Description medications: Amiodarone (Amiodaronum)
Amiodarone (Amiodaronum) *. [2-Butyl-3-benzofuranyl] - [4- (2-diethyl-aminoethoxy) -3, 5-diyodfenil] ketone hydrochloride.
Synonyms: Cordarone, Palpitin, Amjodaronum, Angoron, Atlansil, Sordaron, Sordinil, Ralpitin, Sedacoron, Trangorex and others.
Amiodarone is the main representative of the group III antiarrhythmic drugs.
Initially, amiodarone has been proposed as koronarorasshiryayuschego (antianginal) for the treatment of chronic ischemic heart disease forms. Subsequently, it was revealed antiarrhythmic properties and currently it is widely used as a highly effective anti-arrhythmic drug. However, as the antianginal agent amiodarone values are not lost.
Antianginal effect of amiodarone is partly due to its antispasmodic (vasodilator) and antiadrenergicheskim action. He has an inhibiting effect on the a and b-adrenergic receptors of the cardiovascular system without causing complete their blockade. At the same time it increases the tone of the sympathetic nervous system. The drug reduces the resistance of the coronary arteries and increase coronary blood flow, heart rate slows, reduces myocardial oxygen demand, increases the energy reserves of the myocardium (increases levels of creatinine, adenosine and glycogen). He slightly lowers peripheral vascular resistance and systemic blood pressure.
Unlike drugs that completely block the b-adrenergic receptors, amiodarone virtually no negative inotropic action.
Like a number of other antianginal drugs with a greater or lesser degree antiadrenergicheskim activity, amiodarone reduces sensitivity to hyperstimulation of the sympathetic nervous system.
The drug has a pronounced effect on the electrophysiological processes of the myocardium. It significantly prolongs the action potential of cardiomyocytes and thus increases the effective refractory period of atrial, ventricular, atrioventricular node, bundle of His and the Purkinje fibers, as well as additional ways of excitation. He is also able to slow down slow (diastolic) depolarization of the membrane of the sinus node cells and other cardiomyocytes and directly affect the cardiac automatism. These and other properties of amiodarone, defining its high efficiency for different types of arrhythmias, gave grounds to allocate it in a special (III) group of antiarrhythmic drugs.
Amiodarone when administered slowly absorbed. Detected in the blood after 1.2 - 4 h. The maximum blood concentration is observed after 5 - 6 hours.
Report from the body very slowly, half-life of 30 days or more. With continuous use of the drug accumulates in the body (accumulation).
The therapeutic effect usually occurs within a few days from the start of the reception and reaches a maximum after 2 - 4 weeks. At high doses, the effect can occur more quickly.