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Description of the medicine: Amiodaronum (Amiodaronum)

AMIODARON (Amiodaronum) *. [2-Butyl-3-benzofuranyl] - [4- (2-diethyl-aminoethoxy) -3, 5-diiodophenyl] ketone hydrochloride.

Synonyms: Cordaron, Palpitin, Аmjodaronum, Аngoron, Аtlansil, Сordaron, Сordinil, Рlpitin, Сеdacoron, Тrangorex, etc.

Amiodarone is the main representative of antiarrhythmic drugs of group III.

Amiodarone was originally proposed as a coronary-expanding (antianginal) agent for the treatment of chronic forms of IHD. In the future, its antiarrhythmic properties were identified and is currently widely used as a highly effective antiarrhythmic drug. However, as an antianginal agent, amiodarone did not lose value.

The antianginal effect of amiodarone is due in part to its antispasmodic (vasodilating) and antiadrenergic action. It has an inhibitory effect on the a and b-adrenergic receptors of the cardiovascular system, without causing their complete blockade. However, it increases the tone of the sympathetic nervous system. The drug reduces the resistance of the coronary vessels of the heart and increases coronary blood flow, reduces heart contractions, reduces the need for myocardium in oxygen, helps increase myocardial energy reserves (increases the content of creatinine sulfate, adenosine and glycogen). It slightly lowers peripheral vascular resistance and systemic blood pressure.

Unlike drugs that completely block β-adrenergic receptors, amiodarone has practically no negative inotropic effect.

Like a number of other antianginal drugs that have antiadrenergic activity to one degree or another, amiodarone decreases the sensitivity to hyperstimulation of the sympathetic nervous system.

The drug has a pronounced effect on the electrophysiological processes of the myocardium. It significantly lengthens the action potential of cardiomyocytes and, thus, increases the effective refractory period of the atria, ventricles, atrioventricular node, His bundle and Purkinje fibers, as well as additional ways of conducting excitation. It is also able to inhibit the slow (diastolic) depolarization of the membrane of the cells of the sinus node and other cardiomyocytes and directly affect the automatism of the heart. These and other properties of amiodarone, which determine its high efficiency in various types of arrhythmias, made it possible to isolate it in a special (III) group of antiarrhythmic drugs.

Amiodarone is slowly absorbed when taken orally. It is detected in the blood after 1/2 - 4 hours. The maximum concentration in the blood is observed after 5 - 6 hours.

It is eliminated from the body extremely slowly, the half-life is 30 days or more. With continuous use, the drug accumulates in the body (cumulation).

The therapeutic effect usually occurs within a few days from the start of administration and reaches a maximum after 2 to 4 weeks. At high doses, the effect may occur faster.