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Encyclopedia > Amiodarone
Chemical structure of Amiodarone
Amiodarone
Systematic (IUPAC) name
(2-butylbenzofuran-3-yl)- [4-(2-diethylaminoethoxy)- 3,5-diiodo-phenyl]- methanone (as the hydrochloride salt)
Identifiers
CAS number 1951-25-3
ATC code C01BD01
PubChem 2157
DrugBank APRD00288
Chemical data
Formula C25H29I2NO3 . HCl
Mol. weight 681.78 g/mol
Pharmacokinetic data
Bioavailability 20 - 55%
Metabolism Liver
Half life 58 days (range 15-142 days)
Excretion Epithelial cells
Therapeutic considerations
Pregnancy cat.

D(US) Image File history File links Amiodarone chemical structure, drawn by User:Jfdwolff File history Legend: (cur) = this is the current file, (del) = delete this old version, (rev) = revert to this old version. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules . ... DrugBank is a database available at the University of Alberta that provides information about thousands of products. ... A chemical formula (also called molecular formula) is a concise way of expressing information about the atoms that constitute a particular chemical compound. ... The molecular mass of a substance (less accurately called molecular weight and abbreviated as MW) is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of medication that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The liver is an organ in some animals, including mammals (and therefore humans), birds, and reptiles. ... The elimination half-life of a drug (or any xenobiotic agent) refers to the timecourse necessary for the quantity of the xenobiotic agent in the body (or plasma concentration) to be reduced to half of its original level through various elimination processes. ... Excretion is the process of eliminating waste products of metabolism and other materials that are of no use. ... In zootomy, epithelium is a tissue composed of a layer of cells. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ... Motto: (Out Of Many, One) (traditional) In God We Trust (1956 to date) Anthem: The Star-Spangled Banner Capital Washington D.C. Largest city New York City None at federal level (English de facto) Government Federal constitutional republic  - President George Walker Bush (R)  - Vice President Dick Cheney (R) Independence from...

Legal status

Prescription only The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ...

Routes oral or intravenous

Amiodarone belongs to a class of drugs called Vaughan-Williams Class III antiarrhythmic agent. It is used in the treatment of a wide range of cardiac tachyarrhythmias, including both ventricular and supraventricular (atrial) arrhythmias. In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body 1. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. ...

Contents

History

Amiodarone was initially developed in 1961 in Belgium as a treatment for angina. It was widely used throughout Europe as an anti-anginal medication, and was soon found to suppress arrhythmias. 1961 (MCMLXI) was a common year starting on Sunday (the link is to a full 1961 calendar). ... angina tonsillaris see tonsillitis. ... World map exhibiting the location of Europe. ...


Dr. Bramah Singh determined that amiodarone and sotalol belonged to a new class of antiarrhythmic agents (what would become the class III antiarrhythmic agents). Today their mechanism of action is unknown. It is thought to involve prolonging the action potential duration, prolonging the refractory period, or interacting with K+ channels. Based on this, the Argentinian physician Dr. Mauricio Rosenbaum began using amiodarone to treat his patients who suffered from supraventricular and ventricular arrhythmias, with impressive results. Based on papers written by Dr. Rosenbaum, physicians in the United States began prescribing amiodarone to their patients with potentially life-threatening arrhythmias in the late 1970s. By that time, amiodarone was commonly prescribed throughout Europe for the treatment of arrhythmias. Because amiodarone was not approved by the Food and Drug Administration for use in the United States at the time, physicians were forced to directly obtain amiodarone from pharmaceutical companies in Canada and Europe. Sotalol is a drug used in individuals with rhythm disturbances (cardiac arrhythmias) of the heart. ... Motto: En unión y libertad(Spanish) In Union and Freedom Anthem: Himno Nacional Argentino Capital (and largest city)  Buenos Aires Official languages Spanish Government Federal republic  - President Néstor Kirchner  - Vice President Daniel Scioli Independence from Spain   - May Revolution 25 May 1810   - Declared 9 July 1816   - Recognized 1821 (by... The 1970s decade refers to the years from 1970 to 1979, inclusive. ... The Food and Drug Administration (FDA) is an agency of the United States Department of Health and Human Services and is responsible for regulating food (humans and animal), dietary supplements, drugs (human and animal), cosmetics, medical devices (human and animal) and radiation emitting devices (including non-medical devices), biologics, and... World map exhibiting the location of Europe. ...


The FDA was reluctant to officially approve the use of amiodarone, since initial reports had shown increased incidence of serious pulmonary side-effects of the drug. In the mid 1980s, the European pharmaceutical companies began putting pressure on the FDA to approve amiodarone by threatening to cut the supply to the American physicians if it was not approved. In December of 1985, amiodarone was approved by the FDA for the treatment of arrhythmias. This makes amiodarone one of the few drugs approved by the FDA without rigorous randomized clinical trials. The 1980s refers to the years of 1980 to 1989. ... 1985 (MCMLXXXV) was a common year starting on Tuesday of the Gregorian calendar. ...


Dosing

Amiodarone is available in oral and intravenous formulations.


Orally, it is available under the trade names Pacerone® (produced by Upsher-Smith Laboratories, Inc.) and Cordarone® (produced by Wyeth-Ayerst Laboratories) in 200mg and 400 mg tablets; It is also available under the trade name Aratac® in 100 mg and 200 mg tablets in Australia and New Zealand. The milligram (symbol mg) is an SI unit of mass. ...


It is also available in intravenous ampules and vials, typically in 150 mg increments.


The dose of amiodarone administered is tailored to the individual and the dysrhythmia that is being treated. When administered orally, the bioavailability of amiodarone is quite variable. Absorption ranges from 22 to 95%, with better absorption when it is given with food.[1] In pharmacology, bioavailability is used to describe the fraction of an administered dose of medication that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ...


Amiodarone is fat-soluble, and tends to concentrate in tissues including fat, muscle, liver, lungs, and skin. This confers a high volume of distribution (5000 liters in a 70 kg adult) and a long half-life. Due to the long half-life of amiodarone, oral loading typically takes days to weeks. The volume of distribution (VD) is a pharmacological term used to quantify the distribution of a drug throughout the body after oral or intravenous dosing. ...


An oral loading dose is typically a total of 10 grams, divided over one to two weeks. Once an individual is loaded, a typical maintenance dose of amiodarone is 100 or 200 mg either once or twice daily.


An intravenous loading dose is typically 300 mg in 20-30cc D5W for cardiac arrest. The loading infusion for dysrhythmias is typically 150 mg in a 100cc bag of D5W given over 10 minutes. Both can be followed by a 360 mg slow infusion over 6 hours then a maintenance infusion of 540 mg over 18 hours.


Mechanism of action

Amiodarone is categorized as a class III antiarrhythmic agent, and prolongs phase 3 of the cardiac action potential. It has numerous other effects however, including actions that are similar to those of antiarrhythmic classes Ia, II, and IV. Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. ... The cardiac action potential is the electrical activity of the individual cells of the electrical conduction system of the heart. ...


Amiodarone shows beta blocker-like and calcium channel blocker-like actions on the SA and AV nodes, increases the refractory period via sodium- and potassium-channel effects, and slows intra-cardiac conduction of the cardiac action potential, via sodium-channel effects. Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... Calcium channel blockers are a class of drugs with effects on the muscle of the heart and the muscles of the rest of the body. ... The sinoatrial node (abbreviated SA node, also called the sinus node) is the impulse generating (pacemaker) tissue located in the right atrium of the heart. ... The atrioventricular node (abbreviated AV node) is the tissue between the atria and the ventricles of the heart, which conducts the normal electrical impulse from the atria to the ventricles. ... The cardiac action potential is the electrical activity of the individual cells of the electrical conduction system of the heart. ...


Indications for use

Because amiodarone has a low incidence of pro-arrhythmic effects, it has been used both in the treatment of acute life-threatening arrhythmias as well as the chronic suppression of arrhythmias. It is useful both in supraventricular arrhythmias and ventricular arrhythmias.


Ventricular fibrillation

The treatment of choice for ventricular fibrillation (VF) is electrical defibrillation. However, amiodarone can be useful in shock-refractory VF. In the ARREST trial, amiodarone was shown to improve survival to hospital admission (when compared to placebo) in individuals who suffer cardiac arrest with shock-refractory VF.[2] It is on the basis of this study that the guidelines created by the American Heart Association for the treatment of VF include amiodarone as a second line agent (after epinephrine or vasopressin). ARREST was not adequately powered to demonstrate survival to hospital discharge. Ventricular fibrillation (V-fib or VF) is a cardiac condition which consists of a lack of coordination of the contraction of the muscle tissue of the large chambers of the heart that eventually leads to the heart stopping altogether. ... A physician visiting the sick in a hospital. ... // A placebo is a medicine or preparation which has no inherent pertinent pharmacologic activity but which is effective only by virtue of the factor of suggestion attendant upon its administration. ... The American Heart Association (AHA) is a non-profit organization in the United States that fosters appropriate cardiac care in an effort to reduce disability and deaths caused by cardiovascular disease and stroke. ... Adrenaline redirects here. ... Arginine vasopressin (AVP), also known as argipressin or antidiuretic hormone (ADH), is a human hormone that is mainly released when the body is low on water; it causes the kidneys to conserve water by concentrating the urine and reducing urine volume. ...


Ventricular tachycardia

Amiodarone may be used in the treatment of ventricular tachycardia in certain instances. Individuals with hemodynamically unstable ventricular tachycardia should not initially receive amiodarone. These individuals should be cardioverted out of their unstable rhythm. Through electricity or drug therapy, cardioversion converts heart arrhythmias to normal rhythms. ...


Amiodarone can be used in individuals with hemodynamically stable ventricular tachycardia. In these cases, amiodarone can be used regardless of the individual's underlying heart function and the type of ventricular tachycardia; it can be used in individuals with monomorphic ventricular tachycardia as well as individuals with polymorphic ventricular tachycardia. The dose of amiodarone is 150 mg IV administered over 10 minutes. Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of over 100 beats per minute. ... The milligram (symbol mg) is an SI unit of mass. ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ...


Atrial fibrillation

Individuals who have undergone open heart surgery are at an increased risk of developing atrial fibrillation (or AF) in the first few days post-procedure. In the ARCH trial, intravenous amiodarone (2 grams administered over 2 days) has been shown to reduce the incidence of atrial fibrillation after open heart surgery when compared to placebo.[3] However, clinical studies have failed to demonstrate long-term efficacy and have shown potentially fatal side effects such as pulmonary toxicities. While Amiodarone is not approved for AF by the FDA, it is a commonly prescribed off-label treatment due to the lack of efficacious treatment alternatives. Early in a coronary artery bypass surgery during vein harvesting from the legs (left of image) and the establishment of bypass (placement of the aortic cannula) (bottom of image). ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... An intravenous drip in a hospital Intravenous therapy or IV therapy is the administration of liquid substances directly into a vein. ... BIC pen cap, about 1 gram. ...


So called acute onset atrial fibrillation defined by the the North American Society of Pacing and Electrophysiology (NASPE)in 2003 responds well to short duration treatment with amiodarone. This has been demonstrated in seventeen randomised controlled trials, of which five included a placebo arm. The incidence of severe side effects in this group is low. The benefit of amiodarone in the treatment of atrial fibrillation in the critical care population has yet to be determined but it may prove to be the agent of choice where the patient is haemodynamically unstable and unsuitable for DC cardioversion. It is recommended in such a role by the UK government's National Institute for Health and Clinical Excellence (NICE). The National Institute for Health and Clinical Excellence or NICE is an agency of the National Health Service in the United Kingdom. ...


Contraindications

The only absolute contraindications to the administration of amiodarone is allergic reaction (ie: anaphylaxis) to the compound. However, because of the wide spectrum of the mechanism of action of amiodarone and the numerous side effects possible, there are a number of groups for which care should be taken when administering the drug. }} In medicine, anaphylaxis is a severe and rapid multi-system allergic reaction. ...


Individuals who are pregnant or may become pregnant are strongly advised to not take amiodarone. Since amiodarone can be expressed in breast milk, women taking amiodarone are advised to stop nursing. A pregnant woman Pregnancy is the process by which a mammalian female carries a live offspring from conception until it develops to the point where the offspring is capable of living outside the womb. ...


It is contraindicated in individuals with sinus nodal bradycardia, atrioventricular block, and second or third degree heart block who do not have an artificial pacemaker. The sinoatrial node (abbreviated SA node, also called the sinus node) is the impulse generating (pacemaker) tissue located in the right atrium of the heart. ... The atrioventricular node (abbreviated AV node) is the tissue between the atria and the ventricles of the heart, which conducts the normal electrical impulse from the atria to the ventricles. ... A pacemaker A pacemaker (or artificial pacemaker, so as not to be confused with the hearts natural pacemaker) is a medical device designed to regulate the beating of the heart. ...


Individuals with baseline depressed lung function should be monitored closely if amiodarone therapy is to be initiated.


The injection should not be given to neonates, because the benzyl alcohol it contains may cause the fatal "gasping syndrome".


Metabolism

Amiodarone is extensively metabolized in the liver, and can affect the metabolism of numerous other drugs. The major metabolite of amiodarone is desethylamiodarone (DEA), which also has antiarrhythmic properties. The metabolism of amiodarone is inhibited by grapefruit juice, leading to elevated serum levels of amiodarone. Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... Binomial name Citrus paradisi Macfad. ... Blood plasma is the liquid component of blood, in which the blood cells are suspended. ...


Interactions with other drugs

The pharmacokinetics of numerous drugs, including many that are commonly administered to individuals with heart disease, are affected by amiodarone. Particularly, doses of digoxin should be halved in individuals taking amiodarone. Pharmacokinetics is a branch of pharmacology dedicated to the study of the time course of substances and their relationship with an organism or system. ... Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... The heart and lungs, from an older edition of Grays Anatomy. ... Digoxin is a cardiac glycoside extracted from the foxglove plant, digitalis. ...


Amiodarone potentiates the action of warfarin. Individuals taking both of these medications should have their warfarin dose halved and their anticoagulation status (measured as prothrombin time (PT) and international normalized ratio (INR)) measured more frequently. The effect of amiodarone in the warfarin concentration can be as early as a few days after initiation of treatment, or can be delayed a few weeks. Warfarin (also known under the brand names of Coumadin®, Jantoven®, Marevan®, and Waran®) is an anticoagulant medication that is administered orally or, very rarely, by injection. ... The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. ... The prothrombin time (PT) and its derived measures of prothrombin ratio (PR) and international normalized ratio (INR) are measures of the extrinsic pathway of coagulation. ...


Amiodarone inhibits the action of the cytochrome P450 isozyme family. This reduces the clearance of many drugs, including the following: - Cytochrome P450 Oxidase (CYP2E1) Cytochrome P450 oxidase (commonly abbreviated CYP) is a generic term for a large number of related, but distinct, oxidative enzymes (EC 1. ... Isozymes, (or isoenzymes) are isoforms (closely related variants) of enzymes. ...

Ciclosporin (INN), cyclosporine or cyclosporin (former BAN), is an immunosuppressant drug. ... Digoxin is a cardiac glycoside extracted from the foxglove plant, digitalis. ... Flecainide acetate is a class Ic antiarrhythmic agent used to prevent and treat tachyarrhythmias (abnormal fast rhythms of the heart). ... Procainamide (trade name Pronestyl®) is a pharmaceutical antiarrhythmic agent used for the medical treatment of cardiac arrhythmias, classified by the Vaughan Williams classification system as class Ia. ... Quinidine is a pharmaceutical agent that acts as a class I antiarrhythmic agent in the heart. ... Sildenafil citrate, sold under the names Viagra, Revatio and generically under various other names, is a drug used to treat male erectile dysfunction (impotence) and pulmonary arterial hypertension (PAH), developed by the pharmaceutical company Pfizer. ... Simvastatin (INN) (IPA: ) is a hypolipidemic drug belonging to the class of pharmaceuticals called statins. It is used to control hypercholesterolemia (elevated cholesterol levels) and to prevent cardiovascular disease. ... Theophylline is a methylxanthine drug used in therapy for respiratory diseases such as COPD or asthma under a variety of brand names. ... Warfarin (also known under the brand names of Coumadin®, Jantoven®, Marevan®, and Waran®) is an anticoagulant medication that is administered orally or, very rarely, by injection. ...

Excretion

Unlike most other drugs, which are excreted via the urine or feces, amiodarone is excreted via shedding of epithelial cells. This includes loss of skin cells and loss of the cells of the lining of the gastrointestinal system. While the human body sheds millions of cells a day, the amount of amiodarone lost per day is small, giving a long half life (13 to 103 days). Therefore, if an individual was taking amiodarone on a chronic basis, if it is stopped it will remain in the system for months. Oral medication A medication is a licenced drug taken to cure or reduce symptoms of an illness or medical condition. ... This article or section is in need of attention from an expert on the subject. ... Feces, faeces, or fæces (see spelling differences) is waste product from an animals digestive tract expelled through the anus (or cloaca) during defecation. ... In zootomy, epithelium is a tissue composed of a layer of cells. ... For the Physics term GUT, please refer to Grand unification theory The gastrointestinal or digestive tract, also referred to as the GI tract or the alimentary canal or the gut, is the system of organs within multicellular animals which takes in food, digests it to extract energy and nutrients, and... Half-Life – often abbreviated as HL or HL1 – is a sci-fi first-person shooter computer game developed by Valve Software, first released by Sierra Studios on November 19, 1998. ...


Side effects

Amiodarone has numerous side effects. Most individuals administered amiodarone on a chronic basis will experience at least one side effect.


Thyroid

Due to the iodine content of the agent (37.3% by weight), abnormalities in thyroid function are common. Amiodarone is structurally similar to thyroxine (a thyroid hormone), which contributes to the effects of amiodarone on thyroid function. The incidence of hypothyroidism is about 6%, while the incidence of hyperthyroidism is about 2%. They are called Wolff-Chaikoff effect and Jodbasedow effect separately. The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... This article or section does not cite its references or sources. ... Hyperthyroidism (or overactive thyroid gland) is the clinical syndrome caused by an excess of circulating free thyroxine (T4) or free triiodothyronine (T3), or both. ... Wolff-Chaikoff effect is used to described hypothyroidism caused by intravenous infusion of a large amount of iodine. ... Jodbasedow effect is used to described hyperthyroidism caused by intravenous infusion of iodine. ...


Measurement of free thyroxine (FT4) alone may be unreliable and thyroid-stimulating hormone (TSH) should therefore also be checked every 6 months.[4] The thyroid hormones, thyroxine (T4) and triiodothyronine (T3), are tyrosine-based hormones produced by the thyroid gland. ... Thyroid-stimulating hormone (also known as TSH or thyrotropin) is a hormone synthesized and secreted by thyrotrope cells in the anterior pituitary gland which regulates the endocrine function of the thyroid gland. ...


Thyroid uptake measurements (I-123 or I-131), which are used to differentiate causes of hyperthyroidism, are generally unreliable in patients who have been taking amiodarone. Because of the high iodine content of amiodarone, the thyroid gland is effectively saturated, thus preventing further uptake of isotopes of iodine. However, the radioactive iodine uptake (nuclear thyroid uptake test) may still be helpful in the diagnosis and management of amiodarone-induced hyperthyroidism.


Eye

Corneal micro-deposits (Corneal verticillata, also called vortex keratopathy) are almost universally present (over 90%) in individuals taking amiodarone for at least 6 months. These deposits typically do not cause any symptoms. About 1 in 10 individuals may complain of a blueish halo. Optic neuropathy occurs in 1-2% of people and is not dosage dependent. Bilateral optic disk swelling and mild and reversible visual field defects can also occur. The cornea is the transparent front part of the eye that covers the iris, pupil, and anterior chamber, providing most of an eyes optical power [1]. Together with the lens, the cornea refracts light and, as a result, helps the eye to focus. ...


Gastrointestinal system

Liver toxicity due to amiodarone is quite rare. A drug-induced hepatitis (inflammation of the liver) may occur and is sometimes reversible by lowering the dose. Hepatitis is a gastroenterological disease, featuring inflammation of the liver. ...


Skin

Long-term administration of amiodarone is associated with a blue-grey discoloration of the skin, "smurf syndrome." This is more commonly seen in individuals with lighter skin tones. The discoloration may revert upon cessation of the drug. However, the skin color may not return completely to normal.


Individuals taking amiodarone may become more sensitive to the harmful effects of UV-A light. Taking sunblock that also blocks UV-A rays appears to prevent this side effect. The solar corona as seen in deep ultraviolet light at 17. ...


Lung

The most serious reaction that is due to amiodarone is interstitial lung disease. The incidence of pulmonary fibrosis is not dose related. Some individuals were noted to develop pulmonary fibrosis after a week of treatment, while others did not develop it after years of continuous use. There are no known factors that increase the incidence of amiodarone-induced pulmonary fibrosis in a particular individual. Common practice is to avoid the agent if possible in individuals with decreased lung function. Interstitial lung disease (ILD), also known as diffuse parenchymal lung disease (DPLD), refers to a group of lung diseases (including idiopathic pulmonary fibrosis), affecting the alveolar epithelium, pulmonary capillary endothelium, basement membrane, perivascular and perilymphatic tissues. ...


The most specific test of pulmonary toxicity due to amiodarone is a dramatically decreased DLCO noted on pulmonary function testing. There are very few or no other articles that link to this one. ... Spirometry, also known as Pulmonary Function Testing (PFT), is the measurement of lung function, specifically by measuring the volume and speed of air that can be inhaled and exhaled. ...


See also

Advanced cardiac life support (ACLS) is a detailed medical protocol for the provision of lifesaving cardiac care in settings ranging from the pre-hospital environment to the hospital setting. ... Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. ... Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). ... The cardiac action potential is the electrical activity of the individual cells of the electrical conduction system of the heart. ... Dronedarone (also known as SR33589) is a drug under development by Sanofi-Aventis, mainly for the indication of cardiac arrhythmias (irregular heartbeat). ... Tachycardia is an abnormally rapid beating of the heart, defined as a resting heart rate of over 100 beats per minute. ...

References

  1. ^ Siddoway LA. Amiodarone: Guidelines for Use and Monitoring. American Family Physician Dec. 1, 2003. (Full text)
  2. ^ Kudenchuk PJ, Cobb LA, Copass MK, Cummins RO, Doherty AM, Fahrenbruch CE, Hallstrom AP, Murray WA, Olsufka M, Walsh T. Amiodarone for resuscitation after out-of-hospital cardiac arrest due to ventricular fibrillation. N Engl J Med. 1999 September 16;341(12):871-8. (Medline abstract)
  3. ^ Guarnieri T, Nolan S, Gottlieb SO, Dudek A, Lowry DR. Intravenous amiodarone for the prevention of atrial fibrillation after open heart surgery: the Amiodarone Reduction in Coronary Heart (ARCH) trial. J Am Coll Cardiol. 1999 August;34(2):343-7. (Medline abstract)
  4. ^ British National Formulary guidance on thyroid function monitoring (BNF Amiodarone)

Otherwise known as the doctors prescribing Bible the British National Formulary (BNF) contains a wide spectrum of information on prescribing and pharmacology, among others indications, side effects and costs of the prescription of all medication drugs available on the National Health Service. ...

External links

  • Links to external chemical sources


Antiarrhythmic agents (C01B)edit
class Ia:

Ajmaline, Disopyramide, Prajmaline, Procainamide, Quinidine, Sparteine Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress fast rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. ... A section of the Anatomical Therapeutic Chemical Classification System. ... Ajmaline is a class Ia antiarrhythmic agent. ... Disopyramide (INN, trade names Norpace® and Rythmodan®) is an antiarrhythmic medication. ... Prajmaline is a class 1a antiarrhythmic agent. ... Procainamide (trade name Pronestyl®) is a pharmaceutical antiarrhythmic agent used for the medical treatment of cardiac arrhythmias, classified by the Vaughan Williams classification system as class Ia. ... Quinidine is a pharmaceutical agent that acts as a class I antiarrhythmic agent in the heart. ... Sparteine is a class 1a antiarrhythmic agent. ...

class Ib:

Aprindine, Lidocaine, Mexiletine, Tocainide Aprindine is a class 1b antiarrhythmic agent. ... Lidocaine (INN) (IPA: ) or lignocaine (former BAN) (IPA: ) is a common local anesthetic and antiarrhythmic drug. ... Mexiletine (INN, sold under the trade name Mexitil®) belongs to the Class IB anti-arrhythmic group of medicines. ... Tocainide is a class Ib antiarrhythmic agent. ...

class Ic:

Encainide, Flecainide, Lorcainide, Moricizine, Propafenone Encainide is a class Ic antiarrhythmic agent. ... Flecainide acetate is a class Ic antiarrhythmic agent used to prevent and treat tachyarrhythmias (abnormal fast rhythms of the heart). ... Lorcainide is a class 1c antiarrhythmic agent. ... Moricizine is used to treat a blood disorder (high platelet count) which can cause blood clots to form. ... Propafenone ( proe-pa-FEEN-none)(brand name Rythmol®) is a class Ic anti-arrhythmic medication. ...

class II:

Propranolol, Metoprolol, Nadolol, Atenolol, Acebutolol, Pindolol, Propranolol (INN) (IPA: ) is a non-selective beta blocker mainly used in the treatment of hypertension. ... Metoprolol is a beta blocker drug used in treatment of several diseases of the cardiovascular system. ... Nadolol (Corgard) is a non-selective beta-blocker used in the treatment of high blood pressure and chest pain. ... Atenolol is a drug belonging to the group of beta blockers, a class of drugs used primarily in cardiovascular diseases. ... Acebutolol is a beta blocker. ... Pindolol is a beta blocker drug. ...


see Beta blockers (C07) Beta blockers or beta-adrenergic blocking agents are a class of drugs used to treat a variety of cardiovascular conditions and some other diseases. ... A section of the Anatomical Therapeutic Chemical Classification System. ...

class III:

Amiodarone, Bretylium tosylate, Bunaftine, Dofetilide, Ibutilide, Sotalol Bretylium (also bretylium tosylate) blocks the release of noradrenaline from the peripheral sympathetic nervous system, and is used in emergency medicine, cardiology, & other specialties for the acute management of ventricular tachycardia & ventricular fibrilation. ... Bunaftine is a class III antiarrhythmic agent. ... Dofetilide is a class III antiarrhythmic agent that is approved by the FDA for the maintenance of sinus rhythm in individuals prone to the formation of atrial fibrillation and flutter, and for the chemical cardioversion to sinus rhythm from atrial fibrillation and flutter. ... Ibutilide (ibutilide fumarate) is a class III antiarrhythmic agent. ... Sotalol is a drug used in individuals with rhythm disturbances (cardiac arrhythmias) of the heart. ...

class IV:

Verapamil, Diltiazem see Calcium channel blockers (C08) Verapamil (brand names: Isoptin®, Verelan®, Calan®) is a medical drug that acts as an L-type calcium channel blocker. ... Diltiazem is a member of the group of drugs known as Benzothiapines , which are a class of calcium channel blockers, used in the treatment of hypertension, angina pectoris, and some types of arrhythmia. ... Calcium channel blockers are a class of drugs with effects on the muscle of the heart and the muscles of the rest of the body. ... A section of the Anatomical Therapeutic Chemical Classification System. ...

class V:

Adenosine, Atropine, Digoxin The chemical structure of adenosine Adenosine is a nucleoside comprised of adenine attached to a ribose (ribofuranose) moiety via a β-N9-glycosidic bond. ... Atropine is a tropane alkaloid extracted from the deadly nightshade (Atropa belladonna) and other plants of the family Solanaceae. ... Digoxin is a cardiac glycoside extracted from the foxglove plant, digitalis. ...


 
 

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