ETRIPAMIL for SVT

ETRIPAMIL

On-Demand Intranasal Therapy for PSVT

(Guideline-Directed Overview)

WHAT IS ETRIPAMIL

• Intranasal, ultra-short-acting AV-nodal calcium channel blocker

• FDA-approved for on-demand termination of paroxysmal supraventricular tachycardia (PSVT)

ROUTE & PHARMACOKINETICS

• Route: Nasal spray (self-administered)

• Onset: 2–5 minutes

• Duration: ~20–30 minutes

MECHANISM OF ACTION

• Transient AV-nodal calcium channel blockade

• Interrupts re-entry circuit

• Terminates AVNRT and AVRT

GUIDELINE-DIRECTED ROLE

• Hemodynamically stable PSVT

• Recurrent, self-terminating episodes

• Suitable for out-of-hospital use

• Alternative to IV adenosine when access is limited

• Aligns with ACC/AHA/HRS SVT management principles (acute AV-nodal blockade)

KEY ADVANTAGES

• No IV access required

• No adenosine-like chest discomfort or flushing

• Rapid symptom relief

• Potential reduction in emergency department visits

ADVERSE EFFECTS

• Mild nasal irritation or congestion

• Transient bradycardia

• Transient hypotension

NOT INDICATED FOR

• Atrial fibrillation

• Atrial flutter

• Hemodynamically unstable tachycardia

CLINICAL IMPACT

• Empowers patient-initiated therapy

• Improves quality of life in recurrent PSVT

• Shifts care from ER-based to home-based management

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