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<title>Disopyramide</title>

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<h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Disopyramide</span></h1>

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<td colspan="2" class="entete defaut" style="background-color:#FFDEAD;color:black;">Disopyramide

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<td colspan="2" style="text-align:center;"><a href="%C3%89nantiom%C3%A8re" class="mw-redirect" title="Énantiomère">Énantiomère</a> R du disopyramide (à gauche) et S-disopyramide (à droite)</td>

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<th colspan="2" style="padding:4px; text-align:center; background-color:#FFDEAD; color:#000000">Identification</th></tr>

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<td>223-110-2

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<th scope="row"><a href="Simplified_Molecular_Input_Line_Entry_System" title="Simplified Molecular Input Line Entry System">SMILES</a>

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<td><div class="NavFrame" title="[afficher]/[masquer]" style="border: none; padding: 0;"><div class="NavContent" style="display: none; text-align: left;">c1([C@@](c2ccccn2)(CCN(C(C)C)C(C)C)C(N)=O)ccccc1 <br><span class="reflink neverexpand"><a rel="nofollow" class="external text" href="http://pubchem.ncbi.nlm.nih.gov/search/?smarts=c1%28%5BC%40%40%5D%28c2ccccn2%29%28CCN%28C%28C%29C%29C%28C%29C%29C%28N%29%3DO%29ccccc1">PubChem</a></span>, <span class="reflink neverexpand"><a rel="nofollow" class="external text" href="http://chemapps.stolaf.edu/jmol/jmol.php?title=Disopyramide&model=c1%28%5BC%40%40%5D%28c2ccccn2%29%28CCN%28C%28C%29C%29C%28C%29C%29C%28N%29%3DO%29ccccc1">vue 3D</a></span></div></div>

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<th scope="row"><a href="International_Chemical_Identifier" title="International Chemical Identifier">InChI</a>

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<td><div class="NavFrame" title="[afficher]/[masquer]" style="border: none; padding: 0;"><div class="NavContent" style="display: none; text-align: left;"><b>InChI :</b> <span class="reflink neverexpand"><a rel="nofollow" class="external text" href="http://chemapps.stolaf.edu/jmol/jmol.php?title=Disopyramide&model=InChI%3D1%2FC21H29N3O%2Fc1-16%282%2924%2817%283%294%2915-13-21%2820%2822%2925%2C18-10-6-5-7-11-18%2919-12-8-9-14-23-19%2Fh5-12%2C14%2C16-17H%2C13%2C15H2%2C1-4H3%2C%28H2%2C22%2C25%29">vue 3D</a></span> <br>InChI=1/C21H29N3O/c1-16(2)24(17(3)4)15-13-21(20(22)25,18-10-6-5-7-11-18)19-12-8-9-14-23-19/h5-12,14,16-17H,13,15H2,1-4H3,(H2,22,25) <br></div></div>

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<th colspan="2" style="padding:4px; text-align:center; background-color:#FFDEAD; color:#000000">Propriétés chimiques</th></tr>

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<th scope="row"><a href="Formule_chimique" title="Formule chimique">Formule</a>

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<td><a href="Carbone" title="Carbone">C</a><sub>21</sub><a href="Hydrog%C3%A8ne" title="Hydrogène">H</a><sub>29</sub><a href="Azote" title="Azote">N</a><sub>3</sub><a href="Oxyg%C3%A8ne" title="Oxygène">O</a>  <span class="page_h"><a href="C21H29N3O" class="mw-redirect" title="C21H29N3O"><small>[Isomères]</small></a></span><br>

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<th scope="row"><a href="Masse_molaire" title="Masse molaire">Masse molaire</a><sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup>

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<th colspan="2" style="padding:4px; text-align:center; background-color:#f7efa8; color:#000000">Propriétés physiques</th></tr>

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<th scope="row"><a href="Point_de_fusion" title="Point de fusion"><abbr class="abbr" title="Température">T°</abbr> fusion</a>

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<td colspan="2" style="text-align:center;">Unités du <a href="Syst%C3%A8me_international_d'unit%C3%A9s" title="Système international d'unités">SI</a> et <a href="Conditions_normales_de_temp%C3%A9rature_et_de_pression" title="Conditions normales de température et de pression"><abbr title="conditions normales de température et de pression">CNTP</abbr></a>, sauf indication contraire.</td>

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<p>Le <b>disopyramide</b> est un <a href="Antiarythmique" title="Antiarythmique">antiarythmique</a> de classe Ia utilisé pour le traitement <a href="M%C3%A9decine" title="Médecine">médical</a> des <a href="Arythmie_cardiaque" class="mw-redirect" title="Arythmie cardiaque">arythmies cardiaques</a>. Il n'est plus guère utilisé, sauf cas particuliers, devant des arguments faisant penser qu'il augmente la mortalité.

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<div class="mw-heading mw-heading2"><h2 id="Mode_d'action"><span id="Mode_d.27action"></span>Mode d'action</h2></div>

<p>Il bloque les <a href="Canal_sodique" class="mw-redirect" title="Canal sodique">canaux sodiques</a> ce qui fait qu'il appartient à la classe Ia de la classification de Vaughan-Williams. Il a également des propriétés <a href="Nerf_vague" title="Nerf vague">vagolytiques</a> (comme l'<a href="Atropine" title="Atropine">atropine</a>), permettant d'accélérer la <a href="Fr%C3%A9quence_cardiaque" title="Fréquence cardiaque">fréquence cardiaque</a>.

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<div class="mw-heading mw-heading2"><h2 id="Efficacité"><span id="Efficacit.C3.A9"></span>Efficacité</h2></div>

<p>Il réduit le risque de récidive d'une <a href="Fibrillation_atriale" title="Fibrillation atriale">fibrillation atriale</a> après <a href="Cardioversion" title="Cardioversion">cardioversion</a><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup>.

</p><p>Lors d'une <a href="Cardiomyopathie_hypertrophique" title="Cardiomyopathie hypertrophique">cardiomyopathie hypertrophique</a> obstructive, il diminue les symptômes et le gradient de pression intraventriculaire<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup>.

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<div class="mw-heading mw-heading2"><h2 id="Effets_secondaires">Effets secondaires</h2></div>

<p>Il peut prolonger, sur l'<a href="%C3%89lectrocardiogramme" class="mw-redirect" title="Électrocardiogramme">électrocardiogramme</a>, l'espace QT avec un risque de survenue de <a href="Torsades_de_pointe" title="Torsades de pointe">torsades de pointe</a>. Il semble augmenter la mortalité<sup id="cite_ref-4" class="reference"><a href="#cite_note-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>.

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<div class="mw-heading mw-heading2"><h2 id="Notes_et_références"><span id="Notes_et_r.C3.A9f.C3.A9rences"></span>Notes et références</h2></div>

<li id="cite_note-1"><span class="mw-cite-backlink"><a href="#cite_ref-1">↑</a> </span><span class="reference-text">Masse molaire calculée d’après <span class="ouvrage">« <a rel="nofollow" class="external text" href="http://www.chem.qmul.ac.uk/iupac/AtWt/"><cite style="font-style:normal;"><span class="lang-en" lang="en">Atomic weights of the elements 2007</span></cite></a> », sur <span class="italique">www.chem.qmul.ac.uk</span></span>.</span>

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<li id="cite_note-2"><span class="mw-cite-backlink"><a href="#cite_ref-2">↑</a> </span><span class="reference-text">Karlson BW, Torstensson I, Abjorn C et al. <a rel="nofollow" class="external text" href="http://eurheartj.oxfordjournals.org/content/9/3/284.long"><i>Disopyramide in the maintenance of sinus rhythm after electroconversion of atrial fibrillation: a placebo-controlled one-year follow-up study</i></a>, Eur Heart J, 1988;9:284–290</span>

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<li id="cite_note-3"><span class="mw-cite-backlink"><a href="#cite_ref-3">↑</a> </span><span class="reference-text">Sherrid MV, Barac I, McKenna WJ et al. <a rel="nofollow" class="external text" href="http://www.sciencedirect.com/science/article/pii/S0735109714017409"><i>Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy</i></a>, J Am Coll Cardiol, 2005;45:1251–1258</span>

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<li id="cite_note-4"><span class="mw-cite-backlink"><a href="#cite_ref-4">↑</a> </span><span class="reference-text">Lafuente-Lafuente C, Mouly S, Longas-Tejero MA et al.

<a rel="nofollow" class="external text" href="http://archinte.jamanetwork.com/article.aspx?articleid=410132"><i>Antiarrhythmic drugs for maintaining sinus rhythm after cardioversion of atrial fibrillation: a systematic review of randomized controlled trials</i></a>, Arch Intern Med, 2006;166:719–728</span>

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<td colspan="2" class="entete medecine" style="background-color:#6ABF84;color:#000000;">Disopyramide<style data-mw-deduplicate="TemplateStyles:r224760757">

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<th colspan="2" style="padding:4px; text-align:center; background-color:#6ABF84; color:#000000">Informations générales</th></tr>

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<th scope="row"><a href="M%C3%A9dicament" title="Médicament">Princeps</a>

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<ul><li>ISORYTHM (France),</li>

<li>Rythmodan (Belgique, France),</li>

<li>(N'est plus commercialisé en Suisse)</li></ul>

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<th scope="row"><a href="Classe_pharmacologique" title="Classe pharmacologique">Classe</a>

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<td><a href="Antiarythmique" title="Antiarythmique">Antiarythmique</a>

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<th colspan="2" style="padding:4px; text-align:center; background-color:#6ABF84; color:#000000">Identification</th></tr>

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<td>C01BA03

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<th scope="row">DrugBank

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