The antisympathetic action and the block of calcium and potassium channels are responsible for the negative dromotropic effects on the sinus node and for the slowing of conduction and prolongation of refractoriness in the atrioventricular (AV) node. Peak concentrations after 10-minute infusions of 150 mg intravenous amiodarone in patients with ventricular fibrillation (VF) or hemodynamically unstable ventricular tachycardia (VT) range between 7 and 26 mg/L. This inhibition can result in unexpectedly high plasma levels of other drugs which are metabolized by those CYP450 enzymes or are substrates for p-glycoprotein. Experience with thyroidectomy as a treatment for amiodarone-induced thyrotoxicosis is limited, and this form of therapy could induce thyroid storm. In clinical trials, after 48 hours of continued infusions (125,500 or 1000 mg/day) plus … Bradycardia and AV block may require temporary pacing. Additional 10-minute infusions of 150 mg intravenous amiodarone were given for "breakthrough" VT/VF more frequently to the 125 mg dose group, thereby considerably reducing the planned 8-fold differences in total dose to 1.8- and 2.6-fold, respectively, in the two studies.The prospectively defined primary efficacy end point was the rate of VT/VF episodes per hour. During or after treatment with Amiodarone Hydrochloride Injection, patients may be transferred to oral amiodarone therapy Use Amiodarone Hydrochloride Injection for acute treatment until the patient's ventricular arrhythmias are stabilized. Findings have included pulmonary infiltrates and masses on X-ray, bronchospasm, wheezing, fever, dyspnea, cough, hemoptysis, and hypoxia. The recommended starting dose of amiodarone is about 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:After the first 24 hours, continue the maintenance infusion rate of 0.5 mg/min (720 mg per 24 hours) utilizing a concentration of 1 to 6 mg/mL (Use a central venous catheter for amiodarone concentrations greater than 2 mg/mL). Nonmedicinal ingredients: hydrophobic colloidal silica, lactose monohydrate, magnesium stearate, and microcrystalline cellulose.
Amiodarone and DEA cross the placenta and both appear in breast milk. Pulmonary toxicity is a well-recognized complication of long-term amiodarone use (see package insert for oral amiodarone).Cases of optic neuropathy and optic neuritis, usually resulting in visual impairment, have been reported in patients treated with oral amiodarone. Amiodarone is not dialyzable.Amiodarone Hydrochloride Injection contains Amiodarone Hydrochloride (C25H29I2NO3•HCl), a class III antiarrhythmic drug. Monitor hepatic enzyme concentrations closely. Amiodarone inhibits CYP2D6.Cholestyramine increases enterohepatic elimination of amiodarone and may reduce its serum levels and t½.Disopyramide causes QT prolongation which could induce arrhythmia.Fluoroquinolones, macrolide antibiotics, and azoles are known to cause QTc prolongation. Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of irregular heartbeats. Manage hypothyroidism by reducing the amiodarone dose and considering the need for thyroid hormone supplement.
By Y. Bandaro. Get now! Reserve the combination of amiodarone with other antiarrhythmic therapies that prolong the QTc to patients with life-threatening ventricular arrhythmias who are incompletely responsive to a single agent.Fluoroquinolones, macrolide antibiotics, and azoles are known to cause QTc prolongation.
The action of antithyroid drugs may be especially delayed in amiodarone-induced thyrotoxicosis because of substantial quantities of preformed thyroid hormones stored in the gland. At the end of double-blind therapy or after 48 hours, all patients were given open access to whatever treatment (including intravenous amiodarone) was deemed necessary. Amiodarone Hydrochloride is (2-butyl-3-benzo-furanyl)[4-[2-(diethylamino)ethoxy]-3,5-diiodophenyl]methanone hydrochloride.Amiodarone Hydrochloride has the following structural formula:Amiodarone Hydrochloride is a white to slightly yellow crystalline powder, and is very slightly soluble in water. On the other hand, after intravenous amiodarone administration, there is evidence of activity well before significant concentrations of DEA are attained [see Clinical Studies(14)].Amiodarone exhibits complex disposition characteristics after intravenous administration. Seizure, associated with increased lidocaine concentrations, has been reported with concomitant administration of intravenous amiodarone.Dextromethorphan is a substrate for both CYP2D6 and CYP3A. In general, start at the low end of the dosing range in the elderly to reflect the greater frequency of decreased hepatic, renal, or cardiac function, and concomitant disease or other drug therapy.There have been cases, some fatal, of amiodarone overdose. This is especially important for drugs associated with serious toxicity, such as other antiarrhythmics. Amiodarone Hydrochloride Injection also can be used to treat patients with VT/VF for whom oral amiodarone is indicated, but who are unable to take oral medication. While only a limited number of in vivo drug-drug interactions with amiodarone have been reported, chiefly with the oral formulation, the potential for other interactions should be anticipated. Interpreting elevated AST activity can be difficult because the values may be elevated in patients who have had recent myocardial infarction, congestive heart failure, or multiple electrical defibrillations.
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