular block), unless a pacemaker is present to
sustain the cardiac rhythm should complete heart block occur. Flecainide
is also contraindicated in the presence of cardiogenic shock or known
hypersensitivity to the drug.

13. REFERENCES
•DRUG.COM
•DRUGBANK.CA
•WEBMD.COM