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A chest X-ray demonstrating pulmonary fibrosis due to amiodarone. Side effects of oral amiodarone at doses of 400 mg or higher include various pulmonary effects. [44] The most serious reaction is interstitial lung disease. Risk factors include high cumulative dose, more than 400 milligrams per day, duration over two months, increased age, and ...
Amiodarone has both direct and indirect effects on thyroid function. The most notable indirect thyroid altering property is that the drug is approximately one-third iodine by weight. As a result, amiodarone therapy elevates free circulating iodine levels up to 40 times greater than the iodine intake from the average American diet. [2]
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]
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.
Amiodarone is frequently used in the short term in children experiencing JET following heart surgery, although propanolol, flecainide and propafenone are more commonly recommended for long term use due to the frequency of side effects associated with amiodarone.
Khellin, a chemical compound obtained from Visnaga daucoides, was used at one time as a smooth muscle relaxant, but its use is now limited due to adverse side effects. [10] Amiodarone and cromoglycate are synthetic derivatives of khellin with fewer side effects which were developed for use in modern medicine. [medical citation needed]
Dronedarone has been termed a "multichannel blocker". [citation needed] However, it is unclear which channel(s) play a pivotal role in its success. [9]Thus, dronedarone's actions at the cellular level are controversial, with most studies suggesting an inhibition in multiple outward potassium currents including rapid delayed rectifier, slow delayed rectifier and ACh-activated inward rectifier. [10]
Amphotericin B — used for life-threatening fungal infections and primary amoebic meningoencephalitis; [3] its side effects are often severe or potentially fatal. Carbapenems (such as imipenem/cilastatin) — used as a drug of last resort for a variety of different bacterial infections.
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