etripamil (Cardamyst)

Indications

• self treatment of paroxysmal supraventricular tachycardia (PSVT)

Dosage

• 70 mg delivered as 2 nasal sprays of 35 mg, one in each nostril

Pharmacokinetics

• rapid onset, hort half-life (< 5 minutes)

Adverse effects

• nasal discomfort
• nasal congestion
• nasal discharge (rhinorrhea)
• throat irritation

• drug adverse effects of calcium channel blockers
• drug adverse effects of renin-angiotensin-aldosterone system inhibitors (RAAS inhibitors)
• drug adverse effects of antihypertensive agents

Mechanism of action

• L-type calcium influx inhibitor (slow channel blocker or calcium ion antagonist).
• modulates influx of ionic calcium across the cell membrane of the AV nodal cells, arterial smooth muscles & contractile myocardial cells
• etripamil can terminate PSVT by interrupting reentry at the AV node

More general terms

• non-dihydropyridine Ca+2 channel blocker (CCB)
• nasal agent; nasal spray