Abstract
Amiodarone, an iodinated benzofuran derivative, introduced in 1960s as an anti-anginal agent, emerged as a potent anti-arrhythmic agent by 1970s and is currently one of the most commonly prescribed drugs in US for ventricular and atrial arrhythmias. Although amiodarone is considered a class III anti-arrhythmic agent, it also has class I, II, IV actions, making it a unique and effective anti-arrhythmic agent. Because of its minimal negative inotropic activity and very low rate of pro-arrhythmia, it is considered safe in treating arrhythmias in patients with Coronary Artery Disease and Left ventricular systolic dysfunction. Despite these advantages, long-term oral therapy with amiodarone is limited by side effect profile involving various organs like thyroid, lung, heart, liver, skin etc. Though the side effects can be decreased significantly, by keeping the maintenance dose at 200 to 300 mg/day, patients on amiodarone should be followed closely. Amiodarone interacts with medications such as Warfarin, Digoxin, Macrolides, Floroquinolones etc., which share Cytochrome P450 metabolic pathway. Hence reducing their doses prior to starting amiodarone is recommended. Amiodarone, a category D drug, is contraindicated in pregnant and breast feeding women. This review discusses the pharmacokinetics of amiodarone, its evolving clinical indications, management of toxicity and drug interactions.
Keywords: Amiodarone, Atrial Fibrillation, Arrhythmias, Drug Toxicity, Ventricular Arrhythmias
Cardiovascular & Hematological Disorders-Drug Targets
Title: Amiodarone - A ‘Broad Spectrum’ Antiarrhythmic Drug
Volume: 10 Issue: 1
Author(s): Sujeeth R. Punnam, Sandeep K. Goyal, Veera Pavan K. Kotaru, Ajay R. Pachika, George S. Abela and Ranjan K. Thakur
Affiliation:
Keywords: Amiodarone, Atrial Fibrillation, Arrhythmias, Drug Toxicity, Ventricular Arrhythmias
Abstract: Amiodarone, an iodinated benzofuran derivative, introduced in 1960s as an anti-anginal agent, emerged as a potent anti-arrhythmic agent by 1970s and is currently one of the most commonly prescribed drugs in US for ventricular and atrial arrhythmias. Although amiodarone is considered a class III anti-arrhythmic agent, it also has class I, II, IV actions, making it a unique and effective anti-arrhythmic agent. Because of its minimal negative inotropic activity and very low rate of pro-arrhythmia, it is considered safe in treating arrhythmias in patients with Coronary Artery Disease and Left ventricular systolic dysfunction. Despite these advantages, long-term oral therapy with amiodarone is limited by side effect profile involving various organs like thyroid, lung, heart, liver, skin etc. Though the side effects can be decreased significantly, by keeping the maintenance dose at 200 to 300 mg/day, patients on amiodarone should be followed closely. Amiodarone interacts with medications such as Warfarin, Digoxin, Macrolides, Floroquinolones etc., which share Cytochrome P450 metabolic pathway. Hence reducing their doses prior to starting amiodarone is recommended. Amiodarone, a category D drug, is contraindicated in pregnant and breast feeding women. This review discusses the pharmacokinetics of amiodarone, its evolving clinical indications, management of toxicity and drug interactions.
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Cite this article as:
Punnam R. Sujeeth, Goyal K. Sandeep, Kotaru K. Veera Pavan, Pachika R. Ajay, Abela S. George and Thakur K. Ranjan, Amiodarone - A ‘Broad Spectrum’ Antiarrhythmic Drug, Cardiovascular & Hematological Disorders-Drug Targets 2010; 10 (1) . https://dx.doi.org/10.2174/187152910790780032
DOI https://dx.doi.org/10.2174/187152910790780032 |
Print ISSN 1871-529X |
Publisher Name Bentham Science Publisher |
Online ISSN 2212-4063 |
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