Amiodaronum

General characteristics. Structure:

Active ingredient: 50 mg of Amiodaronum in 1 ml of solution.

The drug having antiarrhytmic, anti-anginal effect.

Pharmacological properties:

Pharmacodynamics. Blocks ion channels (mainly potassium, to a lesser extent — calcic and sodium) membranes of cardiomyocytes, slows down excitement alpha and beta adrenoceptors. Increases duration of action potential of all cordial structures due to the expressed decrease in its amplitude. Has negative chronotropic influence. Sympatholytic activity and blockade of potassium and calcium channels reduce the need of a myocardium for oxygen, result in negative dromotropic effect: conductivity is slowed down and the refractory period in sinus and AV nodes is extended. Having property of a vazodilatator, can reduce resistance of coronary vessels.

Pharmacokinetics. Bioavailability after intake makes nearly 50%. Cmax is reached in plasma in 3–7 h after reception of the first dose, average concentration in plasma makes from 1 to 2,5 mg/l. Linkng with proteins of plasma — 96%. Has ability to the expressed accumulation, collects in well perfusing bodies (a liver, lungs and a spleen) and it is deposited in fatty tissue. Breaks a placental barrier (10–50%) and gets into breast milk. The main way of allocation — through bile (insignificant enteropechenochny recirculation can take place). Has low plasma clearance with insignificant renal excretion.

Indications to use:

Heavy arrhythmias (as a rule, at inefficiency or impossibility of other therapy): atrial and ventricular premature ventricular contraction, WPW syndrome, trembling and atrial fibrillation, ventricular tachycardia, fibrillation of ventricles; arrhythmias against the background of coronary or heart failure, ventricular arrhythmias at patients with Shagas's myocarditis.

Route of administration and doses:

In/in, the sating dose — 5 mg/kg in within 15 min. on 2–3 times a day, a maintenance therapy — 10–20 mg/kg/days (250 ml of 5% of aqueous solution).

Inside, from 100 to 400 mg/days (the maximum dose — 600 mg/days) in techeniye8-10 days, the break — 2 days a week is possible.

Features of use:

Use at pregnancy and feeding by a breast. Category of action on a fruit on FDA — D.

ECG control is obligatory. It is not recommended to combine with beta adrenoblockers, verapamil, diltiazem, the laxatives stimulating motility of a GIT. With care combine with the drugs causing a hypopotassemia (diuretics, corticosteroids, Amphotericinum In for in/in introductions), and appoint the patient with heavy and long diarrhea.

At prolonged treatment observation of the oculist, regular control of function of a thyroid gland, radiological control of lungs is necessary.

Side effects:

Retina microamotio, an optic neuritis, hyper - (drug withdrawal is required) or a hypothyroidism, a pneumosclerosis, a pneumonitis, pleurisy, a bronchiolitis, pneumonia, peripheral neuropathies and/or myopathies, an extrapyramidal tremor, an ataxy, craniocereberal hypertensia, nightmares, bradycardia, an asystolia, AV blockade, nausea, vomiting, an abnormal liver function, an alopecia, an epididymite, anemia, a photosensitization, allergic reactions.

Interaction with other medicines:

Beta adrenoblockers increase risk of developing of hypotension and bradycardia. It is incompatible with BKK (the probability of development of AV of blockade and hypotension increases). Colestyraminum reduces T1/2 and level of Amiodaronum in plasma, Cimetidinum — increases. Strengthens effect of indirect anticoagulants, foxglove drugs. Increases concentration of cyclosporine in blood.

Contraindications:

Hypersensitivity (including to iodine), a sinus bradycardia, AV blockade, a syndrome of sinus insufficiency, the expressed conductivity disturbances, cardiogenic shock, dysfunction of a thyroid gland.

Overdose:

Symptoms: bradycardia, the expressed decrease in the ABP, AV blockade, electromechanical dissociation, cardiogenic shock, an asystolia, a cardiac standstill.

Storage conditions:

To store at a temperature of 15-25 °C, in dry, protected from light and the place, unavailable to children. Period of validity 3 years. Not to use after the expiry date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Solution for injections of 50 mg/ml, on 3 ml in each ampoule. On 5 or on 10 ampoules, together with the application instruction in cardboard packaging.