Mindanao State University – Iligan Institute of Technology
PHARMACOLOGY
DRUG STUDY
Brand Name: Mexitil Generic Name : Mexiletine Hydrochloride
Dosage, Route & Frequency
Drug Action
Recommended Prescribed
Ventricular Arrhythmias Analog of lidocaine with
class IB antiarrhythmic
Adult: PO 200–300 mg q8h properties. Shortens action
(max: 1200 mg/day)
 Adult: potential refractory period
PO 1.4–5 mg/kg q8h duration and improves
resting potential. Produces
modest suppression of
sinus node automatically
and AV nodal conduction.
Prolongs the His- to-
ventricular interval only if
patient has preexisting
conduction disturbance.
Has antiarrhythmic proper-
ties for ventricular
disturbances.
PHARMACOKINETICS
Absorption: Readily from
GI tract. Peak: 2–3 h.
Distribution: Distributed
into breast milk.
Metabolism: In liver.
Elimination: In urine; renal
elimination increases with
urinary acidification. Half-
Life: 10–12 h.
Student: Dela Cerna, Angel June
Drug Classification:
Drug-Drug & Drug-Food
Interactions
Drug: Phenytoin,
phenobarbital, rifampin
may decrease mexiletine
levels; cimetidine,
fluvoxamine may increase
mexiletine levels; may
increase theophylline
levels; may increase
proarrhythmic effects of
dofetilide (separate
administration by at least 1
wk).
Class IB Antiarrhythmic
Indications
Acute and chronic
ventricular arrhythmias;
prevention of recurrent
cardiac arrests;
suppression of PVCs due
to ventricular
tachyarrhythmias.
UNLABELED USES:
Wolff-Parkinson- White
syndrome and
supraventricular
arrhythmias.
Section:260_
Contraindications
Contraindications: Severe
left ventricular failure,
cardiogenic shock, severe
bradyarrhythmias.
Preexisting second- or
third-degree heart block
without pacemaker;
cardiogenic shock;
lactation.
Cautions:
Patients with sinus node
conduction irregularities,
intraventricular conduction
abnormalities; hypotension;
severe congestive heart
failure; renal failure; liver
dysfunction; pregnancy
(category C).
Side Effects
(By System)
Nausea, vomiting, upset
stomach, heartburn,
decreased appetite,
headache, blurred vision,
rash, dizziness,
lightheadedness, tiredness,
poor coordination, dry
mouth, diarrhea,
constipation, weakness,
numbness, tingling, and
tremor (shaking).
Adverse Reactions (By
System)
CNS: Dizziness, tremor,
nervousness,
incoordination, headache,
blurred vision,
paresthesias, numbness.
CV: Exacerbated
arrhythmias, palpitations,
chest pain, syncope,
hypotension. GI: Nausea,
vomiting, heartburn,
diarrhea, constipation, dry
mouth, abdominal pain.
Skin: Rash. Body as a
Whole: Dyspnea, edema,
arthralgia, fever, malaise,
hiccups. Urogenital:
Impotence, urinary
retention.
Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment & Drug Effects Patient & Family Education

 Check pulse and BP before administration; make sure both are stabilized.  Learn about pulse parameters to be reported: Changes in rhythm and rate (bradycardia = pulse below 60); symptomatic
 Effective serum concentration range is 0.5–2 mcg/mL. bradycardia (light-headedness, syncope, dizziness), and postural hypotension.
 Lab tests: Baseline and periodic liver function tests.  Do not breast feed while taking this drug.
 Supervise ambulation in the weak, debilitated patient or the older adult during drug stabilization period. CNS adverse
reactions predominate (e.g., intention tremors, nystagmus, blurred vision, dizziness, ataxia, confusion, nausea).
 Encourage drug compliance; affected particularly by the distressing adverse effects of tremor, ataxia, and eye symptoms.
 Check frequently with patient about adherence to drug regimen. If adverse effects are increasing, consult physician. Dose
adjustment or discontinuation may be needed.