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Amiodarone is an antiarrhythmic medication used to treat and prevent a number of types of cardiac dysrhythmias. [4] This includes ventricular tachycardia, ventricular fibrillation, and wide complex tachycardia, atrial fibrillation, and paroxysmal supraventricular tachycardia. [4]
Class I agents interfere with the sodium (Na +) channel. Class II agents are anti-sympathetic nervous system agents. Most agents in this class are beta blockers. Class III agents affect potassium (K +) efflux. Class IV agents affect calcium channels and the AV node. Class V agents work by other or unknown mechanisms.
Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm. Amiodarone prolongation of the action potential is uniform over a wide range of heart rates, so this drug does not have reverse use-dependent action. Amiodarone was the first agent described in this class. [4]
Amiodarone induced thyrotoxicosis (AIT) is a form of hyperthyroidism due to treatment with antiarrhythmic drug, amiodarone. Amiodarone induced thyroid dysfunction more commonly results in hypothyroidism , estimated to occur in 6-32% of patients, whereas hyperthyroidism from amiodarone use is estimated at 1-12%. [ 1 ]
Amiodarone, while primarily blocking the human Ether-a-go-go-Related Gene potassium channel, has shown to significantly reduce persistent sodium current by 50% in cortical neurons [14] as well as in cardiac sodium channel NaV1.5 and is used to treat arrhythmia. [15]
Budiodarone (ATI-2042) is an antiarrhythmic agent and chemical analog of amiodarone that is currently being studied in clinical trials.Amiodarone is considered the most effective antiarrhythmic drug available, [1] [2] [3] but its adverse side effects, including hepatic, pulmonary and thyroid toxicity as well as multiple drug interactions, [4] are discouraging its use.
Celivarone is a non-iodinated benzofuran derivative, structurally related to amiodarone, a drug commonly used to treat arrhythmias. [1] Celivarone has potential as an antiarrhythmic agent, attributable to its multifactorial mechanism of action; blocking Na +, L-type Ca 2+ and many types of K + channels (I Kr, I Ks, I KACh and IK v 1.5), as well as inhibiting β 1 receptors, all in dose ...
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