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Sample records for amiodarone

  1. Treatment with Amiodaron

    DEFF Research Database (Denmark)

    Adelborg, Kasper; Ebbehøj, Eva; Nielsen, Jens Cosedis;

    2014-01-01

    Amiodarone is an effective antiarrhythmic drug for supra-ven-tri-cular and ventricular arrhythmias. A majority of patients treated with amiodarone suffer from mild adverse events, however, serious life-threatening adverse events caused by amiodarone are also seen. This review describes the...... pharmacology, interac-tions, side and adverse effects of amiodarone and highlights the importance of a systematic interdisciplinary follow-up protocol for outpatients treated with amiodarone....

  2. Behandling med amiodaron

    DEFF Research Database (Denmark)

    Adelborg, Kasper; Ebbehøj, Eva; Nielsen, Jens Cosedis;

    2015-01-01

    Amiodarone is an effective antiarrhythmic drug for supra­ven­tri­cular and ventricular arrhythmias. A majority of patients treated with amiodarone suffer from mild adverse events, however, serious life-threatening adverse events caused by amiodarone are also seen. This review describes the...... pharmacology, interac­tions, side and adverse effects of amiodarone and highlights the importance of a systematic interdisciplinary follow-up protocol for outpatients treated with amiodarone....

  3. Hepatotoxicity of amiodarone

    DEFF Research Database (Denmark)

    Rumessen, J J

    1986-01-01

    Amiodarone has proved very effective in the treatment of otherwise resistant cardiac tachyarrhythmias. The use of amiodarone has, however, been limited due to its serious side-effects. A patient with cholestatic hepatitis due to amiodarone treatment is presented below and a review of the...... hepatotoxicity of amiodarone is given. It is concluded that solid evidence exists of hepatic injury due to amiodarone treatment, including steatosis, alterations resembling alcoholic hepatitis, cholestatic hepatitis and micronodular cirrhosis of the liver. Patients receiving amiodarone should be regularly...

  4. Amiodarone-Induced Thyrotoxicosis Recurrence After Amiodarone Reintroduction.

    Science.gov (United States)

    Maqdasy, Salwan; Batisse-Lignier, Marie; Auclair, Candy; Desbiez, Françoise; Citron, Bernard; Thieblot, Philippe; Roche, Béatrice; Lusson, Jean René; Tauveron, Igor

    2016-04-01

    Reintroduction of amiodarone in patients with a history of amiodarone-induced thyrotoxicosis (AIT) is rarely used. To date, the risk of AIT recurrence after amiodarone reintroduction is unpredicted. The aim of the study was to evaluate the risk of AIT recurrence. Retrospectively, from 2000 to 2011, all euthyroid patients with a history of AIT with amiodarone reintroduction were included. Type and severity of the first AIT, amiodarone chronology, and thyroid function evolution after reintroduction of amiodarone were investigated: 46 of 172 patients with AIT history needed amiodarone reintroduction. At first AIT episode, the mean age was 62.2 ± 16 years with male gender predominance; 65% of patients were classified as type 1 AIT. AIT recurred in 14 patients (30%), 12 patients developed hypothyroidism (26%), and 20 patients remained euthyroid (44%). Characteristics of type 1 AIT during the first episode, namely briefer exposure period to amiodarone and longer duration of treatment to normalize thyroid hormones, were predictive of AIT recurrence; 73% of patients (8 of 11) with previous episode of type 1 AIT, who did not receive a preventive thioamide treatment, developed a second episode of AIT. Thioamide preventive treatment could be useful to prevent type 1 AIT recurrence. In conclusion, AIT recurrence after amiodarone reintroduction is 4 times more frequent in patients with type 1 AIT history. Thyroid ablation before amiodarone reintroduction in patients with a history of type 1 AIT is preferred. Preventive thioamide treatment could be suggested in patients with type 1 AIT history pending for surgery. PMID:26853955

  5. Amiodarone and thyroid

    NARCIS (Netherlands)

    S.A. Eskes; W.M. Wiersinga

    2009-01-01

    Assessment of TSH and TPO-Ab before starting amiodarone (AM) treatment is recommended The usefulness of periodic TSH measurement every 6 months during AM treatment is limited by the often sudden explosive onset of AIT, and the spontaneous return Of a Suppressed TSH to not mal values in half of the c

  6. Compound list: amiodarone [Open TG-GATEs

    Lifescience Database Archive (English)

    Full Text Available amiodarone AM 00033 ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Human/in..._vitro/amiodarone.Human.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vit...ro/amiodarone.Rat.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vivo/Live...r/Single/amiodarone.Rat.in_vivo.Liver.Single.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates

  7. Amiodarone -- waxed and waned and waxed again.

    Science.gov (United States)

    Doggrell, S A

    2001-11-01

    Amiodarone has been used as an anti-arrhythmic drug since the 1970s and has an established role in the treatment of ventricular tachyarrhythmias. Although considered to be a class III anti-arrhythmic, amiodarone also has class I, II and IV actions, which gives it a unique pharmacological and anti-arrhythmic profile. Amiodarone is a structural analogue of thyroid hormone and some of its anti-arrhythmic properties and toxicity may be attributable to interactions with nuclear thyroid hormone receptors. The lipid solubility of amiodarone gives it an exceptionally long half-life. Oral amiodarone takes days to work in ventricular tachyarrhythmias, but iv. amiodarone has immediate effect and can be used in life threatening ventricular arrhythmias. Intravenous amiodarone administered after out-of-hospital cardiac arrest due to ventricular fibrillation improves survival to hospital admission. Many survivors of myocardial infarction (MI) die during the subsequent year, probably due to ventricular arrhythmia. Amiodarone reduces sudden death after MI and this benefit is predominantly observed in patients with preserved cardiac function. Sudden cardiac death, predominantly due to ventricular arrhythmias, is also commonly seen in patients with heart failure. The Grupo de Estudio de la Sobrevida en lsuficiencia Cardiaca en Argentina (GESICA) and Estudio Piloto Argentino de Muerte Subita y Amiodarona (EPAMSA) trials showed survival benefit of amiodarone in heart failure, whereas Congestive Heart Failure-Survival Trial of Anti-arrhythmic Therapy (CHF-STAT) did not. Subsequent meta-analysis established a survival benefit of amiodarone in heart failure. Implanted Cardioverter Def ibrillators (ICDs) also give survival benefit to patients at risk of sudden death. In patients with a history of ventricular fibrillation or haemodynamically-compromising ventricular tachycardia, ICDs have been shown to be superior to anti-arrhythmic drugs, principally amiodarone. Further analysis has been

  8. Acute pancreatitis and amiodarone: A case report

    Institute of Scientific and Technical Information of China (English)

    Yen-Yuan Chen; Ching-Yu Chen; Kai-Kuen Leung

    2007-01-01

    Amiodarone, a class m antiarrhythmic drug, is one of the most effective drugs used in the treatment of ventricular and paroxysmal supraventricular tachyarrhythmia. Adverse effects of amiodarone including pulmonary toxicity, hepatotoxicity, aggravation of arrhythmia, and thyroid diseases are well understood. A 66-year old woman with acute pancreatitis was admitted to our hospital with the complaint of epigastralgia radiating to both flanks for two months. Her symptoms and elevation of pancreatic enzymes did not respond to conventional medical treatment of pancreatitis for 18 d. No known causal factors for pancreatitis such as biliary tract stone, hypertriglyceridemia and alcohol consumption could be identified. Under the suspicion of amiodarone-induced acute pancreatitis, amiodarone was substituted by propafenone. Her symptoms soon alleviated and serum lipase level declined. Three months after hospital discharge, the abdominal pain did not recur. Amiodarone was approved to treat recurrent ventricular fibrillation or sustained ventricular tachyarrhythmia that has been resistant to other medications since 1986. Pancreatitis is a very rare adverse effect associated with the use of amiodarone, and only four cases of amiodarone-induced pancreatitis have been reported in literature. We report a patient who developed acute pancreatitis during amiodarone therapy.

  9. [Complications of low-dose amiodarone].

    Science.gov (United States)

    Feigl, D; Gilad, R; Katz, E

    1991-11-15

    Complications of low-dose amiodarone in 83 patients, in whom the drug was effective and who were followed for 1-13 years, are presented. Hypothyroidism was diagnosed in 11 (in 8 by the finding of elevated TSH). In 2 of the 3 in whom clinical signs of hypothyroidism were evident, amiodarone was continued, but thyroxine was also given. In 5 others thyrotoxicosis ensued. Propylthiouracil (PTU) was given and amiodarone was discontinued. PTU was then stopped within 4-8 months, without recurrence of the hyperthyroidism. In 1 patient pneumonitis resolved spontaneously a few weeks after stopping amiodarone. Because of gastrointestinal distress amiodarone was stopped in 1 patient. In none were liver enzymes elevated, nor was the nervous system affected clinically. Photosensitivity in 6 patients and skin discoloration in 2 did not necessitate discontinuation of the drug. Blurred vision was reported by 4, but its connection with amiodarone was not proven. There was sinus bradycardia in 2. There was no arrhythmic effect of amiodarone seen on ECG nor on Holter monitoring, nor was there any mortality. We conclude that amiodarone in low doses causes many complications, most of them mild and transient. However, in only a few cases is discontinuation of the drug indicated. PMID:1752553

  10. Anticonvulsant and hypnotic effects of amiodarone

    Institute of Scientific and Technical Information of China (English)

    Gunnur OZBAKIS-DENGIZ; Aysegul BAKIRCI

    2009-01-01

    Amiodarone hydrochloride is a potent anti-arrhythmic agent, known as a multiple ion-channel blocker in the heart.Although it has been detected in the rat brain, there are no data related to its central nervous system (CNS) effects. In this study, we evaluated anticonvulsant and hypnotic effects of amiodarone. Convulsions were induced by phentylenetetrazole (PTZ) (100 mg/kg) or caffeine (300 mg/kg) in mice. In both models, amiodarone prolonged both latency period and time to death, and acted as an anticonvulsant drug. It was found to be more effective in the PTZ model than in the caffeine model; none of the animals treated with 150 mg/kg dose amiodarone had died in the PTZ model. For hypnotic effect, sleeping was induced with pentobarbital (35 mg/kg) in rats. Amiodarone dose-dependently increased the sleeping time (677.7%~725.9%). In the sleeping test, all rats in 200 mg/kg amiodarone group died. In conclusion, anticonvulsant and hypnotic effects of amiodarone have shown the depressant effects on CNS. These effects may be dependent on its pharmacological properties.

  11. Amiodaron: Effektivität und Sicherheit

    Directory of Open Access Journals (Sweden)

    Hofmann R

    2009-01-01

    Full Text Available Aufgrund neutraler Nettoeffekte auf Herz-Kreislaufparameter hat sich Amiodaron wie kein konventionelles oder neu entwickeltes Antiarrhythmikum zur Behandlung verschiedener Tachyarrhythmien bewährt. Intravenöses Amiodaron ist guidelinekonform das Antiarrhythmikum der Wahl zur Behandlung von bedrohlichen ventrikulären Tachyarrhythmien. Patienten mit hoher Ventrikelfrequenz bei Vorhofflimmern profitieren von einer unmittelbaren Frequenzkontrolle sowie einem Potenzial zur Kardioversion ohne wesentliche Kompromittierung der Hämodynamik. Orales Amiodaron hat eine symptomatische Bedeutung bei Patienten mit ventrikulären Arrhythmien, eine Beeinflussung der Prognose konnte nicht nachgewiesen werden. Bei Patienten mit nichtpermanentem Vorhofflimmern ist Amiodaron das wirksamste Antiarrhythmikum und vor allem bei bestehender Herzinsuffizienz die einzige medikamentöse Option. Die Inzidenz klinisch relevanter Nebenwirkungen wurde historisch überbewertet und reduziert sich abgesehen von Einzelfällen auf Haut- und funktionelle Schilddrüsenveränderungen.

  12. Amiodarone

    Science.gov (United States)

    ... E.S., E-Mycin, Erythrocin); fluoroquinolone antibiotics such as ciprofloxacin (Cipro), levofloxacin (Levaquin), lomefloxacin (not available in the ... your doctor immediately or get emergency medical treatment: rash weight loss or gain restlessness weakness nervousness irritability ...

  13. Amiodarone Induced Morphological Changes in Rabbit Pneumocytes

    Directory of Open Access Journals (Sweden)

    Fereshteh Mehraein

    2009-01-01

    Full Text Available Objective: Amiodarone as an iodinated benzofuran derivative is a potent antiarrhythmicagent currently used for the treatment of ventricular arrhythmias. Pulmonary toxicityis one of the complications of Amiodarone therapy. The aim of this study was todetermine the toxicity of Amiodarone for pneumocytes.Materials and Methods: 14 male white New Zealand rabbits were divided in a controlgroup and an experimental group. The experimental group was subjected to intraperitoneal injection with a single daily dose of 80 mg/kg Amiodarone for two weeks.The control group received only normal saline. At the end of the injection period, thetwo groups were anesthetized and perfused with Karnovsky fixative. The lung tissuewas removed and fixed, then prepared for light and electron microscope studies.Morphometric studies were made on sections to find nucleus profile dimensions.Results: Light microscope observation showed acute changes in the alveolus includingcongestion of alveolar capillaries and infiltration of red blood cells (RBCs intothe lumen of the alveoli. Electron microscope study of lung tissue revealed abnormalinclusion bodies within type ΙΙ & Ι pneumocytes. The micrographs also showedthe presence of vacuoles in 5% of the type ΙΙ pneumocytes. Morphometric studiesshowed that the nucleus of the cells in the experimental group were smaller than inthe control group (p<0.01.Conclusion: These results indicate that Amiodarone administration can cause damageto pnuemocytes and the alveolus of rabbit lung, so the effectiveness of Amiodaronein long term treatment of heart failure patients is limited because of the developmentof lung toxicity.

  14. Amiodarone Pulmonary, Neuromuscular and Ophthalmologic Toxicity

    Directory of Open Access Journals (Sweden)

    Karen EA Burns

    2000-01-01

    Full Text Available Amiodarone is an iodinated benzofuran derivative class III antiarrhythmic that is highly effective in suppressing ventricular and supraventricular arrhythmias. It is also associated with an imposing side effect profile, which often limits its use. Numerous adverse effects have been documented including skin discolouration, photosensitivity, hepatitis, thyroid dysfunction, corneal deposits, pulmonary fibrosis, bone marrow suppression and drug interactions. These side effects are thought to be correlated with the total cumulative dose of amiodarone, but idiopathic reactions have been reported. The majority of adverse reactions resolve with discontinuation of the drug; however, rapid progression may occur, which may be fatal. The present report documents a patient who had a combination of serious amiodarone toxicities that, once recognized, were treated and eventually resulted in a good outcome.

  15. Tissue distribution of amiodarone and desethylamiodarone in rats after multiple intraperitoneal administration of various amiodarone dosages.

    Science.gov (United States)

    Plomp, T A; Wiersinga, W M; Maes, R A

    1985-01-01

    Tissue distribution of amiodarone (Cordarone) and desethylamiodarone in the rat was studied after repeated intraperitoneal administration of the drug. Tissue and serum concentrations of amiodarone and desethylamiodarone were determined by high-performance liquid chromatography. The levels of amiodarone and desethylamiodarone in serum and tissues obtained after repeated intraperitoneal application of doses varying from 25 mg to 200 mg/kg show that the accumulation of amiodarone and desethylamiodarone in the rat is dose-dependent and both drugs are preferentially distributed in decreasing order in adipose tissue, lung, liver, kidney and thyroid gland. The penetration of the drug and its metabolite into brain was poor and with all the applied dosages brain levels were considerably lower than the corresponding serum levels. Desethylamiodarone serum and tissue concentrations were substantially lower than the corresponding amiodarone concentrations and varied from 1 to 48% (mean 15%) depending on the dosage used and the kind of tissue. The amiodarone tissue/serum concentration ratios were exceptionally high in adipose tissue (1,000-4,000) and moderate to high in the other tissues except brain (5-90), and indicate an extensive distribution of the drug with fat as a reservoir with a large storage capacity. The levels of amiodarone and desethylamiodarone, obtained with 50 mg/kg and 100 mg/kg dosages, showed in function of time clearly an increase in serum and tissues. The observed amiodarone tissue/serum ratios in function of time revealed no further significant increase (p less than or equal to 0.05) after 3 injections over a 6-day period, indicating the attainment of "steady-state".(ABSTRACT TRUNCATED AT 250 WORDS) PMID:4039141

  16. Amiodarone-induced pulmonary toxicity mimicking acute pulmonary edema.

    Science.gov (United States)

    Fabiani, Iacopo; Tacconi, Danilo; Grotti, Simone; Brandini, Rossella; Salvadori, Claudia; Caremani, Marcello; Bolognese, Leonardo

    2011-05-01

    Amiodarone is a highly effective antiarrhythmic drug. Its long-term use may, however, lead to several adverse effects, with pulmonary toxicity being the most serious. The article presents the case of a 78-year-old woman with a history of cardiac surgery, who after 2 years of amiodarone therapy for prophylactic treatment of atrial fibrillation developed amiodarone pneumonitis mimicking an acute pulmonary edema. The patient failed to respond to diuretic therapy and several courses of anti-infective therapy. Differential diagnosis of different causes of pulmonary infiltrates did not demonstrate any other abnormality. Lung biopsy findings were consistent with the diagnosis of amiodarone pneumonitis. Given the widespread use of amiodarone as an antiarrhythmic agent, pneumologists and cardiologists should consider this important adverse effect as a differential diagnosis of pulmonary distress refractory to therapy in all patients treated with amiodarone who present with respiratory symptoms and pneumonia-like illness. PMID:19924000

  17. Amiodarone: review of pulmonary effects and toxicity.

    Science.gov (United States)

    Papiris, Spyros A; Triantafillidou, Christina; Kolilekas, Likurgos; Markoulaki, Despoina; Manali, Effrosyni D

    2010-07-01

    Amiodarone, a bi-iodinated benzofuran derivative, is, because of its high effectiveness, one of the most widely used antiarrhythmic agents. However, adverse effects, especially potentially fatal and non-reversible acute and chronic pulmonary toxicity, continue to be observed. This review provides an update of the epidemiology, pathophysiology, clinical presentation, treatment and outcome of amiodarone pulmonary effects and toxicity. Lung adverse effects occur in approximately 5% of treated patients. The development of lung complications appears to be associated with older age, duration of treatment and cumulative dosage, high levels of its desethyl metabolite, history of cardiothoracic surgery and/or use of high oxygen mixtures, use of iodinated contrast media, and probably pre-existing lung disease as well as co-existing respiratory infections. Amiodarone-related adverse pulmonary effects may develop as early as from the first few days of treatment to several years later. The onset of pulmonary toxicity may be either insidious or rapidly progressive. Cough, new chest infiltrates in imaging studies and reduced lung diffusing capacity in the appropriate clinical setting of amiodarone use, after the meticulous exclusion of infection, malignancy and pulmonary oedema, are the cardinal clinical and laboratory elements for diagnosis. Pulmonary involvement falls into two categories of different grades of clinical significance: (i) the ubiquitous 'lipoid pneumonia', the so-called 'amiodarone effect', which is usually asymptomatic; and (ii) the more appropriately named 'amiodarone toxicity', which includes several distinct clinical entities related to the differing patterns of lung inflammatory reaction, such as eosinophilic pneumonia, chronic organizing pneumonia, acute fibrinous organizing pneumonia, nodules or mass-like lesions, nonspecific interstitial pneumonia-like and idiopathic pulmonary fibrosis-like interstitial pneumonia, desquamative interstitial pneumonia

  18. Drug induced lung disease - amiodarone in focus

    Directory of Open Access Journals (Sweden)

    Vasić Nada R.

    2014-01-01

    Full Text Available More than 380 medications are known to cause pulmonary toxicity. Selected drugs that are important causes of pulmonary toxicity fall into the following classes: cytotoxic, cardiovascular, anti-inflammatory, antimicrobial, illicit drugs, miscellaneous. The adverse reactions can involve the pulmonary parenchyma, pleura, the airways, pulmonary vascular system, and mediastinum. Drug-induced lung diseases have no pathognomonic clinical, laboratory, physical, radiographic or histological findings. A drug-induced lung disease is usually considered a diagnosis of exclusion of other diseases. The diagnosis of drug-mediated pulmonary toxicity is usually made based on clinical findings. In general, laboratory analyses do not help in establishing the diagnosis. High-resolution computed tomography scanning is more sensitive than chest radiography for defining radiographic abnormalities. The treatment of drug-induced lung disease consists of immediate discontinuation of the offending drug and appropriate management of the pulmonary symptoms. Glucocorticoids have been associated with rapid improvement in gas exchange and reversal of radiographic abnormalities. Before starting any medication, patients should be educated about the potential adverse effects of the drug. Amiodarone is an antiarrhythmic agent used in the treatment of many types of tachyarrhythmia. Amiodarone-caused pulmonary toxicity is a well-known side effect (complication of this medication. The incidence of amiodarone-induced lung disease is approximately 5-7%.

  19. Chronic amiodarone remodels expression of ion channel transcripts in the mouse heart

    Institute of Scientific and Technical Information of China (English)

    S.LEBOUTER; A.ELHARCHI; C.MARIONNEAU; C.BELLOCQ; A.CHAMBELLAN; K.LEQUANG; JCBELLOCQ; JCCHEVALIER; GLANDE; JJLEGER; FCHARPENTIER; DESCANDE; SDEMOLOMBE

    2004-01-01

    AIM: The basis for the unique effectiveness of chronic amiodarone on cardiac arrhythmias is incompletely understood. The present study investigated the pharmacogenomics profile of amiodarone on genes encoding ion channel subunits. METHODS AND RESULTS: Adult male mice were treated for 6 weeks with vehicle or oral amiodarone at 30,90,or 180 mg·kg-1·d-1, Plasma and myocardial levels of amiodarone and n-desethyl-amiodarone in

  20. Inhibition of intermediary metabolism by amiodarone in dog thyroid slices

    Energy Technology Data Exchange (ETDEWEB)

    Pasquali, D.; Tseng, F.Y.; Rani, C.S.; Field, J.B. (Baylor College of Medicine, Houston, TX (USA))

    1990-10-01

    Amiodarone, an iodine-containing antiarrhythmic drug, has been reported to interfere with thyroid function and thyroid hormone metabolism. We studied the effects of amiodarone on basal and agonist (thyroid-stimulating hormone (TSH), phorbol ester, or carbachol)-stimulated glucose oxidation, 32PO4 incorporation into phospholipids, and adenosine 3',5'-cyclic monophosphate (cAMP) concentration in dog thyroid slices. Slices were preincubated with amiodarone at 37 degrees C for 1 h before the addition of agonist and the appropriate radioisotope. cAMP stimulation was measured after 20 min, glucose oxidation for 45 min, and 32PO4 incorporation into phospholipids for 2 h. Amiodarone (0.5 mM) had no effect on basal 14CO2 formation or 32PO4 incorporation into phospholipids but significantly inhibited TSH, phorbol ester, and carbachol stimulation of these parameters. It also inhibited cAMP stimulation by TSH. Inhibition of TSH-stimulated (14C)glucose oxidation was also obtained with another iodide-containing compound, iopanoic acid (0.5 mM), but not with iothalamate (up to 10 mM). Inhibition by amiodarone was still present, but to a lesser extent, when it was added at the same time as the agonist. Inhibition of stimulated (14C)glucose oxidation persisted even after the slices were incubated without amiodarone for 6 h. Inhibition by amiodarone, in contrast to that by inorganic iodide, was not prevented by 1 mM methimazole added at the same time as amiodarone. These results indicate that the inhibitory effects of amiodarone on thyroid function are not due to dissociation of iodide from the molecule.

  1. Electrophysiological effects of dronedarone (SR 33589), a noniodinated amiodarone derivative in the canine heart: comparison with amiodarone

    OpenAIRE

    Varró, András; Takács, János; Németh, Miklós; Hála, Ottó; Virág, László; Iost, Norbert; Baláti, Beáta; Ágoston, Márta; Vereckei, András; Pastor, Gilbert; Delbruyère, Martine; Gautier, Patrick; Nisato, Dino; Papp, Julius Gy

    2001-01-01

    The electrophysiological effects of dronedarone, a new nonionidated analogue of amiodarone were studied after chronic and acute administration in dog Purkinje fibres, papillary muscle and isolated ventricular myocytes, and compared with those of amiodarone by applying conventional microelectrode and patch-clamp techniques.Chronic treatment with dronedarone (2×25 mg−1 kg−1 day p.o. for 4 weeks), unlike chronic administration of amiodarone (50 mg−1 kg−1 day p.o. for 4 weeks), did not lengthen s...

  2. Haematological and erythrocyte membrane changes induced by amiodarone, in rats.

    Science.gov (United States)

    Padmavathy, B; Devraj, N S; Devraj, H

    1992-10-01

    The effect of Amiodarone (AD), a cationic amphiphilic drug, on erythrocytes and leucocytes was studied. Treatment of rats with AD showed a significant decrease in the red cell count and the level of Hemoglobin. Amiodarone altered the fluidity of the erythrocyte membrane followed by a decrease in the activities of membrane bound enzymes like (Na+, K+)-ATPase, Acetylcholine esterase and NADH dehydrogenase. A slight increase in the leucocyte count was also observed in the treated animals. PMID:1337899

  3. Amiodarone-induced pulmonary toxicity - Predisposing factors, clinical symptoms and treatment

    NARCIS (Netherlands)

    Jessurun, GAJ; Boersma, WG; Crijns, HJGM

    1998-01-01

    Amiodarone is frequently used for the treatment of cardiac arrhythmias. Although the therapeutic efficacy of amiodarone has been established, its use is limited by its safety profile. Amiodarone-induced pulmonary toxicity is one of the most life-threatening complications of this therapy. It is a rel

  4. Amiodarone-Associated Optic Neuropathy: A Critical Review

    Science.gov (United States)

    Passman, Rod S.; Bennett, Charles L.; Purpura, Joseph M.; Kapur, Rashmi; Johnson, Lenworth N.; Raisch, Dennis W.; West, Dennis P.; Edwards, Beatrice J.; Belknap, Steven M.; Liebling, Dustin B.; Fisher, Mathew J.; Samaras, Athena T.; Jones, Lisa-Gaye A.; Tulas, Katrina-Marie E.; McKoy, June M.

    2011-01-01

    Although amiodarone is the most commonly prescribed antiarrhythmic drug, its use is limited by serious toxicities, including optic neuropathy. Current reports of amiodarone associated optic neuropathy identified from the Food and Drug Administration's Adverse Event Reporting System (FDA-AERS) and published case reports were reviewed. A total of 296 reports were identified: 214 from AERS, 59 from published case reports, and 23 from adverse events reports for patients enrolled in clinical trials. Mean duration of amiodarone therapy before vision loss was 9 months (range 1-84 months). Insidious onset of amiodarone associated optic neuropathy (44%) was the most common presentation, and nearly one-third were asymptomatic. Optic disc edema was present in 85% of cases. Following drug cessation, 58% had improved visual acuity, 21% were unchanged, and 21% had further decreased visual acuity. Legal blindness (< 20/200) was noted in at least one eye in 20% of cases. Close ophthalmologic surveillance of patients during the tenure of amiodarone administration is warranted. PMID:22385784

  5. Amiodarone: Effects on thyroid function and the peripheral metabolism of the thyroid hormones

    Energy Technology Data Exchange (ETDEWEB)

    Braverman, L.E.; Safran, M.; Bambini, G.; Pinchera, A.; Martino, E.

    1985-11-01

    In addition to the effects of Amiodarone on the peripheral metabolism of the thyroid hormones and on pituitary TSH secretion, a major complication of therapy is the relatively high frequency of iodide-induced thyroid dysfunction. The mean T/sub 4/ and T/sub 3/ concentration following Amiodarone application was measured in euthyroid, hypothyroid and hyperthyroid patients and in control patients with and without cardiac disorders. Furthermore, the serum TSH was determined in euthyroid Amiodarone-treated euthyroid patients. /sup 131/I uptake was studied in patients with Amiodarone-associated thyrotoxicosis. The difficulties of the therapy of Amiodarone-induced hyperthyroidism are outlined. Preliminary studied of the effect of Amiodarone and its analogues on the metabolism of thyroid hormones in the rat indicate that Amiodarone may act as a thyroid hormone agonist in the pituitary. (MG).

  6. Development and X-ray morphology of amiodarone pneumopathy

    International Nuclear Information System (INIS)

    Besides general extracardiac physical side effects, the antiarrhythmic amiodarone hydrochloride gives rise to morphologically manifest organ changes. Pneumopathy has been reported in up to 8% of the patients treated with this preparation. Radiologically and histologically, the clinical picture can resemble that of exogenous allergic alveolitis. When the course is protracted there is interstitial fibrotic degeneration of the pulmonary parenchyma with a corresponding morphological correlate in the X-ray. The extent to which the changes observed result from dose-dependent toxicity of amiodarone has not been completely elucidated even now, since pulmonary changes suggestive of an immune process can occur even at low doses. When there is reason suspect the presence of amiodarone pneumopathy, the preparation should be discontinued. Radiological and clinical findings generally regress with cortisone treatment. (orig.)

  7. Silymarin and vitamin E reduce amiodarone-induced lysosomal phospholipidosis in rats

    International Nuclear Information System (INIS)

    Several antioxidants have been shown to reduce lysosomal phospholipidosis, which is a potential mechanism of amiodarone toxicity, and prevent amiodarone toxicity by antioxidant and/or non-antioxidant mechanisms. The aim of this study was to test whether the co-administration of two structurally different antioxidants vitamin E and silymarin with amiodarone can reduce amiodarone-induced lysosomal phospholipidosis, and if yes, by reducing the tissue concentration of amiodarone and desethylamiodarone or by their antioxidant action. To this end, male Fischer 344 rats were treated by gavage once a day for 3 weeks and randomly assigned to the following four experimental groups: 1, control; 2, amiodarone (150 mg/(kg per day)); 3, amiodarone (150 mg/(kg per day)) plus vitamin E (100 mg/(kg per day)); 4, amiodarone (150 mg/(kg per day)) plus silymarin (60 mg/(kg per day)) treated groups. Total plasma phospholipid (PL), liver-conjugated diene, thiobarbituric acid reactive substances (TBARSs), amiodarone and desethylamiodarone concentrations were determined and the extent of lysosomal phospholipidosis in the liver was estimated by a semi-quantitative electron microscopic method. Amiodarone treatment increased significantly the liver-conjugated diene (P<0.001), TBARS (P=0.012), plasma total PL (P<0.001) concentrations compared with control. Antioxidants combined with amiodarone significantly decreased the liver-conjugated diene (P<0.001 for both), TBARS (P=0.016 for vitamin E, P=0.053 borderline for silymarin) and plasma total PL (P=0.058 borderline for vitamin E, P<0.01 for silymarin) concentrations compared with amiodarone treatment alone. Silymarin significantly (P=0.021) reduced liver amiodarone, but only tended to decrease desethylamiodarone concentration; however, vitamin E failed to do so. Amiodarone treatment increased lysosomal phospholipidosis (P<0.001) estimated by semi-quantitative electron microscopic method and both antioxidants combined with amiodarone reduced

  8. Amiodarone concentrations in plasma and fat tissue during chronic treatment and related toxicity

    Science.gov (United States)

    Lafuente-Lafuente, Carmelo; Alvarez, Jean-Claude; Leenhardt, Antoine; Mouly, Stéphane; Extramiana, Fabrice; Caulin, Charles; Funck-Brentano, Christian; Bergmann, Jean-François

    2009-01-01

    AIMS To determine if amiodarone, highly lipophilic, accumulates in excess with respect to dose in fat tissue during long-term administration, and study if plasma and fat tissue concentrations are correlated with adverse effects. METHODS Trough concentrations of amiodarone and N-desethyl-amiodarone were measured simultaneously in plasma and fat tissue, in 30 consecutive patients treated with amiodarone for 3 months to 12 years. Subcutaneous adipose tissue was obtained by needle aspiration from lumbar and abdominal areas. Concentrations were measured by liquid chromatography–tandem mass spectrometry. RESULTS Plasma levels of amiodarone and N-desethyl-amiodarone were significantly correlated with daily maintenance doses (R = 0.52, P = 0.003). Amiodarone concentrations in fat tissue were four to 226 times (mean 55) higher than in plasma, and well correlated with plasma levels (R = 0.68, P < 0.001). Concentrations of amiodarone and N-desethyl-amiodarone in adipose tissue did not significantly increase with higher total cumulated doses or longer treatment duration. Nine of 12 patients who had received amiodarone for ≥2 years developed clinically important adverse effects, predominantly hypothyroidism (n = 6), compared with two of 18 patients treated for less time (relative risk 6.75; 95% confidence interval 1.8, 26). The incidence of those adverse effects was not significantly associated with amiodarone concentrations, whether in plasma or in adipose tissue. CONCLUSIONS We found no evidence of excessive or unexpected accumulation of amiodarone in fat tissue on long-term administration. Late amiodarone adverse effects, particularly hypothyroidism, are associated with longer exposure times, but do not seem to be explained by higher concentrations in plasma or in fat tissue. PMID:19552745

  9. INVITRO AND INVIVO MODULATION OF MULTIDRUG RESISTANCE WITH AMIODARONE

    NARCIS (Netherlands)

    VANDERGRAAF, WTA; DEVRIES, EGE; UGES, DRA; NANNINGA, AG; MEIJER, C; VELLENGA, E; MULDER, POM; MULDER, NH

    1991-01-01

    The modulating effect on drug resistance of amiodarone (AM) and its metabolite desethylamiodarone (DEA) was studied in a P-glycoprotein-positive human colon carcinoma cell line COLO 320, and a human small-cell lung carcinoma cell line GLC4 and its adriamycin (Adr)-resistant subline GLC4-Adr (both P-

  10. Phenytoin in treatment of amiodarone-induced Torsades de pointes

    Directory of Open Access Journals (Sweden)

    Saibal Mukhopadhyay

    2012-01-01

    Full Text Available Phenytoin, a class IB anti-arrhythmic agent, is considered the drug of choice for ventricular arrhythmias due to digoxin toxicity. We report successful reversion of polymorphic ventricular tachycardia secondary to amiodarone toxicity by phenytoin administration that was resistant to the conventional drugs (magnesium sulphate, lidocaine and atropine.

  11. Effects of amiodarone on thyroid function in humans

    International Nuclear Information System (INIS)

    The present work studies the effects of the anti-arrhythmic drug amiodarone on thyroidal release slopes (TRS) and peripheral kinetics of /sup 125/I-thyroxine (/sup 125/I-T/sub 4/) and /sup 125/I-triiodothyronine (/sup 125/I-T/sub 3/) during chronic (200-800 mg/day, 2-5 years) or acute (400 mg/day, 5-8 days) treatment with amiodarone. Each patient received a tracer does of /sup 125/I-T/sub 4/ or /sup 125/I-T/sub 3/ iv. TRS were derived from daily plasma ratios of /sup 127/I-T4//sup 125/I-T4 and /sup 127/I-T3//sup 125/I-T3. Double antibody radioimmunoassay techniques were employed to measure serum T4, T3, reverse T3 and thyrotropin (TSH). In the /sup 125/I-T4 studies, 8 chronically-treated patients had a mean TRS value of 0.063 +- 0.033 (SD) versus 0.110 +- 0.030 in controls (NS). Fractional T4 turnover (k) was 70% metabolic clearance rate (MCR) 80% and disposal rate (DS) 79% (NS) of the respective value in control subjects. The acute studies in 5 normal subjects showed no changes with amiodarone. In the /sup 125/I-T3 studies chronic patients had a decreased TRS, k MCR and DR whereas the acute studies showed similar, significant changes during amiodarone treatment. Serum T4 and reverse T3 were significantly elevated serum T3 was decreased and serum TSH was non-significantly increased. The authors conclude that despite the supranormal serum T4 and TSH, amiodarone appeared to depress thyroidal function and to block the thyroid gland response to a peripheral decrease in T4 conversion to T3

  12. THE USE OF AMIODARONE IN CLINICAL PRACTICE: THE PROBLEM OF SIDE EFFECTS

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    O. V. Gaisenok

    2016-01-01

    Full Text Available Characteristics of amiodarone in clinical practice are focused on. Amiodarone pharmacological mode of action and its pro-arrhythmic effect is presented. As well as various side effects that can happen in clinical practice. Special attention is paid to the problem of amiodarone-induced thyrotoxicosis, its classification, diagnosis and treatment. Prospects of new anti-arrhythmic drugs class III, in particular dronedaron are also discussed.

  13. Amiodarone-induced multiorgan toxicity with ocular findings on confocal microscopy

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    Ugur Turk

    2015-01-01

    Full Text Available Amiodarone is an antiarrhythmic medication that can adversely effect various organs including lungs, thyroid gland, liver, eyes, skin, and nerves. The risk of adverse effects increases with high doses and prolonged use. We report a 54-year-old female who presented with multiorgan toxicity after 8 months of low dose (200 mg/day amiodarone treatment. The findings of confocal microscopy due to amiodarone-induced keratopathy are described. Amiodarone may cause multiorgan toxicity even at lower doses and for shorter treatment periods.

  14. Lung injury by amiodarone, an antiarrhythmic drug, in male rats.

    Science.gov (United States)

    Padmavathy, B; Niranjali, S; Devaraj, H

    1992-07-01

    Administration of single dose (175 mg/kg body wt) of amiodarone dissolved in water through gavage for 3 weeks damaged the lung and changed the content of lung lavage. Activities of bronchoalveolar lavage (BAL) angiotensin converting enzyme (ACE) and lactate dehydrogenase (LDH) increased significantly. Also, the protein and lactate content of the lavage fluid increased significantly over the control. The drug also produced marked changes in morphology of the lung of experimental animals. PMID:1459640

  15. Ranolazine versus amiodarone for prevention of postoperative atrial fibrillation

    OpenAIRE

    Burashnikov, Alexander; Antzelevitch, Charles

    2011-01-01

    Postoperative atrial fibrillation (AF) is a major complication of cardiothoracic surgery, leading to significant consequences, including a higher rate of stroke, longer hospital stays and increased costs. Amiodarone is among the most widely used agents for prevention of postoperative AF. Ranolazine, a US FDA-approved antianginal agent, has been shown to effectively, safely prevent and terminate nonpostoperative AF in both experimental and clinical studies. In a recent publication, Miles and c...

  16. Medical image of the week: acute amiodarone pulmonary toxicity

    Directory of Open Access Journals (Sweden)

    Mazursky K

    2015-10-01

    Full Text Available No abstract available. Article truncated after 150 words. A 71 year old man with a medical history significant for chronic obstructive pulmonary disease, coronary artery disease with post-operative status coronary artery bypass grafting, heart failure with reduced ejection fraction (25% and atrial fibrillation/flutter underwent an elective ablation of the tachyarrhythmia at another facility and was prescribed amiodarone post procedure. He started complaining of cough and dyspnea one day post procedure and was empirically treated with 2 weeks of broad spectrum antibiotics. He subsequently was transferred to our facility due to worsening symptoms. He also complained of nausea, anorexia with resultant weight loss since starting amiodarone, which was stopped 5 days prior to transfer. Infectious work up was negative. On arrival to our facility, he was diagnosed with small sub-segmental pulmonary emboli, pulmonary edema and possible acute amiodarone toxicity. His was profoundly hypoxic requiring high flow nasal cannula or 100% non-rebreather mask at all times. His symptoms persisted despite ...

  17. Reduced intravenous toxicity of amiodarone nanosuspension in mice and rats.

    Science.gov (United States)

    Barle, Ester Lovšin; Cerne, Manica; Peternel, Luka; Homar, Miha

    2013-07-01

    The toxicity of amiodarone Lek formulation (test formulation) was investigated after a single intravenous (i.v.) administration to mice and rats. When compared to the reference item, Cordarone (Cordarone(®); Wyeth Pharmaceuticals Inc., Collegeville, Pennsylvania, USA), median lethal dose (LD(50)) after i.v. administration in female mice was 294.0 mg/kg body weight (b.w.) for the test formulation and 227.5 mg/kg b.w. for Cordarone. In female rats after i.v. administration, the LD(50) value was 269.9 mg/kg b.w. for the test formulation and 192.4 mg/kg b.w. for Cordarone. By altering the particle size of amiodarone in the Lek formulation, we were able to improve the solubility of amiodarone, thereby decreasing the number and quantity of excipients needed for preparation of the i.v. formulation and, consequently, reduced the acute toxic effects observed in the present study. PMID:22950665

  18. Treatment of Amiodarone-Induced Thyrotoxicosis Type 2 : A Randomized Clinical Trial

    NARCIS (Netherlands)

    Eskes, Silvia A.; Endert, Erik; Fliers, Eric; Geskus, Ronald B.; Dullaart, Robin P. F.; Links, Thera P.; Wiersinga, Wilmar M.

    2012-01-01

    Context: Amiodarone-induced thyrotoxicosis (AIT) type 2 is self-limiting in nature, but most physicians are reluctant to continue amiodarone. When prednisone fails to restore euthyroidism, possibly due to mixed cases of AIT type 1 and 2, perchlorate (ClO4) might be useful because ClO4 reduces the cy

  19. Effect of continuous versus episodic amiodarone treatment on quality of life in persistent atrial fibrillation

    NARCIS (Netherlands)

    Ahmed, S.; Ranchor, A.V.; Crijns, H.J.; van Veldhuisen, D.J.; van Gelder, I

    2010-01-01

    Aims Amiodarone is associated with significant adverse effects. We hypothesized that episodic amiodarone treatment would be associated with better quality of life (QoL) compared with continuous treatment in the prevention of recurrent atrial fibrillation (AF). Methods and results Quality of life was

  20. Long-term amiodarone administration remodels expression of ion channel transcripts in the mouse heart

    NARCIS (Netherlands)

    Le Bouter, S; El Harchi, A; Marionneau, C; Bellocq, C; Chambellan, A; van Veen, T; Boixel, C; Gavillet, B; Abriel, H; Le Quang, K; Chevalier, JC; Lande, G; Leger, JJ; Charpentier, F; Escande, D; Demolombe, S

    2004-01-01

    Background-The basis for the unique effectiveness of long-term amiodarone treatment on cardiac arrhythmias is incompletely understood. The present study investigated the pharmacogenomic profile of amiodarone on genes encoding ion-channel subunits. Methods and Results-Adult male mice were treated for

  1. Amiodarone cost effectiveness in preventing atrial fibrillation after coronary artery bypass graft surgery

    DEFF Research Database (Denmark)

    Zebis, Lars R; Christensen, Thomas D; Hjortdal, Vibeke E;

    2008-01-01

    BACKGROUND: The purpose of this study was to estimate the costs and health benefits of routinely administered postoperative amiodarone as prevention of atrial fibrillation for patients undergoing coronary artery bypass grafting (CABG) for stable angina. METHODS: This cost-effectiveness study was...... patients were included to receive either 300 mg amiodarone or placebo (5% aqueous dextrose solution) administered intravenously over 20 minutes followed by 600 mg amiodarone/placebo orally twice a day (8 am and 8 pm) for the first 5 postoperative days. RESULTS: In the amiodarone group, there were 14 cases...... of atrial fibrillation compared with 32 in the control group (p < 0.01) whereas there were no differences in the length of stay. The mean total cost per patient was 7,639 euros in the amiodarone group and 7,814 euros in the placebo group (p < 0.01). CONCLUSIONS: Routine use of postoperative...

  2. Amiodarone use in patients with documented allergy to iodine-containing compounds.

    Science.gov (United States)

    Brouse, Sara D; Phillips, Stanley M

    2005-03-01

    The popularity of amiodarone has grown due to its effectiveness in converting arrhythmia and its formulation availability. Formulations of the drug also contain iodine; the iodine content is 75 mg in a 200-mg tablet of amiodarone and 18.7 mg/ml in the intravenous solution. Approximately 10% of the iodine content of oral amiodarone is released into the circulatory system and may increase the risks of hypersensitivity reactions in iodine-sensitive patients. Documented allergies to contrast media or shellfish should not imply that a patient is allergic to iodine. Reactions to contrast media are likely due to the high osmolar or ionic content of the dye. The primary allergen in shellfish that stimulates allergic reactions is tropomyosin. Although amiodarone can cause thyroid disorders due to the high iodine load delivered to the body with each dose, no known association exists between amiodarone and reactions to contrast media or shellfish. Three patients whose medical charts listed an allergy to iodine were administered amiodarone for chemical cardioversion of arrhythmia to normal sinus rhythm. No anaphylactic or anaphylactoid reactions were observed in any of the patients during oral or intravenous amiodarone administration. In patients with true iodine hypersensitivity, however, the potential for such reactions exists. PMID:15843290

  3. Does amiodarone affect heart rate by inhibiting the intracellular generation of triiodothyronine from thyroxine?

    OpenAIRE

    Lindenmeyer, M.; Spörri, S.; Stäubli, M; Studer, A.; Studer, H

    1984-01-01

    The hypothesis that the antiarrhythmic drug amiodarone slows down the heart rate by its inhibitory action on the intracellular conversion of thyroxine (T4) to 3,5,3' triiodothyronine (T3) was investigated. For this purpose we compared the effect of amiodarone with that of another potent inhibitor of the T4----T3 conversion, i.e. the radiographic contrast medium iopanoic acid, on the heart rate of unanaesthetized guinea-pigs. Both amiodarone and, to an even greater extent, iopanoic acid induce...

  4. Amiodarone--induced changes in surfactant phospholipids of rat lung.

    Science.gov (United States)

    Padmavathy, B; Devaraj, H; Devaraj, N

    1993-04-01

    Amiodarone HCl (AD) is a very effective antiarrhythmic drug, but its use is often associated with serious pulmonary complications. It is shown to induce lung phospholipidosis. Nevertheless, the effects of this drug on pulmonary surfactant which is composed of about 75% phospholipids and which prevents alveolar collapse is not known. Therefore, we have examined the effect of AD on the intra- and extracellular surfactant pools and on the levels of phosphatidylcholine (PC), the primary constituent of pulmonary surfactant. Male Wistar rats were fed AD (175 mg/kg) by oral gavage for three weeks. At the end of the experimental period, the rats were killed, the lungs removed and perfused, and surfactant isolated. Some lungs were prepared for ultrastructural examination. Phospholipid was assayed in the intra- and extracellular surfactant. Amiodarone produced a significant increase in both the intra- and extracellular surfactant phospholipid along with an appreciable change in the phospholipid profile. Also, the drug seemed to increase the number of lamellar inclusions in the surfactant producing type II alveolar cells. These data suggest that administration of AD leads to an increase in the lung surfactant phospholipid levels and lamellar bodies in alveolar type II cells. PMID:8510769

  5. Effects of Combination Therapy of Amiodarone and Bisoprolol in Patients With Paroxysmal Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    Rong-qiang YAN; Fang-sheng ZHENG; Qing-hai ZHANG

    2009-01-01

    Objectives To examine the long-term efficacy of combination therapy of amiodarone and bisoprolol in patients with paroxysmal atrial fibrillation (P-AF). Methods Eighty-eight patients with P-AF were divided into two groups: 44 pa-tients treated with bisoprolol and amiodarone were enrolled in group A; 44 patients treated with amiodarone alone were enrolled in group B. Survival rates, rates of conversing to permanent atrial fibrillation (AF), subjective symptom im-provement rates and secondary bradyarrhythmia rates of the two groups were measured and analyzed. Results At 12 and 24 months, the survival rates for patients free from atrial fibrillation recurrence were 75 % and 59. 1% in group A, and 54.5 % and 36.4 % in group B (P0.05, group A vs. Group B). Conclusions In patients with P-AF, bisoprolol appears to enhance the efficacy of amiodarone therapy in maintaining sinus rhythm and improving subjective symptoms.

  6. Amiodarone is a cost-neutral way of preventing atrial fibrillation after surgery for lung cancer

    DEFF Research Database (Denmark)

    Riber, Lars P; Christensen, Thomas D; Pilegaard, Hans K

    2013-01-01

    OBJECTIVES: Our aim was to estimate the costs and health benefits of routinely administered postoperative amiodarone as a prophylactic agent in reducing the risk of atrial fibrillation in patients undergoing surgery for lung cancer. METHODS: This was a cost-effectiveness study, based on the......, Denmark, were included and randomized to receive either 300 mg of amiodarone or placebo (5% aqueous dextrose solution), administered intravenously over 20 min immediately after surgery, followed by 600 mg of amiodarone/placebo orally twice per day (8 a. m. and 6 p. m.) for the first five postoperative...... days. RESULTS: In the amiodarone group there were 11 cases of atrial fibrillation, compared with 38 in the control group (P <0.001). There were no differences in the length of hospital stay or resources used. The mean total costs per patient were equal and amounted to (sic)7288 per patient (P = 0...

  7. Acute lung affection in an endurance-trained man under amiodarone medication

    Directory of Open Access Journals (Sweden)

    Saurbier, Bernward

    2005-06-01

    Full Text Available Patients undergoing treatment with amiodarone can develop severe pulmonary side effects. This effect, which is often highly underestimated, can lead to dyspnea, pneumonitis, and further fibrosis. A recent change in the labeling of amdiodarone by the American Food and Drug Administration (FDA supports this suspicion. Tracing the symptoms back to the causing agent can be difficult, as shown in our report. The subject of this case report is an endurance-trained 65 year old male marathon runner who appeared with atrial fibrillation during a routine check up in autumn 2003. After medical cardioversion with flecainide a complaint free interval of 8 months was followed by a relapse, which resulted in a change of medication to amiodarone. Due to misunderstandings the patient kept on taking the amiodarone loading dose for six weeks and returned with severe dyspnea on exertion. Losses in CO diffusing capacity, a lowered macrophages count and a positive lymphocyte transformation test were the only first hand clinical evidence of amiodarone intoxication, despite the sensation of dyspnea. This case shows that special care has to be taken in treatment with amiodarone. Side effects can be hard to trace and do not evidently show a clear connection to amiodarone.

  8. Effects of amiodarone and thoracic epidural analgesia on atrial fibrillation after coronary artery bypass grafting

    DEFF Research Database (Denmark)

    Nygård, Eigil; Sørensen, Lars H; Hviid, Lamia B;

    2004-01-01

    OBJECTIVE: This study was designed to assess the effects of a perioperative dosing regimen of amiodarone administration, high thoracic epidural anesthesia (TEA), or a combination of the 2 regimens on atrial fibrillation (AF) after coronary artery bypass grafting (CABG). DESIGN AND SETTING: The...... E+A 10 of 35 (28.6%), in group A 10 of 36 (27.8%), and in the control group 20 of 48 (41.7%) patients developed AF (odds ratio amiodarone/nonamiodarone 0.47 [0.24-0.90]; P = 0.02). CONCLUSIONS: The perioperative amiodarone regimen used in this study was effective in reducing the incidence of AF...... randomized to 1 of 4 regimens in which group E had perioperative TEA, group E+A had TEA and amiodarone, group A had amiodarone, and group C served as control. The epidural catheter was inserted at T1-3 the day before surgery. TEA groups received TEA for 96 hours. The amiodarone regimen consisted of a single...

  9. Ameliorative effect of grapefruit juice on amiodarone-induced cytogenetic and testicular damage in albino rats

    Institute of Scientific and Technical Information of China (English)

    Saber Abdelruhman Sakr; Mohamed El-said Zoil; Samraa Samy El-shafey

    2013-01-01

    Objective:To evaluate the ameliorative role of grapefruit juice on the cytogenetic and testicular damage induced by the antiarrythmic drug amiodarone in albino rats. Methods: Animals were divided into four groups. Group I was considered as control. Group II was given grapefruit juice at a dose level of 27 mL/kg body weight. Group III was orally administered amiodarone (18 mg/kg body weight) daily for 5 weeks. Animals were sacrificed after 5 weeks of treatment. Bone marrow was collected from the femurs for analysis of chromosomal aberrations and mitotic indices. Testes were removed and stained with H&E for histological examination. Sperms were collected from epidedymis for detection of sperm head abnormalities. Comet assay was used to detect DNA damage. Results: Amiodarone treatment caused a significant increase in the percentage of chromosomal aberrations, decreased the mitotic index and increased DNA damage. The testis showed many histopathological alterations, inhibition of spermatogenesis and morphometric changes. The number of sperm head abnormalities was increased. Treating animals with amiodarone and grapefruit juice caused a reduction in chromosomal aberrations, mitotic index, DNA damage and testicular alterations caused by amiodarone. Conclusions:The results of this study indicated that grapefruit juice ameliorates the cytotoxicty and testicular alterations induced by amiodarone in albino rats and this is may be due to the potent antioxidant effects of its components.

  10. Prevalence of Amiodarone-Induced Thyrotoxicosis and Associated Risk Factors in Japanese Patients

    Directory of Open Access Journals (Sweden)

    Toyoyoshi Uchida

    2014-01-01

    Full Text Available Amiodarone is a widely used agent for life-threatening arrhythmias. Although amiodarone-induced thyrotoxicosis (AIT is a major adverse effect that can cause recurrence of arrhythmias and exacerbation of heart failure, risk factors for AIT among amiodarone-treated Japanese patients have not been elucidated. Here, we investigated the prevalence and predictive factors for AIT. The study subjects were 225 patients treated with amiodarone between 2008 and 2012, who were euthyroid before amiodarone therapy. All patients with AIT were diagnosed by measurement of thyroid hormones and ultrasonography. Among the 225 subjects, 13 patients (5.8% developed AIT and all the patients were classified as Type 2 AIT. Baseline features of patients with AIT were not different from those who did not develop AIT, except for age (AIT, 55.1 ± 13.8, non-AIT, 68.1 ± 12.0 years, P<0.001. Multivariate analyses using the Cox proportional hazard model identified age as the sole determinant of AIT (hazard ratio: 0.927, 95% confidence interval: 0.891–0.964. Receiver operating characteristic curve analysis identified age of 63.5 years as the cutoff value for AIT with sensitivity of 70.3% and specificity of 69.2%. In summary, this study showed that the prevalence of AIT is 5.8% in Japanese patients treated with amiodarone and that young age is a risk factor for AIT.

  11. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Hugo Van Herendael

    2010-06-01

    Full Text Available Hugo Van Herendael, Paul DorianDivision of Cardiology, St. Michael’s Hospital, University of Toronto, Toronto, CanadaAbstract: Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation. Although the superiority of the transvenous implantable cardioverter defibrillator (ICD over amiodarone has been well established in the preventive treatment of patients at high risk of life-threatening ventricular arrhythmias, amiodarone (if used with a beta-blocker is the most effective antiarrhythmic drug to prevent ICD shocks and treat electrical storm. Both the pharmacokinetics and the electrophysiologic profile of amiodarone are complex, and its optimal and safe use requires careful patient surveillance with respect to potential adverse effects.Keywords: amiodarone, ventricular fibrillation, unstable ventricular tachycardia

  12. ECMO for pulmonary rescue in an adult with amiodarone-induced toxicity.

    Science.gov (United States)

    Benassi, Filippo; Molardi, Alberto; Righi, Elena; Santangelo, Rosaria; Meli, Marco

    2015-05-01

    Amiodarone is a highly effective antiarrhythmic agent. Unfortunately amiodarone-induced pulmonary toxicity is described for medium-long term therapy. We describe a case of a 65-year-old man admitted to our department for breathlessness and with a history of recurrent episodes of atrial fibrillation for which he had been receiving amiodarone (200 mg/day) since 2008. Despite diuretic therapy, along with aspirin, statins and antibiotics the patient continued to complain of severe dyspnea and had a moderate fever. Thus, diagnostic hypotheses different from acute cardiac failure were considered, in particular non-cardiogenic causes of pulmonary infiltrates. Following suspicion of amiodarone-induced pulmonary toxicity, the drug was discontinued and corticosteroid therapy was initiated. Due to the deterioration of the clinical picture, we proceeded to intubation. After few hours from intubation we were forced to institute a veno-venous extracorporeal membrane oxygenation due to the worsening of pulmonary function. The patient's clinical condition improved which allowed us to remove the ECMO after 15 days of treatment. Indications for use of ECMO have expanded considerably. To our knowledge this is the first successful, reported article of a veno-venous ECMO used to treat amiodarone-induced toxicity in an adult. In patients with severe but potentially reversible pulmonary toxicity caused by amiodarone, extracorporeal life support can maintain pulmonary function and vital organ perfusion at the expense of low morbidity, while allowing time for drug clearance. PMID:24604330

  13. Herb-Drug Interaction of Paullinia cupana (Guarana Seed Extract on the Pharmacokinetics of Amiodarone in Rats

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    Márcio Rodrigues

    2012-01-01

    Full Text Available Paullinia cupana is used in weight-loss programs as a constituent of medicinal/dietary supplements. This study aimed to assess a potential herb-drug interaction among a standardized (certified Paullinia cupana extract and amiodarone (narrow therapeutic index drug in rats. In a first pharmacokinetic study rats were simultaneously coadministered with a single dose of Paullinia cupana (821 mg/kg, p.o. and amiodarone (50 mg/kg, p.o., and in a second study rats were pretreated during 14 days with Paullinia cupana (821 mg/kg/day, p.o. receiving amiodarone (50 mg/kg, p.o. on the 15th day. Rats of the control groups received the corresponding volume of vehicle. Blood samples were collected at several time points after amiodarone dosing, and several tissues were harvested at the end of the experiments (24 h after dose. Plasma and tissue concentrations of amiodarone and its major metabolite (mono-N-desethylamiodarone were measured and analysed. A significant reduction in the peak plasma concentration (73.2% and in the extent of systemic exposure (57.8% to amiodarone was found in rats simultaneously treated with Paullinia cupana and amiodarone; a decrease in tissue concentrations was also observed. This paper reports for the first time an herb-drug interaction between Paullinia cupana extract and amiodarone, which determined a great decrease on amiodarone bioavailability in rats.

  14. Herb-Drug Interaction of Paullinia cupana (Guarana) Seed Extract on the Pharmacokinetics of Amiodarone in Rats.

    Science.gov (United States)

    Rodrigues, Márcio; Alves, Gilberto; Lourenço, Nulita; Falcão, Amílcar

    2012-01-01

    Paullinia cupana is used in weight-loss programs as a constituent of medicinal/dietary supplements. This study aimed to assess a potential herb-drug interaction among a standardized (certified) Paullinia cupana extract and amiodarone (narrow therapeutic index drug) in rats. In a first pharmacokinetic study rats were simultaneously coadministered with a single dose of Paullinia cupana (821 mg/kg, p.o.) and amiodarone (50 mg/kg, p.o.), and in a second study rats were pretreated during 14 days with Paullinia cupana (821 mg/kg/day, p.o.) receiving amiodarone (50 mg/kg, p.o.) on the 15th day. Rats of the control groups received the corresponding volume of vehicle. Blood samples were collected at several time points after amiodarone dosing, and several tissues were harvested at the end of the experiments (24 h after dose). Plasma and tissue concentrations of amiodarone and its major metabolite (mono-N-desethylamiodarone) were measured and analysed. A significant reduction in the peak plasma concentration (73.2%) and in the extent of systemic exposure (57.8%) to amiodarone was found in rats simultaneously treated with Paullinia cupana and amiodarone; a decrease in tissue concentrations was also observed. This paper reports for the first time an herb-drug interaction between Paullinia cupana extract and amiodarone, which determined a great decrease on amiodarone bioavailability in rats. PMID:23304200

  15. The Characteristics of Amiodarone-induced Thyrotoxicosis in a Moderate Iodine Deficit Area

    Directory of Open Access Journals (Sweden)

    Ancuța-Elena Cota

    2013-08-01

    Full Text Available Introduction: Amiodarone (AMI, a class III anti-arrhythmic drug, is associated with a number of side effects, including thyroid dysfunction (both hypo- and hyperthyroidism, which is due to amiodarone's high iodine content and its direct toxic effect on the thyroid. Objective: To evaluate the incidence of Amiodarone induced thyrotoxicosis (AIT (type, rate of occurrence and to identify the risk factors involved in its occurrence. Material and method: We examined patients treated with amiodarone, between January 2002 and December 2011, who presented to our Department of Endocrinology Târgu Mures for thyroid dysfunctions. Results: The retrospective study included 87 patients with thyroid dysfunctions; 58 (66.7% patients had AIT and 29 (33.3% had Amiodarone induced hypothyroidism (AIH. In the AIT group: 35 were women (60.3%, 23 were men (39.7%; the average age was 61.60 ± 12.39 years. Risk factors identified for the AIT group were male gender (RR = OR = 3.8; Chi-squer = 5.7, p = 0.004 and pre-existing thyroid abnormalities (RR = 2.5, Chi-square = 4.1, p = 0.005. The thyroid dysfunction occurrence was heterogeneous (0.2-183 months. The patients with previous thyroid abnormalities developed earlier thyroid dysfunction compared to those with an apparently normal thyroid gland (22.25 ± 4.14 months versus 32.09 ± 7.69 months, p = 0.02, T test. Conclusion: In the context of the specific iodine geoclimatic intake and the area of origin, amiodarone - induced thyroid dysfunction spectrum is dominated by thyrotoxicosis. Screening and monitoring of thyroid function for patiens under chronic amiodarone treatment is necessary

  16. May toxicity of amiodarone be prevented by antioxidants? A cell-culture study

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    Durukan Ahmet

    2012-06-01

    Full Text Available Abstract Background Atrial Fibrillation is the most common arrhythmia encountered following cardiac surgery. The most commonly administered drug used in treatment and prophylaxis is amiodarone which has several toxic effects on major organ functions. There are few clinical data concerning prevention of toxic effects and there is no routinely suggested agent. The aim of this study is to document the cytotoxic effects of amiodarone on cell culture media and compare the cytoprotective effects of commonly used antioxidant agents. Methods L929 mouse fibroblast cell line was cultured and 100,000 cells/well-plate were obtained. First group of cells were treated with increasing concentrations of amiodarone (20 to 180 μM alone. Second and third group of cells were incubated with one-fold equimolar dose of vitamin C and N-acetyl cysteine prior to amiodarone exposure. The viability of cells were measured by MTT assay and the cytoprotective effect of each agent was compared. Results The cytotoxicity of amiodarone was significant with concentrations of 100 μM and more. The viabilities of both vitamin C and N-acetyl cysteine treated cells were higher compared to untreated cells. Conclusions Vitamin C and N-acetyl cysteine are commonly used in the clinical setting for different purposes in context of their known antioxidant actions. Their role in prevention of amiodarone induced cytotoxicity is not fully documented. The study fully demonstrates the cytoprotective role of both agents in amiodarone induced cytotoxicity on cell culture media; more pronounced with vitamin C in some concentrations. The findings may be projectile for further clinical studies.

  17. Amiodarone impairs trafficking through late endosomes inducing a Niemann-Pick C-like phenotype.

    Science.gov (United States)

    Piccoli, Elena; Nadai, Matteo; Caretta, Carla Mucignat; Bergonzini, Valeria; Del Vecchio, Claudia; Ha, Huy Riem; Bigler, Laurent; Dal Zoppo, Daniele; Faggin, Elisabetta; Pettenazzo, Andrea; Orlando, Rocco; Salata, Cristiano; Calistri, Arianna; Palù, Giorgio; Baritussio, Aldo

    2011-11-01

    Patients treated with amiodarone accumulate lysobisphosphatidic acid (LBPA), also known as bis(monoacylglycero)phosphate, in airway secretions and develop in different tissues vacuoles and inclusion bodies thought to originate from endosomes. To clarify the origin of these changes, we studied in vitro the effects of amiodarone on endosomal activities like transferrin recycling, Shiga toxin processing, ESCRT-dependent lentivirus budding, fluid phase endocytosis, proteolysis and exosome secretion. Furthermore, since the accumulation of LBPA might point to a broader disturbance in lipid homeostasis, we studied the effect of amiodarone on the distribution of LBPA, unesterified cholesterol, sphingomyelin and glycosphyngolipids. Amiodarone analogues were also studied, including the recently developed derivative dronedarone. We found that amiodarone does not affect early endosomal activities, like transferrin recycling, Shiga toxin processing and lentivirus budding. Amiodarone, instead, interferes with late compartments of the endocytic pathway, blocking the progression of fluid phase endocytosis and causing fusion of organelles, collapse of lumenal structures, accumulation of undegraded substrates and amassing of different types of lipids. Not all late endocytic compartments are affected, since exosome secretion is spared. These changes recall the Niemann-Pick type-C phenotype (NPC), but originate by a different mechanism, since, differently from NPC, they are not alleviated by cholesterol removal. Studies with analogues indicate that basic pKa and high water-solubility at acidic pH are crucial requirements for the interference with late endosomes/lysosomes and that, in this respect, dronedarone is at least as potent as amiodarone. These findings may have relevance in fields unrelated to rhythm control. PMID:21878321

  18. Magnesium sulphate and amiodarone prophylaxis for prevention of postoperative arrhythmia in coronary by-pass operations

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    Huysal Kagan

    2009-02-01

    Full Text Available Abstract Background The aim of this study was to investigate the use of prophylactic magnesium sulphate and amiodarone in treating arrhythmias that may occur following coronary bypass grafting operations. Methods The study population consisted of 192 consecutive patients who were undergoing coronary artery bypass grafting (CABG. Sixty-four patients were given 3 g of magnesium sulphate (MgSO4 [20 ml = 24.32 mEq/L Mg+2] in 100 cc of isotonic 0.9% solution over 2 hours intravenously at the following times: 12 hours prior to the operation, immediately following the operation, and on postoperative days 1, 2, and 3 (Group 1. Another group of 64 patients was given a preoperative infusion of amiodarone (1200 mg on first post-operative day (Group 2. After the operation amiodarone was administered orally at a dose of 600 mg/day. Sixty-four patients in group 3 (control group had 100 cc. isotonic 0.9% as placebo, during the same time periods. Results In the postoperative period, the magnesium values were significantly higher in Group 1 than in Group 2 for all measurements. The use of amiodarone for total arrhythmia was significantly more effective than prophylactic treatment with magnesium sulphate (p = 0.015. There was no difference between the two drugs in preventing supraventricular arrhythmia, although amiodarone significantly delayed the revealing time of atrial fibrillation (p = 0.026. Ventricular arrhythmia, in the form of ventricular extra systole, was more common in the magnesium prophylaxis group. The two groups showed no significant differences in other operative or postoperative measurements. No side effects of the drugs were observed. Conclusion Prophylactic use of magnesium sulphate and amiodarone are both effective at preventing arrhythmia that may occur following coronary by-pass operations. Magnesium sulphate should be used in prophylactic treatment since it may decrease arrhythmia at low doses. If arrhythmia should occur despite this

  19. Comparative efficacy of amiodarone with ivabradin combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation recurrence in pa- tients with left ventricular diastolic dysfunction

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    K. G. Adamyan

    2015-11-01

    Full Text Available Aim. To study the efficacy of use of amiodarone with ivabradine combination or amiodarone with bisoprolol combination in the prevention of atrial fibrillation (AF recurrence in patients (pts with left ventricular diastolic dysfunction (LVDD after conversion to sinus rhythm. Material and methods. 65 patients (40 males, 25 females aged 53±8 years with persistent AF and LVDD were included into the study and randomized into 3 groups to receive ivabradine and amiodarone (22 pts, bisoprolol and amiodarone (22 pts or amiodarone alone (21 pts. Left atrium (LA volume indices, LA longitudinal strain rate (LASR in systole, LV mass index, mean heart rate (HR, 24-hour HR variability and the incidence of AF by 96 h ECG monitoring were measured after the titration period, and after 3 and 6 months of follow-up. Results. After 6 months of follow-up group 1 revealed significantly lower maximum LA volume index (21.3±2.4 vs 25.2±3.0 and 28.7±3.6 ml/m2 in the 2nd and control groups, respectively, P-wave LA volume index (15.3±3.5 versus 18.1±3.8 and 20.4±4.0 ml/m2 in the 2nd and control groups, respectively, and LA systolic volume index (7.3±1.2 versus 9.4±1.6 and 9.6±1.7 ml/m2 in 2nd and control groups, respectively. The incidence of side effects in group 1 was significantly less than that in group 2 and was not different compared with control group. Conclusion. Ivabradine and amiodarone combination provides better prevention of AF recurrence and less side-effects in pts with LVDD and persistent AF after sinus rhythm restoration as compared with bisoprolol and amiodarone combination, it also reduces LA maximum, conduit and systolic volumes, and increases LASR.

  20. A general mechanism for drug promiscuity: Studies with amiodarone and other antiarrhythmics.

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    Rusinova, Radda; Koeppe, Roger E; Andersen, Olaf S

    2015-12-01

    Amiodarone is a widely prescribed antiarrhythmic drug used to treat the most prevalent type of arrhythmia, atrial fibrillation (AF). At therapeutic concentrations, amiodarone alters the function of many diverse membrane proteins, which results in complex therapeutic and toxicity profiles. Other antiarrhythmics, such as dronedarone, similarly alter the function of multiple membrane proteins, suggesting that a multipronged mechanism may be beneficial for treating AF, but raising questions about how these antiarrhythmics regulate a diverse range of membrane proteins at similar concentrations. One possible mechanism is that these molecules regulate membrane protein function by altering the common environment provided by the host lipid bilayer. We took advantage of the gramicidin (gA) channels' sensitivity to changes in bilayer properties to determine whether commonly used antiarrhythmics--amiodarone, dronedarone, propranolol, and pindolol, whose pharmacological modes of action range from multi-target to specific--perturb lipid bilayer properties at therapeutic concentrations. Using a gA-based fluorescence assay, we found that amiodarone and dronedarone are potent bilayer modifiers at therapeutic concentrations; propranolol alters bilayer properties only at supratherapeutic concentration, and pindolol has little effect. Using single-channel electrophysiology, we found that amiodarone and dronedarone, but not propranolol or pindolol, increase bilayer elasticity. The overlap between therapeutic and bilayer-altering concentrations, which is observed also using plasma membrane-like lipid mixtures, underscores the need to explore the role of the bilayer in therapeutic as well as toxic effects of antiarrhythmic agents. PMID:26573624

  1. A role for the autophagy regulator Transcription Factor EB in amiodarone-induced phospholipidosis.

    Science.gov (United States)

    Buratta, Sandra; Urbanelli, Lorena; Ferrara, Giuseppina; Sagini, Krizia; Goracci, Laura; Emiliani, Carla

    2015-06-01

    The antiarrhythmic agent amiodarone, a cationic amphiphilic drug, is known to induce phospholipidosis, i.e. the accumulation of phospholipids within lysosomal structures to give multi-lamellar inclusion bodies. Despite the concerns raised about phospholipidosis in the recent years, the molecular mechanisms underlying amiodarone- or other cationic amphiphilic drug-induced phospholipidosis are still under investigation. Here we demonstrated that amiodarone doses able to induce phospholiposis according to NBD-PC uptake assay (1-12 μM, 24 h) activates Transcription Factor EB (TFEB), a pivotal regulator of the autophagic pathway, in human HepG2 cells. Further evidences confirmed the effect of amiodarone on the autophagic-lysosomal system in HepG2 and BEAS-2B cells: lysosomal β-hexosaminidase isoenzymes secretion, transcriptional up-regulation of the lysosomal β-hexosaminidase α-subunit, alteration of cathepsin B, D and L intracellular maturation in a cell- and protease-specific manner. Autophagy activation was also demonstrated by increased conversion of LC3-I into LC3-II and reduced phosphorylation of the mTORC1 target S6 kinase. Besides, we provided evidence that TFEB over-expression prevents amiodarone-induced phospholipid accumulation, suggesting that this transcription factor could be a possible target to develop strategies for phospholipidosis attenuation. PMID:25881747

  2. Development and X-ray morphology of amiodarone pneumopathy. Die Entwicklung und Roentgenmorphologie der Amiodaronpneumopathie

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    Billmann, P. (Kreiskrankenhaus Lahr (Germany, F.R.). Radiologisches Inst.); Fleischmann, D. (Kreiskrankenhaus Lahr (Germany, F.R.). Kardiologische Klinik); Baumeister, L. (Sankt-Josefs-Krankenhaus, Offenburg am Main (Germany, F.R.). Radiologische Abt.)

    1991-04-01

    Besides general extracardiac physical side effects, the antiarrhythmic amiodarone hydrochloride gives rise to morphologically manifest organ changes. Pneumopathy has been reported in up to 8% of the patients treated with this preparation. Radiologically and histologically, the clinical picture can resemble that of exogenous allergic alveolitis. When the course is protracted there is interstitial fibrotic degeneration of the pulmonary parenchyma with a corresponding morphological correlate in the X-ray. The extent to which the changes observed result from dose-dependent toxicity of amiodarone has not been completely elucidated even now, since pulmonary changes suggestive of an immune process can occur even at low doses. When there is reason suspect the presence of amiodarone pneumopathy, the preparation should be discontinued. Radiological and clinical findings generally regress with cortisone treatment. (orig.).

  3. Amiodarone Induced Hyponatremia Masquerading as Syndrome of Inappropriate Antidiuretic Hormone Secretion by Anaplastic Carcinoma of Prostate

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    Pinaki Dutta

    2014-01-01

    Full Text Available Syndrome of inappropriate antidiuretic hormone secretion (SIADH is one of the most common causes of hyponatremia. The usual causes are malignancies, central nervous system, pulmonary disorders, and drugs. Amiodarone is a broad spectrum antiarrhythmic agent widely used in the management of arrhythmias. The different side effects include thyroid dysfunction, visual disturbances, pulmonary infiltrates, ataxia, cardiac conduction abnormalities, drug interactions, corneal microdeposits, skin rashes, and gastrointestinal disturbances. SIADH is a rare but lethal side effect of amiodarone. We describe a 62-year-old male who was suffering from advanced prostatic malignancy, taking amiodarone for underlying heart disease. He developed SIADH which was initially thought to be paraneoplastic in etiology, but later histopathology refuted that. This case emphasizes the importance of detailed drug history and the role of immunohistochemistry in establishing the diagnosis and management of hyponatremia due to SIADH.

  4. Acutely Onset Amiodarone-Induced Angioedema in a Patient with New Atrial Fibrillation

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    Hossein Vakili

    2014-01-01

    Full Text Available A 50-year-old man was admitted to our emergency department due to new episode of palpitation. He had history of angioplasty of right coronary artery (RCA with drug eluting stent 2 years ago. His electrocardiogram revealed atrial fibrillation (AF. Intravenous amiodarone 150 mg during 10 minutes and then 1 mg/min infusion were started to achieve rate control and pharmacologic conversion to sinus rhythm. After 60 minutes of starting amiodarone infusion, he developed swelling of the skin around his mouth and eyes, and also mucosa of the mouth, eyes and tongue. To conclude, angioedema should be considered a rare side effect of amiodarone which is used broadly in cardiovascular field.

  5. Recurrence of arrhythmia following short-term oral AMIOdarone after CATheter ablation for atrial fibrillation

    DEFF Research Database (Denmark)

    Darkner, Stine; Chen, Xu; Hansen, Jim;

    2014-01-01

    AIMS: Patients undergoing catheter ablation for atrial fibrillation (AF) often experience recurrent arrhythmias within the first few months post-ablation. We aimed to investigate whether short-term use of amiodarone to prevent early arrhythmias following radiofrequency ablation for AF could reduce...... history of previous ablation], 206 patients were available for analysis of the primary end-point which was any documented atrial tachyarrhythmia lasting >30 s following a blanking period of 3 months. This was observed in 42/107 (39%) in the amiodarone group vs. 48/99 (48%) in the placebo group (P = 0.......18). Among the secondary end-points, the amiodarone group showed significantly lower rate of atrial tachyarrhythmia-related hospitalizations [rate ratio = 0.43; 95% confidence interval (CI) = 0.23-0.77, P = 0.006] and cardioversions (rate ratio = 0.36; 95% CI = 0.20-0.62, P = 0.0004) within the blanking...

  6. Drug-induced lupus: simvastatin or amiodarone? A case report in elderly

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    Mauro Turrin

    2013-03-01

    Full Text Available Reports of systemic lupus erythematosus (SLE seen during treatment with amiodarone are rare in the literature. SLE or immunological abnormalities induced by treatment with statins are more frequent. In this issue we report a case of a 81-year-old male who, after a 2-year therapy with amiodarone, developed a clinical and serologic picture of drug-induced SLE (DILE. He was admitted for congestive heart failure in mechanical aortic valve prosthesis, permanent atrial fibrillation (anticoagulation with warfarin, hypercholesterolaemia, and hypothyroidism. Amiodarone was started two years earlier for polymorphic ventricular tachycardia, statin and L-thyroxine the following year. At admission he presented pleuro-pericardical effusion detected by CT-scan (also indicative of interstitial lung involvement and echocardiography. Serological main indicative findings were: elevation of inflammatory markers, ANA (Anti-Nuclear Antibodies titers = 1:320 (indirect immune-fluorescence – IIF – assay on HEp-2, homogeneous/fine speckled pattern, anti-dsDNA titers = 1:80 (IIF on Crithidia luciliae, negative ENA (Extractable Nuclear Antigens and antibodies anti-citrulline, rheumatoid factor = 253 KU/l, normal C3-C4, negative HbsAg and anti-HCV, negative anticardiolipin antibodies IgG and IgM, negative anti-beta2GPI IgG and IgM. Amiodarone was discontinued and methylprednisolone was started, since the patient was severely ill. At discharge, after a month, the patient was better and pleuro-pericardical effusion was reduced. Readmitted few weeks later for bradyarithmia and worsening of dyspnoea, pericardial effusion was further reduced but he died for refractory congestive heart failure and pneumonia. Clinical picture (sierositis, neither skin nor kidney involvement, other typical side effects of amiodarone (hypothyroidism and lung interstitial pathology and serological findings are suggestive of amiodarone-induced SLE.

  7. Rhythminotropic Reactions of Human Myocardium in Ischemic and Rheumatic Heart Diseases against the Background of Amiodarone

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    Boris N. Kozlov, PhD, ScD

    2012-03-01

    Full Text Available In human heart failure, Ca2+ homeostasis gets disturbed due to a decrease in the function of the sarcoplasmic reticulum (SR. We studied the differences in the SR function in patients with rheumatic and coronary heart disease, against the background of amiodarone. Cardiac preparations from the atrium of 21 patients with coronary artery disease (CAD and 14 patients with rheumatic heart disease (RHD were used in this study. Myocardial strips perfused with oxygenated Krebs-Henzelait solution without and with amiodarone (1 mM/l at 37°C. The steady state stimulation rate of the muscle strips was 0.5 Hz. The single extraordinary impulse was given as 0.2-1.5 sec after the steady state beat. Then, the first beat after a 4- to 60-sec rest period was evaluated. The extrasystoles of the myocardium in both groups, after long intervals, were decreased after amiodarone treatment. The amplitude of post extrasystoles of amiodarone-treated myocardium showed differences only after long intervals in both groups. Two types of inotropic responses of a failing myocardium after rest periods were observed. Type I post-rest contractions maintained the steady state amplitude after all rests. However, type II was characterized by a reduction in the amplitude of the contractions. Amiodarone treatment of the myocardium showing type I reactions led to an increase in the potentiation after rests, but showed no effect on the reaction of the muscle with the type II response. The results suggested that SR dysfunction was different in CAD and RHD. The realization of the therapeutic effect of amiodarone was found to be dependent on the functional activity of the SR.

  8. Effects of amiodarone on cardiac function and mitochondrial oxidative phosphorylation during ischemia and reperfusion.

    Science.gov (United States)

    Moreau, D; Clauw, F; Martine, L; Grynberg, A; Rochette, L; Demaison, L

    1999-04-01

    This study was carried out in order to determine if the efficiency of amiodarone, a class III antiarrhythmic agent, is associated with changes in mitochondrial oxidative phosphorylation. A population of 30 rats were treated with amiodarone (100 mg/kg/day) for 5 days. A second population receiving only vehicle was used as control. The hearts were perfused according to the working mode. After 15 min of normoxic perfusion, the left main coronary artery was ligated and the ligation was maintained for 20 min. The ligation was removed and reperfusion continued for a further 30 min. The electrocardiogram was monitored continuously. At the end of perfusion, the ischemic and non ischemic areas were visually separated and mitochondria were harvested from each area. Their oxidative and energy metabolism were assessed with palmitoylcarnitine as substrate in 2 respiration media differing in their free calcium concentration (0 or 0.34 microm). In normoxic conditions, amiodarone treatment increased the cardiac metabolic efficiency (mechanical work to oxygen consumption ratio). The local ischemia decreased the aortic and coronary flows without modifying the cardiac metabolic efficiency. Amiodarone treatment maintained the aortic flow at a significantly higher value; the duration of severe arrhythmias was significantly decreased by the drug. The reperfusion of the ischemic area allowed the partial recovery of fluid dynamics. The coronary flow was restored to 89% of the pre ischemic value. Conversely, the aortic flow never exceeded that measured at the end of ischemia, partly due to the important development of severe arrhythmias. The recovery of aortic flow and metabolic efficiency during reperfusion was improved by amiodarone treatment; ventricular tachycardia and fibrillation duration were reduced. In the mitochondria issued from the normoxic area, the energy metabolism was not altered by the amiodarone treatment, but the presence of calcium in the respiration medium modified the

  9. Effect of Lidocaine and Amiodarone on Transmural Heterogeneityricular Repolarization in Isolated Rabbit Hearts Model of Sustained Global Ischemia

    Institute of Scientific and Technical Information of China (English)

    YOU Binquan; PU Jun; LIU Nian; YU Ronghui; RUAN Yanfei; LI Yang; WANG Lin

    2005-01-01

    To study the effect of of lidocaine and amiodarone on the transmural heterogeneity of ventricular repolarization in isolated rabbit hearts model of sustained global ischemia and to explore the mechanisms underlying the antiarrhythmic activity of lidocaine and amiodarone, rabbits were randomly divided into 4 groups: control group, ischemia group, lidocaine group and amiodarone group. By the monophasic action potential (MAP) recording technique, MAPs of recorded across the left ventricular free wall in rabbit hearts perfused transmural dispersion of repolarization (TDR) and arrhythmic induced by ischemia. Our results showed that TDR of three myocardial layers in ischemia group were significantly lengthened after ischemia. TDR was increased from 17.5±3.9 ms to 31.2±4.6 ms at the time that concided with the onset of sustained ventricle arrhythmic. Amiodarone could decrease TDR, but lidocaine could increase TDR at initial ischemia, and no significant difference was found at other ischemia time points. 5 cases had ventriclar arrhythmia in ischemia group (62.5 %), but no case in lidocaine group (P<0.01) and only 1 case in amiodarone group had ventrilar arrhythmia (P< 0.01). No significant difference was found between amiodarone group and lidocaine group. It is concluded that TDR of of three myocardial layers increases significantly at ischemia and it is closely associated with development of ventricular arrhythmia, and amiodarone could decrease TDR, but lidocaine could increase TDR at initial ischemia and has no effects at other ischemia time points.

  10. The role of CYP 3A4 and 1A1 in amiodarone-induced hepatocellular toxicity.

    Science.gov (United States)

    Wu, Qiangen; Ning, Baitang; Xuan, Jiekun; Ren, Zhen; Guo, Lei; Bryant, Matthew S

    2016-06-24

    Amiodarone is a widely used potent antiarrhythmic for the treatment of cardiac disease; however, its use is often discontinued due to numerous adverse effects, including hepatotoxicity. To investigate the role of drug metabolism in this liver toxicity, amiodarone and its major metabolite desethylamiodarone were incubated with HepG2 cells overexpressing a series of cytochrome P450 (CYP) isoforms. Significantly higher cytotoxicity of amiodarone was observed in HepG2 cells overexpressing CYP3A4 or CYP1A1, compared with that observed in empty vector transduced control cells. Further, higher levels of the more potent hepatotoxic metabolite desethylamiodarone were detected in CYP3A4 or CYP1A1 expressed cells. The CYP3A4 inhibitor ketoconazole and the CYP1A1 inhibitor α-naphthoflavone drastically inhibited the metabolism of amiodarone to desethylamiodarone. Along with the inhibition of CYP1A1 or CYP3A4, the cytotoxicity of amiodarone was significantly reduced. These data indicate that the metabolism of amiodarone to desethylamiodarone by CYP1A1 or CYP3A4 plays an important role in the hepatocellular toxicity of amiodarone. PMID:27113703

  11. Comparison of Ventricular Electrophysiological Effects of Amiodarone in Canine Models With Congestive Heart Failure and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Shuxian Zhou; Yuling Zhang; Juan Lei; Wei Wu; Xuming Zhang

    2008-01-01

    Objectives This study compared the effects of amiodarone on ventricular electrophysiological properties in normal dogs and CHF dogs.Methods Dogs(n=44) were randomized into four groups:Group 1(n=10)was the control.Group 2(n=10) was given amiodarone orally 300 mg·d-1 for4 to 5 weeks.Group 3(n=12)was the congestive heart failure(CHF)models induced by right ventricular rapid pacing(240 pulses·rain-1 for 4 to 5 weeks).Group 4 (n=12) was the CHF models given amiodarone orally 300 mg·d-1 for 4 to 5 weeks.The ventricular electrophysiological variables were evaluated by standard electric stimulation and monophasic action potential(MAP)recording.Results Amiodarone prolonged sinus cycle length(SCL),intra-ventricular conduction time(IVCT),MAP duration(MAPD90),ventricular effective period(VERP),ventricular activation time(VAT)and ventficular recovery time(VRT)without significant effects on the ratio of VERP to MAPD90 (VERP/MAPD90),ventricular fibrillation threshold(VFT),the dispersion of VRT(VRTD),and ventricular late repolarization duration(VLRD)in normal dogs.However,amiodarone did not further prolong the prolonged SCL,MAPD90,VERP,VAT and VRT,but further prolonged IVCT in CHF dogs.Amiodarone normalized the abnormal ventficular electrophysiological properties in CHF dogs as manifested by increasing the decreased VERP/MAPD90 and VFT,shortening the prolonged VLRD,and decreasing the increased VRTD.Amiodarone did not worsen the hemodynamic parameters in normal and CHF dogs.Conclusions Amiodarone had different effects on ventricular electrophysiological properties in normal and CHF dogs.The favorable effects of amiodarone in normalizing some abnormal cardiac electrophysiological properties in CHF models may have potential value on the prevention and treatment of ventricular arrhythmias and sudden cardiac death in CHF.

  12. Effects of Amiodarone plus Losartan on Electrical Remodeling in Rapid Atrial Pacing in Rabbits

    Institute of Scientific and Technical Information of China (English)

    Liye Wei; Yue Xia; Guoqing Qi; Qingwen Zhang

    2008-01-01

    Objectives To investigate the electrical remodeling and the effects of amiodarone and losartan on electrical remode-ling in rapid atrial pacing on rabbit model. Methods 40 normal rabbits were randomly divided into 4 groups: the sa-line group (control group), amiodarone group, losartan group, ami + los group. All rabbits were raised drugs in a week. The atrial effective refractory period (AERP) was measured. Then, take a rapid atrial pacing (600 bpm) and the AERP was measured after 0. 5, 1, 2, 4, 6 and 8 hours pacing and 30 minutes after the termination of rapid pacing. Results ① In control group, after 8 hours rapid pacing, AERP 200 and AERP 150 were significantly shortened 16. 11%± 3. 1% (P <0. 01) and 9. 99%±4. 2% (P <0. 01). And the degree of AERP shortening induced by rapid pacing was greater at basic cycle lengths of 200 ms (BCL200) than that at BCL150. The AERP of amiodarone, losartan group and anti + los group were not shortened during rapid pacing.② In the control group, after the termination of rapid pacing, the AERP gradually increased. The AERP at all of the BCLS examined recovered to almost the 95.78% and 96. 76% of baseline values within the first 10 minutes and recovered to almost the 99. 07% and 99. 39% of baseline values within the first 30 minutes. Condusions Short-term atrial rapid pacing can induce the atrial electrical remodeling. Amiodarone and losartan can prevent the electrical remodeling.

  13. Hyperacute drug-induced hepatitis with intravenous amiodarone: case report and review of the literature

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    Nasser M

    2013-09-01

    Full Text Available Mohammad Nasser, Timothy R Larsen, Barryton Waanbah, Ibrahim Sidiqi, Peter A McCullough Providence Hospitals and Medical Centers, Department of Medicine, Division of Cardiology, Southfield and Novi, MI, USA Abstract: Amiodarone is a benzofuran class III antiarrhythmic drug used to treat a wide spectrum of ventricular tachyarrhythmias. The parenteral formulation is prepared in polysorbate 80 diluent. We report an unusual case of acute elevation of aminotransaminase concentrations after the initiation of intravenous amiodarone. An 88-year-old Caucasian female developed acute hepatitis and renal failure after initiating intravenous amiodarone for atrial fibrillation with a rapid ventricular response in the setting of acutely decompensated heart failure and hepatic congestion. Liver transaminases returned to baseline within 7 days after discontinuing the drug. Researchers hypothesized that this type of injury is related to liver ischemia with possible superimposed direct drug toxicity. The CIOMS/RUCAM scale identifies our patient’s acute hepatitis as a highly probable adverse drug reaction. Future research is needed to understand the mechanisms by which hyperacute drug toxicity occurs in the setting of impaired hepatic perfusion and venous congestion. Keywords: intravenous amiodarone, acute hepatotoxicity, liver transaminases, drug-induced liver toxicity

  14. Is amiodarone a safe antiarrhythmic to use in supraventricular tachyarrhythmias after lung cancer surgery?

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    Barbetakis Nikolaos

    2004-06-01

    Full Text Available Abstract Background Supraventricular arrhythmias after thoracotomy for pulmonary resections are well documented. There has been considerable interest in their incidence, nature, predictability from preoperative assessment and treatment. The purpose of this study is to define prevalence, type, risk factors for post-thoracotomy supraventricular arrhythmias and to assess the efficacy of amiodarone as an antiarrhythmic drug. Methods The records of 250 patients undergoing pulmonary resection for lung cancer during last two years were followed up in this prospective study with particular attention to possible risk factors (gender, age, extent and side of resection, diabetes mellitus, hypertension, tobacco smoking, beta-blocker ingestion. Patients underwent biopsy only were excluded. Once onset of supraventricular arrhythmia was monitored or documented in the electrocardiogram, intravenous infusion of amiodarone was started with a loading dose of 5 mg/kg in 30 minutes and a maintenance dose of 15 mg/kg until remission of it. Results Forty-three episodes (21.6% of supraventricular arrhythmias were documented with atrial fibrillation being the most common (88.3%. Rhythm disturbances were most likely to develop on the second postoperative day. Pneumonectomy, lobectomy and age >65 years were the statistically significant factors. The overall postoperative mortality was 3.2% and 2.3% for the patients with postoperative supraventricular arrhythmias. In none of the cases did supraventricular arrhythmia cause cardiac failure leading to death. Sinus rhythm was achieved with amiodarone in 37 out of 43 patients (86%. Electrical cardioversion was necessary for 6 patients who were hemodynamically unstable. The most common amiodarone-related complication was bradycardia (13.5%. Conclusions Postoperative supraventricular arrhythmias are a common complication in elderly patients undergoing lung resection surgery (especially pneumonectomy or lobectomy. Amiodarone is

  15. In vivo probe-based confocal laser endomicroscopy in amiodarone-related pneumonia.

    Science.gov (United States)

    Salaün, Mathieu; Roussel, Francis; Bourg-Heckly, Geneviève; Vever-Bizet, Christine; Dominique, Stéphane; Genevois, Anne; Jounieaux, Vincent; Zalcman, Gérard; Bergot, Emmanuel; Vergnon, Jean-Michel; Thiberville, Luc

    2013-12-01

    Probe-based confocal laser endomicroscopy (pCLE) allows microscopic imaging of the alveoli during bronchoscopy. The objective of the study was to assess the diagnostic accuracy of pCLE for amiodarone-related pneumonia (AMR-IP). Alveolar pCLE was performed in 36 nonsmoking patients, including 33 consecutive patients with acute or subacute interstitial lung disease (ILD), of which 17 were undergoing treatment with amiodarone, and three were amiodarone-treated patients without ILD. Nine out of 17 patients were diagnosed with high-probability AMR-IP (HP-AMR-IP) by four experts, and three separate observers. Bronchoalveolar lavage findings did not differ between HP-AMR-IP and low-probability AMR-IP (LP-AMR-IP) patients. In HP-AMR-IP patients, pCLE showed large (>20 μm) and strongly fluorescent cells in 32 out of 38 alveolar areas. In contrast, these cells were observed in only two out of 39 areas from LP-AMR-IP patients, in one out of 59 areas from ILD patients not receiving amiodarone and in none of the 10 areas from amiodarone-treated patients without ILD (p<0.001; HP-AMR-IP versus other groups). The presence of at least one alveolar area with large and fluorescent cells had a sensitivity, specificity, negative predictive value and positive predictive value for the diagnosis of AMR-IP of 100%, 88%, 100% and 90%, respectively. In conclusion, pCLE appears to be a valuable tool for the in vivo diagnosis of AMR-IP in subacute ILD patients. PMID:23018901

  16. Effect of prophylactic amiodarone in patients with rheumatic valve disease undergoing valve replacement surgery

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    Kar Sandeep

    2011-01-01

    Full Text Available The study was carried out to evaluate the effect of prophylactic single-dose intravenous amiodarone in patients undergoing valve replacement surgery. Maintenance of sinus rhythm is better than maintenance of fixed ventricular rate in atrial fibrillation (AF especially in the presence of irritable left or right atrium because of enlargement. Fifty-six patients with valvular heart disease with or without AF were randomly divided into two groups. Group I or the amiodarone group (n=28 received amiodarone (3 mg/kg in 100 ml normal saline and group II or the control group received same volume of normal saline. The standardized protocol for cardiopulmonary bypass was maintained for all the patients. AF occurred in 7.14% patients in group I, and in group II, 28.57% (P=0.035; ventricular tachycardia/fibrillation was observed in 21.43% patients in group I and 46.43% patients in group II (P=0.089 after release of aortic clamp. Most of the patients in group I (92.86% maintained sinus rhythm without cardioversion or defibrillation after release of aortic cross clamp (P=0.002. Defibrillation or cardio version was needed in 7.14% patients in group I and 28.57% patients in group II (P=0.078. A single prophylactic intraoperative dose of intravenous amiodarone decreased post bypass arrhythmia in this study in comparison to the control group. Single dose of intraoperative amiodarone may be used to decrease postoperative arrhythmia in open heart surgery.

  17. Effect of amiodarone, an antiarrhythmic drug, on serum and liver lipids and serum marker enzymes in rats.

    Science.gov (United States)

    Padmavathy, B; Devaraj, S N; Devaraj, H

    1992-12-01

    Administration of amiodarone (AD) to rats leads to marked damage to liver, as evidenced by pathological changes and significant increases in activities of serum marker enzymes and levels of lipids like cholesterol and phospholipids with no alteration in the triglyceride levels. The risk factor, that is the total cholesterol/HDL cholesterol ratio, exhibited increase in the experimental animals, indicating that amiodarone treatment may lead to the development of coronary heart disease. PMID:1294474

  18. Acute effect of amiodarone on cardiovascular reflexes of normotensive and renal hypertensive rats

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    Oliveira P.F.

    2005-01-01

    Full Text Available The aim of the present study was to evaluate the effect of amiodarone on mean arterial pressure (MAP, heart rate (HR, baroreflex, Bezold-Jarisch, and peripheral chemoreflex in normotensive and chronic one-kidney, one-clip (1K1C hypertensive rats (N = 9 to 11 rats in each group. Amiodarone (50 mg/kg, iv elicited hypotension and bradycardia in normotensive (-10 ± 1 mmHg, -57 ± 6 bpm and hypertensive rats (-37 ± 7 mmHg, -39 ± 19 bpm. The baroreflex index (deltaHR/deltaMAP was significantly attenuated by amiodarone in both normotensive (-0.61 ± 0.12 vs -1.47 ± 0.14 bpm/mmHg for reflex bradycardia and -1.15 ± 0.19 vs -2.63 ± 0.26 bpm/mmHg for reflex tachycardia and hypertensive rats (-0.26 ± 0.05 vs -0.72 ± 0.16 bpm/mmHg for reflex bradycardia and -0.92 ± 0.19 vs -1.51 ± 0.19 bpm/mmHg for reflex tachycardia. The slope of linear regression from deltapulse interval/deltaMAP was attenuated for both reflex bradycardia and tachycardia in normotensive rats (-0.47 ± 0.13 vs -0.94 ± 0.19 ms/mmHg and -0.80 ± 0.13 vs -1.11 ± 0.13 ms/mmHg, but only for reflex bradycardia in hypertensive rats (-0.15 ± 0.02 vs -0.23 ± 0.3 ms/mmHg. In addition, the MAP and HR responses to the Bezold-Jarisch reflex were 20-30% smaller in amiodarone-treated normotensive or hypertensive rats. The bradycardic response to peripheral chemoreflex activation with intravenous potassium cyanide was also attenuated by amiodarone in both normotensive (-30 ± 6 vs -49 ± 8 bpm and hypertensive rats (-34 ± 13 vs -42 ± 10 bpm. On the basis of the well-known electrophysiological effects of amiodarone, the sinus node might be the responsible for the attenuation of the cardiovascular reflexes found in the present study.

  19. Interaction of rivaroxaban with amiodarone, verapamil and diltiazem in patients with atrial fibrillation: terra incognita

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    S. N. Bel'diev

    2016-03-01

    Full Text Available Currently there are no generally accepted guidelines for the use of rivaroxaban together with amiodarone, verapamil or diltiazem in patients with creatinine clearance (CrCl<80 ml/min. Some researchers suggest that in renal failure amiodarone, verapamil and diltiazem contribute to a significant increase in plasma concentrations of rivaroxaban that is accompanied by increased risk of bleeding. According to preliminary calculations, it seems rational to reduce the dose of rivaroxaban when co-administered with these drugs: to 15 mg/day in patients with ClCr 50-79 ml/min and to 10 mg/day in patients with ClCr<50 ml/min.

  20. Amiodarone toxicity presenting as pulmonary mass and peripheral neuropathy: the continuing diagnostic challenge

    OpenAIRE

    Azzam, I; Tov, N; Elias, N.; Naschitz, J. E.

    2006-01-01

    A 64 year old man receiving long term amiodarone treatment presented with dyspnea, cough, and weight loss. Radiographs and computed tomography showed a lung mass with associated multiple pulmonary nodules. Biopsies of the pulmonary mass showed foamy histiocytes without malignant cells. However, findings on FDG‐PET scan were consistent with a malignant tumour. These findings on computed tomography and PET scan and the unusually late resolution of the pulmonary lesions after withdrawal of amiod...

  1. Use of amiodarone and digoxin specific Fab antibodies in digoxin overdosage.

    OpenAIRE

    Nicholls, D P; Murtagh, J. G.; Holt, D W

    1985-01-01

    A 61 year old man with mild aortic stenosis and chronic depression took 12.5 mg digoxin in a suicide attempt. Ventricular tachycardia and fibrillation were resistant to lignocaine and to phenytoin but responded to intravenous amiodarone, with restoration of pacing. Because of persistent hyperkalaemia he was also treated with Fab fragments of digoxin specific antibody, which bound most of the ingested digoxin. It is suggested that the treatment of choice in severe digoxin poisoning is amiodaro...

  2. Comparative in vitro and in vivo evaluation of three tablet formulations of amiodarone in healthy subjects

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    J Emami

    2010-09-01

    Full Text Available "nBackground and the purpose of the study:The relative in vivo bioavailability and in vitro dissolution studies of three chemically equivalent amiodarone generic products in healthy volunteers was evaluated in three separate occasions. The possibility of a correlation between in vitro and in vivo performances of these tablet formulations was also evaluated. "nMethods: The bioequivalence studies were conducted based on a single dose, two-sequence, cross over randomized design. The bioavailability was compared using AUC0-72, AUC0-∞, Cmax and Tmax. Similarity factor, dissolution efficiency (DE, and mean dissolution time (MDT was used to compare the dissolution profiles. Polynomial linear correlation models were tested using either MDT vs mean residence time (MRT or fraction of the drug dissolved (FRD vs fraction of the drug absorbed (FRA. "nResults: Significant differences were found in the dissolution performances of the tested formulations and therefore they were included in the development of the correlation. The 90% confidence intervals of the log-transformed AUC0-72, AUC0-∞, and Cmax of each two formulations in each bioequivalence studies were within the acceptable range of 80-125%. Differences were not observed between the untransformed Tmax values. Poor correlation was found between MRT and MDT of the products. A point-to-point correlation which is essential for a reliable correlation was not obtained between pooled FRD and FRA. The dissolution condition which was used for amiodarone tablets failed for formulations which were bioequivalent in vivo and significant difference between the dissolution characteristics of products (f2<50 did not reflect their in vivo properties. Major conclusions: Bioequivalence studies should be considered as the only acceptable way to ensure the interchangeability and in vivo equivalence of amiodarone generic drug products. The dissolution conditions used of the present study could be used for routine and in

  3. Effects of Amiodarone and N-desethylamiodarone on Cardiac Voltage-Gated Sodium Channels

    OpenAIRE

    Ghovanloo, Mohammad-Reza; Abdelsayed, Mena; Ruben, Peter C.

    2016-01-01

    Amiodarone (AMD) is a potent antiarrhythmic drug with high efficacy for treating atrial fibrillation and tachycardia. The pharmacologic profile of AMD is complex. AMD possesses biophysical characteristics of all of class I, II, III, and IV agents. Despite its adverse side effects, AMD remains the most commonly prescribed antiarrhythmic drug. AMD was described to prolong the QT interval and can lead to torsades de pointes. Our goal was to study the effects of AMD on peak and late sodium curren...

  4. Study with radio aerosol of DTPA technetium-99 m in individuals with pulmonary disease by amiodarone

    International Nuclear Information System (INIS)

    In order to evaluate the role of the clearance of 99 m Technetium chelated to diethylenetriamine-penta-acetate (99 m Tc-DTPA) in amiodarone induced pulmonary disease, 40 individuals were studied in four groups. After spirometry, where a volume-time curve was registered, all individuals inhaled 740 MBq of 99 m Tc-DTPA diluted in 4 ml of saline, for five minutes. Pulmonary images were obtained in a computerized scintillation camera and 9 regions of interest were selected. (author)

  5. Trastornos tiroideos por amiodarona The effects of amiodarone on the thyroid

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    M. Toni

    2009-12-01

    (59% vs 41%, lo que puede estar justificado por ser Navarra una comunidad con déficit de yodo. Es necesario el seguimiento de la función tiroidea durante al menos 2-3 años después del inicio del tratamiento con amiodarona.Background. Amiodarone is a drug widely used for the treatment of arrhythmias. In 16% of amiodarone-treated patients it causes changes in the thyroid function. The aim of this study was to determine the importance of amiodarone-induced thyroid dysfunction in the population of Navarre, studied between 2001 and 2007. Methods. We present a retrospective study that considers the characteristics of 182 amiodarone-treated patients with thyroid dysfunction who had been referred to our Institute. We determined a series of biochemical and instrumental investigations (measurement of thyrotrophin, free thyroid hormones and thyroid autoantibodies; thyroid sonography and thyroid scintigraphy uptake. Results. Screening of the thyroid function, recommended before starting amiodarone treatment, was carried out in only 20.9 % of the patients. Forty-one percent of patients developed amiodarone induced hypothyroidism; in 76% of them the drug was withdrawn. Hypothyroidism appears after 21 (± 12 months of amiodarone treatment. Forty-eight point six developed permanent hypothyroidism. This group of patients had higher serum levels of TSH (thyrotropin and were treated for less time with amiodarone. Fifty-nine percent of patients developed amiodarone induced thyrotoxicosis; 59.4 % were diagnosed with thyrotoxicosis (AIT type 1, 30.6% AIT type 2 and the remaining 10 % were diagnosed with mixed thyrotoxicosis. Thyrotoxicosis appears after 29.5 (± 17 months of amiodarone treatment. The serum levels of free thyroxine were significantly higher in the AIT type 2 than in the AIT type1. All patients were treated with antithyroid drugs and/or corticoids. Some patients were admitted to hospital due to the severity of their illness. Conclusions. In our study, amiodarone induced

  6. Cryptogenic organizing pneumonia due to amiodarone: long-term follow-up after corticosteroid treatment.

    Science.gov (United States)

    Schindler, Katja; Schima, Wolfgang; Kaliman, Josef F

    2010-08-01

    Cryptogenic organizing pneumonia (formerly known as bronchiolitis obliterans organizing pneumonia) is a clinicopathological entity with characteristical radiographic findings such as bilateral, asymmetrical, sometimes migrating, patchy infiltrates in chest radiograph and ground-glass opacities in computed tomography. The disease has been observed in the context of gastrointestinal disorders, certain lung infections, autoimmune-mediated diseases (such as Wegener granulomatosis), inhalation of toxic fumes, bone marrow transplantation and administration of drugs. The benzofuran amiodarone, a commonly used antiarrythmic drug for atrial fibrillation, can exhibit several pulmonary adverse effects, amongst them cryptogenic organizing pneumonia as a rarely diagnosed and published one. We report a case of cryptogenic organizing pneumonia secondary to amiodarone treatment, its clinical course with significant improvement of clinical symptoms within a few days after discontinuation of amiodarone treatment and administration of corticosteroids. Also the infiltrations found in chest X-ray and computed tomography responded well and showed remarkable resolution tendency quickly. During 5 months of corticoid therapy pulmonary abnormalities gradually resolved almost completely and remained equal during the 8 months follow-up after corticoid termination. PMID:20668958

  7. In vitro study of lovastatin interactions with amiodarone and with carbon tetrachloride in isolated rat hepatocytes

    Institute of Scientific and Technical Information of China (English)

    AZ Krasteva; MK Mitcheva; MS Kondeva-Burdina; VA Descatoire

    2007-01-01

    AIM: To investigate the interactions at a metabolic level between lovastatin, amiodarone and carbon tetrachloride in isolated rat hepatocytes.METHODS: For cell isolation two-step collagenase liver perfusion was performed. Lovastatin was administered alone in increasing concentrations (1 μmol/L, 3 μmol/L,5 μmol/L and 10 μmol/L) and in combination with CCl4 (86 μmol/L). The cells were also pretreated with 14 μmol/Lamiodarone and then the other two compounds were added.RESULTS: Lovastatin promoted concentration-dependent significant toxicity estimated by decrease in cell viability and GSH level by 45% and 84%, respectively. LDH-activity increased by 114% and TBARS content by 90%. CCl4 induced the expected severe damage on the examined parameters. CCl4 induced toxicity was attenuated after lovastatin pretreatment, which was expressed in less increased values of LDH activity and TBARS levels, as well as in less decreased cell viability and GSH concentrations. However, the pretreatment of hepatocytes with amiodarone abolished the protective effect of lovastatin.CONCLUSION: We suggest that the observed cytoprotective effect was due to interactions between lovastatin,CCl4 and amiodarone at a metabolic level.

  8. Comparison of amiodarone vs magnesium sulphate in the prevention of atrial fibrillation after coronary artery bypass grafting surgery

    International Nuclear Information System (INIS)

    Background: Atrial fibrillation (AF) is common in patients after coronary artery bypass grafting (CABG) and can result in increased morbidity and mortality, increased length of hospital stay, and increased cost. In this study we compared the efficacy of amiodarone versus magnesium sulphate in the prophylaxis of post-CABG atrial fibrillation. Objective: This study was carried out to assess the efficacy of amiodarone in comparison to magnesium sulphate in the prevention of atrial fibrillation after coronary artery bypass grafting. Study Design: Randomized controlled trials. Place and duration of study: The study was carried out at Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi from July 2010 to December 2011 Patients and Methods: Total 240 patients were included in the study and randomly divided in two groups of 120 each using random number table. Patients in Group A (Amiodarone group) were given a loading dose of amiodarone 5 mg/Kg after induction of anesthesia which was then continued as infusion at 5 micro gm/Kg/minute on first postoperative day. This was followed by an oral dose of 600 mg/day postoperatively for 5 days. Those in Group B (Magnesium Sulphate group) received 2 g of magnesium sulphate in 100 ml of isotonic 0.9% solution intravenously over 1 hour at following times: preoperatively, immediately following the operation, and on postoperative days 1, 2, and 3. Results: Thirteen patients (10.8%) developed AF in Amiodarone group, compared to 31 patients (25.8%) in magnesium sulphate group. The results proved amiodarone to be more effective than magnesium sulphate in preventing post-CABG AF (p<0.001). Thirty one patients who developed AF postoperatively in the magnesium group were treated with amiodarone, and all patients recovered normal sinus rhythm. In the amiodarone prophylaxis group, 9 patients regained sinus rhythm in 6 - 8 hours, while for 4 remaining patients cardioversion was attempted out of which 2

  9. Histopathological and Biochemical Toxic Effect of Amiodarone on Thyroid Gland in Albino Rat

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    Ola A. El Sayed*, Safaa E. Gawish

    2007-12-01

    Full Text Available Backgrounds: Amiodarone AMD (Cordarone was a benzofuran derivative, used in management of angina and refractory ventricular arrhythmia. Its effect on the thyroid gland structure and function was investigated in this study. Material and Methods: Fifty adult male albino rats were used and divided into three groups. The first group was consisted of 10 rats which served as control, received distilled water orally (1ml. The second group was consisted of 20 rats used as therapeutic dose treated group, received 40 mg/Kg b. w. of amiodarone while the third group was consisted of 20 rats used as a toxic dose treated group which received 60 mg/Kg b. w. of amiodarone orally daily for three months. Body weight of animals was determined. Serum concentration of tri-iodothyonine (T3, thyroxine (T4, thyrotrophin (TSH, interleukin 6 (IL6, tumour marker P53 and tissue residue for amiodarone in plasma, fat, liver, lung, thyroid gland and heart was determined. Results: Specimens from thyroid gland were taken and prepared for light and electron microscope examination. Highly significant decrease in body weight (P<0.001 were observed in both therapeutic and toxic doses treated groups in comparison to the control one. A very highly significant increase (P<0.001 of serum (T4 & T3 with Concomitant suppression of (TSH (P<0.001. Serum levels of IL6 and P53 showed also a very highly significant increase (P<0.001. Amiodarone concentration in plasma, fat, liver, lung, thyroid gland and heart showed significant increase in therapeutic dose treated group and highly significant increase in toxic dose treated group. Histopathological examination of thyroid gland of therapeutic dose treated group by light microscope showed marked evidence of thyotoxicosis in the form of microcystic follicular changes and peripheral scalloping, cellular degeneration with scanty cytoplasm and vesicular nuclei appeared. These changes became more severe in toxic dose treated group in the form of

  10. Investigating herb-drug interactions: the effect of Citrus aurantium fruit extract on the pharmacokinetics of amiodarone in rats.

    Science.gov (United States)

    Rodrigues, Márcio; Alves, Gilberto; Falcão, Amílcar

    2013-10-01

    Citrus aurantium extract has been largely used in weight loss and sports performance dietary supplements. However, the safety of C. aurantium-containing products has been questioned mainly due to the association of its use with adverse events in the cardiovascular system. Therefore, this work aimed to assess the potential for herb-drug interactions among a standardized C. aurantium extract (GMP certificate) and amiodarone (narrow therapeutic index drug) in rats. In a first pharmacokinetic study, rats were simultaneously co-administered with a single-dose of C. aurantium (164 mg/kg, p.o.) and amiodarone (50 mg/kg, p.o.); in a second study, rats were pre-treated during 14 days with C. aurantium (164 mg/kg/day, p.o.) and received amiodarone (50 mg/kg, p.o.) on the 15th day. Rats of the control groups received the corresponding volume of vehicle. Overall, after analysis of the pharmacokinetic data, it deserves to be highlighted the significant increase of the peak plasma concentration of amiodarone in rats pre-treated with C. aurantium extract, while the extent of systemic exposure was comparable between both groups. This paper reports, for the first time, data on the potential of herb-drug interaction between C. aurantium extract and amiodarone. However, specific clinical trials should be performed to confirm these results in humans. PMID:23886819

  11. Alternative methods of local amiodarone delivery for atrial fibrillation prevention in patients after coronary artery bypass grafting

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    Bockeria L.A.

    2016-03-01

    Some anti-inflammatory agents have shown good results in postoperative AF prevention, including such as non-steroidal anti-inflammatory drugs, Colchicine, glucocorticoids and statins. The method of using of epicardial patches with antyarrhythmic drugs is limited with short drug exposition duration time. Epicardial application of the adhesive hydrogel with amiodarone is less invasive, safe, technically simple and effective method of atrial fibrillation prevention. The results of preclinical and known clinical trials have shown the possibility of this method using for AF prevention with lower risk of systemic and local adverse effects of amiodarone in comparison with oral and systemic use.

  12. Dysfunction of the thyroid gland during amiodarone therapy: a study of 297 cases

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    Czarnywojtek A

    2016-04-01

    Full Text Available Agata Czarnywojtek,1,2,* Maria Teresa Płazińska,3,* Małgorzata Zgorzalewicz-Stachowiak,4 Kosma Woliński,1 Adam Stangierski,1 Izabela Miechowicz,5 Joanna Waligórska-Stachura,1 Paweł Gut,1 Leszek Królicki,3 Maja Zioncheck,6 Marek Ruchała1 1Department of Endocrinology, Metabolism and Internal Medicine, 2Department of Pharmacology, Poznan University of Medical Sciences, Poznan, 3Nuclear Medicine Department, Medical University of Warsaw, Warsaw, 4Department of Health Prophylaxis, Laboratory of Medical Electrodiagnostics, 5Department of Computer Science and Statistics, 6Poznan University of Medical Sciences, Poznan, Poland *These authors contributed equally to this work Aim: This study aims to explore and compare the efficacy of radioiodine treatment (RIT in hyperthyroid and euthyroid patients who have been treated with amiodarone (AM in the past or are currently undergoing AM treatment. Clinical observation of a group of patients with amiodarone-induced hypothyroidism during a 12-month follow-up period was used for comparison.Design: This was a observational, two-centered study. Patients were assessed at baseline and at 2 months, 6 months, 8 months, and 12 months after RIT.Patients: Group A: At baseline (61 males [M] and 17 females [F], mean age 50±19 years, there were 78 euthyroid patients with cardiac arrhythmias, who were treated with AM and developed amiodarone-induced thyrotoxicosis, and currently require retreatment with AM. Group B: Hyperthyroid patients (92 M and 26 F, mean age 72±11.8 years after AM therapy in the past. Group C: Hyperthyroid patients (66 M and 13 F, mean age 63.9±13.2 years currently treated by AM. Group D: Hypothyroid patients (6 M and 16 F, mean age 61.4±10.4 years after AM therapy. The patients from Groups A, B, and C were retreated with AM after ~3–6 weeks of RIT.Results: In Group A, after 12 months of RIT therapy, recurrent thyrotoxicosis was observed in six (7.7% cases, and persistent

  13. Use of lidocaine, propranolol, amiodarone, and verapamil in toad envenoming (genus bufo in dogs

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    M. SAKATE

    2001-12-01

    Full Text Available Toad envenoming in dogs can cause death by cardiac fibrilation (CVF. Traditional therapy consists mainly of atropine and propranolol, the last one used to prevent the CVF, that is preceded by negative ventricular deflections (NVDs in the QRS complex of the electrocardiogram. This study intended to verify, comparatively, the lidocaine, propranolol, amiodarone, and verapamil abilities to prevent CVF in experimentally envenomed dogs. Thirty-six dogs were divided into 6 groups (GL, GP, GA, GV, GST, and GSV with n=6; the dogs were submitted to volatile anaesthesia. The animals of the groups GL, GP, GA, and GV received 0.38g of toad venom through oro-gastric catheter and were treated with the following drugs respectively: lidocaine (4mg/Kg, propranolol (0.1mg/Kg, amiodarone (8mg/Kg, and verapamil (2mg/Kg. These drugs were repeated if NVDs reappeared with cardiac frequency >150, GST was not treated and GSV was just anaesthetized. The following results were obtained: GL, NVDs present in 4 animals, 100% recuperation with 3.66 doses/animal; GP, NVDs present in 2 animals, 100% recuperation with 1.66 dose/animal, with bradycardia at the anaesthetic return; GA, NVDs present in 3 animals, 33.33% recuperation with 1.5 dose/animal; GV, NVDs present in 4 animals, 100% recuperation with 2.16 doses/animal; GST, NVD present in 6 animals, 100% death and GSV, NVDs absent, 100% recuperation. As a conclusion, the anaesthetic proceedings used, did not cause NVDs, the envenoming that was not treated was lethal, and among the antiarrhythmics drugs used, verapamil was the most efficient, as it did not cause any serious bradycardia at the anaesthetic return and did not require repeated administrations. For lidocaine, it was efficient but required various administrations; amiodarone could not prevent the death of 4 animals; propranolol was efficient in relation to NVDs control, but caused serious bradycardia at the anaesthetic return.

  14. Amiodarona y disfunción tiroidea Amiodarone and thyroid dysfunction

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    Leonardo F. L. Rizzo

    2012-02-01

    Full Text Available La amiodarona es un análogo estructural de la hormona tiroidea, y algunas de sus propiedades antiarrítmicas como así también su toxicidad son atribuibles a su interacción con los receptores nucleares de las hormonas tiroideas. Por ser muy lipofílica, la amiodarona se concentra en muchos tejidos y se elimina, por consecuencia, muy lentamente. Se emplea preferentemente para el tratamiento de arritmias graves tales como fibrilación y taquicardia ventriculares. Otras indicaciones incluyen la fibrilación auricular y el aleteo, la insuficiencia cardíaca congestiva grave, la prevención de la fibrilación auricular recurrente y situaciones de emergencia médica como la prevención de muerte súbita cardiaca¹. Nuestro objetivo es proporcionar un enfoque actualizado sobre la amiodarona y su influencia sobre la fisiología tiroidea y discutir y analizar en profundidad sus potenciales efectos adversos como el hipotiroidismo y la tirotoxicosis.Amiodarone is a structural analogue of thyroid hormone, and some of its anti-arrhythmic actions and toxicity are attributable to its interaction with nuclear receptors of thyroid hormones. Being highly lipophilic, amiodarone is concentrated in many tissues and is eliminated, consequently, very slowly. It is preferably employed to manage life-threatening arrhythmias, including ventricular fibrillation and unstable ventricular tachycardia. Other indications include atrial fibrillation and flutter, severe congestive heart failure, prevention of atrial fibrillation recurrence, and even in emergency medical situations to prevent sudden cardiac death. The aim of this review is to provide an updated approach on amiodarone and its influence on thyroid physiology and to discuss and analyze in depth its potential and not infrequent thyroidal adverse effects such as hypothyroidism and thyrotoxicosis.

  15. Role of Pre-incision, Intravenous Prophylactic Amiodarone to Control Arrhythmias in Patients with Rheumatic Valvular Heart Disease undergoing Mitral Valve Replacement

    International Nuclear Information System (INIS)

    Objective: To evaluate the effect of intra-operative single intra venous dose of amiodarone on post operative cardiac arrhythmias in patients undergoing valvular heart surgery. Study Design: Randomized controlled trials. Place and Duration of surgery: This study was performed at Armed forces Institute of Cardiology Rawalpindi from Jan 01, 2011 to Dec 31, 2011. Patients and Methods: In this study 80 patients with rheumatic valvular heart disease and undergoing elective mitral valve replacement were randomly divided into two groups. Group I, n = 40 (Amiodarone group) was given single intravenous dose of amiodarone (5 mg/kg in 100 ml of saline over 30 min) before sternotomy incision. Group II, n = 40(control / placebo group) was given 100 ml of saline over 30 min. Result: In the amiodarone group, after removal of aortic cross clamp 75% patients had sinus rhythm compared to 47.5% in control group. p=0.045. Similarly 15% had AF, 5% JR and 5% VT/VF in amiodarone group in contrast to 32.5% with AF, 12.5% JR and 7.5% Vt/VF in control group. (p=0.045). Response to cardioversion was positive in 75% of the patients requiring shocks in amiodarone group as against 43.75% in the control group. (p=0.044). Conclusion: A single intravenous bolus dose of amiodarone is effective in decreasing the incidence of cardiac arrhythmias after mitral valve replacement in patients with rheumatic MVD. (author)

  16. A CASE REPORT OF AMIODARONE INDUCED MYOPATHY IN A PATIENT OF VENTRICULAR ARRHYTHMIA

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    Rajat

    2014-09-01

    Full Text Available Myopathies are disorders with structural changes or functional impairment of muscle. Voluntary muscle is subject to a range of hereditary and acquired disorders affecting either its structure, or the biochemical processes which convert the chemical energy derived from cell metabolism into mechanical energy in a controlled manner. These disorders present in a limited number of ways, most commonly a symmetrical weakness of the large, power-generating proximal muscles. Drug induced myopathy comes under acquired causes of myopathy. Here we shall be presenting a case of Amiodarone induced myopathy in a 40 years old male patient of ventricular arrhythmia. We shall also discuss the further management of this presentation.

  17. Effect of Aronia melanocarpa fruit juice on amiodarone-induced pneumotoxicity in rats

    OpenAIRE

    Valcheva-Kuzmanova, Stefka; Stavreva, Galya; Dancheva, Violeta; Terziev, Ljudmil; Atanasova, Milena; Stoyanova, Angelina; Dimitrova, Anelia; Shopova, Veneta

    2014-01-01

    Background: The fruits of Aronia melanocarpa (Michx.) Elliot is extremely rich in biologically active polyphenols. Objective: We studied the protective effect of A. melanocarpa fruit juice (AMFJ) in a model of amiodarone (AD)-induced pneumotoxicity in rats. Materials and Methods: AD was instilled intratracheally on days 0 and 2 (6.25 mg/kg). AMFJ (5 mL/kg and 10 mL/kg) was given orally from day 1 to days 2, 4, 9, and 10 to rats, which were sacrificed respectively on days 3, 5, 10, and 28 when...

  18. [Brown urine : Myoglobin-induced renal failure after concomitant administration of simvastatin and amiodarone].

    Science.gov (United States)

    Pietsch, U; Müller-Höcker, C; Filipovic, M

    2016-05-01

    Rhabdomyolysis is a rare but well-known complication of statin therapy. The risk is considerably increased when concomitant drugs are administered that inhibit metabolism and breakdown via the cytochrome CYP3A4. We report a case of myoglobin-induced acute renal failure secondary to the concomitant use of simvastatin and amiodarone. The risk of rhabdomyolysis is mainly determined by the statin dose; in the case of the concomitant use of CYP3A4 inhibitors, a maximal daily dose of 20 mg is recommended to avoid harmful drug interactions. PMID:27142363

  19. Effect of single intraoperative dose of amiodarone in patients with rheumatic valvular heart disease and atrial fibrillation undergoing valve replacement surgery

    Directory of Open Access Journals (Sweden)

    Selvaraj Thiruvenkadam

    2009-01-01

    Full Text Available Maintenance of sinus rhythm (SR is superior to rate control in atrial fibrillation (AF. In order to achieve SR, we administered single-dose intravenous amiodarone intraoperatively and evaluated its effect on conversion of rheumatic AF to SR in patients undergoing valvular heart surgery. Patients were randomly assigned to amiodarone ( n = 42 or control ( n = 40 group in a double blind manner. The amiodarone group received amiodarone (3 mg/kg intravenously prior to the institution of cardiopulmonary bypass and the control group received the same volume of normal saline. In the amiodarone group, the initial rhythm after the release of aortic cross clamp was noted to be AF in 14.3% ( n = 6 and remained so in 9.5% ( n = 4 of patients till the end of surgery. In the control group, the rhythm soon after the release of aortic cross clamp was AF in 37.5% ( n = 15 ( p = 0.035 and remained so in 32.5% ( n = 13 of patients till the end of surgery ( p = 0.01. At the end of first post-operative day 21.4% ( n = 9 of patients in amiodarone group and 55% ( n = 22 of patients in control group were in AF ( p = 0.002. The requirement of cardioversion/defibrillation was 1.5 (±0.54 in amiodarone group and 2.26 (±0.73 in the control group ( p = 0.014, and the energy needed was 22.5 (±8.86 joules in the amiodarone group and 40.53 (±16.5 in the control group ( p = 0.008. A single intraoperative dose of intravenous amiodarone increased the conversion rate of AF to normal sinus rhythm, reduced the need and energy required for cardioversion/defibrillation and reduced the recurrence of AF within one day.

  20. Safety and Efficacy of Prophylactic Amiodarone in Preventing Early Junctional Ectopic Tachycardia (JET) in Children After Cardiac Surgery and Determination of Its Risk Factor.

    Science.gov (United States)

    Amrousy, Doaa El; Elshehaby, Walid; Feky, Wael El; Elshmaa, Nagat S

    2016-04-01

    Postoperative arrhythmia is a common complication after open heart surgery in children. JET is the most common and dangerous arrhythmia. We aimed to assess safety and efficacy of prophylactic amiodarone in preventing JET in children underwent cardiac surgery and to assess risk factors for JET among our patients. In total, 117 children who underwent cardiac surgery for CHD at Tanta University Hospital from October 2011 to April 2015 were divided in two groups; amiodarone group (65 patients) was given prophylactic amiodarone intraoperatively and placebo group (52 patients). Amiodarone is started as loading dose of 5 mg/kg IV in the operating room after induction of anesthesia and continued for 3 days as continuous infusion 10-15 μg/kg/min. Primary outcome and secondary outcomes of amiodarone administration were reported. We studied pre-, intra- and postoperative factors to determine risk factors for occurrence of JET among these children. Prophylactic amiodarone was found to significantly decrease incidence of postoperative JET from 28.9 % in placebo group to 9.2 % in amiodarone group, and symptomatic JET from 11.5 % in placebo group to 3.1 % in amiodarone group, and shorten postoperative intensive care unit and hospital stay without significant side effects. Risk factors for occurrence of JET were younger age, lower body weight, longer cardiopulmonary bypass, aortic cross-clamp time, hypokalemia, hypomagnesemia, acidosis and high dose of inotropes. JET was more associated with surgical repair of right ventricular outlet obstruction as in case of tetralogy of Fallot and pulmonary stenosis. Most of JET 15/21 (71.4 %) occurred in the first day postoperatively, and 6/21 occurred in the second day (28.6 %). Prophylactic amiodarone is safe and effective in preventing early JET in children after open heart surgery. PMID:26818850

  1. COMPARATIVE EFFICACY OF AMIODARONE AND BISOPROLOL IN TREATMENT OF VENTRICULAR PREMATURE BEATS IN PATIENTS WITH METABOLIC SYNDROME

    Directory of Open Access Journals (Sweden)

    V. M. Provotorov

    2016-01-01

    Full Text Available Aim. Comparative study of amiodarone and bisoprolol efficacy in patients with ventricular arrhythmia and metabolic syndrome.Methods. 146 patients with the AHA/NHLBI 2005 metabolic syndrome and symptomatic ventricular arrhythmia were included in the study. 52 patients received regular oral amiodarone (200 mg daily, 5 days a week therapy, 55 patients received bisoprolol (10 mg daily treatment and 39 patients did not receive any antiarrhythmic therapy (control group. Treatment efficacy was evaluated by Holter monitoring (before start and after 1, 3, 6, 9, 12 months of therapy.Results. Significant efficacy advantage of bisoprolol vs this of amiodarone was observed in 12 months of therapy (50.0% of effectively treated patients vs 17.3%, p=0.02. Significant difference in a number of patients ceased therapy because of antiarrhythmic effect loss was also revealed (20.0% vs 46.1%, p=0.004. A number of patients stopped therapy because of side effects was comparable in the both groups. Patient age younger than 42 years old in combination with a number of ventricular premature beats morphology less than 4 allowed predicting effective antiarrhythmic treatment for both drugs with sensitivity of 70.3% and specificity of 65.0%.Conclusion. Bisoprolol have an advantage (versus amiodarone within 9-12 month therapy in patients with ventricular premature beats and metabolic syndrome. Drug refractoriness and side effects monitoring is necessary.

  2. A Comparative Study on the Effect of Amiodarone and Metaprolol for Prevention of Arrythmias after Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Nayeem‑ul‑hassan

    2013-03-01

    Full Text Available Objectives: The aim of this study was to compare the effect of amiodarone and metaprolol in prevention of atrial fibrillation in patients, following open heart surgery. Methods: This prospective study was carried out between May 2008 to Nov. 2010, and comprised a total of 50 patients with normal preoperative sinus rhythm undergoing open heart surgery using cardio pulmonary bypass. Results: Mean age of patients was 47+2.7 years, of which 60% who developed atrial fibrillation aged from 51 to 60 years. Most patients (62% were in NYHA Class III. Patients who received amiodarone showed significant improvement in LVEF compared to those treated with Metaprolol. Amiodarone treated group exhibited lesser incidence and short-lasting atrial fibrillation, lower ventricular rate, shorter hospitalization, and lesser cost of care than those in metaprolol group. Conclusions: The present study showed that amiodarone was more efficient in controlling post-operative atrial fibrillation as compared to metaprolol. However, a larger randomized controlled trial is needed to corroborate the result of this study.

  3. Efficacy of i.v. amiodarone in converting rapid atrial fibrillation and flutter to sinus rhythm in intensive care patients.

    Science.gov (United States)

    Faniel, R; Schoenfeld, P

    1983-03-01

    Twenty-six consecutive patients (14 males, 12 females--mean age 66.6) were admitted to an intensive care unit (ICU) because of a rapid ventricular response to atrial fibrillation (RAF). Fourteen of them had been unsuccessfully treated by drugs (other than amiodarone) and/or DC shock before admission. A loading dose of i.v. amiodarone was administered (repeated boluses of 3 mg/kg in 3 min, or 30 min-infusions of 5 to 7.5 mg/kg), followed by continuous infusion, in order to reach a maximal total dosage of 1500 mg in 24 h. This treatment was considered efficacious if a reversion to stable sinus rhythm (SSR) occurred within 24 h and was maintained for more than 48 h. This was achieved in 21 out of 26 patients (80.8%). The mean time between the administration of therapy and the occurrence of SSR was 171 min. The total dose of amiodarone delivered to effect SSR was 6.9 +/- 2.3 mg/kg. No adverse reactions were encountered during the bolus injection but we recommend that continuous infusion be carried out through a central venous catheter to avoid phlebitis. The administration of 7 mg/kg of intravenous amiodarone delivered in 30 min proved a safe and successful first choice of management in atrial fibrillation with a rapid ventricular response. PMID:6861767

  4. Estudio farmacocinético de amiodarona en perros Pharmacokinetic study of amiodarone in dogs

    Directory of Open Access Journals (Sweden)

    I. SAAVEDRA

    1999-01-01

    Full Text Available Se estudiaron las características farmacocinéticas de amiodarona en 6 perros mestizos sanos. Después de la aplicación de una infusión endovenosa de 5 mg/Kg. de peso en 2 minutos, se determinaron las concentraciones de la droga y de su metabolito principal, la desetilamiodarona, en tiempos predeterminados, usando el método analítico de HPLC que se describe. Las curvas de concentraciones plasmáticas en el tiempo fueron analizadas por un programa computacional, modelo farmacocinético independiente, obteniéndose los siguientes resultados: AUC: 9.95 ± 2.91 mg/mL/hr, b: 0.25 ± 0.27 L/hr, Cl: 8.82 ± 1.95 mL/min./Kg, TMR: 7.38 ± 1.52 hrs, t1/2b :5.056 ± 4,5 hrs y Vd: 3.424 ± 2.3 L/Kg. Los resultados obtenidos presentan una rápida distribución y disminución de amiodarona en la sangre en los primeros 30 minutos post-administración y, luego, una fase de eliminación lenta. Se concluye que amiodarona es una alternativa a ser considerada en las patologías cardíacas de los perros, ya que de los parámetros farmacocinéticos, parecidos a los obtenidos en humanos, se pueden deducir regímenes de dosis adecuadosPharmacokinetic variables of Amiodarone were studied in six healthy dogs. Plasma levels of amiodarone and its metabolite, desethylamiodarone, were determinated by HPLC at different moments, after an i.v. administration as infusion of 5 mg/Kg in two minutes. A compartment model independent pharmacokinetic analysis program was used to evaluate plasma levels of amiodarone vs time. The following results were obtained: AUC: 9.95 ± 2.91 mg/mL/hr, b: 0.25 ± 0.27 L/hr, Cl: 8.82 ± 1.95 mL/min./Kg, TMR: 7.38 ± 1.52 hrs, t1/2b 5.056 ± 4.5 hrs and Vd: 3.424 ± 2.3 L/Kg. Amiodarone pharmacokinetic disposition presented a rapid distribution and decrease from blood during the first 30 minutes after i.v. Then it was slowly eliminated. It is concluded that amiodarone is an alternative to be considered in cardiac pathology in dogs, since the

  5. Lowered threshold for ventricular fibrillation in amiodarone-treated pigs undergoing cardiopulmonary bypass and cardioplegic arrest with St. Thomas' cardioplegic solution

    DEFF Research Database (Denmark)

    Gøtzsche, L S; Pedersen, Erik Morre; Paulsen, P K

    1993-01-01

    The antiarrhythmic agent amiodarone has been suspected of causing reduced cardiac performance after extracorporeal circulation and cardioplegic arrest in patients. This has recently been confirmed in an experimental model where pigs were exposed to cardiopulmonary bypass and cold cardioplegic...... arrest with Bretschneider's solution. Due to the high concentration of the cardio-depressant agent procain in Bretschneider's solution, it could be speculated whether it is the combination of amiodarone and this solution that may be potentially deleterious, rather than amiodarone alone. To investigate...... this, adult pigs (75 +/- 2 kg at surgery) were treated with amiodarone for 30 +/- 2 days (1400 mg/day: n = 8, untreated controls: n = 4, blind experiment), followed by exposure to cardiopulmonary bypass with universal cooling to 28 degrees C and topical cold cardioplegic arrest with St. Thomas...

  6. Edoxaban vs. warfarin in patients with atrial fibrillation on amiodarone: a subgroup analysis of the ENGAGE AF-TIMI 48 trial

    OpenAIRE

    Steffel, J.; Giugliano, R. P.; Braunwald, E; Murphy, S. A.; Atar, D.; HEIDBUCHEL, Hein; Camm, A. J.; Antman, E. M.; Ruff, C. T.

    2015-01-01

    Background In the ENGAGE AF-TIMI 48 trial, the higher-dose edoxaban (HDE) regimen had a similar incidence of ischaemic stroke compared with warfarin, whereas a higher incidence was observed with the lower-dose regimen (LDE). Amiodarone increases edoxaban plasma levels via P-glycoprotein inhibition. The current pre-specified exploratory analysis was performed to determine the effect of amiodarone on the relative efficacy and safety profile of edoxaban. Methods and results At randomization, 249...

  7. The class III anti-arrhythmic agent, amiodarone, inhibits voltage-dependent K(+) channels in rabbit coronary arterial smooth muscle cells.

    Science.gov (United States)

    Li, Hongliang; Kim, Han Sol; Kim, Hye Won; Shin, Sung Eun; Jung, Won-Kyo; Ha, Kwon-Soo; Han, Eun-Taek; Hong, Seok-Ho; Firth, Amy L; Bae, Young Min; Choi, Il-Whan; Park, Won Sun

    2016-07-01

    We examined the inhibitory effect of amiodarone, a class III anti-arrhythmic agent, on voltage-dependent K(+) (Kv) currents in freshly isolated rabbit coronary arterial smooth muscle cells, using a whole-cell patch clamp technique. Amiodarone inhibited Kv currents in a concentration-dependent manner, with a half-maximal inhibitory concentration (IC50) value of 3.9 ± 1.44 μM and a Hill coefficient of 0.45 ± 0.14. Amiodarone did not have a significant effect on the steady-state activation of Kv channels, but shifted the inactivation current toward a more negative potential. Application of consecutive pulses progressively augmented the amiodarone-induced Kv channel inhibition. Another class III anti-arrhythmic agent, dofetilide, did not inhibit the Kv current or change the inhibitory effect of amiodarone on Kv channels. Therefore, these results strongly suggest that amiodarone inhibits Kv currents in a concentration- and state-dependent manner. PMID:27030392

  8. Twenty-four hour radioactive iodine uptake in 35 patients with amiodarone associated thyrotoxicosis

    International Nuclear Information System (INIS)

    Amiodarone associated thyrotoxicosis (AAT) occurs in approximately 10% of patients treated with this iodine rich drug in areas of mild iodine deficiency. The thyroid radioactive iodine uptake (RAIU) is usually undetectable or very low in iodine-induced thyrotoxicosis. In the present study, 35 patients with AAT were evaluated. Twelve patients had no thyroid abnormalities by physical exam and all had 24-hr RAIU less than or equal to 4%. In contrast, nine of 11 patients with AAT and diffuse goiters and eight of 12 patients with AAT and nodular goiters had RAIU values greater than 8%. In patients with AAT and goiter it appears possible that the thyroid fails to adapt normally to the excess iodide load, resulting in an inappropriately high RAIU in the presence of excess plasma iodine

  9. Concurrent Chagas’ disease and borderline disseminated cutaneous leishmaniasis: The role of amiodarone as an antitrypanosomatidae drug

    Directory of Open Access Journals (Sweden)

    Alberto E Paniz-Mondolfi

    2008-06-01

    Full Text Available Alberto E Paniz-Mondolfi1,4, Alexandra M Pérez-Álvarez1, Oscar Reyes-Jaimes2, Gustavo Socorro1, Olga Zerpa3, Denisa Slova4, Juan L Concepción51Laboratorio de Estudio de Antígenos, Instituto de Biomedicina, “Hospital José Gregório Hernández”, Instituto Venezolano de los Seguros Sociales, Caracas, Venezuela; 2Departamento de Dermopatología, Instituto de Biomedicina, 3Sección de Leishmaniasis, Instituto de Biomedicina, Caracas, Venezuela; 4Department of Pathology and Laboratory Medicine, St. Luke’s – Roosevelt - Beth Israel Medical Center, University Hospital of Columbia University College of Physicians and Surgeons, New York, USA; 5Laboratorio de Enzimología de Parásitos, Facultad de Ciencias, Universidad de Los Andes, Mérida, VenezuelaAbstract: The occurrence of mixed infections of Trypanosoma cruzi and Leishmania spp. is becoming a common feature in Central and South America due to overlapping endemic areas. Unfortunately, the possibilities for treating flagellated kinetoplastid infections are still very limited and most of the available drugs exhibit severe side effects. Although the development of new drugs for Leishmania has markedly improved in the last years, the tendency is still to employ antimonial compounds. On the other hand, treatment for Chagas’ disease is only available for the acute phase with no effective therapeutical options for chronic stage disease. The following case report substantiates the recently discovered effect of amiodarone as a nonconventional antiparasitic drug, particularly against Leishmania, breaching a new perspective in the therapeutic management of these important infectious parasitic diseases.Keywords: Chagas’ disease, leishmaniasis, chemotherapy, amiodarone

  10. Amiodarone Exposure During Modest Inflammation Induces Idiosyncrasy-like Liver Injury in Rats: Role of Tumor Necrosis Factor-alpha

    OpenAIRE

    Lu, Jingtao; Jones, A. Daniel; Harkema, Jack R.; Roth, Robert A.; Ganey, Patricia E.

    2011-01-01

    Amiodarone [2-butyl-3-(3′,5′-diiodo-4’α-diethylaminoethoxybenzoyl)-benzofuran] (AMD), a class III antiarrhythmic drug, is known to cause idiosyncratic hepatotoxic reactions in human patients. One hypothesis for the etiology of idiosyncratic adverse drug reactions is that a concurrent inflammatory stress results in decreased threshold for drug toxicity. To explore this hypothesis in an animal model, male Sprague-Dawley rats were treated with nonhepatotoxic doses of AMD or its vehicle and with ...

  11. Multiple modes of inhibition of human cytochrome P450 2J2 by dronedarone, amiodarone and their active metabolites.

    Science.gov (United States)

    Karkhanis, Aneesh; Lam, Hui Yuan; Venkatesan, Gopalakrishnan; Koh, Siew Kwan; Chai, Christina Li Lin; Zhou, Lei; Hong, Yanjun; Kojodjojo, Pipin; Chan, Eric Chun Yong

    2016-05-01

    Dronedarone, a multiple ion channel blocker is prescribed for the treatment of paroxysmal and persistent atrial fibrillation. While dronedarone does not precipitate toxicities like its predecessor amiodarone, its clinical use has been associated with idiosyncratic hepatic and cardiac adverse effects and drug-drug interactions (DDIs). As dronedarone is a potent mechanism-based inactivator of CYP3A4 and CYP3A5, a question arose if it exerts a similar inhibitory effect on CYP2J2, a prominent cardiac CYP450 enzyme. In this study, we demonstrated that CYP2J2 is reversibly inhibited by dronedarone (Ki=0.034μM), amiodarone (Ki=4.8μM) and their respective pharmacologically active metabolites namely N-desbutyldronedarone (NDBD) (Ki=0.55μM) and N-desethylamiodarone (NDEA) (Ki=7.4μM). Moreover, time-, concentration- and NADPH-dependent irreversible inactivation of CYP2J2 was investigated where inactivation kinetic parameters (KI, kinact) and partition ratio (r) of dronedarone (0.05μM, 0.034min(-1), 3.3), amiodarone (0.21μM, 0.015min(-1), 20.7) and NDBD (0.48μM, 0.024min(-1), 21.7) were observed except for NDEA. The absence of the characteristic Soret peak, lack of recovery of CYP2J2 activity upon dialysis, and biotransformation of dronedarone and NDBD to quinone-oxime reactive metabolites further confirmed the irreversible inactivation of CYP2J2 by dronedarone and NDBD is via the covalent adduction of CYP2J2. Our novel findings illuminate the possible mechanisms of DDIs and cardiac adverse effects due to both reversible inhibition and irreversible inactivation of CYP2J2 by dronedarone, amiodarone and their active metabolites. PMID:26972388

  12. Amiodarone Induces Overexpression of Similar to Versican b to Repress the EGFR/Gsk3b/Snail Signaling Axis during Cardiac Valve Formation of Zebrafish Embryos

    Science.gov (United States)

    Lee, Hung-Chieh; Lo, Hao-Chan; Lo, Dao-Ming; Su, Mai-Yan; Hu, Jia-Rung; Wu, Chin-Chieh; Chang, Sheng-Nan; Dai, Ming-Shen; Tsai, Chia‐Ti; Tsai, Huai-Jen

    2015-01-01

    Although Amiodarone, a class III antiarrhythmic drug, inhibits zebrafish cardiac valve formation, the detailed molecular pathway is still unclear. Here, we proved that Amiodarone acts as an upstream regulator, stimulating similar to versican b (s-vcanb) overexpression at zebrafish embryonic heart and promoting cdh-5 overexpression by inhibiting snail1b at atrioventricular canal (AVC), thus blocking invagination of endocardial cells and, as a result, preventing the formation of cardiac valves. A closer investigation showed that an intricate set of signaling events ultimately caused the up-regulation of cdh5. In particular, we investigated the role of EGFR signaling and the activity of Gsk3b. It was found that knockdown of EGFR signaling resulted in phenotypes similar to those of Amiodarone-treated embryos. Since the reduced phosphorylation of EGFR was rescued by knockdown of s-vcanb, it was concluded that the inhibition of EGFR activity by Amiodarone is s-vcanb-dependent. Moreover, the activity of Gsk3b, a downstream effector of EGFR, was greatly increased in both Amiodarone-treated embryos and EGFR-inhibited embryos. Therefore, it was concluded that reduced EGFR signaling induced by Amiodarone treatment results in the inhibition of Snail functions through increased Gsk3b activity, which, in turn, reduces snail1b expression, leading to the up-regulation the cdh5 at the AVC, finally resulting in defective formation of valves. This signaling cascade implicates the EGFR/Gsk3b/Snail axis as the molecular basis for the inhibition of cardiac valve formation by Amiodarone. PMID:26650936

  13. New viewpoint of clinical treatment of amiodarone%胺碘酮临床治疗的新观点

    Institute of Scientific and Technical Information of China (English)

    朱彩玲

    2015-01-01

    Amiodarone is widely used in clinical.It has an important role in the treatment of arrhythmia and anti angina pectoris and so on.It has good treatment effect,at the same time,amiodarone also has more adverse reactions,which should arouse the attention of clinicians.In this paper,the author briefly introduces the new viewpoint of clinical treatment of amiodarone,to provide study for clinical.%胺碘酮在临床有着广泛的应用,其在治疗心律失常和抗心绞痛等方面有着重要的作用.在发挥较好治疗作用的同时,胺碘酮也有着较多的不良反应,应引起临床医生的注意.本文简要介绍胺碘酮临床治疗的新观点,为临床提供依据.

  14. Effects of Amiodarone on Transmural Dispersion of Ventricular Effective Refractory Periods across Myocardial Layers in the Normal and Hypertrophic Canine Heart

    Institute of Scientific and Technical Information of China (English)

    WANG Lan; L(U) Jiagao; ZHANG Fanzhi; BAI Rong; WANG Lin

    2006-01-01

    The effects of amiodarone on transmural dispersion of ventricular effective refractory periods (ERPs) in the normal and hypertrophic canine heart were investigated in vivo. By using the programmed stimulation protocol, the ERPs of epicardium (Epi), midmyocardium (Mid) and endocardium (Endo) were measured by inserting specially-designed electrodes into the three myocardial layers before and after mainlining of amiodarone. No significant ERPs-dispersion was observed in the three layers before and after mainlining of amiodarone in the normal group. In contrast, ERPs of all the three layers were prolonged in the hypertrophic heart, while the ERPs-dispersion was reduced significantly after mainlining of amiodarone. The ERPs-dispersion was significantly increased in the hypertrophic heart but not in the normal heart using "long-short" and "short-long" interval stimulation technique. It was concluded that (1) the differences in ERPs-dispersion among the three layers were significant in hypertrophic heart, and differences were not significant in normal canine heart;(2) ERPs of each three-myocardial layers were significantly prolonged after using amiodarone, but the ERPs-dispersion decreased in hypertrophic heart and (3) the programmed extrastimulus technique of "long-short" and "short-long" intervals increased the transmural ERPs-dispersion in the hypertrophic heart.

  15. Low-dose amiodarone for the prevention of atrial fibrillation after coronary artery bypass grafting in patients older than 70 years

    Institute of Scientific and Technical Information of China (English)

    GU Song; SU Pi-xiong; LIU Yan; YAN Jun; ZHANG Xi-tao; WANG Tian-you

    2009-01-01

    Background Atrial fibrillation (AF) is one of the most common arrhythmia after coronary artery bypass grafting (CABG), which not only increases the suffering of the patients, but also prolongs hospital stay and enhances cost of care, especially for patients older than 70 years. This study was designed to evaluate the efficacy and safety of low-dose amiodarone in the prevention of AF after CABG, especially for the elderly.Methods Two hundred and ten senile patients undergoing off-pump CABG were included in this prospective, randomized, double-blind and placebo controlled study. Patients were given 10 mg/kg of amiodarone (low-dose amiodarone group, n=100) or placebo (control group, n=110) daily for 7 days before surgery and followed by 200 mg of amiodarone or placebo daily for 10 days postoperatively.Results Postoperative AF occurred in 16 patients (16%) receiving amiodarone and in 36 (37.7%) patients receiving placebo (P=0.006). AF occurred at (58.13±16.63) hours after CABG in the low-dose amiodarone group and at (45.03±17.40) hours in the control group (P=0.018). The maximum ventricular rate during AF was significantly slower in the low-dose amiodarone group ((121.42±28.91) beats/min) than in the control group ((134.11 ±30.57) beats/min, P=0.036). The duration of AF was (10.92±9.56) hours for the low-dose amiodarone group compared with (14.81 ±10.37) hours for the control group (P=0.002). The postoperative left ventricular ejection fraction (LVEF) was significantly improved in the low-dose amiodarone group (from (59.9 ±10.3)% to (63.4±11.4)%, P=0.001), and significantly higher compared with the control group ((58.5±10.7)%, P=0.002). Both groups had a similar incidence of complication other than rhythm disturbances (12.0% vs 16.4%, P=0.368). The low-dose amiodarone group patients had shorter hospital stays ((11.8±3.2) days vs (13.8±4.7) days, P=0.001) and lower cost of care (RMB (79 115±16 673) Yuan vs RMB (84 997±21 587) Yuan, P=0.031) than that of

  16. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation

    DEFF Research Database (Denmark)

    Camm, A John; Capucci, Alessandro; Hohnloser, Stefan H;

    2011-01-01

    Objectives This randomized double-blind study compared the efficacy and safety of intravenous vernakalant and amiodarone for the acute conversion of recent-onset atrial fibrillation (AF). Background Intravenous vernakalant has effectively converted recent-onset AF and was well tolerated in placebo......-controlled studies. Methods A total of 254 adult patients with AF (3 to 48 h duration) eligible for cardioversion were enrolled in the study. Patients received either a 10-min infusion of vernakalant (3 mg/kg) followed by a 15-min observation period and a second 10-min infusion (2 mg/kg) if still in AF, plus a sham...... amiodarone infusion, or a 60-min infusion of amiodarone (5 mg/kg) followed by a maintenance infusion (50 mg) over an additional 60 min, plus a sham vernakalant infusion. Results Conversion from AF to sinus rhythm within the first 90 min (primary end point) was achieved in 60 of 116 (51.7%) vernakalant...

  17. Comparative effect of amiodarone and amiodarone combined with other drugs in treatment of atrial fibrillation%胺碘酮与胺碘酮联合用药治疗心房纤颤疗效的比较

    Institute of Scientific and Technical Information of China (English)

    陈士良; 辛卫鹏; 高谊

    2011-01-01

    AIM: To compare the effect of amiodarone alone and amiodarone combined with other drugs in treatment of atrial fibrillation ( AF). METHODS: A total of 119 patients with AF were divided into single drug group ( n = 54) and multiple drug group ( n = 65 ). The single drug group received amiodarone treatment, whereas the multiple drug group received treatment of amiodarone together with glucose-insulin-potassium and diuretics. The recovery rate of AF and the maintenance rate of sinus rhythm were observed and compared after 6 months treatment. RESULTS: A significant increase in the recovery rate (from 80% vs. 94% ) and a significant decrease in the recovery duration of sinus rhythm from (55 ± 19) h to (39 ±15) h were observed in the multiple drug group. The maintenance rate increased from 81% to 95% , left atrial diameter decreased from (46 ±6) mm to (42 ±6) mm and the left ventricular diastolic diameter decreased from (52 ±7) mm to (45 ±6) mm in the multiple drug group. However, these phenomena were not seen in the single drug group. CONCLUSION: Compared with amiodarone alone, amiodarone combined with other drugs significantly increases the recovery rate and the maintenance rate in patients with AF.%目的:观察单纯用药与联合用药对心房纤颤(房颤)治疗效果.方法:选择119例房颤患者随机分为2组:单纯用药组54例,给予静脉胺碘酮150~300 mg后,继之以口服胺碘酮维持;联合用药组65例,使用极化液、硝酸甘油和小剂量利尿剂、胺碘酮,胺碘酮使用的剂量与方法同单纯用药组.观察两组房颤转复率和窦性维持率.结果:联合用药组的房颤转复率较单纯组明显提高(80% vs.94%,P<0.05),复律时间减少[(55±19)vs.(39±15)s,P<0.05],追踪复律半年后的维持率,联合用药组明显高于单纯用药组(81% vs.95%,P<0.05).复查B超显示:联合用药后,左心房内经明显缩小,从[(46±6)mm减少到(42±6)mm,P<0.05],左心

  18. Treatment of Atrial Fibrillation with Amiodarone Combined with Simvastatin and Amiodarone: A Meta-analysis%胺碘酮联合辛伐他汀与单用胺碘酮治疗心房颤动的Meta分析

    Institute of Scientific and Technical Information of China (English)

    易欣; 黎明江

    2012-01-01

    目的 评价胺碘酮联合辛伐他汀与单用胺碘酮治疗心房颤动(房颤)的疗效.方法 计算机检索Cochrane图书馆、EMBASE及万方医学数据库等1990~2011年收录的文献,对其中胺碘酮联合辛伐他汀(试验组)与单用胺碘酮(对照组)治疗房颤的随机对照试验进行Meta分析.结果 共纳入12篇文献954例.经异质性检验发现各研究结果具有同质性(P=1.0,I2=0%),故选择固定效应模型合并进行两组疗效的Meta分析,求得OR=2.98,95%CI(2.21,4.02),对总体效应进行假设检验得Z=7.18,P<0.00001,提示试验组治疗房颤的效果较对照组好.漏斗图分析结果显示两组疗效Meta分析结果存在偏倚的可能性较小.Meta分析结果示两组治疗房颤不良反应发生率比较差异无统计学意义.结论 胺碘酮联合辛伐他汀治疗房颤较单用胺碘酮效果好.%Objective To evaluate the effectiveness of Amiodarone combined with Simvastatin and Amiodarone in treating atrial fibrillation. Methods We retrieved the literature of Cochrane Library, EMBASE and Wangfang medical Databases, etc, which were published during 1990 to 2011. A Meta-analysis was conducted on the outcomes of randomized controlled trials (RCT) of Amiodarone with simvastatin (experimental group) and Amiodarone (control group) in treating atrial fibrillation. Results We included 954 cases of 12 records in the analysis. The test for heterogeneity in all studies showed that various research results were of heterogeneity (P = 1.0,I2 =0% ) , so a fixed effect model of Meta-analysis was conducted. The total odds ratio was 2.95, 95% confidence interval (95% CI) was from 2.21 to 4.02. The test of hypothesis for overall effects: Z =7. 18, P < 0.00001. The results in treatment of atrial fibrillation were better in experimental group than in control group. There was little deflective possibility in Meta-analysis result of treatment effectiveness from infundibular schema in the two groups. Mela

  19. Antiproliferative, Ultrastructural, and Physiological Effects of Amiodarone on Promastigote and Amastigote Forms of Leishmania amazonensis

    Directory of Open Access Journals (Sweden)

    Sara Teixeira de Macedo-Silva

    2011-01-01

    Full Text Available Amiodarone (AMIO, the most frequently antiarrhythmic drug used for the symptomatic treatment of chronic Chagas' disease patients with cardiac compromise, has recently been shown to have also specific activity against fungi, Trypanosoma cruzi and Leishmania. In this work, we characterized the effects of AMIO on proliferation, mitochondrial physiology, and ultrastructure of Leishmania amazonensis promastigotes and intracellular amastigotes. The IC50 values were 4.21 and 0.46 μM against promastigotes and intracellular amastigotes, respectively, indicating high selectivity for the clinically relevant stage. We also found that treatment with AMIO leads to a collapse of the mitochondrial membrane potential (ΔΨm and to an increase in the production of reactive oxygen species, in a dose-dependent manner. Fluorescence microscopy of cells labeled with JC-1, a marker for mitochondrial energization, and transmission electron microscopy confirmed severe alterations of the mitochondrion, including intense swelling and modification of its membranes. Other ultrastructural alterations included (1 presence of numerous lipid-storage bodies, (2 presence of large autophagosomes containing part of the cytoplasm and membrane profiles, sometimes in close association with the mitochondrion and endoplasmic reticulum, and (3 alterations in the chromatin condensation and plasma membrane integrity. Taken together, our results indicate that AMIO is a potent inhibitor of L. amazonensis growth, acting through irreversible alterations in the mitochondrial structure and function, which lead to cell death by necrosis, apoptosis and/or autophagy.

  20. Study of the influence of ascorbyl palmitate and amiodarone in the stability of unilamellar liposomes.

    Science.gov (United States)

    Benedini, Luciano; Antollini, Silvia; Fanani, Maria Laura; Palma, Santiago; Messina, Paula; Schulz, Pablo

    2014-01-01

    Amiodarone (AMI) is a low water-solubility drug, which is very useful in the treatment of severe cardiac disease. Its adverse effects are associated with toxicity in different tissues. Several antioxidants have been shown to reduce, and prevent AMI toxicity. The aim of this work was to develop and characterize Dimyristoylphosphatidylcholine (DMPC) liposomal carriers doped with ascorbyl palmitate (Asc16) as antioxidant, in order to either minimize or avoid the adverse effects produced by AMI. The employment of liposomes would avoid the use of cosolvents in AMI formulations, and Asc16 could minimize the adverse effects of AMI. To evaluate the partition and integration of AMI and Asc16 in lipid membranes, penetration studies into DMPC monolayers were carried out. The disturbance of the liposomes membranes was studied by generalized polarization (GP). The stability of liposomes was evaluated experimentally and by means of the Derjaguin-Landau-Verwey-Overbeek (DLVO) theory. The size particle and zeta potential (ζ) values of the liposomes were used for application in calculations for attractive and repulsive forces in DLVO theory. In experimental conditions all of these vesicles showed stability at time 0, but only DMPC + Asc16 10% + AMI 10% liposomes kept their size stable and ζ during 28 days. These results are encouraging and suggest that such systems could be suitable for AMI delivery formulations. PMID:24650150

  1. EFFICACY AND SAFETY OF SINUS RHYTHM RESTORATION WITH AMIODARONE AND PROPAFENONE IN OUTPATIENTS, ECONOMIC ASPECTS (BASED ON DATA OF N.A. SEMASHKO NORTHERN MEDICAL CLINICAL CENTER

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    T. A. Istomina

    2016-01-01

    Full Text Available Aim. To study efficacy and safey of sinus rhythm restoration with amiodarone and propafenone in outpatients with recurrent atrial fibrillation (AF, and to estimate pharmacoeconomic efficiency of such cardioversion in comparison with hospital treatment.Material and methods. Patients (n=199; aged 59.2±1.36 with paroxysmal (73.9% or persistent (26.1% AF were included into the multicenter prospective study. Follow-up period was 13.14 months (min 1 month, max 36 months. Patients with arrhythmia relapse <48 h received outpatient cardioversion with amiodarone or propafenone orally. Daily outpatient examination, including ECG and blood pressure monitoring every 30-60 min, was carried out to evaluate efficacy of cardioversion and hemodynamics. Phone contact with patients was available. Patients with unstable hemodynamics received cardioversion in hospital. Patients received propafenone in cumulative dose of 600 mg (150-300 mg every hour, and amiodarone 600-800 mg daily. The cost/effectiveness ratio (CER was estimated. This ratio shows the cost of one unit of effect.Results. Outpatient cardioversion with amiodarone was started 24 h earlier (p=0.029 and with propafenone — 4.5 h earlier (p=0.002 than that in hospital. The average dose of amiodarone in ambulatory cardioversion was 1.3 times less (713.7±84,62 mg, p=0.345 than that in hospital cardioversion. Outpatient treatment with amiodarone restored sinus rhythm 8.7 h earlier, and with propafenone - 3.5 h earlier than the same treatments in hospital. Efficiency of hospital cardioversion with amiodarone was 70%, with propafenone - 80%, and efficiency of outpatient cardioversion — 96,1% and 98,4%, respectively. Outpatient treatment did not cause any severe side effects. Expenses for outpatient cardioversion made up 143 724.25 rubles, and for hospital cardioversion — 92 870.47 rubles. Average treatment costs for one patient in hospital was 6 times greater than for an outpatient. Outpatient

  2. Linking progression of fibrotic lung remodeling and ultrastructural alterations of alveolar epithelial type II cells in the amiodarone mouse model.

    Science.gov (United States)

    Birkelbach, Bastian; Lutz, Dennis; Ruppert, Clemens; Henneke, Ingrid; Lopez-Rodriguez, Elena; Günther, Andreas; Ochs, Matthias; Mahavadi, Poornima; Knudsen, Lars

    2015-07-01

    Chronic injury of alveolar epithelial type II cells (AE2 cells) represents a key event in the development of lung fibrosis in animal models and in humans, such as idiopathic pulmonary fibrosis (IPF). Intratracheal delivery of amiodarone to mice results in a profound injury and macroautophagy-dependent apoptosis of AE2 cells. Increased autophagy manifested in AE2 cells by disturbances of the intracellular surfactant. Hence, we hypothesized that ultrastructural alterations of the intracellular surfactant pool are signs of epithelial stress correlating with the severity of fibrotic remodeling. With the use of design-based stereology, the amiodarone model of pulmonary fibrosis in mice was characterized at the light and ultrastructural level during progression. Mean volume of AE2 cells, volume of lamellar bodies per AE2 cell, and mean size of lamellar bodies were correlated to structural parameters reflecting severity of fibrosis like collagen content. Within 2 wk amiodarone leads to an increase in septal wall thickness and a decrease in alveolar numbers due to irreversible alveolar collapse associated with alveolar surfactant dysfunction. Progressive hypertrophy of AE2 cells and increase in mean individual size and total volume of lamellar bodies per AE2 cell were observed. A high positive correlation of these AE2 cell-related ultrastructural changes and the deposition of collagen fibrils within septal walls were established. Qualitatively, similar alterations could be found in IPF samples with mild to moderate fibrosis. We conclude that ultrastructural alterations of AE2 cells including the surfactant system are tightly correlated with the progression of fibrotic remodeling. PMID:25957292

  3. Effects of Amiodarone and N-Desethylamiodarone on Cardiac Voltage-gated Sodium Channels

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    Mohammad-Reza eGhovanloo

    2016-03-01

    Full Text Available Amiodarone (AMD is a potent antiarrhythmic drug with high efficacy for treating atrial fibrillation and tachycardia. The pharmacologic profile of AMD is complex. AMD possesses biophysical characteristics of all of class I, II, III, and IV agents. Despite its adverse side effects, AMD remains the most commonly prescribed antiarrhythmic drug. AMD was described to prolong the QT interval and can lead to torsades de pointes. Our goal was to study the effects of AMD on peak and late sodium currents (INa,P and INa,L and determine whether these effects change as AMD is metabolized into N-Desethylamiodarone (DES. We hypothesized that AMD and DES block both INa,P and INa,L with similar profiles due to structural similarities. Given the inherent small amounts of INa,L in NaV1.5, we screened AMD and DES against the Long QT-3-causing mutation, ∆KPQ, to better detect any drug-mediated effect on INa,L. Our results show that AMD and DES do not affect WT or ∆KPQ activation; however, both drugs altered the apparent valence of steady-state fast-inactivation. In addition, AMD and DES preferentially block ∆KPQ peak conductance compared to WT. Both compounds significantly increase INa,L and window currents. We conclude that both compounds have pro-arrhythmic effects on NaV1.5, especially ∆KPQ; however, DES seems to have a greater pro-arrhythmic effect than AMD.

  4. Effect of Aronia melanocarpa fruit juice on amiodarone-induced pneumotoxicity in rats

    Science.gov (United States)

    Valcheva-Kuzmanova, Stefka; Stavreva, Galya; Dancheva, Violeta; Terziev, Ljudmil; Atanasova, Milena; Stoyanova, Angelina; Dimitrova, Anelia; Shopova, Veneta

    2014-01-01

    Background: The fruits of Aronia melanocarpa (Michx.) Elliot is extremely rich in biologically active polyphenols. Objective: We studied the protective effect of A. melanocarpa fruit juice (AMFJ) in a model of amiodarone (AD)-induced pneumotoxicity in rats. Materials and Methods: AD was instilled intratracheally on days 0 and 2 (6.25 mg/kg). AMFJ (5 mL/kg and 10 mL/kg) was given orally from day 1 to days 2, 4, 9, and 10 to rats, which were sacrificed respectively on days 3, 5, 10, and 28 when biochemical, cytological, and immunological assays were performed. Results: AMFJ antagonized AD-induced increase of the lung weight coefficient. In bronchoalveolar lavage fluid, AD increased significantly the protein content, total cell count, polymorphonuclear cells, lymphocytes and the activity of lactate dehydrogenase, acid phosphatase and alkaline phosphatase on days 3 and 5. In AMFJ-treated rats these indices of direct toxic damage did not differ significantly from the control values. In lung tissue, AD induced oxidative stress measured by malondialdehyde content and fibrosis assessed by the hydroxyproline level. AMFJ prevented these effects of AD. In rat serum, AD caused a significant elevation of interleukin IL-6 on days 3 and 5, and a decrease of IL-10 on day 3. In AMFJ-treated rats, these indices of inflammation had values that did not differ significantly from the control ones. Conclusion: AMFJ could have a protective effect against AD-induced pulmonary toxicity as evidenced by the reduced signs of AD-induced direct toxic damage, oxidative stress, inflammation, and fibrosis. PMID:24914278

  5. Efficacy of magnesium-amiodarone step-up scheme in critically ill patients with new-onset atrial fibrillation : a prospective observational study

    NARCIS (Netherlands)

    Sleeswijk, Mengalvio E; Tulleken, Jaap E; Van Noord, Trudeke; Meertens, John H J M; Ligtenberg, Jack J M; Zijlstra, Jan G

    2008-01-01

    Amiodarone is considered a first-choice antiarrhythmic drug in critically ill patients with new-onset atrial fibrillation (AF). However, evidence supporting the use of this potentially toxic drug in critically ill patients is scarce. Magnesium sulphate (MgSO4) has shown to be effective for both rate

  6. Amiodarone use after acute myocardial infarction complicated by heart failure and/or left ventricular dysfunction may be associated with excess mortality

    DEFF Research Database (Denmark)

    Thomas, Kevin L; Al-Khatib, Sana M; Lokhnygina, Yuliya;

    2008-01-01

    BACKGROUND: We sought to assess the association of amiodarone use with mortality during consecutive periods in patients with post-acute myocardial infarction with left ventricular systolic dysfunction and/or HF treated with a contemporary medical regimen. METHODS: This study used data from VALIANT...

  7. No elevation of glutathione S-transferase-a1-1 by amiodarone loading in intensive care unit patients with atrial fibrillation.

    NARCIS (Netherlands)

    Hilkens, M.; Pickkers, P.; Peters, W.H.M.; Hoeven, J.G. van der

    2009-01-01

    Hepatocellular toxicity is a putative side-effect of amiodarone. The hepatic detoxification enzyme glutathione S-transferase-A1-1 (GSTA1-1) is a sensitive indicator of hepatocellular damage. We investigated the occurrence of subclinical liver injury, as measured by plasma GSTA1-1 in intensive care u

  8. Effect of amiodarone on the conversion of thyroxine to triiodotironine in rat myocardium in vivo and in vitro

    International Nuclear Information System (INIS)

    It was studied the effect of the antiarrhythmic drug amiodarone, on the conversion of T4 to T3 by rat myocardium and liver. Wistar rats were injected with amiodarone (AM) or iopanoic acid (IOP), afterwards the liver and the heart were homogenized in krebs-ringer phosphate. Aliquots of 400μl of the homogenized were separated and DTT 8mM and 10-2μCi 125I-T4 or 125I-T3 were added (either the conversion of T4 to T3 or degradation of T3 are measured). In vitro: were added AM 0,1 mM or IOP 10mM. Incubation proceeded for 2 hours at 37 deg C and aliquots were chromatographied. The conversion of T4 to T3 in the myocardium and liver in vivo decreased, but in vitro did not have any deiodination of T4 and the IOP reduced the production of T3 by heart. Neither drug altered the deiodination of T3 by heart or liver homogenates. Serum TSH and T3 were decreased by AM and serum T4 increased. IOP caused similar variations in T4 and T3, but serum TSH was increased. It is concluded that blocking the T3 miocardial production by AM may not be the cause of the antiarrhythmic effect of the drug. (M.E.L.)

  9. 普罗帕酮联合胺碘酮使用对混合性心律失常控制的临床观察%Propafenone Joint Amiodarone Use of Mixed Arrhythmia Controlled Clinical Observation

    Institute of Scientific and Technical Information of China (English)

    连献杰

    2015-01-01

    Objective Observation of propafenone joint amiodarone use and separate use of amiodarone on mixed arrhythmia converting the curative effect of contrast. Methods Wil exist more than two kinds of new 34 cases of arrhythmia patients were randomly divided into into propafenone joint amiodarone group (19 cases) and amiodarone group (15 cases), the selected cases not including slow arrhythmia. Propafenone joint amiodarone group was given propafenone 35~70 mg (5~10 min after injection) intravenous injection, if invalid, 20 min after repeated 1 time, rhythm control give amiodarone after 1 mg/min to the micro pump pumping control; Amiodarone group, give amiodarone 150 mg of diluted intravenous glucose injection (10~15 min after injection), if the invalid 10~15 min after repeated injections, rhythm control give amiodarone after 1 mg/min to the micro pump pumping control. If two groups patients 3 consecutive load intravenous drug can not control the rhythm of the heart, it wil give amiodarone to the micro pump pumping 1 mg/min.Results Propafenone group joint amiodarone amiodarone and converting efficiency were 95% (18/19) and 73% (11/15) (P<0.05); Propafenone joint amiodarone group average converting time (1.2 h), amiodarone group average converting time (3.5 h). Conclusion Propafenone joint amiodarone use on converting mixed arrhythmia in curative effect is better than the separate use of amiodarone.%目的 观察普罗帕酮联合胺碘酮使用与单独使用胺碘酮对混合性心律失常转复的疗效对比.方法 将同时存在有2种以上新发心律失常的患者34例随机分为成普罗帕酮联合胺碘酮组(19例)和胺碘酮组(15例)(此次所选病例不包括缓慢型心律失常).普罗帕酮联合胺碘酮组给予普罗帕酮35~70 mg(5~10 min注完)静脉注射,若无效,20 min后重复1次,心律控制后给予胺碘酮1 mg/min持继微量泵泵入控制;胺碘酮组,给予胺碘酮150 mg以葡萄糖注射液稀释后静脉注射(10~15 min

  10. AMIODARONE INDUCES THE SYNTHESIS OF HSPS IN SACCHAROMYCES CEREVISIAE AND ARABIDOPSIS THALIANA CELLS

    Directory of Open Access Journals (Sweden)

    Pyatrikas D.V.

    2012-08-01

    Full Text Available Many biotic and abiotic stresses cause an increase of cytosolic Ca2+ level in cells. Calcium is one of the most important second messengers, regulating many various activities in the cell and was known to affect expression of stress activated genes. Mild heat shock induces the expression of heat shock proteins (Hsps which protect cell from drastic heat shock exposure. There are some literature data permitting to suggest that transient elevation of cytosolic Ca2+ level in plant cells is important for activation of Hsps expression. On the other hand mitochondria are known to regulate the intracellular calcium and reactive oxygen species signaling. It has been shown recently that mild heat shock induces hyperpolarization of inner mitochondrial membrane in plant and yeast cells and this event is critically important for activation of Hsps expression. To reveal the relationship between mitochondrial activity, intracellular calcium homeostasis and Hsps expression an antiarrhythmic drug amiodarone (AMD have been used. AMD is known to cause transient increase of cytosolic Ca2+ level in Saccharomyces cerevisiae. Obtained results have showed that AMD treatment induced the synthesis of Hsp104p in S. cerevisiae cells and Hsp101p in A. thaliana cell culture. Induction of Hsp104p synthesis leads to enhanced yeast capability to survive lethal heat shock exposure. Development of S. cerevisiae thermotolerance depended significantly on the presence of Hsp104p. Elevation of Hsp104p level in the result of AMD treatment was shown to be governed by activity of Msn2p and Msn4p transcription factors. Deletion of the MSN2 and MSN4 genes abrogated the AMD ability to induce Hsp104p synthesis. Mild heat shock and AMD treatment induced the hyperpolarization of the inner mitochondrial membrane in yeast and Arabidopsis cells which accompanied by HSP synthesis and development of thermotolerance. It was suggested that increase of cytosolic Ca2+ level after AMD treatment

  11. The safety assessment of saffron (Crocus sativus L.) on sympathovagal balance and heart rate variability; a comparison with amiodarone.

    Science.gov (United States)

    Joukar, Siyavash; Dehesh, Mohammad-Moein

    2015-12-01

    Dry stigmas of the Crocus sativus L. (Saffron) are well known in world as a popular flavouring and therapeutic agent. The anxiolytic, antidepressant, anticonvulsant and antiarrhythmic effects of saffron suggest that it may affect the autonomic control of the heart. This study assessed its safety on cardiac sympathovagal balance and heart rate variability in rat. Experimental groups were control, Saf50, Saf100, Saf200 (received saffron at dosages of 50 and 100 and 200 mg/kg/d, orally, respectively) and Amio (received 30 mg/mL/kg/d of amiodarone, orally, for 7 days) groups. On day 8, the frequency domain and time domain indices of animals' electrocardiograms were calculated. The heart rate decreased and RR interval increased in Saf200 and Amio groups (Psaffron not only has no harmful effect on activity of cardiac autonomic nervous system, but it may improve the stability of heart sympathovagal balance in normal rat. PMID:27329172

  12. Combined etiology of anaphylactic cardiogenic shock: Amiodarone, epinephrine, cardioverter defibrillator, left ventricular assist devices and the Kounis syndrome

    Directory of Open Access Journals (Sweden)

    Nicholas G Kounis

    2015-01-01

    Full Text Available Anaphylactic shock is a life-threatening condition which needs detailed and mediculous clinical assessment and thoughtful treatment. Several causes can join forces in order to degranulate mast cells. Amiodarone which is an iodine-containing highly lipophilic benzofuran can induce allergic reactions and anaphylactic shock in sensitized patients. Epinephrine is a life saving drug, but in sulfite allergic patients it should be given with caution due its metabisulfite preservative. Metals covering cardiac defibrillators and pacemakers can act as antigens attached to serum proteins and induce allergic reactions. In anaphylactic shock, myocardial involvement due to vasospasm-induced coronary blood flow reduction manifesting as Kounis syndrome should be always considered. Clinically, combined treatment targeting the primary cause of anaphylaxis together with protection of cardiac tissue seems to be of paramount importance.

  13. 胺碘酮联用缬沙坦治疗阵发性房颤临床观察%Effect of amiodarone combined with valsartan in treating paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王会玖; 王智斌; 杨迅

    2011-01-01

    目的 观察口服胺碘酮联合应用血管紧张素Ⅱ受体拮抗剂(ARB)缬沙坦在阵发性心房颤动(简称房颤)复律后维持窦律的疗效及对左心房功能的影响.方法 将68例阵发性房颤患者分为单纯口服胺碘酮组(对照组,34例)和胺碘酮加缬沙坦组(治疗组,34例),疗效观察12个月.结果 共66例完成治疗,随访12个月,治疗1、3个月后两组左心房内径比较差异无统计学意义,但6、12个月后两组差异有统计学意义(P<0.05),窦性心律维持6、12个月后比较差异有统计学意义(P<0.05).结论 胺碘酮与缬沙坦联合治疗阵发性房颤维持窦性心律的疗效优于单用胺碘酮,并能延缓左心房扩大.%Objective To investigate the efficacy of amiodarone combined with angiotensin Ⅱ receptor antagonist(ARB)valsartan on paroxysmal atrial fibrillation and left atrial function.Methods A total of 68 patients with paroxysmal atrial fibrillation were randomly divided into two groups:simple amiodarone group(control group,34 cases),amiodarone + valsartan group(stydy group,34 cases),they were treated for 12 months,following-up for 12 months.Results Totally 66 cases completed the treatment.The left atrium in simple amiodarone group was significantly higher than that in amiodarone + valsartan group 6-12 months after treatment(P < 0.05); the maintenance rates of 6 months,12 months of sinus rhythm in amiodarone + valsartan group were significantly higher than those in simple amiodarone group(P < 0.05).Conclusions Amiodarone combined with valsartan can reverse expansion of left atrium,and is more effective for transfer and maintain sinus rhythm compared with simple amiodarone treatment in patients with paroxysmal atrial fibrillation.

  14. Preparation of liposomal amiodarone and investigation of its cardiomyocyte-targeting ability in cardiac radiofrequency ablation rat model

    Directory of Open Access Journals (Sweden)

    Zhuge Y

    2016-05-01

    Full Text Available Ying Zhuge,1,* Zhi-Feng Zheng,1,* Mu-Qing Xie,2 Lin Li,2 Fang Wang,1 Feng Gao2,3 1Department of Cardiology, Shanghai First People’s Hospital of Nanjing Medical University, 2Department of Pharmaceutics, School of Pharmacy, 3Shanghai Key Laboratory of Functional Materials Chemistry, East China University of Science and Technology, Shanghai, People’s Republic of China*These authors contributed equally to this workAbstract: The objective of this study was to develop an amiodarone hydrochloride (ADHC-loaded liposome (ADHC-L formulation and investigate its potential for cardiomyocyte targeting after cardiac radiofrequency ablation (CA in vivo. The ADHC-L was prepared by thin-film method combined with ultrasonication and extrusion. The preparation process was optimized by Box–Behnken design with encapsulation efficiency as the main evaluation index. The optimum formulation was quantitatively obtained with a diameter of 99.9±0.4 nm, a zeta potential of 35.1±10.9 mV, and an encapsulation efficiency of 99.5%±13.3%. Transmission electron microscopy showed that the liposomes were spherical particles with integrated bilayers and well dispersed with high colloidal stability. Pharmacokinetic studies were investigated in rats after intravenous administration, which revealed that compared with free ADHC treatment, ADHC-L treatment showed a 5.1-fold increase in the area under the plasma drug concentration–time curve over a period of 24 hours (AUC0–24 h and an 8.5-fold increase in mean residence time, suggesting that ADHC-L could facilitate drug release in a more stable and sustained manner while increasing the circulation time of ADHC, especially in the blood. Biodistribution studies of ADHC-L demonstrated that ADHC concentration in the heart was 4.1 times higher after ADHC-L treatment in CA rat model compared with ADHC-L sham-operated treatment at 20 minutes postinjection. Fluorescence imaging studies further proved that the heart

  15. 胺碘酮与西地兰控制快速心房颤动的疗效观察%Clinical effect of Amiodarone and Cedilanid in the patients with rapid atrial fibrilation

    Institute of Scientific and Technical Information of China (English)

    廖祖发

    2013-01-01

    Objective: Observe clinical effect of Amiodarone and Cedilanid in the patients with rapid atrial fibrilation.Methods: 70 patients with rapid atrial fibrilation patients were randomly divided into two groups,35 cases in each group, amiodarone and Cedilanid was used respectively in two groups.Result: atrial fibrilation cardioversion success rate of Amiodarone group (74.3%) was significantly higher than Cedilanid group (48.6%), the cardioversion successful time on amiodarone group (6.3± 1.4h) was significantly shorter than Cedilanid group(9.7 ± 3.5h), the difference was statisticaly significant. Conclusion: Intravenous bolus amiodarone in clinical efficacy to control rapid ventricular rate of AF significantly better than Cedilanid. Conclusion: Intravenous bolus amiodarone in clinical efficacy to control rapid ventricular rate of atrial fibrilation significantly better than Cedilanid.%  目的:观察胺碘酮与西地兰在控制快速心房颤动心室率上的临床疗效。方法:将70例快速房颤患者随机分组,每组35例,分别行胺碘酮和西地兰治疗。结果:胺碘酮组的房颤转复成功率(74.3%)显著高于西地兰组(48.6%),转复成功时间上,胺碘酮组(6.3±1.4h)明显短于西地兰组(9.7±3.5h),差异具有统计意义。结论:静脉推注胺碘酮在控制快速房颤心室率的临床疗效上显著优于西地兰。

  16. 120例胺碘酮不良反应分析%Analysis of 120 amiodarone adverse reactions

    Institute of Scientific and Technical Information of China (English)

    彭庚; 谢文燕; 刘东亮; 董艳彩

    2015-01-01

    Objective To investigate adverse drug reaction (ADR) caused by amiodarone, in order to provide reference for clinical safety and rational drug use.Methods There were 120 patients with adverse drug reaction cases caused by amiodarone. Statistical analysis was made on their age, gender, underlying disease, administration route, drug dosage, history and clinical manifestation of adverse reactions.Results Among 120 patients with amiodarone ADR, there were 77 male (64.17%) and 43 female (35.83%). There were 83 cases over 60-year-old (69.17%). 107 cases had circulation system disease as mainly underlying disease (89.17%). 101 cases had arrhythmia as administration reason (84.17%), among them atrial fibrillation was the main cause with 56 cases (46.67%). There were 2 administration routes, as oral administration in 27 cases (22.50%) and intravenous administration in 93 cases (77.50%). Among reports of 120 ADR cases, there were 100 cases with normal ADR(83.33%), and 20 cases with severe ADR (16.67%). Main clinical manifestations included hepatic damage, phlebitis, anaphylactoid reaction, lung damage, hypotension, arrhythmia, and thyroid dysfunction. After measures of dose decrease and drug withdrawal, there were 35 cured cases (29.17%), 76 improved cases (63.33%), 8 cases with sequelae (6.67%), and 1 death case (0.83%).Conclusion As a safe antiarrhythmic agent in clinical application, amiodarone still provides various ADR manifestations. Close monitoring on ADR in clinical work is necessary for reducing incidence of severe adverse reactions.%目的:探讨胺碘酮所致不良反应(ADR)的发生情况,为临床安全、合理用药提供参考。方法120例胺碘酮所致不良反应患者,对其年龄、性别、基础疾病、用药途径、用药剂量、不良反应史、不良反应的临床表现等进行统计分析。结果120例胺碘酮ADR患者中,男77例(64.17%),女43例(35.83%),发生在60岁以上病例83例(69.17%);原患疾病以

  17. Liver cirrhosis induced by long-term administration of a daily low dose of amiodarone: A case report

    Institute of Scientific and Technical Information of China (English)

    Hiroki Oikawa; Kazuyuki Suzuki; Tomoyuki Masuda; Chihaya Maesawa; Ryo Sato; Kanta Oikawa; Hiroyuki Yamada; Seizo Oriso; Sadahide Ono; Akiko Yashima-Abo; Koji Kotani

    2005-01-01

    The anti-arrhythmic agent amiodarone (AD) is associated with numerous adverse effects, but serious liver disease is rare. The improved safety of administration of daily low doses of AD has already been established and this regimen is used for long-term medication. Nevertheless,asymptomatic continuous liver injury by AD may increase the risk of step-wise progression of non-alcoholic fatty liver disease. We present an autopsy case of AD-induced liver cirrhosis in a patient who had been treated with a low dose of AD (200 mg/d) daily for 84 mo. The patient was a 85-year-old male with a history of ischemic heart disease.Seven years after initiation of treatment with AD, he was admitted with cardiac congestion. The total dose of AD was 528 g. Mild elevation of serum aminotransferase and hepatomegaly were present. Liver biopsy specimens revealed cirrhosis, and under electron microscopy numerous lysosomes with electron-dense, whorled, lamellar inclusions characteristic of a secondary phospholipidosis were observed. Initially, withdrawal of AD led to a slight improvement of serum aminotransferase levels, but unfortunately his general condition deteriorated and he died from complications of pneumonia and renal failure.Long-term administration of daily low doses of AD carries the risk of progression to irreversible liver injury. Therefore,periodic examination of liver function and/or liver biopsy is required for the management of patients receiving long-term treatment with AD.

  18. Clinical observation of amiodarone in the treatment of atrial fibril ation%胺碘酮在心房颤动治疗中的疗效观察

    Institute of Scientific and Technical Information of China (English)

    陈思光

    2013-01-01

    Objective Comparative Study on efficacy of amiodarone and digitalis drug treatment of atrial fibril ation to control ventricular rate.Methods October 2009 to October 2011, 110 cases of hospitalization of patients with atrial fibril ation in hospital medicine as a research object,The patients were randomly divided into 2 groups,Amiodarone group 54 cases,Digitalis group of 56 cases, Intravenous administration.Results Amiodarone group the total effective rate was 85.2%(46/54),Digitalis group, the total effective rate was 57.1%(32/56),Two groups of patients with total efficiency,Statistical y significant difference(P<0.05).Conclusion Intravenous bolus of amiodarone in the treatment of atrial fibril ation effective than digitalis drugs,Superior to digitalis drugs in the control of ventricular rate.%目的对比研究胺碘酮与洋地黄类药物治疗房颤控制心室率的疗效。方法以2009年10月至2011年10月在本院内科住院110例房颤患者为研究对象,患者随机分成2组,胺碘酮组54例,洋地黄组56例,分别静脉给药胺碘酮和毛花苷C。结果胺碘酮组的总有效率为85.2%(46/54),洋地黄组的总有效率为57.1%(32/56),两组患者的总有效率比较,差异具有统计学意义(P<0.05)。结论静脉推注胺碘酮治疗房颤的疗效优于洋地黄类药物,在控制心室率方面也优于洋地黄类药物。

  19. Tumor Necrosis Factor-alpha Potentiates the Cytotoxicity of Amiodarone in Hepa1c1c7 Cells: Roles of Caspase Activation and Oxidative Stress

    OpenAIRE

    Lu, Jingtao; Miyakawa, Kazuhisa; Roth, Robert A.; Ganey, Patricia E.

    2012-01-01

    Amiodarone (AMD), a class III antiarrhythmic drug, causes idiosyncratic hepatotoxicity in human patients. We demonstrated previously that tumor necrosis factor-alpha (TNF-α) plays an important role in a rat model of AMD-induced hepatotoxicity under inflammatory stress. In this study, we developed a model in vitro to study the roles of caspase activation and oxidative stress in TNF potentiation of AMD cytotoxicity. AMD caused cell death in Hepa1c1c7 cells, and TNF cotreatment potentiated its t...

  20. Real-time monitoring of oxygen uptake in hepatic bioreactor shows CYP450-independent mitochondrial toxicity of acetaminophen and amiodarone.

    Science.gov (United States)

    Prill, Sebastian; Bavli, Danny; Levy, Gahl; Ezra, Elishai; Schmälzlin, Elmar; Jaeger, Magnus S; Schwarz, Michael; Duschl, Claus; Cohen, Merav; Nahmias, Yaakov

    2016-05-01

    Prediction of drug-induced toxicity is complicated by the failure of animal models to extrapolate human response, especially during assessment of repeated dose toxicity for cosmetic or chronic drug treatments. In this work, we present a 3D microreactor capable of maintaining metabolically active HepG2/C3A spheroids for over 28 days in vitro under stable oxygen gradients mimicking the in vivo microenvironment. Mitochondrial respiration was monitored using two-frequency phase modulation of phosphorescent microprobes embedded in the tissue. Phase modulation is focus independent and unaffected by cell death or migration. This sensitive measurement of oxygen dynamics revealed important information on the drug mechanism of action and transient subthreshold effects. Specifically, exposure to antiarrhythmic agent, amiodarone, showed that both respiration and the time to onset of mitochondrial damage were dose dependent showing a TC50 of 425 μm. Analysis showed significant induction of both phospholipidosis and microvesicular steatosis during long-term exposure. Importantly, exposure to widely used analgesic, acetaminophen, caused an immediate, reversible, dose-dependent loss of oxygen uptake followed by a slow, irreversible, dose-independent death, with a TC50 of 12.3 mM. Transient loss of mitochondrial respiration was also detected below the threshold of acetaminophen toxicity. The phenomenon was repeated in HeLa cells that lack CYP2E1 and 3A4, and was blocked by preincubation with ascorbate and TMPD. These results mark the importance of tracing toxicity effects over time, suggesting a NAPQI-independent targeting of mitochondrial complex III might be responsible for acetaminophen toxicity in extrahepatic tissues. PMID:26041127

  1. Aryl radical involvement in amiodarone-induced pulmonary toxicity: Investigation of protection by spin-trapping nitrones

    International Nuclear Information System (INIS)

    Amiodarone (AM), an antidysrrhythmic drug, can produce serious adverse effects, including potentially fatal AM-induced pulmonary toxicity (AIPT). AM-induced cytotoxicity and pulmonary fibrosis are well recognized, but poorly understood mechanistically. The hypothesis of aryl radical involvement in AM toxicity was tested in non-biological and biological systems. Photolysis of anaerobic aqueous solutions of AM, or N-desethylamiodarone (DEA) resulted in the formation of an aryl radical, as determined by spin-trapping and electron paramagnetic resonance (EPR) spectroscopy experiments. The non-iodinated AM analogue, didesiodoamiodarone (DDIA), did not form aryl radicals under identical conditions. The toxic susceptibility of human lung epithelioid HPL1A cells to AM, DEA, and DDIA showed time- and concentration-dependence. DEA had a more rapid and potent toxic effect (LC50 = 8 μM) than AM (LC50 = 146 μM), whereas DDIA cytotoxicity was intermediate (LC50 = 26 μM) suggesting a minor contribution of the iodine atoms. Incubation of human lung epithelial cells with the spin-trapping nitrones α-phenyl-N-t-butylnitrone (PBN, 10 mM) or α-(4-pyridyl N-oxide)-N-t-butylnitrone (POBN, 5.0 mM) did not significantly protect against AM, DEA, or DDIA cytotoxicity. Intratracheal administration of AM to hamsters produced pulmonary fibrosis at day 21, which was not prevented by 4 days of treatment with 150 mg/kg/day PBN or 164 mg/kg/day POBN. However, the body weight loss in AM-treated animals was counteracted by PBN. These results suggest that, although AM can generate an aryl radical photochemically, its in vivo formation may not be a major contributor to AM toxicity, and that spin-trapping reagents do not halt the onset of AM toxicity

  2. Validated HPLC and Ultra-HPLC Methods for Determination of Dronedarone and Amiodarone Application for Counterfeit Drug Analysis.

    Science.gov (United States)

    El-Bagary, Ramzia I; Elkady, Ehab F; Mowaka, Shereen; Attallah, Maria

    2015-01-01

    Two simple, accurate, and precise chromatographic methods have been developed and validated for the determination of dronedarone (DRO) HCl and amiodarone (AMI) HCl either alone or in binary mixtures due to the possibility of using AMI as a counterfeit of DRO because of its lower price. First, an RP-HPLC method is described for the simultaneous determination of DRO and AMI. Chromatographic separation was achieved on a BDS Hypersil C18 column (150×4.6 mm, 5 μm). Isocratic elution based on potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6-methanol (10+90, v/v) at a flow rate of 2 mL/min with UV detection at 254 nm was performed. The second method is RP ultra-HPLC in which the chromatographic separation was achieved on an AcclaimTM RSLC 120 C18 column (100×2.1 mm, 2.2 μm) using isocratic elution with potassium dihydrogen phosphate buffer with 0.1% triethylamine pH 6-methanol (5+95, v/v) at a flow rate of 1 mL/min with UV detection at 254 nm. Linearity, accuracy, and precision of the two methods were found to be acceptable over the concentration ranges of 5-80 μg/mL for both DRO and AMI. The results were statistically compared using one-way analysis of variance. The optimized methods were validated and proved to be specific, robust, precise, and accurate for the QC of the drugs in their pharmaceutical preparations. PMID:26651561

  3. Model steatogenic compounds (amiodarone, valproic acid, and tetracycline alter lipid metabolism by different mechanisms in mouse liver slices.

    Directory of Open Access Journals (Sweden)

    Ewa Szalowska

    Full Text Available Although drug induced steatosis represents a mild type of hepatotoxicity it can progress into more severe non-alcoholic steatohepatitis. Current models used for safety assessment in drug development and chemical risk assessment do not accurately predict steatosis in humans. Therefore, new models need to be developed to screen compounds for steatogenic properties. We have studied the usefulness of mouse precision-cut liver slices (PCLS as an alternative to animal testing to gain more insight into the mechanisms involved in the steatogenesis. To this end, PCLS were incubated 24 h with the model steatogenic compounds: amiodarone (AMI, valproic acid (VA, and tetracycline (TET. Transcriptome analysis using DNA microarrays was used to identify genes and processes affected by these compounds. AMI and VA upregulated lipid metabolism, whereas processes associated with extracellular matrix remodelling and inflammation were downregulated. TET downregulated mitochondrial functions, lipid metabolism, and fibrosis. Furthermore, on the basis of the transcriptomics data it was hypothesized that all three compounds affect peroxisome proliferator activated-receptor (PPAR signaling. Application of PPAR reporter assays classified AMI and VA as PPARγ and triple PPARα/(β/δ/γ agonist, respectively, whereas TET had no effect on any of the PPARs. Some of the differentially expressed genes were considered as potential candidate biomarkers to identify PPAR agonists (i.e. AMI and VA or compounds impairing mitochondrial functions (i.e. TET. Finally, comparison of our findings with publicly available transcriptomics data showed that a number of processes altered in the mouse PCLS was also affected in mouse livers and human primary hepatocytes exposed to known PPAR agonists. Thus mouse PCLS are a valuable model to identify early mechanisms of action of compounds altering lipid metabolism.

  4. Endoscopic autofluorescence micro-spectroimaging of alveoli: comparative spectral analysis of amiodarone-induced pneumonitis patients and healthy smokers

    Science.gov (United States)

    Bourg-Heckly, G.; Vever-Bizet, C.; Blondel, W.; Salaün, M.; Thiberville, L.

    2011-03-01

    Fibered confocal fluorescence microscopy (FCFM) with spectroscopic analysis capability was used during bronchoscopy, at 488nm excitation, to record autofluorescence images and associated emission spectra of the alveoli of 5 healthy smoking volunteers and 7 non-smoking amiodarone-induced pneumonitis (AIP) patients. Alveolar fluorescent cellular infiltration was observed in both groups. Our objective was to assess the potential of spectroscopy in differentiating these two groups. Methods: We previously demonstrated that in healthy smokers alveolar elastin backbone and tobacco tar contained in macrophages contribute to the observed signal. Each normalized spectrum was modeled as a linear combination of 3 components: Sexp(λ) = Ce.Se(λ)+Ct.St(λ)+CG.SG(λ), Ce, Ct and CG are amplitude coefficients. Se(λ) and St(λ) are respectively the normalized elastin and tobacco tar emission spectra measured experimentally and SG(λ) a gaussian spectrum with tunable width and central wavelength. Levenbergt-Marquardt algorithm determined the optimal set of coefficients. Results: AIP patient autofluorescence spectra can be uniquely modelized by the linear combination of the elastin spectrum (Ce = 0.61) and of a gaussian spectrum (center wavelength 550nm, width 40nm); the tobacco tar spectrum coefficient Ct is found to be zero. For healthy smoking volunteers, only two spectral components were considered: the tobacco tar component (Ct = 1,03) and the elastin component (Ce = 0). Conclusion: Spectral analysis is able to distinguish cellular infiltrated images from AIP patients and healthy smoking volunteers. It appears as a powerful complementary tool for FCFM.

  5. Preparation of liposomal amiodarone and investigation of its cardiomyocyte-targeting ability in cardiac radiofrequency ablation rat model

    Science.gov (United States)

    Zhuge, Ying; Zheng, Zhi-Feng; Xie, Mu-Qing; Li, Lin; Wang, Fang; Gao, Feng

    2016-01-01

    The objective of this study was to develop an amiodarone hydrochloride (ADHC)-loaded liposome (ADHC-L) formulation and investigate its potential for cardiomyocyte targeting after cardiac radiofrequency ablation (CA) in vivo. The ADHC-L was prepared by thin-film method combined with ultrasonication and extrusion. The preparation process was optimized by Box–Behnken design with encapsulation efficiency as the main evaluation index. The optimum formulation was quantitatively obtained with a diameter of 99.9±0.4 nm, a zeta potential of 35.1±10.9 mV, and an encapsulation efficiency of 99.5%±13.3%. Transmission electron microscopy showed that the liposomes were spherical particles with integrated bilayers and well dispersed with high colloidal stability. Pharmacokinetic studies were investigated in rats after intravenous administration, which revealed that compared with free ADHC treatment, ADHC-L treatment showed a 5.1-fold increase in the area under the plasma drug concentration–time curve over a period of 24 hours (AUC0–24 h) and an 8.5-fold increase in mean residence time, suggesting that ADHC-L could facilitate drug release in a more stable and sustained manner while increasing the circulation time of ADHC, especially in the blood. Biodistribution studies of ADHC-L demonstrated that ADHC concentration in the heart was 4.1 times higher after ADHC-L treatment in CA rat model compared with ADHC-L sham-operated treatment at 20 minutes postinjection. Fluorescence imaging studies further proved that the heart-targeting ability of ADHC-L was mainly due to the CA in rats. These results strongly support that ADHC-L could be exploited as a potential heart-targeting drug delivery system with enhanced bioavailability and reduced side effects for arrhythmia treatment after CA.

  6. 胺碘酮致甲状腺功能异常的诊治进展%The progress on the diagnosis and treatment of amiodarone-induced thyroid dysfunction

    Institute of Scientific and Technical Information of China (English)

    许宇静; 洪侃

    2011-01-01

    Amiodarone is an effective medication approved for the treatment of cardiac arrhythmias. However, this drug has high iodine content, and this feature plus the intrinsic effects on the body which make amiodarone toxic to the thyroid gland would induce a series of disfunction,even result in overt hypothyroidism or thyrotoxicosis. So far,the diagnosis and treatment of amiodarone-induced hypothyroidism(AIH) is clear and definite, whereas that of amiodarone-inducedthyrotoxicosis(AIT) and the ability to distinguish between the subtypes of the diease have much more challenge. And confirming the subtype of AIT is instructive to the treatment.%胺碘酮是治疗心律失常的常用药物.但由于其富含碘及自身固有的特性,可导致一系列甲状腺功能的紊乱,甚至引发明显的甲状腺功能减退(甲减)或甲状腺功能亢进(甲亢).对于胺碘酮所致甲减(AIH)的诊断和治疗目前比较清晰,但对胺碘酮所致甲亢(AIT)的诊断、鉴别其亚型及治疗有一定的难度.

  7. 冠心病快速心律失常应用胺碘酮治疗的临床效果分析%The Clinical Effect of Coronary Heart Disease Tachyarrhythmia Analysis Amiodarone Therapy

    Institute of Scientific and Technical Information of China (English)

    陈铸雄

    2014-01-01

    Objective Clinical efficacy in patients with coronary heart disease tachyarrhythmia amiodarone therapy. Methods In our hospital from January 2012 to January 2014 were treated 60 cases of coronary heart disease complicated by tachyarrhythmias in patients of all emergency patients were given amiodarone therapy, and efficacy determination. Results The group of 60 patients after amiodarone total effective rate of 90.0%, adverse reactions were mild and no serious adverse events. Conclusions Amiodarone in the treatment of coronary artery disease in patients with tachyarrhythmia safe and effective.%目的:冠心病快速心律失常患者应用胺碘酮治疗的临床疗效。方法选取我院在2012年1月至2014年1月收治的冠心病并发快速心律失常患者60例,对所有患者均急诊给予胺碘酮治疗,并对疗效进行判定。结果本组60例患者经过胺碘酮治疗总有效率达90.0%,不良反应均较轻微,无严重不良反应发生。结论胺碘酮在冠心病快速心律失常患者的治疗中安全、有效。

  8. Research on the Flow Setting Type Infusion Intravenous Amiodarone in Prevention of Phlebitis%流量设定微调式输液器静脉滴注可达龙预防静脉炎的研究

    Institute of Scientific and Technical Information of China (English)

    李兴芳

    2014-01-01

    目的:探讨使用流量设定微调式输液器静脉滴注可达龙预防静脉炎的临床效果。方法将200例需要使用可达龙患者随机分两组, A组100例,B组100例,A组使用流量设定微调式输液器静脉滴注可达龙。B组使用微量注射泵输注可达龙。结果 A组静脉炎发生率明显低于B组对照组。结论使用流量设定微调式输液器静脉滴注可达龙可有效预防静脉炎发生,值得临床推广。%Objective To explore the use of flow set type infusion intravenous amiodarone in prevention of phlebitis curative effect. Methods 200 cases require the use of amiodarone were randomly divided into two groups,100 cases in A group, 100 cases in B group, group A using flow set type infusion intravenous amiodarone, group B using microinjection pump infusion of cordarone. Results in A group, the incidence of phlebitis was significantly lower than the control group. Conclusion using the flow set type infusion intravenous amiodarone may be effective in preventing phlebitis, worthy of clinical application.

  9. 胺碘酮治疗心衰伴心律失常的临床分析%Therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia

    Institute of Scientific and Technical Information of China (English)

    周兰珠

    2010-01-01

    目的 评价胺碘酮治疗心力衰竭(HF)伴心律失常的疗效.方法 选择心力衰竭合并心律失常患者96例,在抗心衰治疗同时给予口服胺碘酮6周.结果 治疗6周后观察总有效率91.9%.结论 胺碘酮治疗HF伴心律失常安全、有效.%Objective To evaluate the the therapeutic effects of amiodarone on chronic heart failure complicated by arrhythmia. Methods From 2006 to 2008,96 chronic congestive heart failure patients with arrhythmia were enrolled. All patients were given standard medical treatment according to the current practice guidelines with a β-blocker, an angiotensin-converting enzyme(ACE) inhibitor, and diuretics. At the same time,they were also given oral amiodarone for six weeks. Results After 6 weeks' treatment with amiodarone,the total effective therapeutic effects was 91.9 percent. Conclusion For patients with chronic congestive heart failure complicated by with arrhythmia, amiodarone treatment for six weeks is safe and effective.

  10. Treatment of 200 cases with atrial fibrillation by Shensong Yangxin capsules compared with amiodarone%参松养心胶囊对比胺碘酮治疗心房纤颤200例

    Institute of Scientific and Technical Information of China (English)

    马军

    2015-01-01

    目的:对比参松养心胶囊和胺碘酮治疗心房纤颤的疗效和安全性。方法:100例心房纤颤患者随机分为参松养心胶囊组和胺碘酮组。结果:参松养心胶囊组和胺碘酮组治疗心房纤颤总有效率分别为55%、60%,统计学处理无明显差异(P>0.05)。结论:参松养心胶囊和胺碘酮治疗心房纤颤疗效相当,但参松养心胶囊不良反应更少。%Objective:To compare the clinical effects and safety of Shensong Yangxin capsules and amiodarone in the treatment of atrial fibrillation.Methods:100 cases with atrial fibrillation were divided into Shensong Yangxin capsule group and amiodarone group. Results: Shensong Yangxin capsule group and amiodarone group the total effective rate was 55% and 60% respectively in the treatment of atrial fibrillation, statistically no significant difference (P> 0.05).Conclusion:The therapeutic effects of Shensong Yangxin capsule and amiodarone in the treatment of atrial fibrillation are equal,but Shensong Yangxin capsule with less adverse reactions.

  11. EFFECTS OF AMIODARONE, CYCLOSPORINE-A, AND PSC-833 ON THE CYTOTOXICITY OF MITOXANTRONE, DOXORUBICIN, AND VINCRISTINE IN NON-P-GLYCOPROTEIN HUMAN SMALL-CELL LUNG-CANCER CELL-LINES

    NARCIS (Netherlands)

    VANDERGRAAF, WTA; DEVRIES, EGE; TIMMERBOSSCHA, H; MEERSMA, GJ; MESANDER, G; VELLENGA, E; MULDER, NH

    1994-01-01

    The multidrug resistance (MDR) modulators amiodarone (AM), cyclosporin A (CsA), and PSC 833 were tested for their potential to modulate cytotoxicity of doxorubicin (DOX), vincristine (VCR), and mitoxantrone (MX) in a sensitive human small cell lung carcinoma cell line GLC4 in its DOX-resistant non-P

  12. Curative Effect Observation on Amiodarone in the Treatment of Arrhythmia%胺碘酮治疗心律失常的临床疗效观察

    Institute of Scientific and Technical Information of China (English)

    李光立; 李玲

    2014-01-01

    Objective:To explore the arrhythmia outcomes in patients treated with amiodarone. Method:49 patients were treated with arrhythmia. Result:34 cases were markedly improved(69.4%),effective in 11 cases (accounting for 22.4%),4 cases were ineffective(8.2%),the total effective rate was 91.8%. Conclusion:Oral application of amiodarone in the treatment of arrhythmia in clinical effect is good,and can significantly improve cardiac arrhythmia patients,high security,small side effects,with the value of clinical application and promotion.%目的:探讨心律失常患者采用胺碘酮治疗的疗效。方法:对49例心律失常患者进行胺碘酮治疗。结果:显效34例(69.4%),有效11例(22.4%),无效4例(8.2%),总有效率为91.8%。结论:口服应用胺碘酮在治疗心律失常方面临床效果好,能够明显改善心律失常患者病情,安全性高,副作用小,具有临床应用与推广的价值。

  13. Amiodarona causa vasodilatação dependente do endotélio em artérias coronárias caninas Amiodarone causes endothelium-dependent vasodilation in canine coronary arteries

    Directory of Open Access Journals (Sweden)

    Alfredo José Rodrigues

    2005-03-01

    Full Text Available OBJETIVO: Avaliar os efeitos vasodilatadores da amiodarona em artérias coronárias caninas empregando soluções de amiodarona dissolvida em polisorbato 80 ou em água. MÉTODOS: Anéis de artéria coronária, com e sem o endotélio íntegro, foram imersos em solução de krebs e conectadas a um transdutor para aferição de força isométrica promovida por contração vascular. As artérias foram expostas a concentrações crescentes de polisorbato 80, amiodarona dissolvida em água, amiodarona dissolvida em polisorbato 80 e uma apresentação comercial da amiodarona (Cordarone®. Os experimentos foram conduzidos na presença e na ausência dos seguintes bloqueadores enzimáticos: apenas indometacina, Nômega-nitro-L-arginina associada à indometacina e apenas Nômega-nitro-L-arginina. RESULTADOS: O polisorbato 80 causou pequeno relaxamento não dependente do endotélio. O Cordarone®, a amiodarona dissolvida em água e em polisorbato 80 promoveram relaxamento dependente do endotélio, que foi de maior magnitude para a amiodarona dissolvida em polisorbato e para o Cordarone®. Apenas a associação de indometacina com a Nômega-nitro-L-arginina foi capaz de abolir o relaxamento dependente do endotélio provocado pela amiodarona dissolvida em polisorbato 80. CONCLUSÃO: Os resultados obtidos indicam que a vasodilatação promovida pela amiodarona em artérias coronárias caninas é causada principalmente pela estimulação da liberação de óxido nítrico e fatores endoteliais relaxantes dependentes das ciclo-oxigenases.OBJECTIVE: To assess the vasodilating effects of amiodarone on canine coronary arteries by using solutions of amiodarone dissolved in polysorbate 80 or water. METHODS: Rings of coronary arteries, with or without intact endothelium, were immersed in Krebs solution and connected to a transducer for measuring the isometric force promoted by a vascular contraction. The arteries were exposed to increasing concentrations of

  14. Clinical study on the efficacy and safety of Amiodarone for treating atrial fibrillation in old patients%胺碘酮治疗老年心房纤颤的疗效及安全性观察

    Institute of Scientific and Technical Information of China (English)

    曹丹阳; 曹晶晶; 周冬翠; 武云涛; 陈艳梅; 毕磊

    2011-01-01

    Objective To study the efficacy and safety of Amiodarone for treating atrial fibrillation in old patients. Methods We retrospectively reviewed 40 elderly cases of atrial fibrillation, amiodarone was administered 0.6 g/day initially, then gradually reduced to 0.2 g/day for maintainance, the curative effect and the side effects of amiodarone in treatment of atrial fibrillation was observed. Results The efficiency of amiodarone treatment was 55%, laseris 32.5%, inefficient to 12. 5%. Simultaneous hypothyroidism occurred in 7 cases, thyroid function in hyperthyroidism, pulmonary fibrosis, pigmentation did not happen in all cases. Conclusions Amiodarone for treating atrial fibrillation in old patients is effective and safe.%目的 探讨胺碘酮对老年阵发性房颤治疗的效果和安全性.方法 观察分析40例老年阵发性房颤患者胺碘酮治疗的效果和药物副作用.结果 胺碘酮治疗显效率为55 0%,有效率为32 5%,无效率为12 5%;发生甲状腺功能减退 7例,未发生甲状腺功能亢进、肺纤维化、色素沉着.结论 胺碘酮应用于老年人房颤有效、安全,但需密切观察甲状腺功能和对肺的毒性作用.

  15. Long-term efficacy and safety of very-low-dose amiodarone treatment for the maintenance of sinus rhythm in patients with chronic atrial fibrillation after successful direct-current cardioversion

    Institute of Scientific and Technical Information of China (English)

    JONG Gwo-ping; CHANG Mu-hsin; CHANG Ting-chuan; CHOU Pesus; FU Chong-yau; TIEN Li-yun; CHEN Chung-yin; MA Tso-chiang

    2006-01-01

    Background Long-term maintenance of sinus rhythm after successful conversion of chronic atrial fibrillation (CAF), often ameliorates patients' symptoms, reduces the risk of ischemic stroke and improves cardiovascular hemodynamics. This prospective study aims to evaluate the long-term efficacy and safety of very low-dose amiodarone (100 mg daily) for the maintenance of sinus rhythm after successful direct-current (DC)cardioversion in patients with CAF and rheumatic heart disease (RHD) post intervention.Methods This study was a randomized prospective trial. One day after successful DC cardioversion (remained normal sinus rhythm) in patients with CAF and RHD post intervention for more than six months and adequate anticoagulation, all were randomly administered either amiodarone 200 mg daily in group A or amiodarone 100mg daily in group B.Results A total of 76 patients (40 men and 36 women) were examined from February 1998 to December 1999.The mean age of the patients was (66±10) years, and the mean follow-up was (67±8) months (range 61 to 84months). Actuarial rates of the maintenance of sinus rhythm were similar in the two groups after 5 years of follow-up. Four patients (11%) in group A but none in group B experienced significant adverse effects that necessitated withdrawal of amiodarone. No death occurred during the study period.Conclusion A very low dose of amiodarone results in adequate long-term efficacy and is safe for maintaining sinus rhythm in patients with CAF and RHD post intervention after successful DC cardioversion.

  16. The Clinical Analysis of 24 Cases of Patients with Amiodarone Ventricular Tachycardia%胺碘酮室性心动过速24例临床分析

    Institute of Scientific and Technical Information of China (English)

    宋雪莲

    2014-01-01

    目的:探讨静脉注射胺碘酮治疗室性心动过速疗效。方法自2012年2月~2013年12月对24例室性心动过速患者应用胺碘酮临床治疗资料进行分析。结果经治疗室性心动过速成功复律21例,占87.5%。结论室速发生较多者可用胺碘酮,胺碘酮应采取小剂量负荷,胺碘酮治疗较为安全,维持量亦可相应减少,可提高疗效,提高生活质量。%Objective The effect of intravenous amiodarone treatment of ventricular tachycardia to be investigated. Methods Analyzing clinical treatment data selected from 24 cases of patients with ventricular tachycardia who are given intravenous amiodarone treatment from February 2012 to December 2013. Results With intravenous amiodarone treatment, 21 cases of patients with ventricular tachycardia are cured which make up 87.5 percent of the whole. Conclusions The patients with ventricular tachycardia are suggested to take intravenous amiodarone, but with smal amount of dosage;since the intravenous amiodarone treatment is comparative safe, the dosage can be reduced gradual y with improving the effect and quality of life.

  17. 厄贝沙坦联合胺碘酮治疗阵发性房颤的临床疗效%Effects of the irbesartan combined with amiodarone in the treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    邹丽芳; 张光君; 陈士良

    2012-01-01

    目的 评价胺碘酮联合厄贝沙坦治疗阵发性房颤的临床疗效.方法 78例阵发性房颤的患者随机分为治疗组(胺碘酮+厄贝沙坦)和对照组(胺碘酮),口服给药,疗程均为1年.比较治疗后2组窦性心律维持率和左心房内径的变化.结果 治疗组窦性心率维持率明显高于对照组(P<0.05),左心房内径亦有显著性缩小(P<0.05).结论 胺碘酮联合厄贝沙坦治疗阵发性心房颤动维持窦性心率的疗效优于单用胺碘酮,且能抑制左心房扩大.%Objective To observe clinical efficacy of amiodarone and irbesartan in the treatment of paroxysmal atrial fibrillation. Methods Seventy - eight cases of paroxysmal atrial fibrillation were randomly divided into treatment group ( amiodarone + irbesartan ) and the control group ( single with amiodarone ) . Taking drugs were by orally and the course was a year. Compared the change of sinus rhythm maintenance rate and left atrial diameter after the treatment in two groups. Results Compared with control group, the sinus rhythm maintenance rate in the treatment group was significantly higher than the control group (P < 0. 05 ) , the left atrial diameter in the treatment group also significantly reduced than the control group ( P < 0. 05 ).Conclusion Effects of amiodarone and irbesartan in the treatment of paroxysmal atrial fibrillation to maintain sinus rhythm has better than single amiodarone , and it can inhibit left atrial enlargement.

  18. Curative Effect Observation of Esmolol and Amiodarone in Controlling Rapid Atrial Fibrillation Ventricular Rate%艾司洛尔与胺碘酮控制快速心房颤动心室率的效果观察

    Institute of Scientific and Technical Information of China (English)

    黄金莹; 姚丹林; 李渊

    2016-01-01

    目的:比较急诊静脉注射艾司洛尔、胺碘酮控制快速房颤心室率的疗效及安全性。方法:将115例快速房颤患者随机分为两组,两组分别给予静脉注射胺碘酮和艾司洛尔治疗,比较两组治疗效果。结果:艾司洛尔组心率减慢情况显著优于胺碘酮组,差异有统计学意义(P0.05)。结论:静脉注射艾司洛尔和胺碘酮在控制快速房颤患者心室率方面都同样安全和有效,艾司洛尔较胺碘酮能更快、更有效地控制快速房颤的心室率。%Objective:To evaluate the efficacy and safety of intravenous Esmolol and Amiodarone controlling ventricular rate in the patients with rapid atrial fibrillation.Method:115 patients with rapid atrial fibrillation patients were randomly divided into two groups,two groups were given intravenous injection of amiodarone and esmolol treatment,compared two groups of treatment effect.Result:Esmolol group heart rate was significantly higher than that of amiodarone group,the difference was statistically significant(P0.05).Conclusion:Intravenous Esmolol and Amiodarone in patients with rapid atrial fibrillation ventricular rate are equally safe and effective,Esmolol than Amiodarone can faster,more effective control of rapid atrial fibrillation ventricular rate.

  19. 伊布利特和胺碘酮转复心房扑动及心房颤动的临床观察%Efficacy of ibutilide and amiodarone for termination of atrial fibrillation and flutter

    Institute of Scientific and Technical Information of China (English)

    王磊

    2011-01-01

    目的 观察新一代Ⅲ类抗心律失常药物伊布利特和经典Ⅲ类抗心律失常药物胺碘酮转复心房颤动(房颤)和心房扑动(房扑)的成功率及安全性.方法 选择40 ~ 75岁,持续时间≤90 d的房颤和房扑患者38例,按入院顺序随机分为伊布利特组19例和胺碘酮组19例,伊布利特组体质量≥60 kg者首剂1 mg、体质量<60 kg者首剂0.01 mg/kg,如无效10 min后再给予1 mg或0.01 mg/kg;胺碘酮组首剂150 mg,如无效10 min后再给予150 mg,观察转复率和转复时间,记录不良反应.结果 伊布利特和胺碘酮组4h内转复窦律分别为78.9%和31.5%,24 h内转复窦律分别为84.2%和52.6%,平均转复时间分别为(19±12)min和(48 ±17)min (P<0.01).两组均未发生致命性不良反应.结论 伊布利特与胺碘酮均能终止房颤和房扑,伊布利特转复房颤、房扑的疗效高于胺碘酮,转复时间短于胺碘酮,但须在严格监控下进行.%Objective To investigate the efficacy,safety and tolerance of intravenous ibutilide and amiodarone for conversion of atrial fibrillation( AF) and flutter( AFL) to normal sinus rhythm.Methods Thirty - eight consecutive patients aged 40 - 75 years with AF/AFL were included.The duration of arrhythmia were less than 90 days (ranged from 3 hours to 90 days),and ventricular rate(VR) were more than 60 beats/min.Two groups were assigned randomly.Patients in the ibutilide group( 19 cases) received ibutilide 1 mg if body weight ≥60 kg or 0.01 mg/kg if body weight < 60 kg; Treatment was repeated if atrial fibrillation or flutter was not converted after 10 min of the first dosage.Patients in the amiodarone group( 19 cases) received amiodarone 150 mg,followed by amiodarone 150 mg if atrial fibrillation or flutter persisted after 10 min of the first dosage.Results In 4 hours AF/AFL were converted in 15 of 19 patients(78.9% )in ibutilide group and in 6 of 19 patients(31.5% )in amiodarone group (P < 0.05),and in 24

  20. Clinical Study on Amiodarone in the Treatment of Cardiac Arrhythmia%胺碘酮治疗心律失常的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵明琴

    2016-01-01

    Objective Amiodarone treatment method and its effect for patients with cardiac arrhythmia are to be investigated.MethodsChose 66 patients with cardiac arrhythmia who were treated in hospital from August 2014 to September 2015 and separated them into two groups at random, 37 patients in study group were given Amiodarone treatment, while another 29 patients in control group were given Lidocaine treatment, and then compared treatment effects between two groups.Results Patients’treatment efficacy was 91.89% in study group, which was much higher than 82.76% in control group, thus, treatment efficacy in study group was much better and such a differential had statistic value(P<0.05).Conclusion For patients with cardiac arrhythmia, Amiodarone treatment is quite effective and safe to improve their physical symptom with few side effect.%目的:探究心律失常患者采取胺碘酮治疗的方法和效果。方法选取2014年8月~2015年9月收治的66例心律失常患者进行治疗研究,随机分组,实验组37例患者采取胺碘酮治疗,对照组29例患者选择利多卡因治疗,比较两组患者的治疗效果。结果实验组治疗总有效率为91.89%,对照组治疗总有效率为82.76%,实验组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。结论心律失常患者采取胺碘酮治疗,可改善身体症状,效果显著,不良反应较少,安全性高。

  1. 胺碘酮治疗室性心律失常的临床疗效观察%Effect of amiodarone in the treatment of ventricular arrhythmia

    Institute of Scientific and Technical Information of China (English)

    张育辉

    2015-01-01

    目的:探讨胺碘酮治疗室性心律失常的临床效果。方法:选择观察组40例室性心律失常患者,随机分为观察组和对照组。观察组给予胺碘酮治疗,对照组给予利多卡因治疗,观察两组疗效。结果:观察组显效15例(占75%),有效4例(占20.0%),无效1例(占5.0%);对照组临床效果评定结果:显效9例(占45.0%),有效5例(占25.0%),无效6例(占30.0%);观察组总有效率(95.0%)高于对照组总有效率(70.0%),差异有统计学意义( P<0.05)。结论:胺碘酮治疗室性心律失常疗效显著,值得借鉴。%Objective To explore the clinical effect of amiodarone in treatment of ventricular arrhythmia. Method 40 cases with ven-tricular arrhythmia were selected and randomly divided into observation group and control group. The observation group was treated with amiodarone,the control group was given lidocaine. the curative effect of two groups was observed. Results The effect in observation group:26 cases were significant effect(75%),5 cases were effective(20%),1 cases was invalid(5. 0 %);the effect in control group:9 cases were significant effect(45. 0%),5 cases were effective(25. 0%),6 cases were invalid(30. 0%);the total effective rate in the observa-tion group(95. 0%)was higher than that in the control group(70. 0%),the difference was statistically significant(P<0. 05). Conclu-sion Amiodarone in the treatment of ventricular arrhythmia has significant effect,and which is worth learning.

  2. 急性心肌梗死急诊诊断与治疗分析%Clinical effect of intravenous injection of amiodarone in treatment of acute heart failure with rapid atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    许敏

    2013-01-01

    目的:分析研究AMI(急性心肌梗死)的临床诊断以及治疗效果。方法抽取近年来在我院收治的80例患有急性心肌梗塞的患者,随机分为实验组和对照组,每组各40例患者,其中实验组对患者采取尿激酶溶栓治疗,对照组对患者采取传统常规治疗。结果实验组患者的临床治疗效果明显优于对照组患者,两组间差异具有统计学意义(P<0.05)。结论采取及时有效的临床干预以及治疗对治疗急性心肌梗塞的患者起到至关重要的作用,具有临床推广价值应用。%Objective To investigate the clinical effect of intravenous injection of amiodarone in the treatment of acute heart failure with rapid atrial fibrillation.Methods A total of 172 patients with acute heart failure and rapid atrial fibrillation who were admitted to our hospital from October 2011 to July 2013 were randomly divided into heart failure and atrial fibrillation group and amiodarone group. The heart failure and atrial fibrillation group received conventional treatment, while the amiodarone group received conventional treatment plus injection of amiodarone. The treatment outcomes of the two groups were compared.Results After 7 d of treatment, the amiodarone group had a significant more improvement in cardiac function, a significantly better heart rate control, and a significantly lower mortality rate, as compared with the heart failure and atrial fibrillation group (P<0.05 for all comparisons). ConclusionConventional treatment plus injection of amiodarone can improve cardiac function and control heart rate in the treatment of heart failure.

  3. Clinical analysis of low-dose amiodarone therapy in the management of ventricular arrhythmias%小剂量胺碘酮治疗室性心律失常56例临床分析

    Institute of Scientific and Technical Information of China (English)

    王珍

    2001-01-01

    Objective:To evaluate the efficacy and safety of low-dose amiodarone therapy in the management of ventricular arrhythmias.Methods:56 patients with symptomatic drug refractory managed with low-dose oral amiodarone therapy over 5-year period was analyzed retrospec tively. Loading dose of amiodarone 800 mg daily for 1 week, 400 mg daily for anoth er week, then, 100-200 mg daily as maintenance daily.Mean treatment duration was 29±8 months.Results:The efficacy of amiodarone was 81% in the management of ventricular arrhymias. The cumulative incidence of amiodarone related adverse effects was 9%. 1 patient had thyroid dysfunction, and 1 developed pulmonary int erstitial fibrosis.Conclusion:The higer efficacy and acceptable side effect profile of low amiodarone therapy in the management of ventricular arrhythmias.%目的:观察小剂量胺碘酮长期治疗室性心律失常的疗效和安全性。方法:回顾性分析了我院5年来收治的经其它药物治疗无效的室性心律失常的患者56例,给以胺碘酮负荷量800 mg/日,一周后400 mg/日,一周后100~200 mg/日维持,平均给药时间29±8月。结果:胺碘酮治疗室性心律失常有效率81%。与胺碘酮有关的副作用累计发生率为9%,引起甲状腺功能异常和肺间质纤维化各1例。结论:小剂量胺碘酮治疗室性心律失常是安全有效的。

  4. Disfunção tireoidiana e conduta dos cardiologistas em pacientes usando amiodarona Thyroid dysfunction and cardiological management in patients receiving amiodarone

    Directory of Open Access Journals (Sweden)

    Anna Gabriela Fuks

    2004-06-01

    Full Text Available OBJETIVO: Determinar a prevalência de disfunção tireoidiana em pacientes usando amiodarona e os possíveis fatores associados. Verificar através de questionário aplicado a cardiologistas, a importância do fármaco causar alterações na função tireoidiana. MÉTODO: Avaliados 56 pacientes em uso crônico (> 3 meses de amiodarona com dosagens séricas de TSH, T4 livre, T3 total e Anti-TPO e definidos como portadores de disfunção tireoidiana (DT pacientes com TSH alterado. RESULTADOS: A prevalência de disfunção tireoidiana foi de 33,9%. Não houve diferença entre este grupo e os pacientes sem disfunção, exceto em relação à prevalência de anti-TPO positivo maior nos pacientes com DT (p=0,02. Hipotireoidismo subclínico foi diagnosticado em 10 (17,9% pacientes e hipotireoidismo clínico em 6 (10,7%. A prevalência de hipertireoidismo subclínico foi de 3,6% e de hipertireoidismo clínico de 1,8%. Anticorpos anti-TPO foram positivos em 5 (8% pacientes (dos quais 4 apresentavam disfunção. Quando comparados aos doentes sem anti-TPO positivo este grupo teve maior prevalência de disfunção (80% vs 29,4%; p=0,04. Verificado que apenas 49,2% dos cardiologistas faziam acompanhamento da função tireoidiana rotineiramente e a prevalência de disfunção referida na experiência da maioria era de 1 a 10%. CONCLUSÃO: A prevalência de disfunção tireoidiana na nossa população foi elevada, mostrando a necessidade de implementação de uma rotina laboratorial. Houve grande divergência entre os cardiologistas em relação ao tipo de acompanhamento utilizado nos pacientes em uso de amiodarona.OBJECTIVE: To determine the prevalence of thyroid dysfunction in patients receiving amiodarone, and the possible associated factors. The study also aimed at assessing the effect of amiodarone on thyroid function through the application of a questionnaire to cardiologists. METHOD: Fifty-six patients chronically (> 3 months receiving amiodarone were

  5. Use of Intravenous Amiodarone in the Treatment of Nifekalant-Resistant Arrhythmia: A Review of 11 Consecutive Cases with Severe Heart Failure

    Directory of Open Access Journals (Sweden)

    Tohru Ujihira

    2011-05-01

    Full Text Available Background: Both nifekalant hydrochloride (NIF, a selective IKr blocker, and intravenous amiodarone (AMD, a multi-channel (including IKr blocking blocker, have been reported to be efficacious for refractory arrhythmias. However, the optimal use of those antiarrhythmic drugs for refractory arrhythmia with severe heart failure has not been established. Intravenous AMD might be effective for arrhythmias refractory to NIF in patients with severe heart failure. Here, we report that intravenous amiodarone was effective in the treatment of nifekalant-resistant in a group of arrhythmia patients with severe heart failure. Methods: Eleven severe heart failure patients who had received intravenous AMD for treatment of NIF-resistant arrhythmias were included in this study, and retrospective analysis was performed. Clinical efficacy (terminative and preventive effects on arrhythmia of intravenous AMD was evaluated. Results: All cases were emergent cases and had depressed left ventricular ejection fraction (30 ± 13%. Clinical arrhythmias were ventricular fibrillation (VF in four patients, ventricular tachycardia (VT in six patients, and atrial fibrillation (AF in one patient. NIF was administered to all patients by intravenous injection. After administration of NIF, VT/VF/AF was terminated in seven of the 10 patients, but a preventive effect was not obtained in any of the patients (NIF-resistance. Intravenous AMD (maintenance dose: 484 ± 166 mg/day was effective both in termination (80% and in prevention (80% of VT/VF events in those patients. It was also effective in termination (80% and prevention (60% of AF events refractory to NIF. During continuous AMD administration, no significant adverse effects or proarrhythmic effects were observed in any of the patients. Five patients died within one month, but there was no arrhythmic deaths. Conclusions: Intravenous AMD was effective in NIF-resistant lethal arrhythmias and was relatively safe in emergent cases

  6. Therapeutic effects of amiodarone combined with metoprolol versus amiodarone alone in treatment of paroxysmal atrial fibrillation%胺腆酮与美托洛尔联合应用与单用胺腆酮治疗阵发性心房纤颤的疗效观察

    Institute of Scientific and Technical Information of China (English)

    杨顺兰

    2015-01-01

    目的:探讨胺腆酮与美托洛尔联合应用与单用胺腆酮治疗阵发性心房纤颤的疗效观察。方法抽取2013年10月-2014年10月于我院就诊的阵发性心房纤颤患者共62例,将患者随机分为观察组(n=31)与常规组(n=31),常规组采用单纯胺碘酮治疗,观察组采用胺腆酮与美托洛尔联合治疗,观察两组患者的治疗效果。结果治疗后,观察组SBP、DBP、HR分别为(138.8±3.1)mmHg、(95.2±8.5)mmHg、(73.4±10.1)次/min,明显低于常规组(151.2±10.1)mmHg、(130.2±10.8)mmHg、(100.2±13.1)次/min,差异具有统计学意义(ta=6.535,tb=14.179,tc=9.021,P均小于0.05);观察组总有效率93.5%,明显高于常规组61.3%,差异具有统计学意义(χ2=7.473,P﹤0.05)。结论采用胺腆酮与美托洛尔联合治疗阵发性心房纤颤效果显著,能有效控制患者的血压及心率,值得临床大力推广。%Objective To investigate the therapeutic effects of amiodarone combined with metoprolol versus amiodarone alone in the treatment of paroxysmal atrial fibrillation. Methods Sixty-two patients with paroxysmal atrial fibrillation who were admitted to our hospital from October 2013 to October 2014 were equally and randomly divided into observation group and conventional group (31 cases for each group). The conventional group was given amiodarone alone, while the observation group was given amiodarone combined with metoprolol. The treatment outcomes of patients in the two groups were observed. Results After treatment, the observation group had significantly lower systolic blood pressure (138.8±3.1mmHg vs 151.2±10.1mmHg, t=6.535, P﹤0.05), diastolic blood pressure (95.2±8.5mmHg vs 130.2±10.8mmHg, t=14.179, P﹤0.05), and heart rate (73.4±10.1beats/min vs 100.2±13.1beats/min, t=9.021, P﹤0.05) than the conventional group. The observation group had a significantly higher overall response rate than the conventional

  7. 利多卡因混合制剂湿敷治疗胺碘酮所致静脉炎%Lidocaine mixture wet compress therapy with amiodarone induced phlebitis

    Institute of Scientific and Technical Information of China (English)

    陈秀红

    2012-01-01

      Objective:To investigate the loss and treatment with amiodarone induced phlebitis method. Methods:Using 2%lidocaine, 75%ethanol, dexamethasone, vitamin B12 four kinds of drugs into the mixture wet compress therapy with amiodarone induced phlebitis. 60 patients with amiodarone induced phlebitis were randomly divided into the experimental group 32 cases, 28 cases of the control group. The experimental group used lidocaine mixture wet compress therapy, the control group with 75%alcohol wet compress therapy.Results:in the experimental group were significantly better than the control group, treatment effect.Conclusion:intravenous infusion of amiodarone induced peripheral phlebitis, application of lidocaine mixture wet compress remarkable curative effect, safety and Reliability, no adverse reaction.%  目的:探讨减轻及治疗胺碘酮所致静脉炎的方法。方法:采用2%利多卡因、75%乙醇、地塞米松、维生素B12等四种药物配伍成混合制剂湿敷治疗胺碘酮所致静脉炎。将60例盐酸胺碘酮所致静脉炎患者随机分为实验组32例,对照组28例。实验组用利多卡因混合制剂湿敷治疗,对照组用75%乙醇湿敷治疗。结果:实验组治疗效果显著优于对照组。结论:对于胺碘酮静脉滴注所致的外周静脉炎,应用利多卡因混合制剂湿敷疗效显著,安全可靠,无不良反应。

  8. Clinical Research on Arrhythmia on Metoprolol and Amiodarone Therapy%美托洛尔联合胺碘酮治疗心律失常临床研究

    Institute of Scientific and Technical Information of China (English)

    高春明

    2015-01-01

    目的 分析美托洛尔联合胺碘酮治疗心律失常的效果.方法 选取我院收治的90例心律失常患者作为研究对象,并随机分为45例观察组和45例对照组.对观察组采用美托洛尔和胺碘酮联合疗法,对照组则使用胺碘酮单药疗法,对比两组疗效.结果 经治疗,观察组治疗的总有效率为95.56%,对照组为82.22%,对照组低于观察组,且P<0.05.结论 对心率失常患者采用美托洛尔和胺碘酮联合疗法可有效改善患者心功能水平,促进治疗进程,疗效显著.%Objective Analysis of metoprolol and amiodarone treatment of arrhythmia effect. Methods Select our hospital 90 cases of arrhythmia patients as research subjects, and 45 cases were randomly divided into observation group and 45 patients in the control group. The observation group were metoprolol and amiodarone therapy, the control group amiodarone monotherapy, compared to the two groups. Results After treatment, the observation group total effective rate was 95.56%, 82.22% in the control group, the control group was significantly lower than in the observation group, andP < 0.05. Conclusion Arrhythmia treated withmetoprolol and amiodarone therapy can be effective in improving cardiac function in patients, and promote the process of treatment, a significant effect, can be extended.

  9. Clinical observation of amiodarone in treatment of pulmonary tachyarrhythmia complicated with respiratory failure%胺碘酮治疗呼吸衰竭并快速肺源性心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    张淑立; 王毅

    2012-01-01

    Objective To observe the effect of amiodarone in the treatment of pulmonary tachyarrhythmia complicated with respiratory failure. Methods Multifocal atrial tachycardia, atrial fibrillation, atrial flutter and rapid ventricular arrhythmia were observed in 20 patients with acute exacerbation of chronic respiratory failure in our ICU receiving electrocardiography custody. Amiodarone was first injected intravenously followed by infusion pumps, and then orally. Results After amiodarone being administrated, all kinds of arrhythmia in the 19 patients were greatly reduced or disappeared, while only 1 patient with atrial flutter remained. Serious side effect was not detected during the therapy. Conclusions Amiodarone can be used in the patients with pulmonary tachyarrhythmia complicated with respiratory failure safely and effectively.%目的 观察胺碘酮对呼吸衰竭伴快速肺源性心律失常的疗效.方法 20例慢性呼吸衰竭病人,在监护病房持续心电监护,呼吸衰竭急性加重期出现紊乱性房性心律失常、房颤、房扑以及快速室性心律失常,予胺碘酮先静脉推注、静脉泵入,后序贯为口服.结果 用胺碘酮后19例病人各种心律失常明显减少或消失,1例房扑病人无转复.用药过程中未发现明显副作用.结论 胺碘酮对呼吸衰竭伴快速肺源性快速心律失常安全、有效.

  10. 胺碘酮对急性心肌梗死并发室性心动过速的治疗分析%Clinical analysis on intravenous Amiodarone for continuous ventricular tachycardia in patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    阎晋华; 齐守罡

    2012-01-01

      目的观察静脉注射胺碘酮治疗急性心肌梗死并发室性心动过速的疗效。方法将30例急性心肌梗死患者分为2组,每组15例,分别给予静脉注射利多卡因、胺碘酮治疗,观察2组临床疗效。结果胺碘酮组15例患者中,13例患者室性心动过速得到控制,对照组有8例患者室性心动过速得到控制,胺碘酮组有效率高于对照组。结论静脉注射胺碘酮治疗急性心肌梗死并发室性心动过速安全有效,可提高急性心肌梗死的抢救成功率。%  Objective To investigate the effect of amiodarone to continuous ventricular tachycardia in patients with acute myocardial infarction.Methods 30 cases of acute myocardial infarction patients were divided into 2 groups, 15 cases in each group, were given intravenous lidocaine, amiodarone treatment, observation of clinical curative effect of 2 sets.Results Among 15 cases in the observation group, 13 patients with ventricular tachycardia were under control, in the control group, 8 patients with ventricular tachycardia got controlled heartbeat, amiodarone group was higher than that of control group.Conclusion Intravenous amiodarone is more effective and safer than lidocaine in treating continuous ventricular tachycardia in patients with AMI.

  11. Discuss the Treatment of Amiodarone Combined With Metoprolol in Coronary Heart Disease in Elderly Patients%胺碘酮联合美托洛尔治疗老年冠心病

    Institute of Scientific and Technical Information of China (English)

    王勇; 李连鑫

    2015-01-01

    目的:探讨胺碘酮联合美托洛尔治疗老年冠心病的临床效果。方法将我院于2013年1月~2014年1月收治的156例老年冠心病患者列为研究对象,将其随机平分,观察组给予常规药物加胺碘酮联合美托洛尔口服;对照组给予常规药物加胺碘酮口服,6个月后对较分析其心绞痛、心律失常的改善情况。结果观察组室性心绞痛、心律失常的治疗有效率均明显大于对照组,差异显著(P<0.05),具有统计学意义。结论胺碘酮联合美托洛尔治疗老年冠心病效果比单用胺碘酮疗效好,差异显著。%ObjectiveDiscuss the clinical effect of Amiodarone combined with metoprolol in Coronary heart disease in elderly.Method Selected 156 cases of coronary heart disease in elderly admitted in our hospital, divided them into two groups. Observation group received conventional drugs and oral amiodarone combined with metoprolol, control group received conventional drugs and oral amiodarone, compared their improvement of angina and arrhythmias six months later.Results Observation group' room angina, arrhythmia treatment effective rate was signiifcantly greater than control group, the difference was signiifcant (P<0.05), with statistical significance.Conclusion Amiodarone combined with metoprolol have a better efifcacy in coronary heart disease in elderly patients..

  12. Clinical investigation on potato external application to prevent amiodarone-induced phlebitis%马铃薯外敷预防胺碘酮注射液致静脉炎的临床研究

    Institute of Scientific and Technical Information of China (English)

    宋美燕; 唐菊素; 翁志英

    2013-01-01

    Objective To investigate the effectiveness of potato slices external application to prevent amiodarone-induced phlebitis.Methods A total of 100 patients treated with intravenous amiodarone were randomly divided into observation group and control group.Fresh potato slices were applied externally to the skin above the venipuncture site during intravenous infusion of amiodarone-in the observation group,while no preventive measures were taken in the control group.Results The incidence and severity of phlebitis in the observation group were significantly decreased compared to those in the control group.Conclusions Potato external application can effectively reduce the occurrence of amiodarone-induced phlebitis.%目的 探讨马铃薯外敷预防胺碘酮注射液致静脉炎的效果.方法 将100例静脉泵入胺碘酮的患者随机分为观察组和对照组各50例.观察组在静脉泵入胺碘酮的同时用新鲜马铃薯外敷静脉穿刺点上方皮肤.对照组不做预防性处理.结果 观察组静脉炎的发生率及严重程度显著低于对照组(P<0.01).结论 使用马铃薯外敷可有效降低胺碘酮注射液所致静脉炎.

  13. 34 Cases of Paroxysmal Atrial Fibrillation Treated with Amiodarone and Syndrome Differentiation and Treatment in Chinese Medicine%胺碘酮结合中医辨证论治治疗阵发性心房纤颤34例

    Institute of Scientific and Technical Information of China (English)

    王浩

    2009-01-01

    目的 研究胺碘酮结合中医辨证论治治疗阵发性心房纤颤的临床疗效.方法 将53例阵发性心房纤颤患者分为对照组和治疗组.对照组19例患者给予胺碘酮治疗,治疗组34例患者在对照组治疗基础上加用中医辨证论治方法治疗.观察两组患者治疗后的临床疗效.结果 治疗组总有效率为91.18%,对照组为68.42%,两组比较有显著性差异(P< 0.05).结论 运用胺碘酮结合中医辨证论治方法治疗心房纤颤,疗效显著优于单用胺碘酮.%Objective To investigate clinical efficacy on paroxysmal atrial fibrillation treated with amiodarone and syndrome differentiation and treatment in Chinese medicine.Methods 53 cases of paroxysmal atrial fibrillation were randomly divided into control group and treatment group.19 cases in control group were treated with amiodarone and 34 cases in treatment group were treated according to syndrome differentiation in Chinese medicine.The clinical efficacy was observed after treatment in two groups.Results The total effective rate was 91.18% in treatment group and 68.42% in control group,demonstrating significant difference in comparison(P<0.05).Conclusion The efficacy of combined therapy of amiodarone and syndrome differentiation and treatment of Chinese medicine is superior significantly to that of simple administration of amiodarone.

  14. Observation and Nursing Intervention of Amiodarone in the Treatment of Arrhythmia%胺碘酮治疗心率失常的疗效观察和护理干预分析

    Institute of Scientific and Technical Information of China (English)

    王晓荣

    2015-01-01

    目的:探讨使用胺碘酮治疗心率失常的临床效果及护理干预措施。方法回顾性分析入住我院治疗心率失常的62例患者,随机分为两组做比对性分析。结果观察组患者的治疗效果较好,总有效率高于对照组,差异有统计学意义(P<0.05)。结论使用胺腆酮治疗心率失常的临床疗效确切,加以综合护理干预可有效提高胺腆酮的治疗效果,减少并发症的发生。%Objective To investigate the clinical effect and nursing intervention measures of the use of amiodarone in the treatment of arrhythmia. Methods 62 cases of patients with arrhythmia were analyzed in our hospital, were randomly divided into two groups to do a comparison analysis. Results The effect of the observation group was significantly higher than that of the control group, the difference was statistically significant (P<0.05). Conclusion Use of amiodarone in the treatment of arrhythmia clinical curative effect, the comprehensive nursing intervention can effectively improve the therapeutic effect of amiodarone, reduce complications.

  15. The Clinical Research of Amiodarone in the Treatment of Patients With Heart Failure Combined With Arrhythmia%胺碘酮治疗心衰合并心律失常患者的临床研究

    Institute of Scientific and Technical Information of China (English)

    许波

    2015-01-01

    目的:分析胺碘酮治疗心衰合并心律失常的效果。方法选取心衰合并心律失常患者42例,均给予胺碘酮治疗。结果42例患者总有效率95.2%,用药后心功能较用药前明显改善,无严重不良反应,仅2例胃肠道不适,经对症处理后好转。结论胺碘酮治疗心衰合并心律失常效果显著。%Objective To analysis the effect of amiodarone in the treatment of heart failure combined with arrhythmia. Methods 42 cases of patients with heart failure combined with arrhythmia were selected and all patients were given amiodarone treatment. Results After treatment,the total effective rate was 95.2%in 42 cases. The cardiac function of patients were significantly improved than before treatment. There was no serious adverse reaction. Only 2 patients had gastrointestinal discomfort and they were cured after symptomatic treatment. Conclusion The effect of amiodarone in treatment of heart failure combined with arrhythmia is significantly.

  16. 胺碘酮治疗老年冠心病心律不齐的临床疗效观察%Clinical Efficacy of Amiodarone for Elderly Patients With Coronary Heart Disease Combined With Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    张洪莲

    2016-01-01

    Objective To investigate the efficacy of amiodarone in the treatment of CHD combined with Arrhythmia for elderly patients.Methods We divided 80 patients into two groups,the control group used conventional therapy,and observation group used amiodarone treatment.Results The efficiency and incidence of adverse reactions of observation group were significantly better than control group(P<0.05).ConclusionThe effect of of amiodarone in the treatment of CHD combined with Arrhythmia is ideal.%目的:观察胺碘酮治疗老年冠心病心律不齐的效果。方法随机将我院收治的80例冠心病心律不齐老年患者平均分为两组,对照组行常规治疗,观察组行胺碘酮治疗。结果观察组总有效率、不良反应发生率等优于对照组(P<0.05)。结论胺碘酮治疗老年冠心病心律不齐效果理想。

  17. 胺碘酮联合美托洛尔静注治疗快速心律失常的临床观察%Clinical observation of amiodarone combined with metoprolol injection in the treatment of rapid arrhythmia

    Institute of Scientific and Technical Information of China (English)

    戴志刚

    2014-01-01

    目的:探讨胺碘酮联合美托洛尔静脉注射治疗快速心律失常的临床疗效。方法:2009年1月-2013年8月收治快速心律失常患者60例,对照组给予胺碘酮治疗,研究组给予胺碘酮联合美托洛尔静注治疗。结果:研究组临床治疗效果明显优于对照组,两组差异具有统计学意义(P<0.05);研究组与对照组均未发生严重的不良反应,两组差异不具备统计学意义(P>0.05)。结论:研究胺碘酮联合美托洛尔静脉注射治疗快速心律失常的临床疗效好于单用胺碘酮治疗,安全性、有效性较高,值得在临床治疗中推广使用。%Objective:To investigate the clinical efficacy of amiodarone combined with metoprolol injection in the treatment of rapid arrhythmia.Methods:60 patients with rapid arrhythmia were selected from January 2009 to August 2013.The control group received the treatment of amiodarone,while the research group were treated with amiodarone combined with metoprolol injection therapy.Results:The clinical effect of the treatment group was better than that of the control group,and the difference was statistically significant between two groups(P0.05).Conclusion:The therapeutic effect of amiodarone combined with metoprolol injection is better than single amiodarone in the treatment of rapid arrhythmia.This treatment has high safety,and it also effective,so it worth to be popularized in clinical treatment.

  18. The clinical effect observation of amiodarone combined with esmolol in rapid paroxysmal atrial fibrillation%胺碘酮联合艾司洛尔治疗快速阵发房颤疗效观察

    Institute of Scientific and Technical Information of China (English)

    黄金莹; 姚丹林

    2016-01-01

    Objective To observe the clinical effect of amiodarone combined with esmolol in rapid paroxysmal atrial fibrillation. Methods 93 cases patients with rapid paroxysmal atrial fibrillation were randomly divided into observation group and control group. Observation group was treated by amiodarone and esmolol. Control group was treated by amiodarone. After treatment,compared the clinical effect and adverse reactions. Results The total efficiency of observation group(91. 5% )was higher than that of control group(80. 4% ),the difference was statistically significant(P 0. 05). Conclu-sion The effect of amiodarone combined with esmolol in rapid paroxysmal atrial fibrillation is better than amiodarone,and without increased adverse events,worthy of promotion.%目的:观察胺碘酮联合艾司洛尔治疗快速阵发房颤的疗效及安全性。方法将93例快速阵发房颤患者随机分为2组,观察组静脉注射胺碘酮联合艾司洛尔治疗,对照组单独静脉注射胺碘酮治疗,比较2组治疗效果和不良反应。结果观察组总有效率为91.5%高于对照组的80.4%,差异有统计学意义(P <0.05)。2组均无严重不良反应发生,且其发生率比较差异无统计学意义(P >0.05)。结论胺碘酮联合艾司洛尔治疗快速阵发房颤的疗效明显优于单独使用胺碘酮患者,且不增加不良反应,值得临床推广。

  19. 胺碘酮与决奈达隆对家兔急性心房颤动作用的比较%Comparsion of the effects of amiodarone and dronedarone on acute atrial fibrillation in rabbits

    Institute of Scientific and Technical Information of China (English)

    李妙龄; 李芳; 顾磊; 唐悦; 刘志强; 梁华; 范新荣; 曾晓荣

    2015-01-01

    Objective To compare the different efficacy of amiodarome and dronedarone in treating acute atrial fibrillation. Methods: Acute atrial fibrillation model was induced by rapid atrial pacing with stimulus frequency of 17Hz. Results The successful rate of atrial fibrillation model was about 40.5%. Amiodarone and dronedarone both significantly decreased the duration and occurrence frequence of atrial fibrillation .Compared with amiodarone, dronedarone produced more potent efficacy for preventing atrial fibrillation. Amiodarone pretreatment was superior to dronedarone pretreatment in preventing atrial fibrillation recurrence. Ventricuiar rate decreased more significantly by dronedarone than by amiodarone. Conclusion In acute atrial fibrillation,amiodarone and dronedarone have similar antiarrhythmic effect with different efficacy.%目的::比较胺碘酮和决奈达隆抗家兔急性心房颤动的作用差异。方法:以17 Hz刺激频率建立心房颤动模型,观察建立模型前后给予胺碘酮和决奈达隆对家兔心房颤动的抑制作用。结果:经心电图分析,家兔急性心房颤动模型成功率为40.5%,模型建立成功后分别给予胺碘酮(5 mg/kg)和决奈达隆(5 mg/kg)均可以明显抑制房颤的持续时间和降低房颤的发作频率;与胺碘酮相比,决奈达隆抑制作用更强(P<0.05);胺碘酮预处理后预防房颤的再发作用强于决奈达隆,决奈达隆心室率抑制作用强于胺碘酮。结论:在急性房颤中,胺碘酮与决奈达隆具有相似的抗心房颤动作用,药物疗效有差异。

  20. 胺碘酮治疗心房颤动23例的临床体会%Clinical Experience of 23 Cases of Atrial Fibrillation Treated with Amiodarone

    Institute of Scientific and Technical Information of China (English)

    赵文霞; 刘成涛

    2015-01-01

    Objective To investigate the amiodarone treatment the clinical curative ef ect of new onset atrial fibril ation.Methods Our hospital from May 2011 to May 2015 were 23 cases of amiodarone treatment for atrial fibril ation patients as the research object. In the strong heart diuresis expansion blood vessel, etc on the basis of routine therapy and amiodarone treatment. Results 23 cases, 13 cases were markedly improved (57%), 7 cases (30%), ef ective invalid in 3 patients (22%), the total ef ective rate was 87%. The group were markedly improved in 1 case because of gastrointestinal symptoms and recur ence after the drug was stopped, take amiodarone after converting. Conclusion Amiodarone compared with other anti-arrhythmic drugs, can more safely and ef ectively control and prevent the occur ence of ventricular ar hythmias, atrial fibril ation and does not af ect heart function.%目的:探讨胺碘酮治疗新发心房纤颤的临床疗效。方法选取本院自2011年5月~2015年5月收治的23例胺碘酮治疗心房房颤动患者作为研究对象。在强心利尿扩血管等常规治疗的基础上采用胺碘酮治疗。结果23例中显效13例(57%),有效7例(30%),无效3例(22%),总有效率87%。其中的显效组中1例因出现胃肠道症状而自行停药后复发,续服胺碘酮后转复。结论胺碘酮与其他抗心律失常药相比,能更安全有效地防治房颤和预防室性心律失常的发生,且不影响心功能。

  1. Preliminary Observation and Evaluation of the Effect of Small Dose Amiodarone in the Treatment of Amiodarone%心律失常治疗中小剂量胺碘酮治疗的效果初步观察及评估

    Institute of Scientific and Technical Information of China (English)

    桑艳平

    2015-01-01

    目的:探究中小剂量胺碘酮治疗心力衰竭合并心律失常的临床疗效。方法择取我院2013年1月~2015年1月收治的心力衰竭合并心律失常患者50例作为本次的观察对象,并给予胺碘酮进行临床治疗,分析治疗效果。结果治疗有效率达到92.0%(46/50);且仅有2例患者在连续治疗6个月后显示FT3、FT4水平增高,不良反应发生率为4.0%(2/50)。结论对心力衰竭合并心律失常患者给予中小剂量胺碘酮治疗效果好,药物不良反应少,安全性高,可改善患者临床症状。%ObjectiveTo explore the clinical effect of smal dose amiodarone in the treatment of heart failure combined with arrhythmia.MethodsChose my courtyard 50 cases with heart failure combined with arrhythmia in 2013 January to January 2015 as the object.Al patients used amiodarone for clinical treatment,therapeutic effect was analyzed. ResultsThe effective rate of treatment was 92%(46/50),and only 2 patients showed increased FT3 and FT4 levels after 6 months of continuous treatment, the incidence of adverse reactions was 4% (2/50).Conclusion The clinical effect of smal dose of amiodarone in patients with heart failure combined with arrhythmia is significant,with less adverse drug reaction,high safety and can improve the clinical symptoms.

  2. Validation of a direct non-destructive quantitative analysis of amiodarone hydrochloride in Angoron((R)) formulations using FT-Raman spectroscopy.

    Science.gov (United States)

    Orkoula, M G; Kontoyannis, C G; Markopoulou, C K; Koundourellis, J E

    2007-09-15

    Raman spectroscopy was applied for the direct non-destructive analysis of amiodarone hydrochloride (ADH), the active ingredient of the liquid formulation Angoron((R)). The FT-Raman spectra were obtained through the un-broken as-received ampoules of Angoron((R)). Using the most intense vibration of the active pharmaceutical ingredient (API) at 1568cm(-1), a calibration model, based on solutions with known concentrations, was developed. The model was applied to the Raman spectra recorded from three as-purchased commercial formulations of Angoron((R)) having nominal strength of 50mgml(-1) ADH. The average value of the API in these samples was found to be 48.56+/-0.64mgml(-1) while the detection limit of the proposed technique was found to be 2.11mgml(-1). The results were compared to those obtained from the application of HPLC using the methodology described in the European Pharmacopoeia and found to be in excellent agreement. The proposed analytical methodology was also validated by evaluating the linearity of the calibration line as well as its accuracy and precision. The main advantage of Raman spectroscopy over HPLC method during routine analysis is that it is considerably faster and no solvent consuming. Furthermore, Raman spectroscopy is non-destructive for the sample. However, the detection limit for Raman spectroscopy is much higher than the corresponding for the HPLC methodology. PMID:19073025

  3. Mechanisms of amiodarone and valproic acid induced liver steatosis in mouse in vivo act as a template for other hepatotoxicity models.

    Science.gov (United States)

    Vitins, Alexa P; Kienhuis, Anne S; Speksnijder, Ewoud N; Roodbergen, Marianne; Luijten, Mirjam; van der Ven, Leo T M

    2014-08-01

    Liver injury is the leading cause of drug-induced toxicity. For the evaluation of a chemical compound to induce toxicity, in this case steatosis or fatty liver, it is imperative to identify markers reflective of mechanisms and processes induced upon exposure, as these will be the earliest changes reflective of disease. Therefore, an in vivo mouse toxicogenomics study was completed to identify common pathways, nuclear receptor (NR) binding sites, and genes regulated by three known human steatosis-inducing compounds, amiodarone (AMD), valproic acid (VPA), and tetracycline (TET). Over 1, 4, and 11 days of treatment, AMD induced changes in clinical chemistry parameters and histopathology consistent with steatosis. Common processes and NR binding sites involved in lipid, retinol, and drug metabolism were found for AMD and VPA, but not for TET, which showed no response. Interestingly, the pattern of enrichment of these common pathways and NR binding sites over time was unique to each compound. Eleven biomarkers of steatosis were identified as dose responsive and time sensitive to toxicity for AMD and VPA. Finally, this in vivo mouse study was compared to an AMD rat in vivo, an AMD mouse primary hepatocyte, and a VPA human primary hepatocyte study to identify concordance for steatosis. We conclude that concordance is found on the process level independent of species, model or dose*time point. PMID:24535564

  4. Comparison of the Frequency-dependent Effects of Amiodarone on Ventricular Electrophysiology in Congestive Heart Failure Canine Models and Normal Dogs

    Institute of Scientific and Technical Information of China (English)

    Zhou Shuxian; Zhang Yuling; Lei Juan; Wu Wei; Zhang Xuming

    2007-01-01

    Objectives To compare the frequency-dependent effects of amiodarone (Ami) on ventricular electrophysiology in right ventricular rapid pacing-induced congestive heart failure (CHF) canine models.Methods Thirty-two dogs were randomized into four groups: the control group, the Ami group in which the normal dogs were given Ami orally 300 mg a day for 4~5 weeks, the CHF group induced by right ventricular rapid pacing ( 240 pulses. min -1 for 4 ~ 5 weeks), and the group of CHF dogs fed with Ami orally 300 mg a day for 4 ~ 5 weeks. The techniques of electrical stimulation and monophasic action potential (MAP) recording were used in the electrophysiology studies. Results The effects of Ami on ventricular MAP duration(MAPD90) and effective refractory period (VERP)were not frequency-dependent in CHF dogs. There was also no frequency-dependent effect on the increase in the ratio of VERP to MAPD90 (VERP/MAPD90). The prolongation of ventricular conduction time was frequencydependent. Conclusions The frequency-dependent effects of Ami on ventricular electrophysiology in CHF dogs were similar to that in normal dogs.

  5. Methanolic extract of Moringa oleifera leaf and low doses of gamma radiation alleviated amiodarone-induced lung toxicity in albino rats

    Directory of Open Access Journals (Sweden)

    Hasan Hesham F.

    2016-01-01

    Full Text Available This study aimed to evaluate the effects of methanolic extract of Moringa oleifera (MO and/or low doses of gamma radiation (LDR on amiodarone (AMD-induced lung toxicity in rats. AMD administered to female albino rats (100 mg/kg body weight for 10 consecutive days. Rats received methanolic extract of MO (250 mg/kg bwt for 15 successive days and/or were exposed to whole body LDR (0.25Gy on the 1st and 10th days, up to a total dose of 0.5Gy. MO administration induced a significant decrease in serum tumor necrosis factor-alpha (TNF-α and transforming growth factor-beta (TGF-β levels as well as lactate dehydrogenase (LDH activity. Also, the content of malondialdehyde (MDA and hydroxyproline (HYP was significantly decreased in lung tissue. Furthermore, MO significantly increased reduced glutathione (GSH content in lung tissue as compared with AMD. The histopathological investigation of lung tissue revealed the appearance of interstitial pneumonia in rats treated with AMD. The oral administration of MO and/or exposure to LDR reversed the biochemical and histopathological alterations induced by AMD. It can be posited that MO and LDR might have a considerable role in the prevention of lung toxicity induced by AMD.

  6. OBSERVATION AND PREVENTION OF PHLEBITIS DURING CONTINUOUSLY INJECTION OF AMIODARONE THROUGH MICRO INFUSION%持续微泵静脉注射可达龙药物的观察与静脉炎防治护理

    Institute of Scientific and Technical Information of China (English)

    向岚; 魏军华; 李雪雁

    2011-01-01

    [目的]加强可达龙用药期间的观察及静脉炎的防治护理.[方法]培养专科护士全面了解药物作用与特殊性,加强用药期间的观察,正确识别副作用、并发症,及时评估血管,采取有效地预防及处置.[结果]减少了用药期间的并发症,提高了药物疗效及工作效率.[结论]专科用药实施严密综合管理,保证了用药期间的安全,减轻了患者痛苦与经济负担.%[Objective] To enforce the nursing observation and prevention of phlebitis during using of amiodurone. [Methods] Effective education and training about the drug effect and specification of amiodarone were given to nurses. The nursing observation during the using of the drug was enforced and the bad effects and complications were correctly identified. The stale of the vein was evaluated and effective prevention measures and treatments were taken in time. [Results] Through these effective nursing measures above, the complications were significantly reduced while the treatment effects of amiodarone and the work efficiency were dramatically improved. [Conclusion] Through rigid integrated management to the nursing during the using of amiodarone, the security can be assured and the agony and economy burden of patients can be relived.

  7. 胺碘酮治疗老年冠心病心律不齐的临床研究%Clinical Research on Amiodarone for the Treatment of Senile Coronary Heart Disease and Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    程红伟

    2015-01-01

    目的:研究分析胺碘酮应用于老年冠心病心律不齐患者的临床治疗中所取得的效果。方法选择本院76例冠心病心律不齐老年患者,选择胺碘酮以及普罗帕酮对患者实施分组治疗,对比两组患者的临床疗效。结果采用胺碘酮的观察组总治疗有效率为95.6%,明显优于对照组(采用普罗帕酮)的76.5%,两组患者临床治疗有效率比较存在明显差异,具有统计学意义(P<0.05);观察组患者的不良反应发生率明显低于对照组患者(P<0.05)。结论针对老年冠心病心律不齐患者,采用胺碘酮进行治疗能够取得明显疗效,建议推广应用。%Objective To study the clinical application of amiodarone treatment in elderly patients with coronary heart disease arrhythmia in multi effect has been achieved. Methods 76 cases of elderly patients with coronary heart disease arrhythmia amiodarone and propafenone in our hospital, choice of implementation of grouping treatment of patients, the clinical efficacy were compared between two groups. Results The effective rate of observation group with amiodarone total treatment was 95.6%, significantly better than the control group (using propafenone) 76.5% (P<0.05). Conclusion In elderly coronary heart disease patients with amiodarone for the treatment of arrhythmia, can obtain obvious effect, application suggestions.

  8. 稳心颗粒联合小剂量胺碘酮治疗心律失常50例%Wenxin Granules Combined with Low-Dose Amiodarone in Treating 50 Cases of Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    戴仁森

    2012-01-01

    目的 观察稳心颗粒联合小剂量胺碘酮治疗心律失常的临床疗效及安全性.方法 选择心律失常患者100例,随机分成两组,每组各50例,对照组给予大剂量的胺碘酮治疗,治疗组给予稳心颗粒联合小剂量胺碘酮治疗.疗程均为4周,观察两组临床疗效及不良反应发生情况.结果 临床总有效率和早搏总有效率对照组为80.00%和70.00%,治疗组为92.00%和88.00%;不良反应对照组有9例,治疗组有4例.结论 稳心颗粒联合小剂量胺碘酮治疗心律失常疗效较好、不良反应少,值得临床推广.%Objective To study the clinical efficacy and safety of Wenxin Granules combined low dose amiodarone in the treatment of arrhythmia. Methods 100 patients with arrhythmia were randomly divided into two groups, 50 cases in each group. The control group was treated by large - dose amiodarone, while the treatment group received Wenxin Granules combined low - dose amiodarone. The treatment course in the two groups was 4 weeks. The clinical efficacy and adverse events were observed. Results The clinical total effective rate and the total effective rate of premature beat was 80.00% and 70.00% in the control group, and 92.00% and 88.00% in the treatment group, respectively. The control group had 9 cases of adverse reactions and the treatment group had 4 cases. Conclusion Wenxin Granules combined with low - dose amiodarone has a good effect and less adverse reactions in the treatment of arrhythmia and is worthy of clinically promoted.

  9. Clinical Experience of Amiodarone Combined with Wenxinkeli in Treating New Atrial Fibrillation%胺碘酮联合稳心颗粒治疗新发心房纤颤的临床体会

    Institute of Scientific and Technical Information of China (English)

    李晓渝

    2014-01-01

    Objective To analyze the clinical efficacy of amiodarone combined with Wenxinkeli in treating new atrial fibrillation. Methods A total of 46 patients with new atrial fibrillation in our hospital from April 2O1O to March 2O14 were se-lected,and then they were divided into control group(23 cases)and observation group(23 cases). The control group was treated with amiodarone combined with verapamil,the observation group was treated with amiodarone combined with Wenxinkeli. Clinical efficacy of two groups were compared. Results The total effective rate of the observation group was higher than that of control group,the difference was statistically significant( PAmiodarone combined with Wenxinkeli has significant clinical efficacy in treating new atrial fibrillation,which,can improve patients'physical fitness and quality of life.%目的:探讨胺碘酮联合稳心颗粒治疗新发心房纤颤的临床疗效。方法选取2O1O年4月-2O14年3月于本院接受治疗的新发心房纤颤患者46例作为研究对象。将其分成对照组及观察组,各23例。对照组给予盐酸胺碘酮联合维拉帕米治疗;观察组给予胺碘酮及稳心颗粒的联合治疗。比较两组患者的临床疗效。结果观察组临床治疗的总有效率高于对照组,差异有统计学意义( P

  10. Efifcacy of Amiodarone Combined With Metoprolol Treatment of Coronary Heart Arrhythmia%胺碘酮联合美托洛尔治疗冠心病心律不齐的疗效分析

    Institute of Scientific and Technical Information of China (English)

    赵强; 刘泉

    2015-01-01

    Objective To observe the effect of amiodarone in combination with metoprolol in treatment of patients with coronary heart arrhythmia. Methods Information our hospital’s 106 cases of patients selected from July 2013 to July 2014 with coronary heart arrhythmia were randomly divided into study group and control group , each group had 53 cases. the study group amiodarone used US metoprolol treatment, the control group, only used amiodarone treatment, the clinical effect of two groups were compared. Results Heart rate, blood pressure in the study group were significantly better than the control group (P 0.05). Conclusion The effect of Amiodarone combined with metoprolol in treatment of coronary heart arrhythmia was more signiifcant.%目的:观察胺碘酮联合美托洛尔治疗冠心病心律不齐的疗效。方法资料选取2013年7月~2014年7月本院收治的106例冠心病心律不齐患者,将其随机分为研究组和对照组,每组均为53例,研究组应用胺碘酮联合美托洛尔治疗,对照组仅应用胺碘酮治疗,比较两组的临床疗效。结果研究组的心率、血压改善均明显优于对照组(P<0.05);研究组不良反应发生率7.55%与对照组9.43%比较无明显差异(P>0.05)。结论胺碘酮联合美托洛尔治疗冠心病心律不齐的疗效较为显著。

  11. Clinical application of Amiodarone combined with Irbesartan on treatment in paroxysmal atrial fibrillation patients%胺碘酮联合厄贝沙坦治疗阵发性心房颤动疗效观察

    Institute of Scientific and Technical Information of China (English)

    徐爱琴

    2011-01-01

    Aim To observe the effect of Amiodarone combined with Irbesartan treating paroxysmal atrial fibrillation. Method From May 2008 to May 2010,83 paroxysmal atrial fibrillation patients were enrolled and randonly divided into treatment group and control group. The treatmrent group was treated with Amiodarone and Irbesartan, and the control group only with Amiodarone. All the patients had been observed for 12 months. Results The sinus rhythm maintenance rate in treatment group was higher than that in control group and the atrial diameter decreased remarkably in treatment group than in control group (P < 0.05). Conclusion Irbesartan can inhibit e lectronic and anatomical remodeling of atrial, reduce the recurrence rate of atrial fibrillation, prevent persistence of atrial fibrillation and maintain the sinus rhythm rate more effectively than Amiodarone only,and it can also inhibit the increase of the left atrial diameter.%目的 观察胺碘酮联合厄贝沙坦治疗阵发性房颤的疗效.方法 选择2008年5月~2010年5月期间该院83例阵发性房颤患者,随机分为治疗组(胺碘酮+厄贝沙坦)和对照组(单用胺碘酮),疗程均为一年.结果 治疗组窦性心率维持率明显高于对照组(P<0.05),左房内径亦有显著性缩小(P<0.05).结论 厄贝沙坦具有抑制心房电重构和解剖重构,降低房颤复发率及阻止房颤持续的作用,胺碘酮联合厄贝沙坦治疗阵发性心房颤动维持窦性心率的疗效优于单用胺碘酮,且能抑制左房扩大.

  12. Application Effect of Amiodarone on Patients With Congestive Heart Failure and Arrhythmias%心力衰竭并心律失常患者胺碘酮的应用效果观察

    Institute of Scientific and Technical Information of China (English)

    雷娜

    2015-01-01

    目的 研究探讨对心力衰竭合并心律失常患者应用胺碘酮的临床疗效.方法 选择我院心内科自2013年1月~2015年1月收治的80例心力衰竭合并心律失常的患者作为研究对象,所有患者均予以胺碘酮进行治疗,对其临床效果进行回顾性分析.结果 经胺碘酮治疗研究患者的总有效率为90.0%,不良反应发生率为8.7%,且心脏功能较治疗前改善(P<0.05),差异具有统计学意义.结论 在临床中应用胺碘酮治疗心力衰竭合并心律失常患者具有有效率高及不良反应率低等优点,并且可显著改善患者的心脏功能.%Objective To investigate the clinical efifcacy in patients with heart failure, arrhythmia amiodarone. Methods Hospital Cardiology from 80 cases of patients with heart failure with cardiac arrhythmia from January 2013 to January 2015 admitted to the study, all patients were to be treated with amiodarone were retrospectively analyzed clinical Results . Results Amiodarone therapy in patients with total effective rate was 90.0% incidence of adverse reactions was 8.7%, and heart function was significantly improved compared with before treatment (P < 0.05), a statistically significant difference. Conclusion The clinical application of amiodarone treatment of heart arrhythmia the patient has high efficiency and low adverse reaction rate, etc., and can significantly improve the patient's cardiac function.

  13. 胺碘酮在心力衰竭合并室性心律失常中的临床应用研究%Clinical Analysis of Amiodarone for Heart Failure Patients of Ventricular Arrhythmia

    Institute of Scientific and Technical Information of China (English)

    齐芳

    2014-01-01

    Objective To investigate the clinical effect of amiodarone on heart failure complicated with ventricular. Methods 80 cases with chronic heart failure complicated with ventricular arrhythmia were selected and randomly divided into observation group and control group. The two groups were given routine anti heart failure treatment,and amiodarone was given to observation group at the same time. The efficacy of the two groups was evaluated. Results The total effective rate, the left ventricular ejection fraction and heart rate in the observation group after treatment compared with those in the control group after treatment, the difference was statistical y significant (P <0.05). Conclusion The curative effect of amiodarone on heart failure complicated with ventricular arrhythmiatreatment is significant,and amiodarone is helpful to improve clinical symptoms and signs.%目的:探讨胺碘酮在心力衰竭合并室性心律失常中的临床应用效果。方法:选取来我院进行治疗的心力衰竭合并室性心律失常患者82例作为研究对象,随机分为观察组和对照组,所有患者均给予常规心力衰竭治疗,此外,观察组患者给予胺碘酮。比较两组患者的治疗效果以及组患者左室射血分数和心率。结果:治疗后观察组患者的总有效率、左室射血分数和心率与观察组相比,差异有统计学意义(P<0.05)。结论:胺碘酮治疗心力衰竭合并室性心律失常疗效显著,值得临床推广。

  14. Effect of Wenxin Particle Combined with Amiodarone on Premature Ventricular Beats%步长稳心颗粒联合胺碘酮治疗室性期前收缩的疗效观察

    Institute of Scientific and Technical Information of China (English)

    郑硕

    2012-01-01

    Objective To evaluate the therapeutic efficacy and safety of Wenxin Particle combined with amiodarone in the treatment of premature ventricular beats.Methods 78 cases with premature ventricular beats were divided into observation group(n=40)and control group(n=38).The observation group was treated with Wenxin Particle and amiodarone,the control group was treated amiodarone with only.The improvement of clinical symptoms and premature ventricular beats and the side effects were observed.Results Total effective rate was 78.94% in control group,92.50% in observation group.There was a significantly statistical difference between two groups(P<0.05).Conclusion Wenxin Particle combined with amiodarone in treating premature ventricular beats can improve the clinical effect and have no obvious side effect,so it is worth being used widely.%目的 观察步长稳心颗粒联合胺碘酮治疗室性期前收缩的临床疗效及安全性.方法 将78例室性期前收缩患者随机分为治疗组和对照组.治疗组40例,予以步长稳心颗粒加胺碘酮治疗;对照组38例,单用胺碘酮治疗.观察两组患者治疗前后临床症状、室性期前收缩改善情况及不良反应.结果 治疗组总有效率92.50%,对照组总有效率78.94%,两组差异有统计学意义(P<0.05).结论 步长稳心颗粒联合胺碘酮治疗室性期前收缩可以显著提高治疗效果,无明显毒副作用,值得临床推广.

  15. 胺碘酮对心力衰竭并心房颤动病人的疗效观察%Efficacy of amiodarone in heart failure patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王向阳

    2014-01-01

    目的:就胺碘酮对心力衰竭并心房颤动病人的疗效观察进行探讨。方法选择我院2008年11月到2013年1月所收治的心力衰竭并心房颤动患者50例,随机将所有患者分为2组,分别是治疗组、对照组,。对照组采用常规治疗方法,而治疗组在此基础上增加静脉注射胺碘酮溶液及口服胺碘酮。结果治疗组有效率为96%,对照组有效率为82%,二者存在着较为明显的差异,具有统计学意义(P0.05)。两组患者在治疗后都没有出现肾功能、肝功能损害、恶性心律失常、不可耐受性低血压等严重不良反应。结论胺碘酮对心力衰竭并心房颤动病人的疗效较佳,安全有效,无较为严重的不良反应,可以作为首选治疗药物,值得推广应用。%Objective To investigate the efficacy of amiodarone in heart failure patients with atrial fibrillation. Methods Fifty heart failure patients with atrial fibrillation admitted to our hospital from November 2008 to January 2013 were randomly divided into treatment group and control group. The control group received routine treatment, while the treatment group was intravenously injected with amiodarone solution and orally given amiodarone in addition to the routine treatment. Results The treatment group had a significantly higher response rate than the control group (96% vs 82%, P 0.05). No patients developed severe adverse reactions, such as renal function impairment, liver function impairment, malignant arrhythmia, and intolerable hypotension, after treatment. Conclusion Amiodarone has good efficacy and high safety and does not cause severe adverse reactions in heart failure patients with atrial fibrillation. This therapy can be used as the first choice of medication and holds promise for clinical application.

  16. Analysis of the clinical effect of amiodarone on heart failure complicated with atrial fibrillation%胺碘酮应用于心力衰竭伴发房颤治疗的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    范怀周

    2014-01-01

    Objective To explore clinical effect of amiodarone on heart failure complicated with atrial fibrillation. Methods Selecting 76 patients with heart failure complicated with atrial fibrillation and randomly dividing them into observation group and control group. Two groups were given conventional treatment in the hospital. The observation group was given amiodarone on the basis of conventional treatment, the control group was given acetyl lanatoside, ventricular rate control was observed in two groups. Results The ventricular rate in the observation group and the control group after treatment compared with those in two groups before treatment respectively, the difference was statistically significant(P<0.05);the ventricular rate in the observation group after treatment compared with that in control group before treatment, the difference was statistically significant(P<0.05). Conclusion Amiodarone applied on heart failure complicated with atrial fibrillation has significantly clinical effect and amiodarone may control the ventricular rate of the patients.%目的:探讨胺碘酮应用于心力衰竭伴发房颤治疗的临床效果。方法选择本院76例慢性充血性心力衰竭患者,随机分为观察组和对照组。两组患者均在入院后给予常规治疗。观察组在常规治疗基础上给予胺碘酮治疗,对照组给予乙酰毛花苷治疗。观察两组患者心室率控制情况。结果观察组和对照组治疗后心室率分别与本组治疗前比较,差异有统计学意义(P<0.05);观察组治疗后心室率和对照组治疗后心室率比较,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论胺碘酮应用于心力衰竭伴发房颤治疗的临床效果显著,能够有效控制患者的心室率,值得借鉴。

  17. Efficacy and safety of small dose of amiodarone in treatment of arrhythmia%小剂量胺碘酮在心律失常治疗中的疗效及安全性

    Institute of Scientific and Technical Information of China (English)

    冯杰

    2015-01-01

    目的:探讨小剂量胺碘酮在心律失常治疗中的疗效和安全性。方法将该院2013年10月—2014年9月医治的54例心律失常患者随机分为常规组与观察组。两组患者在常规治疗基础上分别使用普鲁帕酮与小剂量的胺碘酮进行治疗。比较两组患者不同药物治疗后总有效率和不良反应情况。结果在治疗后,观察组、对照组总有效率分别为88.89%(24/27)、59.26%(16/27),观察组疗效优于对照组(P<0.05);观察组不良反应情况明显低于对照组(P<0.05)。结论使用小剂量胺碘酮治疗室性心律失常,治疗效果明显,安全、有效,值得推广。%Objective To investigate the efficacy and safety of small dose of amiodarone in treatment of arrhythmia. Methods 54 patients with arrhythmia were divided into control group and observation group randomly. Two groups of patients were given propafenone and small dose of amiodarone on the basis of conventional treatment. the clinical efficacy and adverse reactions of propafenone situation with a small dose of amiodarone. Results after treatment, the observation group, the control group total effectiveness respectively is 88.89% (24/27), 59.26% (16/27), the effect of observation group is better than control group (P <0.05); the adverse reactions observed was significantly lower than control group (P < 0.05). Conclusion the use of small dose amiodarone in therapeutic room, arrhythmia, obvious curative effect, safety, effective, worthy of promotion.

  18. Combinatorial release of dexamethasone and amiodarone from a nano-structured parylene-C film to reduce perioperative inflammation and atrial fibrillation

    Science.gov (United States)

    Robinson, Erik; Kaushal, Sunjay; Alaboson, Justice; Sharma, Sudhish; Belagodu, Amogh; Watkins, Claire; Walker, Brandon; Webster, Gregory; McCarthy, Patrick; Ho, Dean

    2016-02-01

    Suppressing perioperative inflammation and post-operative atrial fibrillation requires effective drug delivery platforms (DDP). Localized anti-inflammatory and anti-arrhythmic agent release may be more effective than intravenous treatment to improve patient outcomes. This study utilized a dexamethasone (DEX) and amiodarone (AMIO)-loaded Parylene-C (PPX) nano-structured film to inhibit inflammation and atrial fibrillation. The PPX film was tested in an established pericardial adhesion rabbit model. Following sternotomy, the anterior pericardium was resected and the epicardium was abraded. Rabbits were randomly assigned to five treatment groups: control, oxidized PPX (PPX-Oxd), PPX-Oxd infused with DEX (PPX-Oxd[DEX]), native PPX (PPX), and PPX infused with DEX and AMIO (PPX[AMIO, DEX]). 4 weeks post-sternotomy, pericardial adhesions were evaluated for gross adhesions using a 4-point grading system and histological evaluation for epicardial neotissue fibrosis (NTF). Atrial fibrillation duration and time per induction were measured. The PPX[AMIO, DEX] group had a significant reduction in mean adhesion score compared with the control group (control 2.75 +/- 0.42 vs. PPX[AMIO, DEX] 0.25 +/- 0.42, P inflammation and a diminished atrial fibrillation duration. Epicardial application of AMIO, DEX films is a promising strategy to prevent post-operative cardiac complications.Suppressing perioperative inflammation and post-operative atrial fibrillation requires effective drug delivery platforms (DDP). Localized anti-inflammatory and anti-arrhythmic agent release may be more effective than intravenous treatment to improve patient outcomes. This study utilized a dexamethasone (DEX) and amiodarone (AMIO)-loaded Parylene-C (PPX) nano-structured film to inhibit inflammation and atrial fibrillation. The PPX film was tested in an established pericardial adhesion rabbit model. Following sternotomy, the anterior pericardium was resected and the epicardium was abraded. Rabbits were

  19. Sensitivity (SE), specificity (SP) and predictive value (PV) of 131I uptake (U) and goiter (G) in diagnosing type of amiodarone induced thyrotoxicosis (AIT)

    International Nuclear Information System (INIS)

    Full text: Two types of AIT were initially described: Type I (TI) with underlying autonomy, and Type II (TII) with destructive thyroiditis. Since treatment differs, differential diagnosis is mandatory. U was reported as detectable or high in TI and absent in TII. As absent U was seen in TI, mixed forms were claimed. So the presence of G was proposed as a better marker. But destructive thyroiditis can develop in a non-autonomous goiter, and apparently normal thyroids may have autonomous foci. As thyroiditis is a transient phenomena, evolution clarifies diagnosis. Objective: Compare usefulness of U and G in diagnosing type of AIT in relation to evolution. Methods: In 5 years, 53 amiodarone treated patients, submitted to out rule AIT, had TSH3, T4 (QL), TRAb (radio receptor assay) were determined. Presence or absence of G was recorded. U was performed in 35 (in 9 no delay in treatment was allowed). When hyperthyroidism persisted for more than 4 months requiring antithyroid therapy patients were considered as TI, and TII when it resolved before that time. Statistics: Exact Fisher Test. Results: U was absent in 7/17 TI and 18/18 TII p<0.001. G was present in 20/21 TI (1 with no G had positive TRAb) and in 3/23 TII p <0.001. Conclusion: 1) Detectable or high U was useful in diagnosing TI with positive prediction value of 100%, while absent U didn't exclude it. 2) Presence of goiter was important in diagnosing TI with positive prediction value of 86.9%, while its absence diagnosed TII with positive prediction value of 95.2%. Both parameters were important but only detectable or high uptake was absolute in diagnosing TI. (author)

  20. Amiodarone induced pulmonary interstitial fibrosis and respiratory failure:a case report and literature review%胺碘酮致肺间质纤维化呼吸衰竭1例并文献复习

    Institute of Scientific and Technical Information of China (English)

    吴巧珍; 胡晓蕴; 徐东风; 赵金泉

    2013-01-01

    Objective To intensify the knowledge about amiodarone induced pulmonary interstitial fibrosis,and improve the level of diagnosis and treatment.Methods A retrospective analysis of one case of amiodarone induced pulmonary interstitial fibrosis with literature review was conducted.Results A 60-year-old patient,who received inappropriate high dose of amiodarone (total 30 g) for 50 days due to paroxysmal supraventicuar fachycardia,was admitted to hospital with chief complaint of cough,fatigure and chilly for two days.The symptoms of the patient included short of breath,sychnosphygmia,cyanosis of lip and a nail bed,bilateral moist rales and crackles.Laboratory tests revealed the following levels and values:white blood cell 11.18 × 109/L,neutrophilic granulocyte 0.87,alanine transaminase 70 U/L,albumin 26.3 g/L,total protein 55.9 g/L,C-reactive protein 102.50 mg/L,pH 7.441,PO2 34.80 mm Hg,PCO2 29 mm Hg,SaO268.9 %.CT scan revealed bilateral pulmonary interstitial fibrosis,especially in the right lung.Lung function testing indicated severe mixed ventilation function obstacle and severe decrease in pulmonary diffusion capacity.The diagnosis was amiodarone induced pulmonary interstitial fibrosis with infection and type Ⅰ respiratory failure.After withdrawing the drug,treatments with inhaling oxygen through a face mask,levofloxacin,cefoperazone/sulbactam,vancomycin,fluconazole,corticosteroid and acetylcysteine therapy were implemented,and the results showed clear clinical,functional and radiological improvement.The treatment with corticosteroid and acetylcysteine totally lasted for seven months,and then a seven months follow up was carried out.The results showed the patient had no obvious short of breath after activities,and obvious fibrosis change was not observed in the lung CT images.Conclusions Pulmonary interstitial fibrosis is one of the common adverse reactions of amiodarone.It is recommended that the benefit/risk ratio should be evaluated at the beginning of

  1. 胺碘酮联合β受体阻断药治疗冠脉搭桥术后早期新发房颤%The Effect of Amiodarone and β Blockers on 102 Cases of the Early Arrhythmia after Coronary Artery Bypass Grafting

    Institute of Scientific and Technical Information of China (English)

    陈雪; 唐泓波; 胡大清; 曾宁

    2012-01-01

    [目的]:观察胺碘酮联合β受体阻断药治疗冠状动脉搭桥(CABG)术后早期新发房颤(AF)的效果和不良反应.[方法]:102例CABG术后早期发生快室率房颤患者随机分为对照组48例和治疗组54例,对照组给予胺碘酮注射液静脉泵入,治疗组在对照组基础上加用艾司洛尔注射液或美托洛尔注射液.观察心电监护、心电图及24h动态心电图心率变化,比较两组1周内转复为窦性心律的有效率和不良反应发生率.[结果]:两组有效率分别为79.1%和94.4%,差异有统计学意义(P<0.05).两组不良反应发生率比较,差异无统计学意义(P>0.05).[结论]:胺碘酮联合艾司洛尔或美托洛尔转复CABG术后早期新发房颤效果优于单用胺碘酮.不良反应少,安全性高,值得临床推荐.%Objective:To investigate the effect and side effect of Amiodarone and β blockers on the arrhythmia after Coronary artery bypass grafting( CABG). Methods; 102 AF patients after CABG were randomly divided into two groups; Amiodarone group and Amiodarone and β blockers combined group. There were 48 cases with Amiodarone alone, 54 cases with Amiodarone and β blockers. The heart rale of ambulatory Holter monitor,electrocardiogram ( ECG) and dynamic electrocardiogram were recorded. The effective rate and complication rate of the two groups whose heart rate turned to sinus rhythm in one week were recorded. Results:The effective rate of combined group was superior to the Amiodarone group, 94.4% to 79.1 % (P 0.05). Conclusion: Using combined group on AF patients after CABG can achieve better results comparing to the Amiodarone group. Side effect is low and the combination drug therapy is worth to clinical recommenclation.

  2. Analysis on curative effect of metoprolol combined with amiodarone in patients with congestive heart failure and taehyarrhythmia%胺碘酮联合美托洛尔治疗充血性心力衰竭患者快速型室性心律失常的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    邓志元

    2014-01-01

    目的:观察美托洛尔联合胺碘酮治疗充血性心力衰竭并快速性心律失常的治疗效果。方法:选择慢性心功能不全合并室性心律失常43例。心功能按NYHA分级为Ⅱ~Ⅳ级,随机分为胺碘酮治疗组、胺碘酮+美托洛尔治疗组。结果:胺碘酮+美托洛尔治疗组临床有效率90%(18/20),胺碘酮治疗组的总有效率60.87%(14/23)。2组差异有统计学意义(P<0.05)。结论:联合应用胺碘酮及美托洛尔治疗慢性心功能不全合并室性心律失常疗效明显优于单用胺碘酮或美托洛尔,不良反应无增加。%Objective:To investigate the curative effect of metoprolol combined with amiodarone in patients with congestive heart failure and taehyarrhythmia .Methods:A total of 43 NYHA classⅡ-Ⅳpatients with CHF complicated by ventricular arrhythmia were randomly divided into amiodarone group and amiodarone +metoprolol group .The therapeutic effects were evaluated .Results:The clinical effective rate was 90%(18/20)in amiodarone+metoprolol group,while that was 60.87%(14/23)in amiodarone group,the difference was statisti-cally significant(P<0.05).Conclusion:The combination of amiodarone and metoprolol could produce better effect than amiodarone alone in the treatment of CHF complicated by ventricular arrhythmia .

  3. The treatment effect and relapse prevention of cardioversion of atrial fibrillation with Wenxin granules and amiodarone%稳心颗粒与胺碘酮联合转复心房颤动及预防复发的疗效观察

    Institute of Scientific and Technical Information of China (English)

    张玉榕; 史继利; 贾荣波

    2011-01-01

    目的 观察稳心颗粒联合胺碘酮转复及预防心房颤动复发的疗效.方法 选择慢性心房颤动患者共60例,随机分为稳心颗粒联合胺碘酮组(A组)及单纯胺碘酮组(B组)各30例,所有患者入院后静脉应用胺碘酮24 h同时口服胺碘酮由600 mg/d逐渐减量至200 mg/d维持,另外A组同时给予口服步长稳心颗粒(9 g,3次/d)共4周.观察2组患者4周内转复窦性心律情况及半年内复发情况.结果 第2、3、4周内累积转复窦性心律例数A组显著高于B组(分别是73.3%与43.3%,x2=5.55:83.3%与63.3%,x2=3.07;90.0%与66.7%,x2=4.81;P均<0.05),半年内复发B组有高于A组的趋势.结论 稳心颗粒联合应用胺碘酮转复心房颤动疗效优于单纯应用胺碘酮,并且半年内复发率可能更低.%Objective To observe the treatment effect and relapse prevention of cardioversion of atrial fibrillation with Wenxin granules and amiodarone. Methods Sixty patients of chronic atrial fibrillation were divided randomly into treatment of Wenxin granules and amiodarone group (group A) and treatment of simple amiodarone gorup(group B),Thirty cases in each group. All cases were treated with amiodarone by intravenous drip along with oral amiodarone. Thirty cases in group A were treated with Wenxin granules (9 grams,per day) additionally for 4 weeks. Results Patients in group A resumed normal sinus rhythm significantly higher than that in group B. The increasing relapse tendency of atrial fibrillation was higher in group B within 6 months. Conclusion Drug combination with Wenxin granules and amiodarone has better effect than simple amiodarone in the relapse prevention of cardioversion of atrial fibrillation.

  4. 胺碘酮治疗充血性心力衰竭合并心房颤动临床研究%The Clinical Research of Amiodarone Treatment Congestive Heart Failure Merger Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    胡华元; 刘建修; 廖远雄

    2011-01-01

    Objective:The objective of this essay was to observe the clinial research of Amiodarone treatment congestive heart failure merger atrial fibrillation.Methods:180 patients randomly into two groups of comparison group and observation group with 90 members for each respectively.The observation group treated with fundamental Resistance to heart failure treatment like furosemidum,digoxin and oxygen uptake,and at the same time, added up amiodarone with 600mg/d in the first week,400mg/d in the second week and 200mg/d lasted for three months.The comparison group took advantage of cardiac tonic,diuresis and extender vascular medicine regularly.Results:To compare the clinical results of two groups' Amiodarone treatment congestive heart failure merger atrial fibrillation.the total effective rate of the observation group was 92.22%,while that of the comparison group was 81.11%.Their compparative differences entailed the useful meaning of statistics(P <0.05).To compare the improvement situation of their patients'electrocardiogram,the total effective rate of the observation group was 86.67%,while that of the comparison group was 74.44%.Their comparative differences entailed the useful meaning of statistics(P<0.05).Conclusions:Thus we could draw the conclusion that amiodarone possesses the advantages of high curative effect and small side effects in treating the Amiodarone treatment congestive heart failure merger atrial fibrillation.%目的:观察胺碘酮治疗充血性心力衰竭(CHF)合并心房颤动(AF)的临床疗效.方法:随机将入组180例患者随机分为对照组和观察组各90例.观察组予以速尿、地高辛、吸氧等基础抗心衰治疗,同时加用胺碘酮,第1周600mg/d,第2周400mg/d,以后改用200mg/d持续3个月;对照组常规使用强心、利尿、扩血管药.结果:2组CHF合并AF患者临床疗效比较,观察组总有效率为92.22%,对照组总有效率为81.11%,2组比较差异有统计学意义(P<0.05);2组CHF合并AF

  5. Estudo prospectivo dos efeitos da amiodarona na função tiroidiana de pacientes chagásicos em área de deficiência de iodo Prospective study of amiodarone effects on thyroid function of chagasic patients in an iodine deficient area

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Enes de Barros

    1994-09-01

    Full Text Available Com o objetivo de avaliar a junção tiroidiana após uso crônico da amiodarona, em área de deficiência de iodo e endemia chagásica, 24 pacientes foram analisados antes e após três e nove meses de uso da droga. A avaliação constou de exame clínico, dosagem sérica de T4, T3, rT3, TSH, anticorpo antitiroglobulina e TSH 30 minutos após infusão venosa de uma ampola de 200µg de TRH. A captação do iodo radioativo 131 e a cintilografia datiróide foram realizadas antes e aos 9 meses após tratamento. Disfunção tiroidiana ocorreu em 20,8% dos pacientes sendo 12,5% de hipertiroidismo e 8,3% de hipotiroidismo, com anticorpos antitiroglobulina negativos. Captação do iodo radioativo 131 foi positiva em um paciente hipertiroideo com bócio. O diagnóstico de hipertiroidismo foi melhor evidenciado pela resposta reduzida ou bloqueada do TSH ao TRH e não pela concentração do T3 no soro e o de hipotiroidismo pela concentração elevada do TSH. O TSH elevado desde o início do tratamento pode predispor ao aparecimento de bócio. Concluímos que o uso da amiodarona em nossa região deve serjudiciosamente analisado, sendo a função tiroidiana cuidadosamente monitorizada antes e durante o tratamento.In order to evaluate the development of thyroid dysfunction during chronic amiodarone treatment in an area deficient in iodine and endemic for Chagas 'disease, a group of 24patients wasprospectively studied. Clinical examination and measurement of serum T4, T3, rT3, TSH and antithyroglobulin antibodies were performed before and at 3 and 9 months of use of amiodarone. A TSH response 30 minutes after IV injection of 200µg of TRH was also compared to TSH basal levels before and during amiodarone treatment. Thyroid radioative uptake and scan were obtained before and nine months after amiodarone was started. Elevated rT3 concentrations were unexpectedly found in two thirds of the patients before treatment. Thyroid dysfunction developed during

  6. 雷米普利和替米沙坦与胺碘酮联用治疗阵发性心房颤动的临床观察%Clinical observations of ramipril and telmisartan combined with amiodarone in patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    赵美丽; 刘大钧

    2010-01-01

    目的 探讨雷米普利和替米沙坦与小剂量胺碘酮联用对心功能正常的阵发性心房颤动(房颤)维持窦性心律的长期疗效.方法 将180例阵发性房颤患者完全随机分为胺碘酮组(A组,61例)、胺碘酮+雷米普利组(B组,59例)、胺碘酮+替米沙坦组(C组,60例),随访2年,比较3组治疗后6、12、18、24个月的窦性心律维持率以及治疗前、后的左心房内径.结果 治疗12个月后,A组左心房内径大于B、C组(P<0.05),A组窦性心律维持率明显低于B、C组(P<0.05).试验终点时,A组的窦性心律维持率为58.62%,B组为77.78%,C组为78.57%(P<0.05).结论 胺碘酮分别与雷米普利和替米沙坦配伍治疗阵发性房颤维持窦性心律具有相同的疗效,但优于单用胺碘酮,并能抑制左心房的扩大.%Objective To evaluate the clinical efficacy of ramipril and telmisartan combined with amioda-rone on maintenance of sinus rhythm in patients with idiopathic paroxysmal atrial fibrillation(PAF). Methods One hundred and eighty patients with idiopathic PAF were included in the study and randomly divided into three groups: group A (Amiodarone group, n=61) was treated with amiodarone alone; group B (Amiodarone plus Ramipril, n=59) was treated with amiodarone combined with Ramipril;group C(Amiodarone plus telmisartan group,n=60)was trea-ted with amiodarone combined with telmisartan. The left atrial diameter(LAD) was measured with transthoracic echo-cardiogram before and 6,12,18 and 24 month after treatment. The follow-up was up to 2 years and the primary end point of the study was the first recurrence of AF. Results During the 6 months follow-up, there was no difference in LAD among three groups. After 12 months, LAD in group A was significantly larger than that in group B and group C(P<0.05). At the end of 12 months, the sinus rhythm maintenance of group A was lower significantly than that of group B and group C. At the end of the study, the maintenance of sinus rhythm in

  7. Comparison of the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia%普罗帕酮和胺碘酮治疗阵发性室上性心动过速疗效与安全性比较

    Institute of Scientific and Technical Information of China (English)

    曾益华; 张世杰; 胡爱民

    2011-01-01

    Objective To evaluate the efficacy and safety of propafenone and amiodarone in the treatment of paroxysmal supraventricular tachycardia(PSVT). Methods Total 86 cases of PSVT were randomly divided into propafenone group and amiodarone group. Propafenone group had intravenously injected 70 mg propafenone. The intravenous injections lasted 5 minutes. Amiodarone group were intravenously infused amiodarone(5-7 mg/kg) (the intravenous infusion lasted 30 minutes). Results The termination rate of PSVT was 93.2% in propafenone group and 88.1% in amiodarone group respectively. Cardioversion time showed as follows: propafenone group(12.4 ±7.8 min) was significantly shorter than amiodarone group (30.7 ± 10.3) min (P < 0.01). Side reaction showed that propafenone group(29.5%) was significantly higher than amiodarone group (11.9%) (P < 0.05). Conclusions The effective cardioversion rates of propafenone and amiodarone in treating PSVT are high in emergency department.Propafenone shows faster effect and higher side effects but better outcome for patients without serious organic heart diseases than Amiodarone which is better for patients with serious organic heart diseases.%目的 比较普罗帕酮和胺碘酮静脉用于急诊转复阵发性室上性心动过速的疗效及不良反应.方法 将急诊阵发性室上性心动过速患者86例完全随机分成普罗帕酮组(44例)和胺碘酮组(42例),普罗帕酮组给予普罗帕酮70 mg静脉注射(5 min注完),若无效,20min后重复1次;胺碘酮组给予胺碘酮5~7 mg/kg加入100 ml 5%葡萄糖或0.9%氯化钠注射液中静脉滴注,30 min滴完,继之以1 mg/min的速度持续静脉滴注.观察2组的治疗效果和不良反应发生情况.结果 普罗帕酮组和胺碘酮组转复有效率分别为93.2%(41/44)和88.1%(37/42)(P>0.05);平均转复时间普罗帕酮组[(12.4±7.8)min]明显短于胺碘酮组[(30.7±10.3)min](P<0.01);不良反应发生率普罗帕酮组为[29.5%(13/44)]明显高

  8. 胺碘酮联合磷酸肌酸钠对心肺复苏后心肌的保护作用%Protective effects of amiodarone combined with creatine phosphate sodium on myocardium after cardiopulmonary resuscitation in rabbits

    Institute of Scientific and Technical Information of China (English)

    王芳; 周雨; 许铁

    2013-01-01

    目的 研究胺碘酮联合磷酸肌酸钠对兔心肺复苏(CPR)后心肌的保护作用.方法 用窒息法制作CPR模型.选取健康日本长耳大白兔40只,随机分为A组(假手术组)、B组(生理盐水组)、C组(胺碘酮组)、D组(磷酸肌酸钠组)、E组(胺碘酮联合磷酸肌酸钠组),每组8只,动态监测HR、MAP及血浆CK、CK-MB含量.复苏后6 h处死兔,光镜下观察心肌组织病理学变化.结果 B组、C组、D组和E组兔的HR、MAP比较差异无统计学意义(P>0.05).与A组比较,CPR后B组、C组、D组和E组兔血浆CK、CK-MB含量均增高,差异有统计学意义(P 0.05). Compared with group A, the levels of plasma CK, CK - MB were significantly higher in group B, group C, group D and group E after CPR (P 0.05). In group B, group C, group D and group E, the levels of plasma CK, CK - MB increased gradually after CPR( P < 0. 05 ). Correlation analysis showed that there was significantly postitive relation between the levels of plasma CK, CK - MB and the time after CPR in group B, group C, group D and group E (P < 0. 05 ) . Results of pathology showed that myocardial injury were more seriously in group B than in group C and group D, and myocardial injury were more seriously in group C and group D than in group E. Conclusion Treatment with amiodarone, creatine phosphate sodium, amiodarone combined with creatine phosphate sodium can alleviate myocardial injury after CPR in rabbits, the protective effects of amiodarone combined with creatine phosphate sodium were the best.

  9. Amiodarone in treatment of Wolff-Parkinson-White syndrome combined with rapid ar-rhythmia:35 cases%胺碘酮治疗预激综合征合并快速心律失常35例

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    王一伟

    2015-01-01

    AIM:To investigate the clinical effect of amiodarone on Wolff-Parkinson-White syndrome (WPW)combined with par-oxysmal supraventricular tachycardia.METHODS:35 cases with WPW combined with paroxysmal supraventricular tachycardia were observed.All 35 patients admitted to our hospital were treated with anti-arrhythmic therapy,and amiodarone was prescribed once sinus rhythm was restored.Clinical efficacy was evaluated.RE-SULTS:Upon treatment,1 6 cases were significantly improved, 1 7 cases were effective and no effect was observed in 2 cases, with total effective rate being 94.29% (33 /35 ).In addition, heart rate was significantly decreased (P <0.01 ).CONCLU-SION:The application of amiodarone in treatment of WPW com-bined with paroxysmal ventricular tachycardia has significant cura-tive effect and is worthy of clinical popularization and application.%目的:探讨胺碘酮对预激综合征(WPW)合并阵发性室上性心动过速的临床疗效.方法:选择我院35例 WPW合并阵发性室上性心动过速患者作为观察对象.所有患者入院后均接受抗心律失常治疗,待到恢复窦性心律后,再给予胺碘酮,最终评价患者临床疗效.结果:治疗后,显效16例,有效17例,无效2例,总有效率高达94.29%(33/35).此外,治疗后患者心率显著降低(P <0.01).结论:应用胺碘酮治疗WPW 合并阵发性室上性心动过速疗效显著,值得临床推广应用.

  10. 普罗帕酮与胺碘酮治疗心房颤动的临床研究%Clinical Study on Propafenone and Amiodarone in Treatment of Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    赵晓慧

    2016-01-01

    Objective Treatment methods and effects of Propafenone and Amiodarone for treatment of atrial fibrilation are to be studied.MethodsChose 70 patients of atrial fibrilation who were treated in hospital from August 2014 to October 2015 and separated them into two groups at random. 38 patients in study group were given Amiodarone treatment,while another 32 patients in control group were given Propafenone treatment,and then compared patients’treatment effects and side-effect incidence between two groups.Results Patients’treatment efficacy in study group was 92.11%,which was much higher than 75.0% in control group,there was a differential between two groups and such a differential had statistic value(P<0.05). Conclusion Amiodarone is much more effective in treatment of patients with atrial fibrilation,it is conducive to relieving patients’ symptoms in short time with few side-effects.%目的:探究心房颤动患者采用普罗帕酮和胺碘酮治疗的方法及效果。方法选取2014年8月~2015年10月收治的70例心房颤动患者进行治疗研究,随机分组,实验组38例患者采取胺碘酮治疗,对照组32例患者采用普罗帕酮治疗,对比两种患者的治疗效果和不良反应。结果实验组患者治疗有效率为92.11%,对照组患者治疗有效率为75.0%,实验组患者治疗效果好,差异有统计学意义(P<0.05)。结论心房颤动患者采用胺碘酮的治疗,其治疗效果优,在短时间内即可缓解身体症状,不良反应较少,安全性高。

  11. A tomografia computadorizada de alta resolução na avaliação da toxicidade pulmonar por amiodarona High-resolution computed tomography of amiodarone pulmonary toxicity

    Directory of Open Access Journals (Sweden)

    Daniela Peixoto Consídera

    2006-04-01

    Full Text Available OBJETIVO: Avaliar as principais alterações identificadas na tomografia computadorizada de alta resolução do tórax em pacientes com toxicidade pulmonar pela amiodarona. MATERIAIS E MÉTODOS: Foram avaliadas dez tomografias computadorizadas de alta resolução de tórax de pacientes com pneumonite pela amiodarona, seis desses pacientes do sexo masculino e quatro do sexo feminino, com idade média de 73,5 anos. RESULTADOS: Os achados tomográficos mais relevantes foram opacidades lineares ou reticulares em seis casos (60%, pequenos nódulos com densidade elevada em seis casos (60%, consolidações densas em três casos (30% e aumento da densidade do parênquima hepático em cinco de oito casos em que havia estudo tomográfico do abdome superior (62,5%. CONCLUSÃO: A tomografia computadorizada de alta resolução é um exame importante na avaliação de pacientes com toxicidade pulmonar pela amiodarona, devendo ser realizada sempre que houver suspeita deste diagnóstico. O achado de espessamento de septos interlobulares associado a lesões com aumento de densidade é altamente sugestivo deste diagnóstico.OBJECTIVE: To evaluate the main findings of chest high-resolution computed tomography in patients with amiodarone pulmonary toxicity. MATERIALS AND METHODS: Ten patients - six male and four female, average age of 73.5 years - with amiodarone-induced pneumonitis have undergone chest high-resolution computed tomography. RESULTS: The most relevant tomographic findings were linear or reticular opacities in six cases (60%, small high density nodules in six cases (60%, dense consolidations in three cases (30% and increased density in the hepatic parenchyma in five of eight cases in which there was a superior abdomen CT scan (62.5%. CONCLUSION: The high-resolution computed tomography is a valuable non-invasive test for evaluating patients with amiodarone pulmonary toxicity and should always be performed when one suspects of the presence of this

  12. 阿托伐他汀钙在胺碘酮转复持续性心房颤动中的作用观察%Treatment with atorvastatin and amiodarone in patients with persistent atrial fibrillation.

    Institute of Scientific and Technical Information of China (English)

    李满生; 王会霞; 石建克; 蔡华; 张晓华; 李新峰; 岳修宇

    2011-01-01

    目的 探讨阿托伐他汀钙联合胺碘酮转复持续性心房颤动(简称房颤)及房颤复律后维持窦性心律的作用及其对血清炎症反应的影响.方法 68例持续性房颤患者,随机分为两组.对照组34例给予胺碘酮,治疗组34例给予胺碘酮和阿托伐他汀钙.两组均连续服药6个月,观察房颤转复后窦性心律维持率及转复前后血清高敏C反应蛋白(hs-CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-α)变化.结果 治疗组房颤转复率、窦性心律维持率均较对照组高(79.41% vs 61.76%,76.47% vs 55.88%,P均<0.05),对照组治疗前后hs-CRP、IL-6、TNF-α无变化(P>0.05),治疗组治疗后hs-CRP、IL-6、TNF-α明显降低(P<0.05).结论 阿托伐他汀钙可以降低房颤的复发,其机制可能与抗炎作用相关.%Objective To investigate the preventive effective of atorvastatin and amiodarone on recurrence of persistent atrial fibrillation, maintenance rate of sinus rhythm and change of inflammatory factors. Methods Sixty-eight patients with persistent atrial fibrillation were randomly divided into control group (n = 34, treated with amiodarone) and treated group (re =34, treated with amiodarone and atorvastatin). After 6 months follow-up, observe the change of hs-CRP ,IL-6, TNF-a and maintenance rate of sinus rhythm before and after treatment. Results After treatment, sinus rhythm of control group and treated group was 61. 76% vs 79.41 % ( P 0.05), while in treated group which greatly decreased after treatment ( P < 0.05 ). Conclusion Atorvastatin may reduce recurrence of persistent atrial fibrillation, which is related to is anti-inflammation effect.

  13. 参松养心胶囊联合胺碘酮治疗充血性心力衰竭伴室性心律失常的疗效及安全性观察%Efficacy and Safety of Shensong Yangxin Capsule Combined with Amiodarone for Treatment of Congestive Heart Failure and Ventricular Arrhythmias

    Institute of Scientific and Technical Information of China (English)

    陈勇; 向琳; 胡玉华; 武万娜

    2011-01-01

    Objective To observe the efficacy and safety of Shensong Yangxin eapsule(SYC) combined with amiodarone for treatment of chronic congestive heart failure(CHF) associated with ventricular arrhythmia(VA). Methods One hundred and sixty-eight patients(pts) with CHF and VA were randomly divided into 3 groupssGroup A (n=52) treated with oral SYC,group B(n=56) treated with oral amiodarone and group C (n = 60) treated with SYC and oral amiodarone for 4 weeks. The efficacy and safety were observed after the clinical treatment. Results After 4 weeks,the total effective rate was 76%, 78% and 86% in group A,group B and group C. The total effective rate in group C was significantly higher than that in group A and group B(P<0. 05). Conclusion SYC was effective as amiodarone hydrochloride for treatment of CHF and VA. SYC combined with amiodarone for treatment of CHF with ventricular arrhythmias was more effective than amiodarone or SYC alone.%目的 观察参松养心胶囊联合胺碘酮治疗慢性充血性心力衰竭(CHF)伴室性心律失常(VA)的疗效及安全性.方法 选择充血性心力衰竭合并室性心律失常患者168例,随机分为A组(52例)、B组(56例)及C组(60例).A组给予参松养心胶囊口服,B组给予胺碘酮口服,C组给予参松养心胶囊与胺碘酮口服.观察用药4周后3组的临床疗效与安全性.结果 治疗4周后总有效率A组76%,B组78%,C组86%,C组显著高于A组和B组(P<0.05).结论 参松养心胶囊治疗慢性心力衰竭室性心律失常与盐酸胺碘酮疗效相当,且副反应小;参松养心胶囊与胺碘酮联用治疗CHF室性心律失常的疗效优于单用胺碘酮或单用参松养心胶囊的疗效,并可明显减少胺碘酮的用量.

  14. Observation of curative effects of Amiodarone on patients with acute coronary syndrome (ACS)and chronic heart failure and ventricular arrythmia%胺碘酮治疗急性冠脉综合征伴心力衰竭的室性心律失常疗效观察

    Institute of Scientific and Technical Information of China (English)

    邹培源; 冯小燕

    2011-01-01

    Objective: To observe the efficacy and safety of Amiodarone in treatment of ventricular arrythmia on acute coronary syndrome (ACS) and chronic heart failure patients and ventricular arrythmia. Methods: On the basis of regular treatment, Amiodarone was used in 52 patients with ACS and chronic heart failure and ventricular arrythmia, intravenous loading does of 3-5 mg/kg of Amiodarone was given within 10-20 min, followed by 0.75-1.50. mg/min infusion. If ventricular arrythmia was uncontrolled, additional bolus of 150 mg could be repeated every other 30 min, and oral Amiodarone 0.2 mg, tid, observation treatment for five days. Results: In 52 patients, 35 cases (67.3%) were significant effective, 11 cases (21.2%) were effective, 6 cases (11.5%) were invalid, the total effective rate was 88.5%. There were no significant changes in the P-R, QRS, QT intervals during iv Amiodarone therapy. Conclusion: Amiodarone can be used effectively and safely to control ventricular arrythmia on ACS with chronic heart failure patients.%目的:观察胺碘酮对急性冠脉综合征(ACS)伴心力衰竭患者室性心律失常的疗效和安全性.方法:对52例ACS伴心力衰竭并发室性心律失常的患者,首剂给予胺碘酮3~5mg/kg静注,10~20min注完,之后给予0.75~1.50mg/min 静滴维持.若心律失常控制不满意,可间隔30 min重复注射胺碘酮150 mg一次,同时口服胺碘酮0.2 mg,tid,治疗5 d.结果:52例患者中,显效35例(67.3%),有效11例(21.2%),无效6例(11.5%),总有效率为88.5%,静脉应用早期对P-R、QRS、QT间期均无影响.结论:胺碘酮对ACS伴心力衰竭的室性心律失常有良好的疗效.

  15. 静脉应用胺碘酮与西地兰对快速阵发性房颤的疗效比较%Comparison of the Clinical Efficacy Between Amiodarone and Cedilanid in the Treatment of Rapid Paroxysmal Atrial Fibrillation with Intravenous Ad-ministration

    Institute of Scientific and Technical Information of China (English)

    李妍

    2014-01-01

    目的:比较静脉推注胺碘酮与西地兰治疗快速阵发性房颤的疗效差异。方法选择92例快速阵发性房颤患者,随机分为胺碘酮组和西地兰组各46例,分别静推胺碘酮和西地兰,观察房颤的转复、心室率变化及不良反应。结果胺碘酮组与西地兰组的治疗有效率分别为82.61%和58.70%,差异有统计学意义(P<0.05)。两组治疗前后心室率下降均差异有统计学意义(P<0.05)。其中胺碘酮组效果更明显,两组比较差异有统计学意义(P<0.05)。结论静脉应用胺碘酮治疗快速阵发性房颤,疗效优于西地兰,不良反应轻,值得推广。%Objective To compare the clinical efficacy between amiodarone and cedilanid in the treatment of rapid paroxysmal a-trial fibrillation with intravenous administration. Methods 92 patients with rapid paroxysmal atrial fibrillation were selected and randomly divided into amiodarone group (n=46) and cedilanid group(n=46), and respectively treated with amiodarone and cedilanid intravenously. The effective rate, change of heart rate and adverse reactions of the two groups were observed. Results The total ef-fective rate was 82.61%in the amiodarone group and 58.70%in the cedilanid group, with a significant difference between the two groups (P<0.05). There was statistically significant difference in heart rate of two groups of patients before and after the treatment (P<0.05). Compared with the cedilanid group, the efficacy of amiodarone group was more obvious and the difference between the two groups was statistically significant (P<0.05). Conclusion Intravenous amiodarone is more effective than cedilanid for rapid paroxysmal artrial fibrillation, with minor side effects. It is worthy of clinical promotion.

  16. Importância da toxicidade pulmonar pela amiodarona no diagnóstico diferencial de paciente com dispnéia em fila para transplante cardíaco The importance of amiodarone pulmonary toxicity in the differential diagnosis of a patient with dyspnea awaiting a heart transplant

    Directory of Open Access Journals (Sweden)

    Christiano Pereira Silva

    2006-09-01

    Full Text Available A amiodarona é um antiarrítmico da classe III, amplamente utilizado em arritmias ventriculares¹. Farmacologicamente é classificado como uma drogra ampifílica catiônica, pelos seus constituintes polares e apolares. Nos últimos anos, a amiodarona obteve destaque pelo seu uso em portadores de disfunção ventricular por qualquer etiologia, em especial a chagásica, quando ocorrem arritmias ventriculares². Entretanto, a despeito de seus benefícios hemodinâmicos e eletrofisiológicos, a amiodarona produz efeitos colaterais relevantes, como coloração azulada da pele, fotossensibilidade, disfunção tireoidiana, depósito corneal, neuropatia periférica, supressão da medula óssea, hepatite, bloqueios cardíacos, pneumonites e outros³. Este relato de caso se propõe a abordar uma de suas mais sérias complicações, a toxicidade pulmonar, aqui especialmente descrita como diagnóstico diferencial em um paciente chagásico que aguardava em fila de transplante cardíaco. Pneumonite por amiodarona constitui-se em um importante diagnóstico diferencial entre os pacientes que se apresentam na sala de emergência com dispnéia, quando estes são portadores de insuficiência cardíaca (IC e estão em uso dessa droga.Amiodarone is a class III antiarrhythmic medication used extensively to treat ventricular arrhythmias¹. It is pharmacologically classified as a cationic amphiphilic drug due to its polar and apolar components. During the past few years, amiodarone has proved to be an effective treatment therapy for patients with ventricular dysfunctions, regardless of the etiology, and in particular ventricular arrhythmia associated with Chagas disease². Nevertheless, despite its hemodynamic and electrophysiological benefits, amiodarone produces serious collateral effects such as a bluish skin discoloration, photosensitivity, thyroid dysfunction, corneal deposit, peripheral neuropathy, bone marrow suppression, hepatitis, heart blocks, pneumonitis

  17. The clinical effects of amiodarone combination with atorvastatin in the treatment of heart failure with malignancy arrhythmia in old patients%胺碘酮联用阿托伐他汀治疗老年心衰恶性心律失常观察

    Institute of Scientific and Technical Information of China (English)

    陈晓亮

    2012-01-01

      Objective: To observe the therapeutic effect of amiodarone combination with atorvastatin in the treatment of heart failure with malignancy arrhythmia. Methods: 47 patients were randomly divided into control group and therapy group. 23 patients in control group were treated with amiodarone. 24 patients in therapy group were treated with amiodarone combination with atorvastatin. The curative effects were observed. Results: The two groups both have the therapeutic effects on heart failure with malignancy arrhythmia in old patients. The total effective rate in therapy group was 95.7% which was significantly higher than that in control group (69.6%). Conclusion: Amiodarone combination with atorvastatin was a safety and effective method in the treatment of heart failure with malignancy arrhythmia in old patients.%  目的观察胺碘酮联合阿托伐他汀对老年心力衰竭合并恶性心律失常的治疗效果.方法47例患者随机分为对照组(胺碘酮治疗组)23例和治疗组(阿托伐他汀联合胺碘酮治疗组)24例,观察其疗效.结果两组均对老年心衰恶性心律失常有治疗效果,治疗组总有效率95.7%,显著高于对照组的总有效率69.6%.结论胺碘酮联合阿托伐他汀治疗老年心衰恶性心律失常是安全有效的治疗方法.

  18. Clinical observation of intravenous injection of amiodarone combined with safflower yellow pigment in treatment of tachyarrhythmias%胺碘酮联合红花黄色素静脉注射治疗快速心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    高翔

    2012-01-01

    目的 观察胺碘酮联合红花黄色素静脉注射治疗快速心律失常的临床疗效.方法 将95例快速心律失常患者随机分为两组,在常规治疗的基础上,观察组(50例)使用胺碘酮联合红花黄色素,对照组(45例)使用胺碘酮.结果 观察组总有效率88.0%,对照组总有效率71.1%,两组比较,差异有统计学意义(P<0.05).观察组起效时间短于对照组,治疗后心率较对照组慢,差异均有统计学意义.结论 静脉联用胺碘酮与红花黄色素治疗快速心律失常安全且有效.%[ Objective ] To observe the efficacy of intravenous injection of amiodarone combined with safflower yellow pigment in treatment of tachyarrhythmias. [Methods] A total of 95 cases of tachyarrhythmias were divided into 2 groups. Based on the conventional treatment, the observation group( 50 cases ) received amiodarone and safflower yellow pigment treatment, the control group (45 casese) received amiodarone treatment. [Results] The total effective rate in observation group and control group was 88.0% and 71.1% , respectively, the difference was significant(P<0.05). The onset time of observation group was shorter than that of the control group, with slower heart rate in observation group, compared with the control group. [ Conclusion]Intravenous injection of amiodarone combined with safflower yellow pigment is safe and effective in treatment of tachyarrhythmias.

  19. Observation of clinical effect by Shensongyangxin capsule combined with amiodarone in the treatment of arrhythmia%参松养心胶囊与胺碘酮联合治疗心律失常临床治疗效果观察

    Institute of Scientific and Technical Information of China (English)

    张雪玲; 李建绪

    2015-01-01

    Objective To investigate the clinical effect by Shensongyangxin capsule combined with amiodarone in the treatment of arrhythmia.Methods There were 60 patients with arrhythmia as study subjects. They were divided by their willingness into control group and observation group, with 30 cases in each group. The observation group received Shensongyangxin capsule combined with amiodarone for treatment, and the control group received amiodarone. Curative effects and adverse reactions of the two groups were compared.Results The total effective rates of the observation group and control group were respectively 90.0% and 66.7%, and the difference between the two groups had statistical significance (P0.05).Conclusion Combination of Shensongyangxin capsule and amiodarone can improve control effect on arrhythmia, and this method is worthy of promotion and application.%目的:探讨参松养心胶囊与胺碘酮联合治疗心律失常的临床效果。方法60例心律失常患者作为研究对象,根据患者意愿分为对照组和观察组,每组30例。观察组接受参松养心胶囊和胺碘酮治疗,对照组仅接受胺碘酮治疗,比较两组治疗效果及不良反应。结果观察组和对照组总有效率分别为90.0%和66.7%,组间差异具有统计学意义(P0.05)。结论参松养心胶囊与胺碘酮联合用药可提升心律失常控制效果,值得推广使用。

  20. Clinical Observation of Amiodarone Combined With Wenxin Granule in the Treatment of Heart Failure Complicated With Arrhythmia%胺碘酮联合稳心颗粒治疗心衰合并心律失常的临床观察

    Institute of Scientific and Technical Information of China (English)

    高尚

    2015-01-01

    Objective To explore the clinical effect of amiodarone combined with Wenxin Granule in the treatment of heart failure complicated with arrhythmia. Methods 80 cases of patients with heart failure combined with arrhythmia were randomly divided into observation group and control group, respectively treated with amiodarone and amiodarone combined with Wenxin Granule treatment. Results Observation of curative effect, the patient's heart rate, QT interval, LVEF improvement was superior to the control group, the incidence of adverse reaction was lower than the control group (P<0.05). Conclusion Amiodarone combined with Wenxin Granule in the treatment of heart failure complicated with arrythmia curative effect, worthy of clinical application.%目的:探讨胺碘酮联合稳心颗粒治疗心衰合并心律失常的临床效果。方法将80例心衰合并心律失常患者随机分为观察组和对照组,分别给予胺碘酮治疗和胺碘酮联合稳心颗粒治疗。结果观察组疗效、患者心率、QT间期、LVEF改善情况均优于对照组,不良反应发生率明显低于对照组(P<0.05)。结论胺碘酮联合稳心颗粒治疗心衰合并心律失常疗效确切,值得临床应用推广。

  1. Clinical Analysis of the Treatment of Arrhythmia in Patients with Coronary Heart Disease Combined with the Stability of the Core Particles and Amiodarone%稳心颗粒联合胺碘酮治疗冠心病心律失常疗效分析

    Institute of Scientific and Technical Information of China (English)

    冯宝连

    2016-01-01

    Objective To observe the metacentre grain joint amiodarone treatment of arrhythmia in coronary heart disease clinical curative effect. Methods From October 2009 to October 2009 treatment of 90 cases of patients with arrhythmia in coronary heart disease, were randomly divided into two groups, treatment group 45 cases, on the basis of conventional treatment of oral metacentric particles and amiodarone; Control group 45 cases, on the basis of conventional treatment taking amiodarone, course of six weeks. Look before and after using patients electrocardiogram (ecg) and the improvement of clinical symptoms. Results The curative effect of treatment group is better than that of control group ( < 0.05). Conclusion metacentric particles joint amiodarone has good curative effect of treatment of coronary heart disease (CHD).%目的观察稳心颗粒联合胺碘酮治疗冠心病心律失常的临床疗效.方法选取我院2009年10月~2015年10月治疗的冠心病心律失常患者90例,随机分为两组,治疗组45例,在常规治疗基础上口服稳心颗粒和胺碘酮;对照组45例,在常规治疗基础上服用胺碘酮,疗程6w.观察用药前/后患者心电图及临床症状的改善程度.结果治疗组疗效优于对照组(<0.05).结论稳心颗粒联合胺碘酮治疗冠心病心律失常具有良好的疗效.

  2. Analysis of Clinical Effect on Irbesartan- Amiodarone Combination In Treatment of Chronic Heart Failure With Ventricular Arrhythmia%厄贝沙坦联合胺碘酮治疗慢性心力衰竭合并室性心律失常的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    刘春英

    2015-01-01

    目的:探究厄贝沙坦联合胺碘酮治疗慢性心力衰竭合并室性心律失常的临床疗效。方法对照组慢性心力衰竭合并室性心律失常患者单纯经胺碘酮治疗,观察组经厄贝沙坦联合胺碘酮治疗。结果观察组治疗后心功能临床总有效率与心律失常临床总有效率为92.1%高于对照组;且心率、射血分数及QT离散度临床指标改善程度均优于对照组,具有统计学差异(P<0.05)。结论厄贝沙坦联合胺碘酮治疗慢性心力衰竭合并心律失常,可改善心功能与心律失常情况。%ObjectiveTo explore the clinical effect on irbesartan- amiodarone combination in treatment of chronic heart failure with ventricular arrhythmia.MethodsThe patients in control group with chronic heart failure with ventricular arrhythmia were simply treated with amiodarone treatment, the patients in observation group were treated with irbesartan- amiodarone combination.ResultsThe total effective rate of cardiac function and clinical arrhythmia was 92.1%. was higher than the control group. The improvement of clinical the heart rate, ejection fraction and QT dispersion degree in observation group were superior to control group signiifcantly (P<0.05).Conclusion The clinical effect on irbesartan- amiodarone combination in treatment of chronic heart failure with ventricular arrhythmia is the improvement of heart function and cardiac arrhythmias.

  3. Emprego de altas doses de amiodarona via oral na reversão da fibrilação atrial no pós-operatório de cirurgia cardíaca High dose amiodarone for the reversion of atrial fibrillation during the postoperative period of cardiac surgery

    Directory of Open Access Journals (Sweden)

    João Carlos Vieira da Costa Guaragna

    1997-12-01

    Full Text Available OBJETIVO: Relatar a experiência no emprego de altas doses de amiodarona via oral (1800mg/d na reversão da fibrilação atrial (FA em pacientes submetidos à cirurgia cardíaca. MÉTODOS: Analisados, retrospectivamente, 80 pacientes que apresentaram FA no pós operatório de cirurgia cardíaca, constituindo 2 grupos: grupo A com 28 pacientes em uso de amiodarona e grupo B recebendo digital, sendo que este grupo foi subdividido no grupo C com 21 pacientes onde foi associada amiodarona, quando não houvesse reversão da arritmia em 48h. As diferenças foram consideradas significativas para um valor de PPURPOSE: To report our experience using high dose oral amiodarone (1,800mg/day for the reversion of atrial fibrillation to sinus rhythm in patients submitted to cardiac surgery. METHODS: We retrospectively analyzed the records of 80 patients who had atrial fibrillation during the postoperative period after cardiac surgery, initially divided in two groups: group A, 28 patients that used amiodarone, and group B composed of patients receiving digoxin. The latter group was divided further in a third group (C, with 21 patients in which amiodarone was associated with digoxin if there was no reversion of the arrhythmia after 48 hours of treatment. The observed differences were considered significant at P<0.05. RESULTS: Atrial fibrillation occurred in 19.4% of the patients submitted to surgery, predominating in males, 60 to 69 years-old. In group A there was reversion to sinus rhythm in 78.6% of the cases. In group B digoxin succeeded in 60%, and in group C 90% of the patients reverted to sinus rhythm. CONCLUSION: High dose oral amiodarone, alone or combined to digoxin, can be safe and effective for the treatment of atrial fibrillation after cardiac surgery.

  4. The Clinic Alapplication Value of Amiodarone in the Treatment of Chronic Heart Failure Complicated With Arrhythmia%胺碘酮治疗慢性心力衰竭并发心律失常的临床应用价值

    Institute of Scientific and Technical Information of China (English)

    姜桂菊

    2015-01-01

    目的:讨论胺碘酮治疗慢性心力衰竭衰并发心律失常的临床应用价值。方法对照组采用抗心衰的治疗,研讨组在此基础上联合应用胺碘酮进行治疗。结果研讨组治疗效果、并发症等方面均优于对照组。结论在常规抗心衰的治疗基础上采用胺碘酮治疗心衰并发心律失常安全、有效。%ObjectiveTo investigate the clinic application value of amiodarone in the treatment of chronic heart failure complicated with arrhythmia. Methods The research group was treated with anti heart failure. The research group based on the combined application of amiodarone for the treatment.Results Research group of the treatment effect, complications were better than those of control group. ConclusionOn the basis of routine anti heart failure treatment on the use of amiodarone in the treatment of heart failure complicated with arrhythmia safe, effective.

  5. Comparison of short-term efficacy and safety between amiodarone and esmolol treatment in elderly patients with acute myocardial infarction complicated with ventricular arrhythmia%胺碘酮与艾司洛尔治疗老年患者急性心肌梗死合并室性心律失常的短期疗效与安全性比较

    Institute of Scientific and Technical Information of China (English)

    邹德玲; 刘兴利; 方悦; 陈艳丽; 耿宁; 庞文跃

    2014-01-01

    目的 比较老年急性心肌梗死(AMI)合并严重室性心律失常患者静脉应用胺碘酮或艾司洛尔48 h内疗效及不良反应,为临床安全用药提供依据. 方法 2009年1月至2013年6月在中国医科大学附属盛京医院心脏内科连续住院治疗的老年AMI合并严重室性心律失常患者纳入研究,分为胺碘酮组与艾司洛尔组.胺碘酮组患者在10 min内静脉注射胺碘酮150 mg+ 5%葡萄糖注射液20 ml后经微量注射泵静脉输注胺碘酮1 mg/min共6h,减量至0.5 mg/min静脉输注24~48 h,之后口服胺碘酮0.2g,3次/d,共7d.艾司洛尔组患者在1 min内静脉注射艾司洛尔注射液0.5 mg/kg后经微量注射泵静脉输注艾司洛尔0.1 mg/(kg·min)共6h,减量至0.05 mg/(kg·min)静脉输注24 ~ 48 h,之后口服美托洛尔25 mg,2次/d,共7d.胺碘酮组和艾司洛尔组静脉应用胺碘酮或艾司洛尔6h后仍有室速发作者,分别加用上述艾司洛尔或胺碘酮治疗方案.比较2组患者治疗48 h内有效率和不良反应发生率. 结果 胺碘酮组和艾司洛尔组48 h内有效率分别为92.1%(35/38)和75.0%(27/36),组间差异有统计学意义(P=0.046);不良反应发生率分别为39.5%(15/38)和19.4%(7/36),组间差异无统计学意义(P =0.060).胺碘酮组2例伴有心力衰竭患者静脉用药24 h后出现急性肝损伤,停药并对症治疗2周后肝功能恢复正常. 结论 静脉应用胺碘酮治疗老年患者AMI合并严重室性心律失常有效率优于艾司洛尔.胺碘酮与艾司洛尔均较安全.高龄AMI且伴心力衰竭者静脉应用胺碘酮时需密切监测肝功能,出现肝损伤需立即停药并给予对症治疗.%Objective To compare the efficacy and safety of intravenous application of amiodarone or esmolol in elderly patients with ventricular arrhythmia following acute myocardial infarction (AMI) within 48 hours,and provide reference for safe use of medication in clinical practice.Methods Elderly hospitalized

  6. 炙甘草汤加减配合胺碘酮治疗慢性心力衰竭312例疗效观察%Curative effect observation of Zhi Gan Cao decoction adjusted with amiodarone in the treatment of 312 cases of chronic cardiac failure

    Institute of Scientific and Technical Information of China (English)

    李玉红; 王立娜; 崔骞

    2014-01-01

    目的:观察炙甘草汤加减配合胺碘酮治疗慢性心力衰竭情况。方法:将慢性心力衰竭患者312例按随机数字表法分为观察组160例(炙甘草汤加减配合胺碘酮组)与对照组152例(胺碘酮组)。随访6个月,观察两组总有效率和复发率情况。结果:观察组总有效率98%,复发率10.22%;对照组总有效率82%,复发率32.9%。两者差异有统计学意义(P<0.05)。结论:在预防慢性心力衰竭的复发方面,炙甘草汤加减配合胺碘酮优于单纯应用胺碘酮,值得在临床中推广应用。%Objective:To observe Zhi Gan Cao decoction adjusted with amiodarone in the preventment of recurrence of chronic cardiac failure.Methods:According to random number table method,312 patients with chronic cardiac failure were divided into the observation group in 160 cases(Zhi Gan Cao decoction adjusted with amiodarone group)and the control group in 152 cases(amiodarone group).After 6 months of follow up,the recurrence rates of premature beat in the two groups were observed. Results:In the observation group,the total effective rate was 98%,and the recurrence rate was 10.22%.In the control group, the total effective rate was 82%, and the recurrence rate was 32.9%.The difference was statistically significant(P<0.05).Conclusion:In the preventment of recurrence of chronic cardiac failure,Zhi Gan Cao decoction adjusted with amiodarone is better than the simple application of amiodarone.It is worth of popularization and application in clinical.

  7. 胺碘酮配合中药对慢性心力衰竭并室性早搏的临床干预%Clinical intervention of amiodarone with Traditional Chinese Medicine on chronic heart failure and premature ventricular contractions

    Institute of Scientific and Technical Information of China (English)

    于瑞玲; 宗燕

    2014-01-01

    Objective:T o observe the effect of amiodarone with Traditional Chinese Medicine on prev enting the re currence of chronic h eart failure and p remature ventr icular contractions. Me thods:78 cases with ch ronic heart failur e were randomized into a group given amiodarone with Traditional Chinese Medicine( the treatment group with 40 cases) and a group given amiodarone( the control group with 38 cases) .Followed up for six months, the recurrence r ates of premature w ere observ ed . Results:Th e treatment groups:the t otal effective r ate was 98%, th e re currence ra te w as 10.22%; the control group: the to tal effective rat e was 82%, the re currence rate was 32.9%. The dif ference was st atistically sign ificant ( P<0 .05). C onclusions:In the aspect of prevention of chronic h eart fa ilure and premature ventricular contractions, amiodarone with Traditional Chinese Medicine is better than amiodarone and it is worth y of promotion in clinical applications.%目的:观察中药联合胺碘酮预防慢性心力衰竭并室性早搏复发情况。方法:慢性心力衰竭室性早搏病人78例,随机分为中药联合胺碘酮组(治疗组40例)与胺碘酮组(对照组38例)。随访6个月,观察两组早搏复发率情况。结果:治疗组:总有效率分别为98%,复发率10.22%;对照组:总有效率82%,复发率32.9%。两者有显著性差异(P<0.05)。结论:在预防慢性心力衰竭并室性早搏的复发方面中药联合胺碘酮优于单纯应用胺碘酮,值得在临床中推广应用。

  8. 盐酸胺碘酮联合步长稳心颗粒治疗阵发性快速房颤疗效观察%The Clinical Observation of amiodarone with Wenxinkeli in Treatment of rapid atrial fibrillation in patients with paroxysmal efficacy

    Institute of Scientific and Technical Information of China (English)

    严新美

    2013-01-01

    目的:评价胺碘酮联合步长稳心颗粒治疗阵发性快速房颤的疗效。方法将80例阵发性快速房颤患者随机分为治疗组和对照组,两组均予以吸氧、心电监护、胺碘酮治疗,治疗组加服步长稳心颗粒,共观察6个月。结果观察6个月后,治疗组在有效改善症状、复律时间、及胺碘酮用量方面明显优于对照组,差异有统计学意义(P<0.01)。结论胺碘酮与步长稳心颗粒合用治疗阵发性房颤,能有效改善症状,提高治疗效果且可减少胺碘酮用量,缩短复律时间,有一定的临床应用价值。%Objective Evaluation of amiodarone the joint step Wenxinkeli rapid atrial fibrillation in patients with paroxysmal efficacy. Methods 80 patients with paroxysmal rapid atrial fibrillation were randomly divided into a treatment group and a control group, and both groups are oxygen, ECG, amiodarone,The treatment group took Buchangwenxin particles were observed 6 months. Results Observed after 6 months, the treatment group was effective in improving symptoms, time of cardioversion and amiodarone dosage was significantly better than the control group, the difference was statistically significant (P <0.01). Conclusion the particle combination therapy of paroxysmal atrial fibrillation, amiodarone and Buchangwenxin improve symptoms, improve treatment and reduce amiodarone dosage and shorten the time of cardioversion clinical application value.

  9. 胺碘酮协同卡托普利对老年高血压伴阵发性心房颤动疗效观察%The clinical research of the treatment of Captopril and Amiodarone to elderly hypertensive patients with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    谢基连; 林小青; 李仕宁

    2009-01-01

    Objective: To evaluate the treatment of Captopril and Amiodarone to cure the elder hypertension and paroxysmal atrial fibrillation. Methods: 70 cases of elderly hypertensive patients with paroxysmal atrial fibrillation were randomly divided into Amiodarone group and combination group (Captopril combined Amiodarone), they were treated of 12 months, the rhythm control of the two groups after treatment 3, 6, 9,12 months and the left atrial diameter after treatment 6, 12 months were calculated. Results: There were significant changes of the blood pressure after treatment in each group, but no significant difference between two groups. The rate of rhythm control of the combination group was significant higher than that of the Amiodarone group after 9 and 12 months treatment. The change of the left atrial diameter was significant between the two groups after 12 months treatment. Conclusion: Captopfil combined with Amiodarone can decrease the blood pressure, inhibit left atrial enlargement and effective in preventing recurrence of atrial fibrillation in elderly hypertensive paroxysmal atrial fibrillation.%目的:观察卡托普利联合胺碘酮治疗老年高血压伴阵发性心房颤动(房颤)患者的疗效.方法:将70例老年高血压伴阵发性房颤患者随机分为胺碘酮组和联合用药组(卡托普利联合胺碘酮),治疗12个月,计算两组治疗后第3、6、9、12个月的窦性心律维持率和治疗前及治疗后第6、12个月的左心房内径.结果:研究期结束后各组内治疗前后血压变化比较具有显著性,但两组间治疗后血压无显著性差异.治疗后9、12个月,联合用药组的窦性心律维持率显著高于胺碘酮组.两组间左心房内径在治疗后12个月时胺碘酮组显著高于联合用药组.结论:卡托普利联合胺碘酮治疗老年高血压伴阵发性房颤,可抑制左房扩大,并有效预防房颤复发.

  10. The clinical effect of amiodarone versus lidocaine on the myocardial infarction patients complicated with ventricular tachycardia: A Meta-analysis%胺碘酮与利多卡因治疗急性心肌梗死并室性心动过速疗效及安全性的Meta分析

    Institute of Scientific and Technical Information of China (English)

    党松; 王晞; 胡娟; 王鑫

    2012-01-01

    Objective To retrospectively compare the therapeutic effectiveness of amiodarone and lidocaine in the treatment of ventricular arrhythmia after acute myocardial infarction. Methods PubMed, Cochrane, EMBASE, MEDLINE, CNKI, Wanfang data were searched from the time of self-build library to December 2011 for randomized clinical trials( RCT ) of amiodarone vs. Lidocaine on the myocardial infarction patients complicated with ventricular tachycardia. Two investigators independently screened these data. Pooled estimates were calculate with usage of RevMan 5. 0 software. Results Ten trials were included in the analysis ( 1381 patients ). ( 1 )The effective rate in amiodarone group was higher than that in lidocaine group ( RR = 1. 27 , 95% CI 1. 12 ~ 1.44, P =0.0002 ). ( 2 ) Regardless of the effect of other medicines, the side effects of amiodarone was similar as lidocaine ( RR = 0. 79, 95% CI 0. 42 ~ 1. 48, P = 0. 46 ). ( 3 )The mortality rate in amiodarone group was higher than that in lidocaine group ( RR = 0.48, 95% CI 0. 27 ~ 0. 85, P =0.01). Conclusion The results of this Meta-analysis provide strong evidence that preferable effective of amiodarone therapy on the myocardial infarction patients complicated with ventricular arrhythmia, amiodarone can significantly decrease the incidence of ventricular tachycardia without increase the side effects, and decrease the mortality rate.%目的 运用Meta 分析比较胺碘酮和利多卡因对急性心肌梗死合并室性心动过速的疗效.方法 计算机检索PubMed、Cochrane、EMBASE、MEDLINE、中国知网(CNKI)数据库、万方数据库,查找自建库以来至2011年12月公开发表的比较胺碘酮和利多卡因治疗心肌梗死合并室性心动过速临床随机对照试验(RCT),按纳入排除标准进行RCT 的筛选、资料提取和质量评价,使用RevMan 5.0软件进行数据统计学分析.结果 共纳入10项研究、1381例患者.(1)胺碘酮组治疗有效率显著高于利多卡因组(RR=1

  11. Alta dose de amiodarona em curto período reduz incidência de fibrilação atrial e flutter atrial no pós-operatório de cirurgia de revascularização miocárdica High dose of amiodarone in a short-term period reduces the incidence of postoperative atrial fibrillation and atrial flutter

    Directory of Open Access Journals (Sweden)

    Rafael Vieira Alcalde

    2006-09-01

    Full Text Available OBJETIVOS: Avaliar se a administração de amiodarona, em doses altas e curso rápido, reduz a incidência de fibrilação ou flutter atrial, após cirurgia de revascularização miocárdica e se reduz, também, o tempo de internação hospitalar. MÉTODOS: A amostra se constituiu de 93 pacientes randomizados, em estudo duplo-cego, para receberem amiodarona (46 pacientes ou placebo (47 pacientes. A terapia consistia na aplicação de 600mg de amiodarona, três vezes ao dia, iniciada no mínimo 30 horas e no máximo 56 horas antes da cirurgia. RESULTADOS: Fibrilação ou flutter atrial no pós-operatório ocorreu em 8 dos 46 pacientes no grupo amiodarona (17,4% e em 19 dos 47 pacientes no grupo placebo (40,4% (p=0,027. A dose média de amiodarona foi de 2,8g. Os pacientes do grupo amiodarona ficaram hospitalizados por 8,9±3,1 dias, enquanto a internação dos pacientes do grupo placebo foi de 11,4± 8,7 dias (p=0,07. O tempo de internação foi significativamente prolongado nos pacientes que desenvolveram fibrilação ou flutter atrial após a cirurgia, independente do grupo randomizado. CONCLUSÃO: Esta nova alternativa de administração de amiodarona em alta dose e por um curto período, antes da cirurgia de revascularização miocárdica, reduz a incidência de fibrilação ou flutter atrial no pós-operatório desta cirurgia.OBJECTIVE: To investigate wheter oral amiodarone administered before surgery for a short period in high dose would reduce the incidence of postoperative atrial fibrillation or atrial flutter and reduces the lenght of hospital stay. METHODS: In the double-blind, randomized study, 93 patients were given either oral amiodarone (46 patients or placebo (47 patients. Therapy consisted of 600mg of amiodarone three times a day, started at mininum 30 hours and at maximum 56 hours before surgery. RESULTS: Postoperative atrial fibrillation or atrial flutter occurred in 8 of 46 patients in the amiodarone group (17.4% and 19 of the

  12. Clinical Efficacy of Amiodarone Combined With Perindopril in Patients With Paroxysmal Atrial Fibril ation%胺碘酮联合培哚普利治疗阵发性房颤的临床疗效

    Institute of Scientific and Technical Information of China (English)

    孙楠楠

    2014-01-01

    目的:评价胺碘酮联合培哚普利治疗阵发性房颤的临床疗效,指导在治疗阵发性房颤过程中选择合理的药物以减少阵发性房颤的发生,改善患者的预后。方法将57例阵发性房颤随机分为胺碘酮组(A组,n=28)和胺碘酮+培哚普利(B组,n=29),胺碘酮组(A组)包括男16例,女12例,平均年龄58±5.5岁,胺碘酮组(A组)中原发性高血压8例,特发性房颤2例,冠心病7例,风心病5例;胺碘酮+培哚普利(B组)包括男19例,女10例,平均年龄59±6.1岁,胺碘酮+培哚普利(B组)中原发性高血压9例,特发性房颤2例,冠心病6例,风心病7例。胺碘酮组(A组)患者胺碘酮的服用方法为:0.2g,3次/天服药一周,后减至0.2g,2次/天,服药一周,然后0.2g,一次/天,长期维持;胺碘酮+培哚普利(B组)患者在胺碘酮组(A组)治疗用药的基础上加用培哚普利,服用方法为:2mg,一次/天,服药四天,如无低血压,第五天加量至4mg,,一次/天,治疗随访时间为24个月。计算两组治疗后3、6、9、12、18、24月的窦性心律的维持率和治疗前、治疗后6、12、18个月的左心房内径。结果两组治疗前和治疗后6、12个月左心房内径无差别,18个月后有显著差异(P<0.05),治疗后3、6、9个月,A组窦性心律维持率均低于B组,但无显著差异,而治疗12个月后,两组间有显著性差异(P<0.05),治疗结束时A组的窦性心律维持率为61.26%,B组的窦性心律维持率为83.45%。结论胺碘酮联合培哚普利治疗阵发性房颤在维持窦性心律及减少心房颤动发作次数的疗效均优于单用胺碘酮,并能延缓左心房扩大。%Objective To evaluate the clinical effects of amiodarone combined perindopril to treat paroxysmal atrial fibril ation. Methods 57 cases were randomly divided into treated by amiodarone group (group A, n=28) and treated by

  13. 胺碘酮治疗重度左心衰竭并房颤56例临床报道%Clinical Efficacy of 56 Cases of Amiodarone in Treatment of Severe Left Heart Failure and Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    江波; 江挺

    2015-01-01

    Objective Clinical eficacy of amiodarone in the treatment of severe left heart failure and atrial fibrilation were analyzed and discussed.Methods56 patients in our hospital from March 2012 to March 2014 with severe left heart failure and atrial fibrilation were randomly assigned treatment.Results The observation group treatment eficiency (92.9%) was significantly better than the control group(71.4%). The diference was statisticaly significant,P < 0.05;systolic blood pressure,diastolic and mean arterial pressure and heart rate in the observation group were significantly lower than the control group,and the diference was statisticaly significant,P < 0.05;incidence of adverse reactions in the experimental group was significantly lower than the control group,and the diference was statisticaly significant,P < 0.05.Conclusion Amiodarone in treatment of severe left heart failure and atrial fibrilation is efective and safe.%目的:对胺碘酮治疗重度左心衰竭并房颤的临床疗效进行分析探讨。方法将我院自2012年3月~2014年3月收治的56例重度左心衰竭并房颤患者进行随机分组治疗。结果实验组患者治疗有效率(92.9%)优于对照组患者(71.4%),对比差异,具有统计学意义,P <0.05;实验组患者收缩压、舒张压、平均动脉压及心率均低于对照组,对比差异具有统计学意义,P <0.05;实验组不良反应发生情况低于对照组,对比差异具有统计学意义,P <0.05。结论重度左心衰竭并房颤行胺碘酮治疗,疗效好,安全性高。

  14. Effects of undiluted and diluted amiodarone on defibrillation and haemodynamics in a ventricular fibrillation pig model%胺碘酮原液和稀释液对心室颤动转复作用及血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    武军元; 李春盛; 王胜奇

    2010-01-01

    Objective Amiodarone was diluted to release the side effect of hypotension in clinic, but this maybe unsuitable during cardiopulmonary resuscitation (CPR). This study was designed to observe the effects of undiluted amiodarone, diluted amiodarone, and CPR alone on ventricular fibrillation (VF) in a pig model. Methods VF was induced in 21 pigs. The animals were randomly (random mumber) divided into 3 groups after VF 3 min.① CPR group ( n= 7): standard CPR; ② undiluted amiodarone group ( n= 7): undiluted amiodarone (5 mg/kg)bolus within 3 s, then 20 mL saline flush into the peripheral vein, CPR was started after observed 30 s; ③ diluted amiodarone group ( n = 7): amiodarone was dissolved in 20 mL saline and bolus with 30 s. Defibrillation was attempted at VF 5 min. Results The restoration of spontaneous circulation (ROSC) of CPR and undiluted amiodarone groups were higher than diluted group (85.7% vs. 71.4% vs. 42.9%), but the differences were not significant (all P >0.05). The defibrillation energy and times of CPR group were higher than that of undiluted amiodarone (P= 0.009) and diluted group ( P = 0. 170). The mean arterial pressure of undiluted amiodarone were lower than diluted and CPR groups at ROSC 10 min (all P <0.05), but the differences of undiluted and diluted groups were not significant after ROSC 0.5 h. Conclusions In this study, undiluted amiodaronecan effectively reduced the defibrillation times and energy. Although diluted amiodaronecan release the side effect of hypotension which was transient, it didn't significantly improved cardiac electric activity and delayed to start CPR.%目的 通过猪心室颤动(VF)模型,观察胺碘酮原液、稀释液以及单纯标准CPR对心肺复苏效果的影响.方法 21头北京长白猪,应用程控刺激仪诱导VF,VF 3 min后,将动物随机(随机数字法)分为3组.①单纯CPR组:只进行单纯标准CPR;②胺碘酮原液组:予胺碘酮原液5 mg/kg快速(<3 s)静推,生理盐水20 m

  15. 胺碘酮治疗老年充血性心力衰竭伴快速房颤的疗效观察%Efficiency of intravenous amiodarone in congestive heart failure patients with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    张荣生; 顾翔

    2015-01-01

    ObjectiveTo determine the effect of intravenous amiodarone on the rapid ventricular rate in the patients with atrial fibrillation (AF) and congestive heart failure (CHF).Methods Seventy elderly patients with AF and CHF [ventricular rate>120beats/min, New York Heart Association (NYHA) classⅡ−Ⅳ] hospitalized in theNorthern Jiangsu People’s Hospital from September 2012 to September 2013 were recruited in this study. They were randomized into 2 groups: amiodarone group (n=35, loading dosage of 150mg followed by a dose of 1.5mg/min) anddeslanoside group (n=35, loading dosage of 0.4 or 0.2mg in slow injection, and more 0.2mg should be medicated if no effect occurred in 1h later). The ventricular rate, mean response time, successful cardioversion ratio,brain natriuretic peptide (BNP) level, the adverse effects and follow-up outcomes were recorded after medication.Results The ventricular rate was significantly decreased in 1, 2 and 24h after treatment thanbefore inboth groups (P0.05). In 3 months after discharged from hospital, the ratio of persistent AFafter the medications (amiodarone, metoprorol and digoxin) was 60.0% (21/35) and 82.9% (29/35), respectively, and the rate of adverse effect was 8.6% and 11.4%, respectively, in the 2 groups (P>0.05).Conclusion Amiodarone isof safety, rapid effect andmild adverse effect in treatment of CHF patients with coexisting AF.%目的:观察胺碘酮治疗老年充血性心力衰竭(CHF)伴快速心房纤颤(AF)的疗效。方法选择2012年9月至2013年9月在苏北人民医院住院治疗的老年CHF伴快速AF患者70例,纽约心脏联合会分级(NYHA)Ⅱ~Ⅳ级,心室率≥120次/min;随机分为胺碘酮组和去乙酰毛花苷组,每组各35例。在常规治疗基础上,胺碘酮组首次剂量给予胺碘酮150mg缓慢静注,随后1.5mg/min微量泵维持;去乙酰毛花苷组首次剂量给予去乙酰毛花苷0.4mg或0.2mg缓慢静注,1h后无效者追加0.2mg。观察用药后

  16. 胺碘酮治疗房颤并发静脉炎25例护理体会%The Experience of Nursing for 25 Cases ofP atients with Atrial Fibrillation Complicated Phlebitis with Amiodarone

    Institute of Scientific and Technical Information of China (English)

    安桂香; 王莉

    2011-01-01

    目的:探讨应用胺碘酮注射液治疗快速房颤并发静脉炎的护理方法.方法:加强巡视、按时冲管,并应用微量泵.结果:经及时正确的对症护理,患者静脉炎症状消失,皮温色泽恢复正常.结论:专科护士仔细观察药物疗效和不良反应,及时采取有效的预见性护理,可减轻患者的痛苦.%To investigate the nursing method for patients with atrial fibrillation complicated phlebitis with Amiodarone.Method:Stepped up inspections,washed tube on time to prevent the occurrence of phlebitis, and applied the micro-pump.Result:The symptoms of phlebitis in patients disappeared and the temperature and color of skin came back to normal through timely and correct symptomatic care.Conclusion:The professionl nurses should observe the efficacy and adverse reactions of drugs carefully and take timely and effective nursing care to alleviate the suffering of patients.The best method is to take center intravenous administration.

  17. 静脉注射胺碘酮治疗急性心衰合并快速房颤的临床分析%Clinical effect of intravenous injection of amiodarone in treatment of acute heart failure with rapid atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    常云仙

    2013-01-01

    Objective To investigate the clinical effect of intravenous injection of amiodarone in the treatment of acute heart failure with rapid atrial fibrillation. Methods A total of 172 patients with acute heart failure and rapid atrial fibrillation who were admitted to our hospital from October 2011 to July 2013 were randomly divided into heart failure and atrial fibrillation group and amiodarone group. The heart failure and atrial fibrillation group received conventional treatment, while the amiodarone group received conventional treatment plus injection of amiodarone. The treatment outcomes of the two groups were compared. Results After 7 d of treatment, the amiodarone group had a significant more improvement in cardiac function, a significantly better heart rate control, and a significantly lower mortality rate, as compared with the heart failure and atrial fibrillation group (P<0.05 for all comparisons). Conclusion Conventional treatment plus injection of amiodarone can improve cardiac function and control heart rate in the treatment of heart failure.%目的探讨对静脉通过注射胺碘酮诊治急性心衰伴有快速房颤的具体效果。方法2011年10月至2013年7月,我院有急性心衰伴随快速房颤的病人172例,随机将172例急性心衰伴随快速房颤者分组:心衰房颤组和胺碘酮组。对心衰房颤组实施常规的措施医治,对胺碘酮组实施常规+注射胺碘酮的措施医治。之后,对比心衰房颤组和胺碘酮组的临床疗效。结果对比心衰房颤组和胺碘酮组的用药7天后的疗效,胺碘酮组的心功能改善比心衰房颤组的好,胺碘酮组的心率控制度也比心衰房颤组要好,此外,胺碘酮组的死亡率也比心衰房颤组的低,疗效差异均明显,P<0.05,有统计学意义。结论在抗心衰的治疗中,用常规+注射胺碘酮的措施进行抗心衰诊治,能使心功能、心率分别得到改善、控制。

  18. Reasonable application of amiodarone treatment of senile ventricular arrhythmia 66 cases effectiveness and safety analysis%合理应用胺碘酮治疗老年室性心律失常66例疗效及安全性分析

    Institute of Scientific and Technical Information of China (English)

    王彦欧; 徐凯; 赵斌; 郑海宁

    2011-01-01

    目的:观察合理应用胺碘酮在治疗老年室性心律失常中的疗效及安全性分析.方法:66例老年室性心律失常患者经合理给予胺碘酮治疗4周后观察其疗效及安全性分析.结果:治疗组患者住院期间及随访18个月后无死亡.住院期间及随访24个月后,治疗组抗心律失常治疗有效率为94.2%,对照组为53.1%(P<0.01).结论:合理应用胺碘酮治疗老年室性心律失常副作用少,安全有效.%Objective: To observe reasonable application of amiodarone in the treatment of senile ventricular arrhythmia effectiveness and safety analysis. Methods: 66 cases with ventricular arrhythmia by giving reasonable amiodarone treatment after four weeks were observed the efficacy and safety analysis. Results: During hospitalization and after follow-up 18 months, no patients of treatment group died. During hospitalization and after follow-up 24 months, effective rate of treatment group after antiarrhythmic treatment was 94.2%, that of control group was 53.1% (P<0.01). Conclusion: Reasonable application of amiodarone treatment of senile ventricular arrhythmia is with few side-effects, safe and effective.

  19. Application Analysis of Amiodarone Intravenous Infusion in the Treatment of Rapid Arrhythmia in the Treatment of%胺碘酮静脉滴注在急诊快速心律失常治疗中的应用分析

    Institute of Scientific and Technical Information of China (English)

    崔玉华

    2014-01-01

    Objetc ive To analyze the clinical effects and side effects in the treatment of rapid arrhythmia in the treat -ment of amiodarone intravenous drip.Methods 60 cases of patients with tachyarrhythmia , for the treatment of amioda-rone, and observe the changes of blood pressure , the analysis of cardiac index before and after the treatment of patients and treatment.Results After intravenous injection of amiodarone treatment , the total effective rate was 85%;a total of 6 cases of adverse reactions in patients with blood pressure , cardiac index;patients after treatment was significantly lower than that before treatment , the difference is obvious ( P<0.05 ).Conclusions Intravenous amiodarone in the treatment of patients with tachyarrhythmia , it has obvious curative effect, less adverse reaction , the patient side effects were mild , safe and reliable , and lower the cost of treatment to patients.%目的:分析胺碘酮静脉滴注在急诊快速心律失常治疗中的临床效果及不良反应。方法选取60例快速型心律失常患者,对其使用胺碘酮进行治疗,分析并观察患者治疗效果及治疗前后血压、心律等指标变化状况。结果经胺碘酮静脉滴注治疗,治疗总有效率为85.0%;共6例患者出现不良反应;患者治疗后的血压、心律指标显著低于治疗前,差异明显( P<0.05)。结论胺碘酮静脉滴注治疗快速型心律失常患者,具有显著的治疗效果,不良反应较小,对患者的毒副作用较轻,安全可靠,且治疗费用较低更易于患者接受。

  20. Analysis of Clinical Effect on Amiodarone And Benazepril Combination Treatment to Paroxysmal Atrial Fibrillation%胺碘酮和贝那普利联合用药治疗阵发性心房颤动的临床疗效分析

    Institute of Scientific and Technical Information of China (English)

    吴之娜

    2015-01-01

    目的:观察分析两组患者的治疗效果及发生不良反应的情况。方法对照组患者使用胺碘酮进行药物治疗,实验组患者使用胺碘酮联合贝那普利联合药物治疗,做统计学对比。结果经过两种药物治疗,实验组患者治疗的有效率高达93.75%,对照组患者治疗的有效率为78.13%,且治疗后实验组患者心房内径小于对照组,两组患者治疗效果差异显著(P<0.05),差异具有统计学意义。结论使用胺碘酮联合贝那普利治疗阵发性心房颤动患者临床疗效显著,且治疗后患者未发生其他严重不良反应。%ObjectiveTo analysis the clinical effect and adverse effect of amiodarone combined with benazepril to the patients with paroxysmal atrial fibrillation. Methods The patients of control group were treated with amiodarone, the experimental group patients were treated with amiodarone combined with benazepril. The results were made statistical analysis.ResultsThe effective rate of the experimental group was 93.75% after treatment, the control group was 78.13%, and the atrial diameter of experimental group patients were less than that of the control group, the difference of the effects in two groups was signiifcant (P<0.05).Conclusion The clinical effect on amiodarone and benazepril combination treatment to paroxysmal atrial ifbrillation is obvious, there is no serious adverse effect after treatment. It is worthy to be promoted in clinic.

  1. 静脉注射胺碘酮治疗心力衰竭伴快速性心房颤动的疗效观察%Effect observation of intravenous amiodarone in the treatment of heart failure with rapid atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    巩晓宏; 常海霞; 马锋; 谢铎文; 刘超峰

    2012-01-01

    Objective To Evaluate the effect of intravenous amiodarone for the treatment of heart failure with rapid atrial fibrillation, including the recovery rate of atrial fibrillation,cardioversion rate control, the time of cardioversion, ventricular rate control and its security. Methods 48 cases with heart failure and rapid atrial fibrillation patients were given amiodarone 150 mg plus 50 g o L-1 glucose solution 20 mL intravenous injection. 30 min after injection if no effect observed,the drug was used again,followed by 0. 5-1 mg o min l drops for 48 h. 1,2,6,12,24 and 48 h after cardioversion recovery the adverse reactions were observed. Results Amiodarone can quickly and effectively make rapid atrial fibrillation cardioversion to sinus rhythm,and no serious adverse reaction was observed. Conclusions Intravenous amiodarone in the treatment of heart failure with rapid atrial fibrillation is safe and effective, especially suitable for the merger of structural heart disease.%目的 观察心力衰竭伴快速性心房颤动患者静脉注射胺碘酮转复或控制心室率治疗心力衰竭的疗效,包括心房颤动的转复率、转复时间、心室率的控制、不良反应及安全性.方法 心力衰竭伴快速性心房颤动患者48例,胺碘酮150 mg加50 g·L-1葡萄糖注射液20 mL静脉注射,患者30 min后房颤未转复即再应用1次,继以0.5~1 mg·min-1维持静滴48 h,观察用药后1,2,6,12,24和48 h转复率、心室率、心力衰竭症状的缓解及不良反应.结果 胺碘酮可快速有效使快速房颤转复为窦性心律,控制心室率,纠正心力衰竭,且无严重不良反应发生.结论 心力衰竭伴快速性心房纤颤患者静脉注射胺碘酮治疗安全有效,尤其适用于合并器质性心脏病患者.

  2. 静脉用胺碘酮治疗心衰并发快速房颤的疗效分析%Intravenous amiodarone in the treatment of heart failure with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    凌云

    2012-01-01

    Objective To explore the clinical efficacy of the intravenous amiodarone in the treatment of heart failure with rapid atrial fibrillation. Methods 78 patients with heart failure with rapid atrial fibrillation were included in the study. According to admission order, they were randomly divided into observation group and control group (n=39). The observation group was given amine block ketone 150mg diluted with normal saline was slowly injected intravenous 0. 5mg/min, to maintain total of 24 hours does not exceed 800 mg in the control group were given first Cedilanid 0. 2mg diluted slowly after bolus, if 20 minutes is invalid to give 0. 2mg,24 hours total no more than 1. 0mg. The ventricular rate at different times after the first drug and 24 hours after cardioversion were observed. Results There were ventricular rate after treatment decreased significantly in the control group faster than the observation group, the difference between the groups was statistically significant (P<0. 05). The observation group was higher than that in the control group (P< 0. 05). Conclusion Amiodarone can effectively slow down heart failure complicated by atrial fibrillation, ventricular rate, and some patients with atrial fibrillation cardioversion has important clinical value.%目的 探讨静脉用胺碘酮治疗心衰并发快速房颤的临床疗效.方法 选择心衰并发快速房颤患者78例,接入院先后顺序随机分为观察组与对照组,每组39例.观察组给胺碘酮150mg生理盐水稀释后缓慢注射,然后以0.5mg/min维持静滴,24小时总量不超过800 mg;对照组先用西地兰0.2mg稀释后缓慢静推,若20分钟无效再给0.2mg,24小时总量不超过1.0mg,两组的常规治疗相同.比较首次用药后不同时刻的心室率变化、24小时后复律情况.结果 两组用药后,心室率均明显下降,对照组快于观察组,组间差异有统计学意义(P<0.05);观察组有效率高于对照组,组间差异有统计学意义(P<0.05).

  3. 普罗帕酮与胺碘酮转律阵发性室上性心动过速43例疗效分析%The clinical effect of propafenone and amiodarone on the patients of paroxysmal supraventricular tachycardia(PSVT)plus 43 cases report

    Institute of Scientific and Technical Information of China (English)

    宋晓蓉; 谢陈玲

    2012-01-01

      目的比较静脉注射普罗帕酮与胺碘酮转律阵发性室上性心动过速的疗效.方法将43例阵发性室上性心动过速患者随机分为普罗帕酮组和胺碘酮组,分别静脉注射普罗帕酮70~140 mg和胺碘酮150~300 mg,观察室上性心动过速的转律情况.结果普罗帕酮组21例,转复成功17例(81.0%);胺碘酮组22例,转复成功18例(81.8%),2组比较无显著性差异(P>0.05).转律成功时间:普罗帕酮组(24.2±19.5)min,胺碘酮组(40.5±18.5)min,2组比较差异显著(P0.05). The time of heart beat recovery in Propafenone group were (24.2±19.5)min and Amiodarone group were (40.5±18.5) min,there was significant difference of the time between the two groups Conclusion Propafenone and Amiodarone treatmen are both effective on PSVT.

  4. 胺碘酮治疗急性冠状动脉综合征并发快速心房颤动的疗效观察%Effects of treatment for acute coronary syndrome with fast atrial fibrillation with amiodarone

    Institute of Scientific and Technical Information of China (English)

    戴志江

    2012-01-01

    Objective: To observe the effects and safety of intravenous injection amiodarone on acute coronary syndrome ( ACS) with fast atrial fibrillation(AF). Methods;Forty-eight cases with ACS with fast AF were treated with intravenous injection of amiodarone, and maintained at 0. 5 - 1.0 mg/min for 0.5 - 24 hours. The reversion of AF, the ventricular rates, blood pressure and side-effects were observed at 30 min,2 hour and 24 hour after treatment. Results: Compared with pretreatment, 36 cases were reverted (the reversion rates as 75% ) and the ventricular rates were apparent decline after treatment(P 0.05),但用药后不同时间的舒张压均低于用药前(P<0.01).心功能Ⅰ、Ⅱ级的ACS患者复律率(82.9%)高于心功能Ⅲ、Ⅳ级组复律率(46.2%)(P<0.05).出现窦性心动过缓5例(10.4%),减量或停药后恢复正常;血压偏低4例(8.3%),予多巴胺升压后恢复正常.结论:静脉注射胺碘酮对ACS并发快速AF转复率较高,不良反应较少.

  5. Effects of Propafenone, Amiodarone and Dilthiazem on the potassium channel of c-Type Kv1.4△N%普罗帕酮、胺碘酮、地尔硫卓对Kv1.4△N钾通道的作用

    Institute of Scientific and Technical Information of China (English)

    王智泉; 蒋学俊; 王世敏; 徐林; 王能; 张冬

    2011-01-01

    目的 探讨不同类别抗心律失常药物普罗帕酮、胺碘酮和地尔硫卓对去N端Kv1.4通道(Kv1.4△N)的作用方式,以及这些作用的差异性.方法 将Kv1.4△N的mRNA注射入非洲爪蟾卵母细胞并使用双电极钳制法(two electrodes voltage clamp,TEV),运用Clampfit 9.0软件分别观察三种药物对KV1..4△N电生理特性的影响.结果 三种药物对ELvl.4△N通道的作用都具有浓度、频率和电压依赖性.在亲和力方面,propafenone的IC50最小,dilthiazem次之,amiodarone的IC50最大(P=0.031);在频率抑制性方面,propafenone组达到稳态时为对照组的41%,amiodarone为32%左右,dilthiazem为21%左右(P=0.045);在电压抑制性方面,100μMpropafenone,500μM amiodarone、350μM dilthjazem在+50 mV电压下分别能使fKv1.4△N通道电流抑制到对照组的(54.6±1.9)%,(46.3±3.5)%和(52.8±2.8)%(P=0.046).结论 三者都是fKv1.4△N通道的开放通道阻滞剂,对fKv1.4△N通道的作用和机制既有相同之处,又有不同特点,这可能是三者抗心律失常的机制之一.%Objective To study the effects of the antiarrhythmic drugs of propafenone, amiodarone and dilthiazem on c-type Kv1. 4 channels in Xenopus laevis oocytes with two-electrode voltage-clamp technique. Methods Defolliculated oocytes ( stage Ⅴ - Ⅵ) had transcribed cRNAs of ferret Kv1. 4△N channels injected. The oocytes were continuously perfused with control solution or propafenone, amiodarone and dilthiazem under monitoring of software of Clampfit v 9. 0. Results All of the three drugs blocked ferret Kv1. 4△N channel in voltage-, frequency- and concentration-dependent manners. The values of IC50 (50%inhibiting concentration ) of propafenone, amiodarone and dilthiazem were ( 103.4± 2. 2 ) μ mol/L,(501.22 +5.9) μmol/L and (353.62 +9.9) μmol/L, respectively. The currents under the actions of propafenone , amiodarone and dilthiazem were decreased to 41%, 32% and 21% of control group, respectively. Propafenone

  6. 异搏定和胺碘酮治疗阵发性室上性心动过速患者48例效果观察%Effect observation of the application of verapamil and amiodarone in 48 cases with paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    兰银花

    2014-01-01

    Objective:To observe the clinical effect of verapamil and amiodarone in the treatment of paroxysmal supraventricular tachycardia.Methods:48 cases with paroxysmal supraventricular tachycardia were selected from February 2010 to August 2013. They were randomly divided into the amiodarone group and the verapamil group with 24 cases in each.They were respectively given intravenous amiodarone and verapamil treatment.The treatment effective rate and cardiovascular adverse reactions of patients in two groups were observed.Results:In the amiodarone group,22 cases were effective;2 cases were invalid;the effective rate was 91.7%.In the verapamil group,21 cases were effective;3 cases were invalid;the effective rate was 87.5%.The effective rates of two groups were no significant difference(χ 2=0.2233,P>0.05).The cardiovascular adverse reactions in the amiodarone group included 1 case of sinus bradycardia,1 case of sinus arrest,2 cases of hypotension,and the incidence rate of adverse reaction was 16.67%.The cardiovascular adverse reactions in the verapamil group included 3 cases of sinus bradycardia,2 cases of sinus arrest,2 cases of complete atrioventricular block,4 cases of hypotension,1 case of shock,2 cases of cardiac function deterioration, and the incidence rate of adverse reaction was 58.33%.The incidence rate of cardiovascular adverse reaction in the amiodarone group was significantly lower than that of the verapamil group(χ 2=8.8889,P<0.01).Conclusion:Amiodarone in the treatment of paroxysmal supraventricular tachycardia has exact curative effect.It is safe and reliable.%目的:观察异搏定和胺碘酮治疗阵发性室上性心动过速的临床效果。方法:2010年2月-2013年8月收治阵发性室上性心动过速患者48例,随机分为胺碘酮组和异搏定组,各24例,分别给予静注胺碘酮、异搏定进行治疗,观察两组治疗的有效率及心血管不良反应。结果:胺碘酮组治疗有效22例,无效2例,有效率91

  7. 胺碘酮治疗老年充血性心力衰竭合并心房颤动的临床观察%Clinical Observation of Amiodarone in the Treatment of Elderly Congestive Heart Failure Complicating with Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    代容

    2011-01-01

    目的:观察胺碘酮治疗老年充血性心力衰竭(CHF)合并心房颤动的临床疗效.方法:将我院2004-2010年90例年龄≥65岁的CHF并心房颤动患者,随机1∶1分为治疗组与对照组,对照组给予强心利尿等常规治疗;治疗组在常规治疗的基础上加用胺碘酮,并对其进行随访,观察疗效.结果:治疗组总有效率为95.56%;对照组总有效率为68.89%,2组比较差异有统计学意义(P<0.05).2组均未见严重不良反应发生.结论:胺碘酮治疗老年CHF合并心房颤动既能有效控制心室率,又能显著改善心功能,且不良反应少.%OBJECTIVE: To observe clinical efficacy of amiodarone in the treatment of elderly congestive heart failure (CHF) complicating with atrial fibrillation. METHODS: 90 CHF patients with atrial fibrillation, aged≥65 years of age, in our hospital were randomly divided into treatment group and control group of 45 patients in each group from 2004 to 2010. Control group received conventional treatment such as cardiac diuretic. Treatment group additionally received amiodarone on the basis of conventional therapy. All patients were followed up. RESULTS: In treatment group, the total effective rate was 95.56%. Compared with control group(68.89%) ,the treatment group has significant difference(P<0.05). There was no serious ADRs found in 2 groups. CONCLUSION: Amiodarone can effectively control the ventricular rate in elderly CHF patients with atrial fibrillation, but also significantly improve cardiac function with less ADR.

  8. Efficacy and safety of amiodarone combined with telmisartan for prevention of paroxysmal atrial fibrillation%胺碘酮联合替米沙坦预防阵发性心房颤动的疗效与安全性

    Institute of Scientific and Technical Information of China (English)

    王志敬; 孙波; 周茂峰; 许东伟

    2011-01-01

    目的:观察胺碘酮联用替米沙坦预防阵发性心房颤动的疗效,并评价其安全性.方法:将204例高血压合并阵发性心房颤动病人用随机数字表法分为试验组与对照组.试验组与对照组病人均口服胺碘酮,第1周600 mg/d,第2周400 mg/d,第3周200mg/d,之后100 mg/d.试验组病人同时口服替米沙坦20~80 mg/d;对照组病人服用其他降压药,避免使用血管紧张素转换酶抑制剂(ACEIs)和血管紧张素受体拮抗剂(ARBs).随访6个月,观察两组病人的心房颤动发作次数、复发例数、首次复发时间以及药物不良反应(ADRs)发生率.结果:试验组和对照组分别有91和95例病人完成试验.试验组发生ADRs的例数较对照组显著增加(56 vs 41,P<0.05),主要表现为胃肠道反应发生率升高,但因严重ADRs导致的停药例数组间差异无统计学意义(P>0.05).试验组心房颤动首次复发的时间较对照组明显延长[(94.59±30.51)d vs (84.54±28.73)d,P<0.05],复发次数显著减少(32 vs 53,P<0.05); 3个月内复发例数无显著差异(15 vs 24,P>0.05),6个月内复发例数显著减少(26 vs 42,P<0.05).结论:胺碘酮与替米沙坦联用预防阵发性心房颤动安全、有效.%Objective: To observe the efficacy and safety of amidarone combined with telmisartan for prevention of paroxysmal atrial fibrillation. Methods: A total of 204 patients with hypertension and paroxysmal atrial fibrillation were randomly divided into test and control groups by digit table. Patients in the two groups took amiodarone 600 mg/d in the first week, 400 mg/d in the second week,200 mg/d in the third week and 100 mg/d afterwards. Patients in the test group were also treated with telmisartan at the dose of 20-80 mg/d simultaneously. While patients in the control group were treated with other antihy-pertensive drugs,excluding angiotensin converting enzyme inhibitorsC ACEIs) and angtotensin receptor blockersC ARBs). All the patients were

  9. Analyse the clinical effect of esmolol combined with amiodarone to the elderly patients with ventricular arrhythmias%老年室性心律失常患者应用艾司洛尔与胺碘酮联合治疗的临床效果分析

    Institute of Scientific and Technical Information of China (English)

    郑俊华; 唐浩然; 景丽英; 朱承栋

    2014-01-01

    目的:探讨老年室性心律失常患者应用艾司洛尔联合胺碘酮的临床疗效。方法将135例室性心律失常老年患者随机均分为两组,均给予常规治疗,对照组患者在此基础上口服胺碘酮,观察组患者在对照组基础上静脉滴注艾司洛尔,比较两组的临床疗效。结果研究组疗效优于对照组,差异有显著性(Z=-2.085,P=0.037);两组患者的不良反应主要包括头晕、恶心呕吐、低血压、心动过速、甲状腺功能异常。研究组患者不良反应率发生率为13.42%,对照组为14.70%,两组比较差异无显著性(χ2=0.045,P=0.832)。结论艾司洛尔与胺碘酮联合治疗老年室性心律失常的疗效优于单用胺碘酮,且不良反应小,临床具有重要参考价值。%Objective To study the Esmolol ventricular arrhythmia in elderly patients, the clinical curative effect of amiodarone combined treatment. Method 135 cases of ventricular arrhythmias were elderly patients were randomly divided into two groups, two groups were performed routine therapy and control group on the basis of oral amiodarone, observation group in the control group on the basis of intravenous drip Esmolol, compare the clinical curative effect of two groups. Result Two groups of clinical curative effect comparison, the difference was statistically signiifcant (Z=-2.085, P=0.037), the team curative effect was better than the control group;two group of adverse reactions mainly include dizziness, nausea, vomiting, hypotension, tachycardia, abnormal thyroid function, the team adverse reaction rate was 13.42% and 14.70% in control group, there was no statistically signiifcant difference in the two groups (χ2=0.045, P=0.832). Conclusion Esmolol with amiodarone combined treatment of ventricular arrhythmia in elderly patients with curative effect is better than that of amiodarone alone, and the characteristics of adverse reactions to small clinical has important

  10. Analysis of Clinical Effect of Esmolol Combined with Amiodarone in the Treatment of Ventricular Electrical Storm in 160 Cases%艾司洛尔联合胺碘酮治疗心室电风暴160例临床分析

    Institute of Scientific and Technical Information of China (English)

    魏爽

    2015-01-01

    Objective To explore and analyze the effects of esmolol hydrochloride combined with amiodarone in the treatment of patients with ventricular electrical storm. Methods In our hospital from 2011 September to 2014 June, during the 329 cases of pa-tients with ventricular electrical storm, random and follow the principle of voluntary informed, divided into the observation group (160 cases) and control group (169 cases). Given the drug amiodarone treatment, the observation group were treated by hydrochlo-ric acid esmolol and amiodarone combination therapy, after the treatment, careful observation and comparison of two groups of pa-tients achieved treatment effect. Results In the observation group, the total effective rate was 95%, significantly higher than the control group of 70.4%patients in the two group, the total efficiency of contrast, with significant difference (P<0.01), there is sta-tistical significance;after the treatment, the patients in observation group were systolic blood pressure and heart rate were(104±15) mmHg,(84±13) time / min all lower than the control group, compared the systolic pressure and heart rate of the two groups of pa-tients after the treatment, it has obvious difference (P<0.05), there is statistical significance. Conclusion Using esmolol hydrochlo-ride combined with drug amiodarone better clinical effect of ventricular electrical storm with a common treatment, can improve the life quality of life in patients with ventricular storm, has clinical value.%目的:探讨和分析盐酸艾司洛尔与胺碘酮联合使用在治疗心室电风暴患者的效果。方法整群选取该院在2011年9月-2014年6月期间所收治的329例心室电风暴患者,遵照随机与知情自愿原则,分为观察组(160例)和对照组(169例)。给予药物胺碘酮治疗,对观察组患者采用盐酸艾司洛尔与胺碘酮联合治疗方案,疗程结束后,认真观察和对比两组患者所取得治疗的效果。结

  11. Effects of Benazepril and Amiodarone on Paroxysmal Atrial Fibrillation in Patients with Slow-fast Syndrome after DDD Pacing%贝那普利联合胺碘酮对慢-快综合征患者DDD起搏器植入术后阵发性心房颤动的干预作用

    Institute of Scientific and Technical Information of China (English)

    王兵; 江洪; 陈玲; 丁峰; 董艳芬; 孙玉玲

    2013-01-01

    目的 观察贝那普利联合胺碘酮对慢-快综合征患者DDD起搏器植入术后阵发性心房颤动(简称房颤)的干预作用.方法 将2007年1月至2011年1月由武汉人民医院收治的22例慢-快综合征DDD起搏器植入术后合并阵发性房颤的患者随机分成治疗组和对照组,治疗组采用贝那普利联合胺碘酮进行治疗,对照组采用胺碘酮进行治疗,随访18个月,比较两组治疗后左心房内径及窦性心律的维持率.结果 治疗9个月,两组左心房内径及窦性心律的维持率进行比较,差异均无统计学意义(P>0.05);治疗18个月,治疗组左心房内径较对照组明显缩小,治疗组窦性节律维持率亦明显高于对照组(P<0.05);治疗组治疗后18个月,左心房内径较治疗前亦明显缩小(P<0.05).结论 贝那普利联合胺碘酮治疗的确能降低慢-快综合征患者DDD起搏器植入术后阵发性房颤的发生率和复发率,增加窦性节律的维持率,且能抑制左心房进一步扩大.%Objective To investigate the effects of benazepril and amiodarone on paroxysmal atrial fibri llation( AF for short Jin patients with slow-fast syndrome after DDD pacing.Methods 22 cases with slow-fast syndrome after DDD pacing complicated with paroxysmal atrial fibrillation admitted by People's Hospital of Wuhan University from Jan.2007 to Jan.2011 were divided into 2 groups, observation group and control group.Benazepril and amiodarone were administrated to patients in observation group, while amiodarone to patients in control group,the treatment lasted for 18 months in both groups,and then the inner diameter of the left atrium and sinus rhythm maintenance rate of the 2 groups were compared.Results After 9 months, the maintenance rate of sinus rhythm and left atrial diameter between the 2 groups were not statistically significantly different( P > 0.05 ).After 18 months of treatment, the left atrial diameter of the observation group was significantly reduced

  12. 观察β受体阻滞剂联合不同起始剂量胺碘酮治疗急性顽固性室性心动过速的效果及安全性%Efficacy and safety observation of β-receptor blockers in combination with different initial dose of amiodarone in the treatment of acute refractory ventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    董福林

    2015-01-01

    Objective To observe the efficacy and safety of β-receptor blockers in combination with different initial dose amiodarone in the treatment of acute refractory ventricular tachycardia. Methods Eighty cases of acute refractory ven-tricular tachycardia from January 2012 to December 2013 were chose as the research objects,according to admission order were divided into two groups,each group with 40 cases,both were treated with β-receptor blockers + amiodarone,patients in group A were treated with amiodarone starting dose of 3 mg/ kg,patients in group B were treated with amiodarone starting dose of 1. 5 mg/ kg,the clinical curative effect,adverse reaction and the situation of electrocardiogram(ecg)before and after treatment was compared. Results Total effective rate,incidence of adverse reactions of group A was 95% ,10% ,compared with those of group B(90% ,2. 5% ),there was no significant difference(P ﹥ 0. 05). In addition,of the two groups after treatment,the heart rate,the QTc interphase ecg indexes such comparison had no significant difference(P ﹥0. 05). Conclu-sions Compared to 1. 5 mg/ kg amiodarone,3 mg/ kg of amiodarone in treatment of acute refractory ventricular tachycardia has better curative effect,the adverse reaction is relatively more,but there is no significant difference.%目的:观察β受体阻滞剂联合不同起始剂量胺碘酮治疗急性顽固性室性心动过速的效果及安全性。方法选择曲沃县中医医院2012年1月至2013年12月收治的80例急性顽固性室性心动过速患者为研究对象,按照入院先后顺序将其分为两组,每组40例,均行β受体阻滞剂+胺碘酮治疗,A 组胺碘酮起始剂量为3 mg/ kg,B组为1.5 mg/ kg,对两组临床疗效、不良反应、治疗前后心电图情况进行比较。结果 A 组治疗总有效率、不良反应发生率分别为95%、10%,与 B 组比较差异未见统计学意义(P ﹥0.05)。两组治疗后心率、QTc 间期等心电图指标

  13. 胺碘酮治疗重度左侧心力衰竭合并心房颤动患者的临床疗效%Efficacy of Amiodarone in Treatment of severe left heart Failure Complicated with Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    栗明星

    2015-01-01

    目的:探讨胺碘酮治疗重度左侧心力衰竭合并心房颤动患者的临床疗效。方法对2013年1月至2014年12月收治的60例重度左侧心力衰竭合并心房颤动患者采用胺碘酮进行治疗,比较患者治疗前后的各项指标。结果60例患者治疗后,治疗有效率为95.0%,心功能改善率为90.0%,患者治疗后心率及血压指标均得到明显改善,差异有统计学意义(P<0.05)。结论胺碘酮治疗重度左侧心力衰竭合并心房颤动效果明显,安全性高。%Objective To investigate the amiodarone in the treatment of severe left heart failure complicated with atrial fibrilation clinical curative effect.Methods Of the 60 patients with severe left heart failure complicated with atria fibrilation were treated with amiodarone treatment in our hospital from 2013 January to 2014 December were patients, comparison of the indicators before and after the treatment.Results In 60 patients after the treatment,the effective rate of treatment was 95.0%,the heart function improvement rate was 90.0%,after treatment of heart rate and blood pressure index were significantly improved,the difference was statisticaly significant(P<0.05).Conclusion Amioda- rone in the treatment of severe left heart failure complicated with atrial fibrilation has obvious effect,high safety.

  14. 替米沙坦联合胺碘酮治疗慢性心力衰竭合并阵发性房颤的临床观察%Clinical efficacy of telmisartan combined with amiodarone in the treatment of chronic heart failure with paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    李小明; 王霞

    2013-01-01

    Objective:To investigate the effect of telmisartan combined with amiodarone in the treatment of chronic heart failure with paroxysmal atrial fibrillation.Methods:167 patients of chronic heart failure with paroxysmal atrial fibrillation were enrolled in this study,amiodarone was used to maintain sinus rhythm.All of the patients were divided into the treatment group and the control group according to the combined treatment of telmisartan.After one year's treatment,the hospitalization for heart failure rate,left ventricular ejection fraction,left atrial diameter,the rate of sinus rhythm maintenance and the rate of permanence atrial fibrillation were observed and analysed.Results:The rate of recurrence of atrial fibrillation and the incidence of chronic atrial fibrillation in the treatment group was significantly lower than that of the control group; sinus rhythm maintenance rate was significantly higher than that of the control group,left atrial diameter was significantly reduced compared with the control group,the rate of hospitalization for heart failure was significantly lower than that of the control group (P < 0.05).There was no significant difference in adverse reactions between the two groups (thyroid dysfunction,abnormal liver function,pulmonary fibrosis and hypotension,P > 0.05).Conclusion:The treatment of telmisartan combined with amiodarone for chronic heart failure with paroxysmal atrial could maintain sinus rhythm,reduce the rate of hospitalization for heart failure,and has a better effect on myocardial remodeling with good security.%目的:评价替米沙坦联合胺碘酮治疗慢性心力衰竭合并阵发性房颤的临床疗效及安全性.方法:选择我院收治的慢性心衰合并阵发性房颤患者167例,均使用胺碘酮维持窦性心律,根据患者是否加用替米沙坦分为治疗组及对照组.治疗1年后,观察和比较两组的心衰住院率、左室射血分数、左房内径、心功能分级、窦性心律维持率、

  15. Clinical study on the curative effect for ventricular arrhythmias induced by coronary artery disease by the long-term combination of amiodarone and metoprolol and perindopril%培哚普利和美托洛尔长期联合胺碘酮治疗冠心病性室性心律失常疗效的临床研究

    Institute of Scientific and Technical Information of China (English)

    赵阳; 石宗华; 杨蕾

    2009-01-01

    Objective To observe the curative effect and seurity for ventficular arrhythmias induced by coronary artery disease by the combination of amiodarone,metoprolol and perindopril.Methods Sixty-three patients with ventricular arrhythmias induced by coronary artery disease with or not with heart failure were recruited consecutively from March 2003 to May 2007 who accepted treatmentes in our hospital.They were divided randomly into test group(33 cases)and control group(30 cases).On the routine treatment,the test group accepted amiodarone,metoprolol and pefindopril by PO,and the control group only metoprolol and perindopril.Results At the first and second year follow-up,the test group was better than the control group in curing ventricular arrhythmias and improving LVEF(P>0.05),and might also be better in re-hospitalization rate and sudden death.Severe dys-reaction didn't be found in two groups.Conclusions The long-term and small-dosage combination of amiodarone,metoprolol and perindopril to treat ventricular arrhythmias induced by coronary artery disease with or without heart failure not only is better than only metoprolol and perindopril,but also is safe.%目的 观察长期应用小剂量胺碘酮联合美托洛尔和培哚普利防治冠心病性室性心律失常的疗效及安全性.方法 将63例2003年3月至2007年5月入住我院治疗的伴有室性心律失常的冠心病(伴或不伴心功能不全)患者随机分为观察组(33例)和对照组(30例).在常规治疗基础上,观察组给予口服胺碘酮、培哚普利和美托洛尔治疗,对照组单用培哚普利和美托洛尔.结果 在第1、2年随访时,观察组在防治室性心律失常及改善左室射血分数(LVEF)方面均明显好于对照组(P<0.05);观察组的再住院率及猝死方面可能也好于对照组.两组在2年的随访期间均未出现严重的不良反应.结论 长期小剂量胺碘酮联合美托洛尔和培哚普利比单用美托洛尔和培哚普利能更好

  16. 鲜芦荟外敷联合局部封闭治疗胺碘酮致静脉炎的效果观察%The observation of the clinical effect of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone

    Institute of Scientific and Technical Information of China (English)

    龚兰娟; 叶春燕; 周小敏; 罗桂平; 关雪红; 黄丹

    2014-01-01

    Objective:It was to discuss the observation of the clinical effect of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone with lidocaine. Method It happened to peripheral venous injection amiodarone from May 2011 to May 2013 in our hospital, which led to 50 patients had the phlebitis of grade 1 or more. And they were divided into observation and control group, each group had 25 cases. In the observation group, they used the fresh aloe vera which was for external application and someone united local block in the treatment of lidocaine with the phlebitis of grade 3 or more. In the control group, they were used by 50%magnesium sulfate wet. And it was to assess pain and contrast the clinical effect after giving drugs 4 or 8 hours. Result the clinical and analgesic effects of the observation group was better than that of the control group. Conclusion the clinical and analgesic effects of using the fresh aloe vera which was for external application and uniting local block to treat the phlebitis which was by used amiodarone with lidocaine was much better than that of using 50%magnesium sulfate wet.%目的:探讨鲜芦荟外敷联合利多卡因局部封闭治疗胺碘酮致静脉炎的临床疗效。方法:将2011年5月至2013年5月高州市人民医院收治的外周静脉输注胺碘酮致静脉炎Ⅰ级以上患者50例作为研究对象,分为观察组和对照组各25例,观察组给予鲜芦荟外敷,静脉炎Ⅲ级以上联合利多卡因局部封闭治疗,对照组给予50%硫酸镁湿敷,分别于给药后4、8 h 进行疼痛评估和对比临床疗效。结果:治疗4、8 h 后,观察组止痛效果优于对照组(P<0.05),治疗48 h 后,观察组临床疗效均优于对照组(P<0.05)。结论:采用鲜芦荟外敷联合利多卡因局部封闭治疗胺碘酮所致的静脉炎止痛效果及临床疗效明显优于50%硫酸镁湿敷。

  17. Estudo do efeito da amiodarona sobre o peso corpóreo e sobre determinantes morfológicos e citopatológicos do pulmão em ratos machos e fêmeas das linhagens Wistar, Wistar-Kyoto e SHR Study on the effect of amiodarone on the body weight and on lung morphologic and cytopathologic parameters of male and female Wistar, Wistar-Kyoto, and SHR rats

    Directory of Open Access Journals (Sweden)

    THAIS THOMAZ QUELUZ

    2002-11-01

    não desenvolvam pneumonite; 2 a amiodarona tem maior efeito sobre os determinantes morfológicos e citopatológicos do pulmão em animais do sexo masculino.Introduction: Most of the experimental studies on amiodarone-induced pulmonary toxicity have been performed in male Fischer-344 rats. Objective: To investigate the effect of amiodarone on body weight and on lung morphological and cytopathologic parameters in both genders of other rat strains. Methods: Groups of male and female Wistar, Wistar-Kyoto (WKY and spontaneously hypertensive (SHR rats received, 175 mg/kg/day of amiodarone suspended in saline by gavage for four weeks. Controls received saline alone. Body weight gain, total cellularity, and differential of the bronchoalveolar lavage (BAL and lung histopathology were studied. Results: Mortality due to amiodarone was observed in treated WKY rats, mostly in males. Treated male and female SHR animals had less body weight gain among all strains studied. Male Wistar and SHR treated rats presented more body weight gain than females of the respective strains. BAL of treated SHR rats were hemorrhagic. BAL cellularity was higher in treated males (WKY > Wistar > SHR. In WKY males and females, however, the differential count showed a lesser percent of macrophages and higher of neutrophils than in the other strains. BAL macrophages of treated Wistar rats presented phospholipidosis, whereas most macrophages of treated SHR rats were normal. In lung anatomicopathologic examination, no difference was found related to gender and no pneumonitis was observed. In Wistar rats, the examination was characterized by a marked quantity of intra-alveolar "foamy" macrophages, numerous intraparenchymal abscesses were found in WKY rats, and alveolar hemorrhage was present in SHR rats. Conclusions: 1 amiodarone induces more foamy macrophages in Wistar rats than in the WKY and SHR strains, although they do not develop pneumonitis in the model used; 2 amiodarone has greater effect on lung

  18. 步长稳心颗粒联合小剂量胺碘酮治疗阵发性房颤的临床疗效及安全性%Clinical Efficacy and Safety of Paroxysmal Atrial Fibrillation Treating with Buchang Wenxin Grain in ;Combination with Small Dose Amiodarone

    Institute of Scientific and Technical Information of China (English)

    李新玲

    2014-01-01

    目的:探讨步长稳心颗粒联合小剂量胺碘酮治疗阵发性房颤的临床疗效及安全性。方法:选取本院2012年收治的84例阵发性房颤患者作为研究对象,按照随机数字表法将其分为观察组和对照组各42例,观察组给予步长稳心颗粒联合小剂量胺碘酮治疗,对照组常规给予胺碘酮治疗,对两组患者的临床疗效进行评价,同时治疗期间对P波最大时限和P波离散度,以及治疗过程中的不良反应情况进行记录,并进行对比分析。结果:治疗6个月后,两组痊愈率比较差异无统计学意义(P>0.05),但观察组总有效率明显高于对照组,差异均有统计学意义(P0.05),but the total effective rate of the observation group was obviously higher than that of the control group,the difference was statistically significant(P<0.05).The Pmax and Pd of the two groups patients were significantly lower than treatment before,but the Pmax and Pd after treatment of the observation group were significantly better than the control group,the differences were statistically significant(P<0.01).The incidence of adverse reactions of the observation group during treatment was obviously lower than the control group(P<0.05),and the symptoms were mild.Conclusion:The clinical curative effect of paroxysmal atrial fibrillation treating with Buchang Wenxin grain in combination with small dose amiodarone is satisfied,it has few and mild adverse reactions,and has good security,is worthy of clinical popularization and application.

  19. Glycosaminoglycan synthesis in amiodarone-induced pulmonary fibrosis

    International Nuclear Information System (INIS)

    Glycosaminoglycans (GAG) have previously been demonstrated to be synthesized in greater than normal amounts following a single intratracheal insufflation of bleomycin in hamsters. This suggests that GAG may play a role in the propagation of pulmonary fibrotic reactions. To further test this hypothesis, GAG synthesis was studied in a new hamster model of interstitial lung injury, induced by the cardiac drug, aminodarone. Animals received a single intratracheal instillation of 1.25 mg aminodarone. At 4, 9, and 21 days post-insufflation, the animals were sacrificed, their lungs removed, and 1 mm fragments placed in explant culture for 6 hours at 370C in the presence of 35S-sulfate. The labeled GAG were isolated and measured for 35S incorporation. The author then isolated the hexosamine portions of the respective GAGs, Heparan Sulfate (HEP S), Chondroitin-6-Sulfate (Ch-6-S) and Chondroitin-4-Sulfate and Dermatan Sulfate (CH-4-S and DS) using the enzyme ABC and paper chromatography. They also studied the GAG content and distribution in hamster lung fibroblasts incorporated with 35S for 48 hours and subjected to either 0, 0.01 mg, 0.1 mg, or 1 mg of aminodarone. GAG synthesis is increased at an early stage following the induction of lung injury by aminodarone and remains elevated for a 3 week period. The change in GAG distribution boards elevated CH-4-S and DS may be characteristic of interstitial diseases in general. The GAGs that are synthesized by fibroblasts may be responsible for the increased CH-4-S and DS synthesis

  20. Glycosaminoglycan synthesis in amiodarone-induced pulmonary fibrosis

    Energy Technology Data Exchange (ETDEWEB)

    Farinas, E.M.

    1986-01-01

    Glycosaminoglycans (GAG) have previously been demonstrated to be synthesized in greater than normal amounts following a single intratracheal insufflation of bleomycin in hamsters. This suggests that GAG may play a role in the propagation of pulmonary fibrotic reactions. To further test this hypothesis, GAG synthesis was studied in a new hamster model of interstitial lung injury, induced by the cardiac drug, aminodarone. Animals received a single intratracheal instillation of 1.25 mg aminodarone. At 4, 9, and 21 days post-insufflation, the animals were sacrificed, their lungs removed, and 1 mm fragments placed in explant culture for 6 hours at 37/sup 0/C in the presence of /sup 35/S-sulfate. The labeled GAG were isolated and measured for /sup 35/S incorporation. The author then isolated the hexosamine portions of the respective GAGs, Heparan Sulfate (HEP S), Chondroitin-6-Sulfate (Ch-6-S) and Chondroitin-4-Sulfate and Dermatan Sulfate (CH-4-S and DS) using the enzyme ABC and paper chromatography. They also studied the GAG content and distribution in hamster lung fibroblasts incorporated with /sup 35/S for 48 hours and subjected to either 0, 0.01 mg, 0.1 mg, or 1 mg of aminodarone. GAG synthesis is increased at an early stage following the induction of lung injury by aminodarone and remains elevated for a 3 week period. The change in GAG distribution boards elevated CH-4-S and DS may be characteristic of interstitial diseases in general. The GAGs that are synthesized by fibroblasts may be responsible for the increased CH-4-S and DS synthesis.

  1. Amiodarone induced RVOT VT converting to Scar VT

    Directory of Open Access Journals (Sweden)

    Jayasree Pillarisetti MD;

    2013-02-01

    Full Text Available A 61-year-old African- American male with non-ischemic cardiomyopathy and ejection fraction ( EF of 30%, hypertension, and chronic renal insufficiency status post ICD placement in 2002 was transferred to our academic center for multiple shocks that he had been receiving from his ICD. The patient originally presented at a VA hospital in his town for multiple shocks that he had been receiving since the previous night. The patient’s past medical history included hypertension, hyperlipidemia, chronic renal insufficiency, obstructive sleep apnea on CPAP, mild pulmonary hypertension, chronic obstructive pulmonary disease (COPD and gout. The patient had an ICD placed 6 years ago in 2002 for systolic dysfunction associated with NICM.

  2. Terapia de resgate com amiodarona em crianças com grave disfunção ventricular esquerda causada por veneno de escorpião Terapia de rescate con amiodarona en niños con severa disfunción ventricular izquierda ocasionada por veneno de escorpión Antiadrenergic rescue therapy with amiodarone in children with severe left ventricular dysfunction secondary to scorpion envenomation

    Directory of Open Access Journals (Sweden)

    Justo J. Santiago

    2010-01-01

    ón endotraqueal y soporte respiratorio, electrocardiograma, radiografía de tórax, ecocardiograma y determinación sérica de la norepinefrina y troponina I. Los análisis se repitieron tras 12, 24 y 48 horas. Las siguientes medicaciones intravenosas se administraron: dobutamina 4-6 mcg/kg/min; amiodarona 3 mg/kg durante dos horas, con dosis de mantenimiento de 5 mg/kg/día; y furosemida 0.5 mg/kg. Amiodarona, dobutamina y furosemida se administraron durante las primeras 48 horas. Bloqueante betaadrenergicos e inhibidores de la enzima convertidora de la angiotensina se administraron hasta 48 tras la internación, una vez que el estado clínico había mejorado y la fracción de eyección ventricular izquierda se hallaba superior a un 0,35%. RESULTADOS: Al ingreso, la dosificación de la norepinefrina fue 1727,50± 794,96 pg/ml, la de troponina I 24,53 ± 14,09 ng/ml y la fracción de eyección del ventrículo izquierdo fue 0,20 ± 0,056. Tras 12 horas, los niveles séricos de norepinefrina y de troponina I disminuyeron para la mitad de los valores iniciales y la fracción de eyección aumentó para 0,32 ± 0,059. Durante las 24 y 48 horas subsiguientes, la fracción de eyección se elevó para 0,46 ± 0,045 (pBACKGROUND: Children with scorpion envenomation have massive sympathetic activation and variable degrees of left ventricular systolic dysfunction. OBJECTIVE: To evaluate a rescue protocol for children with severe left ventricular dysfunction secondary to scorpion envenomation. METHODS: Four children, after scorpion envenomation, were subjected to a rescue protocol for acute left ventricular dysfunction: Endotracheal intubation and respiratory assistance, electrocardiograms, chest x-Ray, echocardiograms and blood samples for norepinephrine and troponin I serum levels. Samples and echocardiograms were repeated at 12, 24 and 48 hours. Intravenous medications: Dobutamine: 4-6 μg/kg/min. Amiodarone: 3 mg/kg during a 2 hour period. Maintenance: 5 mg/kg/day. Furosemide: 0.5 mg

  3. Atrial fibrillation and rheumatic valvular heart disease: usefulness of very-low-dose amiodarone

    Institute of Scientific and Technical Information of China (English)

    Tsuyoshi Shiga

    2006-01-01

    @@ Atrial fibrillation (AF) is frequently associated with rheumatic valvular heart disease (RVHD). AF leads to systemic thromboembolic complications,reduced quality of life (QOL), impaired ventricular function and also increased mortality. Multivariate analysis of results from a population-based study has shown that valvular heart disease is one of risk factors for development of AF.1 The frequency of RVHD has decreased in developed countries in recent years, but RVHD now constitutes a significant population for the cardiology services in developing countries.2

  4. Recombinant TSH and Lithium Overcomes Amiodarone-Induced Low Radioiodine Uptake in a Thyrotoxic Female

    OpenAIRE

    Laplano, Nestor Eric R.; Mercado-Asis, Leilani B.

    2012-01-01

    Introduction: Recombinant human thyroid-stimulating hormone(rhTSH) increases radioactive iodine uptake(RAIU) in selected populations, while lithium is used as an adjunct to radioactive iodine (RAI) therapy in Graves’ disease with low RAIU. In this report, both drugs used in combination, overcame low iodine-131 uptake in a Graves’ patient. Clinical Case: A 39-year old female with Graves’ disease, acquired thionamide-induced agranulocytosis, and severe hypokalemia, subsequently went into cardio...

  5. Inhibitory effects of amiodarone on simvastatin metabolism in human liver microsomes

    Institute of Scientific and Technical Information of China (English)

    Chao Wan; Jiang wei Zhang; Ning Zhu; Ling Yang

    2009-01-01

    Objective To investigate the effects ofamiodarone (AMD) on simvastatin (SV) in human liver microsomes and the possible underlying mechanisms. Methods Time-, NADPH- and concentration-dependent inhibitions were tested in HLM. The logarithm of relative inhibition values was plotted versus preincubation time (0, 5, 10, 15, 20min) for a series concentration of AMD used (0, 2, 5,25, 50 μ mol/L), and the slopes determined by linear regression. These slope values represente the observed inactivation rate constants (kobs). A double-reciprocal plot was then constructed using the reciprocal of the ko~ (y-axis) and the reciprocal of the associated inhibitor concentration (x-axis) to estimate the values ofkinact and K, which were two principal kinetic constants that were specific for mechanism-based inhibition (MBI).drug-drug interactions (DDI) potential was predicted based on in vitro data and by using the in vitro-in vivo extrapolation. Results The time-, concentration- and NADPH-dependent charactga'istics confirmed that when SV was the substrate of CYP3A4, the inhibition of AMD to CYP3A4 is MBI. Kj and kinact value were calculated to be 5.1 μ mol/L and 0.018min-1 The Clint of SV was reduced 2.96-5.63 fold when it was administrated with AMD. Conclusion Based on the results, AMD would inhibit SV metabolism via the mechanism-based manner, which would lead to DDI when they are taken together. Careful clinical observation is recommended when AMD and SV have to be simultaneously prescribed.

  6. Pitfalls of testing and summary of guidance on safety monitoring with amiodarone and digoxin

    OpenAIRE

    Smellie, W Stuart A; Coleman, Jamie J

    2007-01-01

    Patients on a range of drug therapies are often not monitored appropriately, even though this can improve patient safety. Knowledge of the effects of drugs on non-target body systems is essential to guide monitoring and interpretation of monitoring tests

  7. Impact of dronedarone in atrial fibrillation and flutter on stroke reduction

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.......Dronedarone has been developed for treatment of atrial fibrillation (AF) or atrial flutter (AFL). It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone....

  8. Model Steatogenic Compounds (Amiodarone, Valproic Acid, and Tetracycline) Alter Lipid Metabolism by Different Mechanisms in Mouse Liver Slices

    NARCIS (Netherlands)

    Szalowska, E.; Burg, van der B.; Man, H.Y.; Hendriksen, P.J.M.; Peijnenburg, A.A.C.M.

    2014-01-01

    Although drug induced steatosis represents a mild type of hepatotoxicity it can progress into more severe non-alcoholic steatohepatitis. Current models used for safety assessment in drug development and chemical risk assessment do not accurately predict steatosis in humans. Therefore, new models nee

  9. Hver sjette patient i amiodaronbehandling udvikler tyrotoksikose eller hypotyreose

    DEFF Research Database (Denmark)

    Olsen, Jimmi Sloth; Carle, Allan Sørensen; Thomsen, Henrik Holm

    2014-01-01

    Amiodarone is associated with multiple side effects among which a substantial number of patients are suffering from amiodarone-induced thyroid disease. In this review we present difficulties in diagnosing, sub typing and treating amiodarone-induced thyroid disease and give views on the future of...... this drug and one of the alternatives, dronedarone. Amiodarone holds a place in modern medicine due to its unique antiarrhythmic effects and associated thyroid diseases requires collaboration between cardiologists and endocrinologists due to the complexity hereof....

  10. About PF

    Science.gov (United States)

    ... nitrofurantoin, sulfasalazine) Heart disease (amiodarone, propranolol) Seizures (phenytoin) Cancer (methotrexate, bleomycin, oxaliplatin, radiation therapy) Genetic/Inherited diseases Approximately ...

  11. A tomografia computadorizada de alta resolução na avaliação da toxicidade pulmonar por amiodarona High-resolution computed tomography of amiodarone pulmonary toxicity

    OpenAIRE

    Daniela Peixoto Consídera; Edson Marchiori; Arthur Soares Souza Jr.; Gláucia Zanetti; Dante L. Escuissato; Emerson L. Gasparetto; César de Araújo Neto; Ronaldo de Souza Leão Lima; Sérgio Salles Xavier; Roberto Coury Pedrosa

    2006-01-01

    OBJETIVO: Avaliar as principais alterações identificadas na tomografia computadorizada de alta resolução do tórax em pacientes com toxicidade pulmonar pela amiodarona. MATERIAIS E MÉTODOS: Foram avaliadas dez tomografias computadorizadas de alta resolução de tórax de pacientes com pneumonite pela amiodarona, seis desses pacientes do sexo masculino e quatro do sexo feminino, com idade média de 73,5 anos. RESULTADOS: Os achados tomográficos mais relevantes foram opacidades lineares ou reticular...

  12. 阿魏酸钠与胺碘酮对家兔心室肌电生理作用的对比研究%Comparison of the cardiac electrophysiological effects of sodium ferulateto amiodarone on rabbit right ventricular myocardium

    Institute of Scientific and Technical Information of China (English)

    周彤; 曾秋棠; 张桂清; 刘锦华; 李屏; 毛奕

    2002-01-01

    目的:研究阿魏酸钠对家兔心室肌复极及有效不应期(ERP) 的影响,探讨其抗心律失常的可能机制.方法:16只家兔随机分为阿魏酸钠组与胺碘酮组,各组同步记录体表心电图(ECG)及右室心内膜单相动作电位(MAP),比较在窦性心律下,用药前及用药后窦性心动周长(SCL)、QRS时限(QRSD)、MAP振幅(MAPA)、ERP及复极90%时程(MAPD90)的变化.结果:阿魏酸钠发挥与胺碘酮一致的时间依赖性延长MAPD90与ERP作用,但不改变ERP/MAPD90比值, 胺碘酮用药15 min,ERP及MAPD90分别由用药前的( 125.00± 16.26)ms、( 143.12± 15.80)ms延长为( 199.00± 21.62)ms、( 216.88± 23.14)ms(P< 0.01);阿魏酸钠用药25 min,ERP及MAPD90分别由用药前的( 122.50± 8.13)ms、( 140.00± 6.25)ms延长为( 143.75± 6.87)ms、( 164.38± 7.19)ms(P< 0.01).结论:经与胺碘酮比较,推测阿魏酸钠具有Ⅲ类抗心律失常药物的抗心律失常特性.

  13. The role of thyroid hormone nuclear receptors in the heart: evidence from pharmacological approaches

    NARCIS (Netherlands)

    W.M. Wiersinga

    2010-01-01

    This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained-at least partly-by the induction of a local 'hypothyroid-like condition' in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding

  14. Efficacy and safety of dronedarone: a review of randomized trials

    DEFF Research Database (Denmark)

    Christiansen, Christine Benn; Torp-Pedersen, Christian; Køber, Lars

    2010-01-01

    IMPORTANCE OF THE FIELD: Dronedarone is developed for treatment of atrial fibrillation (AF) or flutter (AFL). It is a noniodinized amiodarone analogue and believed to be without the adverse effects of amiodarone. However, long-term adverse effects are not yet well investigated. AREAS COVERED IN T...

  15. Dronedarone for atrial fibrillation: a new therapeutic agent

    Directory of Open Access Journals (Sweden)

    Pawan D Patel

    2009-08-01

    Full Text Available Pawan D Patel, Rohit Bhuriya, Dipal D Patel, Bhaskar L Arora, Param P Singh, Rohit R AroraDepartment of Cardiology, Chicago Medical School, Chicago, IL, USAAbstract: Atrial fibrillation is the most common of the serious cardiac rhythm disturbances and is responsible for substantial morbidity and mortality. Amiodarone is currently one of the most widely used and most effective antiarrhythmic agents for atrial fibrillation. But during chronic usage amiodarone can cause some serious extra cardiac adverse effects, including effects on the thyroid. Dronedarone is a newer therapeutic agent with a structural resemblance to amiodarone, with two molecular changes, and with a better side effect profile. Dronedarone is a multichannel blocker and, like amiodarone, possesses both a rhythm and a rate control property in atrial fibrillation. The US Food and Drug Administration approved dronedarone for atrial fibrillation on July 2, 2009. In this review, we discuss the role of dronedarone in atrial fibrillation.Keywords: dronedarone, amiodarone, atrial fibrillation

  16. The role of thyroid hormone nuclear receptors in the heart: evidence from pharmacological approaches

    OpenAIRE

    Wiersinga, W.M.

    2010-01-01

    This review evaluates the hypothesis that the cardiac effects of amiodarone can be explained—at least partly—by the induction of a local ‘hypothyroid-like condition’ in the heart. Evidence supporting the hypothesis comprises the observation that amiodarone exerts an inhibitory effect on the binding of T3 to thyroid hormone receptors (TR) alpha-1 and beta-1 in vitro, and on the expression of particular T3-dependent genes in vivo. In the heart, amiodarone decreases heart rate and alpha myosin h...

  17. Nebivolol

    Science.gov (United States)

    ... Nebivolol is in a class of medications called beta blockers. It works by relaxing blood vessels and slowing ... mention any of the following: amiodarone (Cordarone, Pacerone); beta blockers such as acebutolol (Sectral), atenolol (Tenormin, in Tenoretic), ...

  18. Potent synergistic in vitro interaction between nonantimicrobial membrane-active compounds and itraconazole against clinical isolates of Aspergillus fumigatus resistant to itraconazole.

    NARCIS (Netherlands)

    Afeltra, J.; Vitale, R.G.; Mouton, J.W.; Verweij, P.E.

    2004-01-01

    To develop new approaches for the treatment of invasive infections caused by Aspergillus fumigatus, the in vitro interactions between itraconazole (ITZ) and seven different nonantimicrobial membrane-active compounds--amiodarone (AMD), amiloride, lidocaine, lansoprazole (LAN), nifedipine (NIF), verap

  19. Clinical studies on thyroid diseases

    OpenAIRE

    Fliers, E.; Wiersinga, W.M.; Eskes, S.A.

    2014-01-01

    This thesis focuses on some aspects of thyroid disease: prevention of autoimmune thyroid disease (AITD), diagnosis of related conditions as autoimmune hypophysitis in autoimmune hypothyroidism (Hashimoto’s disease), and treatment of amiodarone-induced thyrotoxicosis (AIT).

  20. CARDIOVASCULAR SYSTEM

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    6.1 Cardiac Arrhythmias2007037 Angiotensin converting enzyme inhibitor improves the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation. JIA Xinwei(贾新未), et al. Dept Cardiol, Affili Hosp, Hebei Univ Baoding 071000. Chin Cir J 2006; 21(57):379-381. Objective To investigate whether angiotensin converting enzyme inhibitor (ACEI) can improve the effect of amiodarone on maintaining sinus rhythm of patients with persistent atrial fibrillation and to elucidate its mechanism.

  1. The effect of drug combination on patients with paroxysmal atrial fibrillation%联合用药对阵发性心房颤动患者疗效观察

    Institute of Scientific and Technical Information of China (English)

    程晓静; 付蓉; 郭丽丽; 潘华; 高悦顺

    2011-01-01

    Objective To observe the effect and safety of amiodarone, spironolactone and irbesartan on sinus rhythm, left atrial internal diameter and brain natruretic peptide(BNP) for patients with nonvalvular paroxysmal atrial fibrillation(AF). Methods One hundred and forty-two patients with nonvalvular paroxysmal atrial fibrillation were divided into amiodarone group(n=47), amiodarone plus spironolactone group (n = 47 ) and amiodarone spironolactone plus irbesartan group ( Combined treatment group, n = 48 ). Three groups were treated with amiodarone.Amiodarone plus spironolactone group was treated with spironolactone in addition. Combined treatment group was treated with irbesartan based on amiodarone and spironolactone. Left atrial internal diameter and BNP were observed after 6 months, 12 months, 18 months respectively and the rate of maintenance of sinus rhythm was observed after 3months, 6 months, 12 months, 18 months, 24 months respectively. The safety of drugs was observed during this study. Results After 6 months treatments, left atrial internal diameter and BNP of three groups was no difference but left atrial internal diameter and BNP of amiodarone plus spironolactone group and Combined treatment group was less than that of amiodarone group after 12 months ( P < 0.05 ). left atrial internal diameter and BNP of combined treatment group was less than those of amiodarone plus spironolactone group after 12 months ( P < 0.05 ). After 3and 6 months treatments, the rate of maintenance of sinus rhythm of amiodarone group was lower than that in amiodarone plus spironolactone group and combined treatment group, but there was no statistically significance difference between amiodarone group and amiodarone plus spironolactone group, amiodarone plus spironolactone group andCombined treatment group. The rate of maintenance of sinus rhythmia of amiodarone group was statistically lower than that in combined treatment group (P<0.05). After 12 months, The rate of mainterance

  2. Estudo prospectivo dos efeitos da amiodarona na função tiroidiana de pacientes chagásicos em área de deficiência de iodo Prospective study of amiodarone effects on thyroid function of chagasic patients in an iodine deficient area

    OpenAIRE

    Maria Aparecida Enes de Barros; Rui Monteiro de Barros Maciel

    1994-01-01

    Com o objetivo de avaliar a junção tiroidiana após uso crônico da amiodarona, em área de deficiência de iodo e endemia chagásica, 24 pacientes foram analisados antes e após três e nove meses de uso da droga. A avaliação constou de exame clínico, dosagem sérica de T4, T3, rT3, TSH, anticorpo antitiroglobulina e TSH 30 minutos após infusão venosa de uma ampola de 200µg de TRH. A captação do iodo radioativo 131 e a cintilografia datiróide foram realizadas antes e aos 9 meses após tratamento. Dis...

  3. 胺碘酮、心律平对犬缺血M细胞电生理的影响%The Cellular Electrophysiologic Effects of Amiodarone on Simulated Ischemic Canine Ventricular Midmyocardial Myocytes (M cells):A Comparative Study with Propafenone

    Institute of Scientific and Technical Information of China (English)

    丁春华; 姜建; 黄德嘉

    2004-01-01

    目的:临床试验表明,Ⅰ类抗心律失常药物虽能抑制心肌梗塞病人的室性心律失常,但增加死亡率,而胺碘酮(Ⅲ类药物)可提高心肌缺血患者的生存率.心室中层肌细胞(M细胞)有其独特的电生理特性并在心律失常发生中起重要作用.方法:采用细胞内玻璃微电极技术,用含胺碘硐或心律平的模拟缺血液灌流M细胞,了解在缺血情况下,两种药物分别对M细胞电生理有何影响.结果:(1)犬左心室M细胞的动作电位呈现出与心外膜层肌细胞相似的峰-谷-穹窿(spike and dome)形态;动作电位时程(APD)随基础起搏周长(BCL)延长而明显延长,即频率依赖性.(2)模拟缺血使M细胞的静息电位(RP)除极、动作电位幅值(APA)和Vmax减小、APD缩短,其APD的频率依赖性减弱或消失.(3)胺碘硐可延缓或减轻缺血引起的电生理变化.(4)心律平明显抑制M细胞的Vmax、APA,并随频率加快而作用增强.进一步加重了缺血引起的动作电位参数的改变,并可造成传导延缓或阻滞.结论:胺碘酮可减轻而心律平则加重缺血引起的M细胞的电生理改变.部分地解释了上述临床试验的结果.

  4. Electrophysiological effects of amiodarone on pacemaker cells in guinea-pig left ventricular outflow tract under conditions of hypoxia, acidosis and treatment with epinephrine%胺碘酮对低O2、酸中毒及肾上腺素条件下豚鼠左心室流出道自律细胞电活动的影响

    Institute of Scientific and Technical Information of China (English)

    赵兰平; 王雪芳; 陈彦静; 杜会博; 胡兴光; 季振慧

    2010-01-01

    目的:研究胺碘酮对豚鼠左心室流出道自律细胞电活动的影响以及胺碘酮对低O2、酸中毒和肾上腺素(EPI)所致该部位自律性改变的影响.方法:采用标准玻璃微电极细胞内电位记录技术,分别观测胺碘酮对豚鼠左心室流出道自发慢反应电位的影响,以及胺碘酮对无糖低氧、pH6.8和EPI导致的该电位改变的影响.结果:(1)0.1 μmol/L胺碘酮可使左心室流出道自发慢反应电位自发放电频率(RPF)减慢,最大舒张电位(MDP)绝对值减小,复极80%时间(APD80)延长(P<0.05);1 μmol/L胺碘酮可引起4相自动除极速度(VDD)和0相最大除极速度(Vmax)减慢,动作电位幅度(APA)减小,复极50%时间(APD50)延长(P<0.05),RPF减慢,MDP减小和APD80延长(P<0.01);10μmol/L胺碘酮可使VDD进一步减慢,APA进一步减小(P<0.01),其它指标的改变维持1 μmol/L胺碘酮灌流时的水平.(2)低O2可使VDD、RPF和Vmax减慢,MDP和APA减小,APD50缩短(P<0.05);和低O2组相比,1 μmol/L胺碘酮+低O2可使RPF和Vmax进一步减慢,MDP增大,APD80延长(P<0.05),VDD进一步减慢,APD50延长(P<0.01).(3)pH6.8的灌流液可使VDD和RPF减慢,APD80缩短(P<0.05),Vmax减慢,APA减小(P<0.01);与pH6.8组相比,pH6.8的1 μmol/L胺碘酮可使RPF进一步减慢,MDP和APA进一步减小,APD80延长(P<0.05),VDD进一步减慢,APD50延长(P<0.01).(4)10 μmol/L EPI可使VDD、RPF和Vmax加快,MDP增大,APD50和APD80缩短(P<0.05),APA增大(P<0.01);μmol/L胺碘酮+10 μmol/L EPI可使VDD和RPF减慢,MDP和APA减小,Vmax减慢,APD50和APD80延长(P<0.05,P<0.01).结论:胺碘酮可降低豚鼠左心室流出道的自律性,同时对低O2、酸中毒和EPI所致的该部位自律性改变有一定的影响.

  5. 胺碘酮在治疗室性心动过速疗效分析

    Institute of Scientific and Technical Information of China (English)

    杨生明; 唐嵩; 高群昭

    2014-01-01

    Objective To investigate the amiodarone in the treatment of patients with ventricular tachycardia efficacy.Methods 56 cases of ventricular tachycardia were randomly divided into two groups, respectively,with lidocaine 26 cases,30 cases of amiodarone treatment, comparing its efficacy.Results The total effective lidocaine group 57.69%,amiodarone group was 80.00%,amiodarone group and lidocaine group, the difference was statistically significant.Conclusion Amiodarone on ventricular tachycardia in patients with relatively good results.%目的:探讨胺碘酮在治疗室性心动过速患者中的疗效。方法将56例室性心动过速患者随机分成两组,分别用利多卡因26例,胺碘酮30例治疗,比较其疗效。结果利多卡因组总有效率57.69%,胺碘酮组总有效率80.00%,胺碘酮组与利多卡因组比较,差异有统计学意义(P<0.05)。结论胺碘酮对室性心动过速患者有比较好的疗效。

  6. Clinical Effect Observation on Propafenone Treatment of Preexcitation Syndrome Complicated with Supraventricular Tachycardia Beckoning%普罗帕酮治疗预激综合征合并室上性心动过速的临床效果观察

    Institute of Scientific and Technical Information of China (English)

    刘瑞浩

    2015-01-01

    Objective To explore the Clinical effect comparison of Propafenone and amiodarone in the treatment of preexcitation syndrome complicated with supraventricular tachycardia beckoning.Methods 58 cases of Preexcitation syndrome complicated with supraventricular tachycardia in patients with beckoning in our hospital from October 2010 to May 2013 were selected ,and were divided into propafenone group and amiodarone group (n=29).Propafenone group were given propafenone intravenous infusion of 70mg treatment,amiodarone group were given amiodarone intravenous infusion of 150mg. Effect of compound rate, average time and the occurrence of adverse reactions were observed.Results There was no significant difference between the treatment efficiency of propafenone group (100%) and amiodarone group (P>0.05); propafenone group complex rate mean time was (27.13 ± 6.98) min and was significantly lower than that of amiodarone group,P0.05);普罗帕酮组复率平均时间(27.13±6.98)min明显低于胺碘酮组,P<0.05,差异具有统计学意义;胺碘酮组不良反应发生率(6.89%)明显低于普罗帕酮组,P<0.05,差异具有统计学意义。结论普罗帕酮及胺碘酮对预激综合征合并室上性心动过速的治疗有着良好的疗效,普罗帕酮可以更加快速的使患者的心率恢复正常,胺碘酮则降低使用药物复率产生的不良反应。

  7. Torsade de pointes tachycardia in a patient on dronedarone therapy.

    Science.gov (United States)

    Huemer, Martin; Sarganas, Giselle; Bronder, Elisabeth; Klimpel, Andreas; Garbe, Edeltraut; Haverkamp, Wilhelm

    2015-05-01

    Dronedarone is a promising, relatively new antiarrhythmic agent characterized by structural similarities to amiodarone but without amiodarone's severe organ toxicity. The proarrhythmic potential of dronedarone, however, is of increasing concern. We describe a 76-year-old woman who had been receiving dronedarone 400 mg twice/day to prevent recurrent atrial tachycardia with rapid ventricular response. Several months later, she came to the emergency department with decompensated congestive heart failure and episodes of atrial tachycardia; digoxin 0.5 mg and furosemide 40 mg were administered intravenously. Thereafter nonsustained torsade de pointes (TdP) tachycardia occurred. She was transferred to the intensive care unit where a dose of amiodarone 150 mg was administered intravenously by mistake. Thereafter, the patient showed sustained TdP necessitating cardiac resuscitation. Dronedarone was discontinued, and digoxin and amiodarone were not administered again. Under dronedarone a relevant QT prolongation was documented that was additionally augmented after concomitant treatment with digoxin and amiodarone. Use of the Naranjo adverse drug reaction probability scale indicated a probable adverse drug reaction to dronedarone (score of 7). To our knowledge, this is the first case report of a patient who experienced TdP tachycardias while receiving dronedarone therapy in connection with a worsening of heart failure and possible drug interactions with digoxin and amiodarone. Clinicians should be aware of this potential adverse drug reaction and perform repeated heart rate-corrected QT (QTc) interval measurements as well as screening for congestive heart failure in patients receiving dronedarone therapy. PMID:25823967

  8. Data on cell viability of human lung fibroblasts treated with polyphenols-rich extract from Plinia trunciflora (O. Berg Kausel

    Directory of Open Access Journals (Sweden)

    Caroline Calloni

    2016-03-01

    Full Text Available Jaboticaba (Plinia trunciflora (O. Berg Kausel is a Brazilian native berry, which presents high levels of polyphenols. Here we provide data related to the effects of the polyphenols-rich extract from jaboticaba on the cell viability, mitochondrial complex I (nicotinamide adenine dinucleotide/CoQ oxidoreductase activity and ATP biosynthesis of human lung fibroblast cells (MRC-5 treated with amiodarone. The data presented in this article demonstrate that the polyphenols-rich extract from jaboticaba was able to reduce cell death as well as the decrease in complex I activity and ATP biosynthesis caused by amiodarone in MRC-5 cells.

  9. A review on dronedarone:Pharmacological, pharmacodynamic and pharmacokinetic profile

    Institute of Scientific and Technical Information of China (English)

    Farah Iram; Sadaf Ali; Aftab Ahmad; Shah Alam Khan; Asif Husain

    2016-01-01

    Dronedarone, a benzofuran containing chemical compound, is a derivative of amiodarone which is classified as a Class III antiarrhythmic agent. It is prescribed to the cardiovas-cular patients who have paroxysmal or persistent atrial fibrillation to lower the chances of hospitalization. Amiodarone, sotalol, procainamide dofetilide, quinidine, ibutilide, fle-cainide, and propafenone are the other useful medicinal products used to treat atrial fibrillation or cardiac arrhythmia. Dronedarone was approved for clinical use in atrial fibrillation by the Food and Drug Administration in 2009. The generic name for drone-darone is Multaq (Sanofi Aventis). This article briefly highlights the important pharma-cological, pharmacodynamic and pharmacokinetic properties of dronedarone.

  10. TREATMENT AND PREVENTION OF ATRIAL TACHYARRHYTHMIAS IN CRITICALLY ILL PATIENT: THE ROLEOF MAGNESIUM SULFATE

    Directory of Open Access Journals (Sweden)

    M. MOJTAHEDZADEH

    1999-09-01

    Full Text Available In this prospective, randomized study, in the general intensive care unit at Shanatee teaching hospital, we evaluated twenty patients, mean age 52+18 years and mean acute physiology and chronic health evaluation II score of 20±8, who were experiencing atrial tachyarrhythmias for more than 1 hour. After correction of their plasma potassium concentration to more than 4.0 mmof/1, patients were randomized to receive either 40 mg/kg magnesium sulfate bolus followed by 30 mg/kg/hr or 5mg/kg amiodarone bolus and 10 mg/kg/24hr infusion. Therapeutic end point was conversion to sinus rhythm over 24 hours. By logistic regression, the probability of conversion to sinus rhythm was significantly better for magnesium than for amiodarone at time 0-4 (0.6 vs.0.4, 12 (0.72 vs 0.45, and 24 (0.72vs.0.45 hours. In patients not converting to sinus rhythm, a significant decrease in ventricular response rate occurred at time zero to 0.5 hour (mean decrease 22 beats/min, P=0.0001, but there was no specific treatment effect between the magnesium and the amiodarone groups. Magnesium sulfate is superior to amiodarone in the conversion of acute atrial tachyarrhythmias, while initial slowing of ventricular response rate in non-converters appears equally efficacious with both agents.

  11. Dofetilide: a new drug to control cardiac arrhythmia

    DEFF Research Database (Denmark)

    Elming, Hanne; Brendorp, Bente; Pedersen, Ole Dyg;

    2003-01-01

    , has been developed and approved for the treatment of AF. In contrast to most antiarrhythmic agents, the development programme included two safety studies in high-risk patients. Dofetilide is effective and safe when an elaborate procedure for dosing is implemented. Along with amiodarone and...

  12. Administration of a Probiotic Can Change Drug Pharmacokinetics: Effect of E. coli Nissle 1917 on Amidarone Absorption in Rats

    Czech Academy of Sciences Publication Activity Database

    Matusková, Z.; Anzenbacherová, E.; Večeřa, R.; Tlaskalová-Hogenová, Helena; Kolář, M.; Anzenbacher, P.

    2014-01-01

    Roč. 9, č. 2 (2014). E-ISSN 1932-6203 R&D Projects: GA ČR GAP303/12/0535; GA ČR(CZ) GAP304/11/1252; GA MZd(CZ) NT13483 Institutional support: RVO:61388971 Keywords : STRAIN NISSLE-1917 * GUT MICROBIOTA * AMIODARONE Subject RIV: EC - Immunology Impact factor: 3.234, year: 2014

  13. Which drugs are contraindicated during breastfeeding? Practice guidelines.

    OpenAIRE

    Moretti, M. E.; Lee, A.; Ito, S.

    2000-01-01

    QUESTION: Many breastfeeding mothers are concerned about taking medications that might affect their babies. Are there any guidelines on which drugs are safe? ANSWER: Only a few drugs pose a clinically significant risk to breastfed babies. In general, antineoplastics, drugs of abuse, some anticonvulsants, ergot alkaloids, and radiopharmaceuticals should not be taken, and levels of amiodarone, cyclosporine, and lithium should be monitored.

  14. Dronedarone in patients with atrial fibrillation

    NARCIS (Netherlands)

    N.M.S. de Groot; C.J. Kirchhof; I.C. van Gelder; J.G. Meeder; A.H.M.M. Balk; A.A. Wilde; M.L. Simoons

    2010-01-01

    Dronedarone is a recently developed new class III antiarrhythmic drug which possesses electrophysiological properties of all four Vaughan-Williams classes. An important difference with amiodarone is that it does not contain an iodine component and therefore lacks the iodine-related adverse effects.

  15. Refractory atrial fibrillation effectively treated with ranolazine

    OpenAIRE

    Vaishnav, Aditi; Vaishnav, Avani; Lokhandwala, Yash

    2014-01-01

    Atrial fibrillation is the most common sustained cardiac arrhythmia which is often troublesome to manage. Currently, rhythm and rate control medications are the mainstays of therapy. In 2 amiodarone-refractory highly symptomatic patients, an innovative approach using ranolazine, which selectively acts on Na+ channels and delays atrial depolarization, was tried successfully.

  16. Miodarone vs Sotalol of Efficacy and Safety in Treating Tachyarrhythmia%胺碘酮和索他洛尔在快速心律失常治疗中的疗效及安全性比较

    Institute of Scientific and Technical Information of China (English)

    张晓丽

    2015-01-01

    Objective To investigate the efficacy and safety amiodarone and sotalol in treating tachyarrhythmia.Methods One hundred and twenty cases of tachyarrhythmia were randomly and respectively assigned into 2 groups. patients in amiodarone group were treated with amiodarone 0.2g tid for 7 d , followed by 0.2g qd for 4 wk .Patients in sotalol group were given 40mg q12h,slowly increase to 120-160mg q12h for maintaining efifcacy,then followed up 1m.ResultsValidity of tredating tachyarrhythmia in amiodarone group signiifcantly preceded than that of sotalol (P <0 .05). Conclusion Amiodarone is effective in treating tachyarrhythmia.%目的:观察胺碘酮与索他洛尔在心律失常治疗中的疗效及安全性。方法选取我院收入的120例快速心律失常的患者随机分为2组,胺碘酮组(n=60):0.2 tid×7天,0.2 bid ×7天,减到0.2 qd 维持。索他洛尔组(n=60):40mg q12h 慢慢加量直到有效控制量120~160 mg q12h。随访1月,观察疗效及不良反应。结果胺碘酮治疗组在控制快速心律失常中疗效优于索他洛尔组(P<0.05)。结论胺碘酮治疗快速性心律失常疗效确切。

  17. Effects of irbesartan on atrial cell electrophysiology

    Institute of Scientific and Technical Information of China (English)

    HUANG Cong-xin; CAO Feng; JIANG Hong; WANG Teng; LI Xia

    2005-01-01

    @@ Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice.1 Its incidence increases with age and the presence of structural heart disease. It is a major cause of stroke, especially in the elderly. It has been shown that angiotensin converting enzyme inhibitor (ACEI) can reduce the incidence of AF after acute myocardial infarction.2 Several studies have shown that activation of the rennin-angiotensin system is associated with the mechanisms of AF. Irbesartan is a long-acting angiotensin Ⅱ type 1 receptor antagonist used widely in the treatment of hypertension.3 In recent years, it has been demonstrated that patients treated with amiodarone plus irbesartan had a lower rate of recurrence of atrial fibrillation than did patients treated with amiodarone alone.4 These findings suggest that the inhibition of angiotensin Ⅱ may prevent AF, but its underlying electrophysiological mechanisms are obscure. The purpose of this study is to investigate the effects of irbesartan on atrial cell electrophysiology.

  18. [Iodine excess induced thyroid dysfunction].

    Science.gov (United States)

    Egloff, Michael; Philippe, Jacques

    2016-04-20

    The principle sources of iodine overload, amiodarone and radiologic contrast media, are frequently used in modern medicine. The thyroid gland exerts a protective effect against iodine excess by suppressing iodine internalization into the thyrocyte and iodine organification, the Wolff-Chaikoff effect. Insufficiency of this effect or lack of escape from it leads to hypo- or hyperthyroidism respectively. Amiodarone induced thyrotoxicosis is a complex condition marked by two different pathophysiological mechanisms with different treatments. Thyroid metabolism changes after exposure to radiologic contrast media are frequent, but they rarely need to be treated. High risk individuals need to be identifed in order to delay the exam or to monitor thyroid function or apply prophylactic measures in selected cases. PMID:27276725

  19. Ventricular tachycardia induced by weight loss pills

    DEFF Research Database (Denmark)

    Pareek, Manan; Hansson, Nils Henrik; Grove, Erik Lerkevang

    2013-01-01

    A previously healthy 29-year-old man was admitted with palpitations, dizziness, and near-syncope after he had recently started taking weight loss pills purchased on the internet. The pills contained caffeine and ephedrine. An electrocardiogram and telemetry revealed multiple episodes of non......-sustained monomorphic ventricular tachycardia, which was successfully treated with amiodarone. In conclusion, unauthorized weight loss pills can be harmful. In particular, ephedrine-containing drugs carry a risk of ventricular tachycardia and should be discouraged....

  20. Administration of a Probiotic Can Change Drug Pharmacokinetics: Effect of E. coli Nissle 1917 on Amidarone Absorption in Rats

    OpenAIRE

    Matuskova, Zuzana; Anzenbacherova, Eva; Vecera, Rostislav; Tlaskalova-Hogenova, Helena; Kolar, Milan; Anzenbacher, Pavel

    2014-01-01

    The growing interest in the composition and effects of microbiota raised the question how drug pharmacokinetics could be influenced by concomitant application of probiotics. The aim of this study was to find whether probiotic E. coli strain Nissle 1917 (EcN) influences the pharmacokinetics of concomitantly taken antiarrhythmic drug amiodarone (AMI). Live bacterial suspension of probiotic EcN (or non-probiotic E. coli strain ATCC 25922) was applied orally to male Wistar rats for seven days, wh...

  1. Fetal tachyarrhythmia with 1:1 atrioventricular conduction. Adenosine infusion in the umbilical vein as a diagnostic test

    Directory of Open Access Journals (Sweden)

    Tiago L. L. Leiria

    2000-07-01

    Full Text Available This is the report of a case of fetal tachyarrhythmia with 1:1 atrioventricular conduction detected by pre-natal echocardiography in a fetus at 25-weeks gestation. Adenosine infusion via cordocentesis was performed as a diagnostic test to differentiate between atrioventricular nodal reentrant supraventricular tachyarrhythmia and atrial flutter. After infusion, transient 2:1 atrioventricular dissociation was obtained and the diagnosis of atrial flutter was made. Transplacental therapy with digoxin and amiodarone was then successfully used.

  2. Atrial flutter complicating severe leptospirosis: a case report

    Directory of Open Access Journals (Sweden)

    Francisco Theogenes Macêdo Silva

    2013-04-01

    Full Text Available Cardiac disturbances are relatively common and electrocardiographic abnormalities may be found in more than 70% of patients with leptospirosis. We report the case of a 68 year-old male with severe leptospirosis who developed atrial flutter. Effective treatment was done with amiodarone. The patient became clinical stable, with complete recovery. Rigorous clinical observation and continuous electrocardiogram (ECG monitoring may facilitate the identification of rhythm disorders, and thus prevent a probable fatal outcome, in severe cases of leptospirosis.

  3. Cost Effectiveness of Implantable Cardioverter Defibrillator Therapy versus Drug Therapy for Patients at High Risk of Sudden Cardiac Death

    OpenAIRE

    Spath, Marian A.; Bernie J. O'Brien

    2002-01-01

    The implantable cardioverter defibrillator (ICD) is a therapy for patients at risk of sudden cardiac death due to ventricular tachycardia (VT) or ventricular fibrillation (VF). But the apparent high cost of ICD therapy relative to antiarrhythmic drugs such as amiodarone has raised questions about the cost effectiveness of ICD therapy versus drug therapy. To inform this debate we reviewed the literature on ICD cost effectiveness. An electronic and manual search was conducted for articles publi...

  4. Acute atrial fibrillation during dengue hemorrhagic fever

    Directory of Open Access Journals (Sweden)

    Veloso Henrique Horta

    2003-01-01

    Full Text Available Dengue fever is a viral infection transmitted by the mosquito, Aedes aegypti. Cardiac rhythm disorders, such as atrioventricular blocks and ventricular ectopic beats, appear during infection and are attributed to viral myocarditis. However, supraventricular arrhythmias have not been reported. We present a case of acute atrial fibrillation, with a rapid ventricular rate, successfully treated with intravenous amiodarone, in a 62-year-old man with dengue hemorrhagic fever, who had no structural heart disease.

  5. Dofetilide: a class III anti-arrhythmic drug for the treatment of atrial fibrillation

    DEFF Research Database (Denmark)

    Torp-Pedersen, C; Brendorp, B; Køber, L

    2000-01-01

    dofetilide. After pharmacological or electrical conversion of atrial fibrillation to sinus rhythm in these studies, the probability of remaining in sinus rhythm during the following year was 75%. Dofetilide has a single significant side effect: risk of developing torsade de pointes ventricular tachycardia...... infarctions, only amiodarone and dofetilide have proven safety and dofetilide is a strong candidate for first choice treatment when the aim is to achieve sinus rhythm....

  6. Antiarrhythmic or time bomb? A severe iatrogenic bradyarrhythmia

    Directory of Open Access Journals (Sweden)

    S. Matheou

    2013-05-01

    Full Text Available We report a case of severe bradyarrythmia with hypotension and extremely large QRS due to proarrhythmic effect of drug combination (amiodarone following infusion of propafenone for the conversion of Paroxysmal Atrial Fibrillation (PAF in a 74 year old woman. The authors focus on the important side effects and complications due to aggressive treatment of not life-threatening arrhythmias, such as PAF without haemodinamic compromise in older patients. At conclusion “primum non nocere“.

  7. Dronedarone: evidence supporting its therapeutic use in the treatment of atrial fibrillation

    OpenAIRE

    Sullivan, Renee M; Brian Olshansky

    2010-01-01

    Renee M Sullivan, Brian OlshanskyDivision of Cardiovascular Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USAIntroduction: Dronedarone, a benzofuran derivative with a structure similar to amiodarone, has been developed as a potential therapy for patients with atrial fibrillation.Aim: To review the published evidence regarding the efficacy and safety of dronedarone use in patients with atrial fibrillation.Evidence review: Available evidence suggests that dronedarone 400 ...

  8. Drug induced linear IgA dermatosis: case report and a short review:

    OpenAIRE

    Arzenšek, Jože; Benedičič, Ana; Berčič, Marija; Kansky, Aleksej; Pejovnik Pustinek, Alenka; Vizjak, Alenka; Wojnarowska, Fenella T.

    2003-01-01

    A significant number of reports incriminate various drugs, especially vancomycin and amiodarone of provoking bullous linear IgA dermatosis. This entity also includes the subset of IgA-mediated epidermolysis bullosa acquisita. We report on a patient with histopathologically and immunologicallyproven bullous linear IgA dermatosis, who developed this condition during treatment for hypertension with enalapril. Treatment with lowdoses of dapsone, 25 mg daily, was efficient. There is strong evidenc...

  9. Contrast induced hyperthyroidism due to iodine excess

    OpenAIRE

    Mushtaq, Usman; Price, Timothy; Laddipeerla, Narsing; Townsend, Amanda; Broadbridge, Vy

    2009-01-01

    Iodine induced hyperthyroidism is a thyrotoxic condition caused by exposure to excessive iodine. Historically this type of hyperthyroidism has been described in areas of iodine deficiency. With advances in medicine, iodine induced hyperthyroidism has been observed following the use of drugs containing iodine—for example, amiodarone, and contrast agents used in radiological imaging. In elderly patients it is frequently difficult to diagnose and control contrast related hyperthyroidism, as most...

  10. Buerger's Disease and Anaesthesia: The Neglected Cardiac Angle

    Directory of Open Access Journals (Sweden)

    Shagun Bhatia Shah

    2015-08-01

    Full Text Available Distal limb amputations and respiratory complications are common in patients with Buerger’s disease. Nicotine in cigarette is arrhythmogenic as it blocks cardiac potassium channels. Preoperative Holter ECG monitoring may be useful if preoperative electrocardiogram is normal. If the patient is undergoing major surgery, preservative free lignocaine & amiodarone infusions and a cardioverter defibrillator should be available for the intraoperative cardiac rhythm disturbances.

  11. Antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts.

    Directory of Open Access Journals (Sweden)

    Yun-Ping Lim

    Full Text Available The objective of this study was to determine the association between the use of antiarrhythmic agents and the risk of malignant neoplasm of liver and intrahepatic bile ducts (MNLIHD.We used the research database of the Taiwan National Health Insurance Program to conduct a population-based, case-control study. We identified 9944 patients with antiarrhythmic history who were first diagnosed as having MNLIHD between 2005 and 2010. We identified an additional 19,497 patients with antiarrhythmic history in the same period who did not develop MNLIHD and were frequency-matched using age, sex, and index year to form a control group. Five commercially available antiarrhythmic agents, amiodarone, mexiletine, propafenone, quinidine, and procainamide, were analyzed.The adjusted odds ratio (OR of MNLIHD was 1.60 (95% confidence interval [CI], 1.45-1.77 for amiodarone users versus nonamiodarone users. In subgroup analysis, amiodarone use was significantly associated with an increased risk of MNLIHD with an adjusted OR of 18.0 (95% CI, 15.7-20.5 for patients with comorbidities compared to an OR of 2.43 (95% CI, 1.92-3.06 for those without comorbidities. After adjustment for age, sex, statins, anti-diabetes medications, non-steroidal antiinflammatory drugs, propafenone use, quinidine use, and comorbidities, the ORs were 1.49, 1.66, and 1.79 for MNLIHD associated with annual mean defined daily doses of ≤ 30, 31-145, and >145, respectively.The results of the present study indicated that amiodarone might be associated with the development of MNLIHD in a dose-dependent manner, particularly among patients with comorbidities.

  12. Managing atrial fibrillation in the elderly: critical appraisal of dronedarone

    Directory of Open Access Journals (Sweden)

    Trigo P

    2011-12-01

    Full Text Available Paula Trigo, Gregory W FischerDepartment of Anesthesiology, Mount Sinai School of Medicine, New York, NY, USAAbstract: Atrial fibrillation is the most commonly seen arrhythmia in the geriatric population and is associated with increased cardiovascular morbidity and mortality. Treatment of the elderly with atrial fibrillation remains challenging for physicians, because this unique subpopulation is characterized by multiple comorbidities requiring chronic use of numerous medications, which can potentially lead to severe drug interactions. Furthermore, age-related changes in the cardiovascular system as well as other physiological changes result in altered drug pharmacokinetics. Dronedarone is a new drug recently approved for the treatment of arrhythmias, such as atrial fibrillation and/or atrial flutter. Dronedarone is a benzofuran amiodarone analog which lacks the iodine moiety and contains a methane sulfonyl group that decreases its lipophilicity. These differences in chemical structure are responsible for making dronedarone less toxic than amiodarone which, in turn, results in fewer side effects. Adverse events for dronedarone include gastrointestinal side effects and rash. No dosage adjustments are required for patients with renal impairment. However, the use of dronedarone is contraindicated in the presence of severe hepatic dysfunction.Keywords: atrial fibrillation, elderly, antiarrhythmic agents, amiodarone, dronedarone

  13. DRUG THERAPY OF PAROXYSMAL ATRIAL FIBRILLATION IN THE ELDERLY OVER 75 YEARS OLD

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    Objective To investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old.Methods Totally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22. 3% ) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used. Results The cardioversion ratio of atrial fibrillation were 9. 5%, 46.9%, 71.7%, 55.9%, 32.7%, and73.6%in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84. 9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group. Conclusion Amiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.

  14. Quinidine for Pharmacological Cardioversion of Long-lasting Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Matteo Baroni MD

    2011-07-01

    Full Text Available Background In the daily clinical practice, patients with atrial fibrillation (AF lasting more than 48h (or not datable at all are not uncommon. In long-lasting AF changes in electrophysiological features (electrical remodeling can occur, resulting in a loss of sensibility to most antiarrhythmic drugs. There is strong evidence that the main mechanism involved in electrical remodeling is a global shortening in refractory period. To assess safety and efficacy of quinidine in pharmacological cardioversion of long-lasting AF, compared with propafenone and amiodarone. Methods and Results Ninety consecutive patients with AF lasting more than 6 weeks were randomized to amiodarone (5mg\\kg bolus, then 15mg\\kg in 24h , propafenone (2 mg\\kg bolus then 0.007mg\\kg for 2h, and quinidine (275mg of quinidine arabogalattan sulphate per os every 2h for 8h maximum for pharmacologic cardioversion. All patients had been previously treated with adequate oral anticoagulation and had been submitted to transthoracic echocardiogram. The 3 groups of patients did not differ for baseline and echocardiographic characteristics. Sinus rhythm was restored in 16 patients treated with quinidine (53%, compared with 6 patients (20% in the amiodarone and propafenone groups (p<0.01. No major adverse effect was reported during the treatment. Conclusions Quinidine seems to be safe and effective in pharmacological cardioversion of long-lasting AF.

  15. Addressing the management of atrial fibrillation – a systematic review of the role of dronedarone

    Directory of Open Access Journals (Sweden)

    Podda GM

    2012-05-01

    Full Text Available Gian Marco Podda,1 Giovanni Casazza,2 Francesco Casella,3 Franca Dipaola,4 Emanuela Scannella,3 Ludovica Tagliabue51Medicina III, Department of Medicine, Surgery and Dentistry, San Paolo Hospital, University of Milan, Milan, Italy; 2Department of Clinical Science, "L. Sacco", University of Milan, Milan, Italy; 3Department of Internal Medicine, L. Sacco Hospital, Milan, Italy; 4Internal Medicine, Istituti Clinici di Perfezionamento Sesto San Giovanni, Italy; 5School of Hygiene and Preventative Medicine, University of Milan, Milan, ItalyBackground: Atrial fibrillation (AF is the most common sustained arrhythmia. It occurs in 1%–2% of the general population and its prevalence increases with age. Dronedarone, a noniodinated benzofuran similar to amiodarone, was developed as an antiarrhythmic agent for patients with atrial fibrillation. The aim of our systematic review was to critically evaluate randomized controlled trials that compared treatment with dronedarone versus placebo or amiodarone in patients with atrial fibrillation.Methods: Electronic databases (MEDLINE, Embase, and Central were searched up to November 2011 with no language restrictions. We included randomized controlled trials in which dronedarone was compared to placebo or other drugs in patients with AF. Internal and external validity was assessed.Results: We identified seven papers corresponding to eight randomized controlled trials. The DAFNE, EURIDIS/ADONIS, and ATHENA trials demonstrated a reduction of AF recurrence with dronedarone as compared to placebo in patients with nonpermanent AF. The DIONYSOS study showed that dronedarone is less effective for the prevention of recurrent AF but improved tolerability as compared to amiodarone. Considering patients with permanent AF, the ERATO trial showed that dronedarone had rate-control effects while the PALLAS study was stopped early since stroke, myocardial infarction, systemic embolism, or death from cardiovascular causes were

  16. 静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床观察%Clinical observation of intravenous esmolol in the treatment of acute myocardial infarction patients with sympathetic storm

    Institute of Scientific and Technical Information of China (English)

    董小燕; 于东明; 郭伟; 袁靖

    2015-01-01

    Objective To observe the clinical efficacy of intravenous injection of esmolol to treat acute myocardial infarction patients with sympathetic storm. Methods A total of 44 acute myocardial infarction patients with sympathetic storms were randomly divided into three groups:an amiodarone group receiving intravenous amiodarone in addition to conventional cardiopulmonary resuscitation and electrical cardioversion (n=15), a metoprolol tartrate group which was treated with intravenous metoprolol tartrate in addition to the above amiodarone therapy (n=15), and an esmolol group which was intravenously injected with esmolol in addition to the above amiodarone therapy (n=14). Results The esmolol group and metoprolol tartrate group produced markedly higher inhibitory rates of recurrent ventricular tachycardia and ventricular fibrillation than the amiodarone group. The esmolol group and metoprolol tartate groups required substantially less times of electric cardioversion to terminate ventricular tachycardia and ventricular fibrillation than the amiodarone group. There was no statistical difference as to the incidences of hypotension and bradycardia among these three groups. Conclusion Based on the conventional therapy, intravenous injection of esmolol can significantly improve the successful rate of rescue for acute myocardial infarction patients with sympathetic storm.%目的:观察静脉注射艾司洛尔治疗急性心肌梗死合并交感风暴的临床疗效。方法急性心肌梗死合并交感风暴患者44例,随机分为3组。其中胺碘酮组(n=15),应用常规心肺复苏及电复律加静脉应用胺碘酮治疗;酒石酸美托洛尔组(n=15),在胺碘酮组治疗基础上静脉联合酒石酸美托洛尔治疗;艾司洛尔组(n=14),在胺碘酮组治疗基础上联合静脉应用艾司洛尔治疗。结果艾司洛尔组及酒石酸美托洛尔组终止反复室性心动过速、心室颤动成功率明显高于胺碘酮组;艾司洛

  17. The effect of in vitro exposure to antisense oligonucleotides on macrophage morphology and function

    Directory of Open Access Journals (Sweden)

    Ann Brasey

    2011-11-01

    Full Text Available Antisense oligonucleotides (AON delivered via inhalation are in drug development for respiratory diseases. In rodents and monkeys, repeated exposure to high doses of inhaled phosphorothioate (PS AON can lead to microscopic changes in the lungs, including accumulation of alveolar macrophages in the lower airway that have a foamy appearance. The functional consequences that result from this morphological change are unclear as there is controversy whether the vacuoles/inclusion bodies reflect normal clearance of the inhaled AON or are early indicators of lung toxicity. The morphological and functional responses of macrophage to PS AON were characterized in vitro using the comparator drug amiodarone, as a known inducer of foamy macrophages. Morphological changes of increased vacuolization with the presence of lamellated structures were observed in macrophages in response to both amiodarone and AON treatment. Functional responses to the drugs clearly differed with amiodarone treatment leading to apoptosis of cells and cell death, release of proinflammatory mediators IL-1RA, MIP-1α and TNFα, decrease in IP-10, a cytokine shown to be involved in protection against pulmonary fibrosis and altered phagocytosis capacity of the cells. In contrast, AON in concentrations up to 30 μM, had no effect on cell viability or apoptosis, had minimal effects on pro-inflammatory cytokines, increased IP-10 levels and did not alter the phagocytic capacity of the cells. Exposure of macrophages to AON in vitro, led to morphological changes of increased vacuolization, but did not lead to functional consequences which were observed with another vacuolization-inducing drug, suggesting that the in vivo phenotypic changes observed following inhalation of AON may be consistent with a clearance mechanism and not an activation or impairment of macrophages.

  18. Dronedarone: current evidence for its safety and efficacy in the management of atrial fibrillation

    Directory of Open Access Journals (Sweden)

    Patrick A Schweizer

    2011-01-01

    Full Text Available Patrick A Schweizer, Rüdiger Becker, Hugo A Katus, Dierk ThomasDepartment of Cardiology, Medical University Hospital, Heidelberg, GermanyAbstract: Atrial fibrillation (AF is the most common sustained arrhythmia. Management of AF includes rate control, rhythm control if necessary, prevention of thromboembolic events, and treatment of the underlying disease. Rate control is usually achieved by pharmacological suppression of calcium currents or by applying β-blockers or digitalis compounds. In contrast, the number of compounds available for rhythm control is still limited. Class Ic agents increase mortality in patients with structural heart disease, and amiodarone harbors an extensive side effect profile despite its efficacy in maintaining sinus rhythm. Furthermore, rhythm control by these compounds has not been shown to reduce patient mortality. Dronedarone is a new antiarrhythmic drug that has been developed to provide rhythm and rate control in AF patients with fewer side effects compared with amiodarone. This review primarily focuses on clinical trials evaluating efficacy and safety of the novel drug. Conclusions from these studies are critically reviewed, and recommendations for clinical practice are discussed. Dronedarone significantly reduced the incidence of hospitalization due to cardiovascular events or death in high-risk patients with atrial fibrillation (ATHENA trial. However, dronedarone was less efficient than amiodarone in maintaining normal sinus rhythm (DIONYSOS trial and is contraindicated in severe or deteriorating heart failure (ANDROMEDA trial. In summary, dronedarone represents a valuable addition to the limited spectrum of antiarrhythmic drugs and is currently recommended in patients with paroxysmal and persistent AF to achieve rate and rhythm control, excluding cases of severe or unstable congestive heart failure.Keywords: dronedarone, atrial fibrillation, antiarrhythmic therapy

  19. Electrophysiological mechanisms of sophocarpine as a potential antiarrhythmic agent

    Institute of Scientific and Technical Information of China (English)

    Zhi-fang YANG; Ci-zhen LI; Wei WANG; Ying-min CHEN; Ying ZHANG; Yuan-mou LIU; Hong-wei WANG

    2011-01-01

    Aim: To examine the electrophysiological effects of sophocarpine on action potentials (AP) and ionic currents of cardiac myocytes and to compare some of these effects with those of amiodarone.Methods: Langendorff perfusion set-up was used in isolated guinea pig heart, and responses to sophocarpine were monitored using electrocardiograph. Conventional microelectrode, voltage clamp technique and perforated patch were employed to record fast response AP (fAP), slow response AP (sAP) and ionic currents in guinea pig papillary muscle or rabbit sinus node cells.Results: Tachyarrhythmia produced by isoprenaline (15 μmol/L) could be reversed by sophocarpine (300 μmol/L). Sophocarpine (10 μmol/L) decreased the amplitude by 4.0%, maximal depolarization velocity (Vmax) of the fAP by 24.4%, and Na+ current (INa) by 18.0%,while it prolonged the effective refractory period (ERP) by 21.1%. The same concentration of sophocarpine could also decrease the amplitude and Vmax of the sAP, by 26.8% and 25.7%, respectively, and attenuated the Ca2+ current (ICaL) and the K+ tail current substantially. Comparison of sophocarpine with amiodarone demonstrated that both prolonged the duration and the ERP of fAP and sAP, both decreased the amplitude and Vmax of the fAP and sAP, and both slowed the automatic heart rate.Conclusion: Sophocarpine could reverse isoprenaline-induced arrhythmia and inhibit INa, IcaL, and Ikr currents. The electrophysiological effects of sophocarpine are similar to those of amiodarone, which might be regarded as a prospective antiarrhythmic agent.

  20. 胺碘酮治疗重度左心衰竭并房颤临床研究

    Institute of Scientific and Technical Information of China (English)

    白帆

    2013-01-01

    Objective To analyze the clinical about amiodarone in the treatment of severe left heart failure complicated with atrial fibrillation. Methods The clinical data of 60 case with severe left heart failure complicated with atrial fibrillation was analysed retrospectively in our hospital from April 2009 to September 2011. Blood pressure, ECG parameters and efficiency were compared. Results 60 patients with severe left heart failure and atrial fibrillation patients after amiodarone treatment, a therapeutically effective 55 cases, 91.7%.Conclusion It is worthy of popularizing for Amiodarone in the treatment of severe left heart failure complicated with atrial fibrillation .%  目的观察胺碘酮治疗重度左心衰竭并房颤患者的临床疗效.方法回顾性分析2009年4月~2011年9月来湖南省华容县人民医院采用胺碘酮治疗的60例重度左心衰并房颤患者的临床疗效,观察比较治疗前后患者的血压,心电图参数及治疗有效率.结果60例重度左心衰并房颤患者经胺碘酮治疗后,治疗有效55例,有效率91.7%.结论胺碘酮治疗重度左心衰并房颤患者疗效显著,值得推广应用于临床.

  1. [Toxic and drug-induced lesions of the pulmonary parenchyma].

    Science.gov (United States)

    Russi, E

    1992-05-01

    Pulmonary tissue may be damaged by certain toxins or drugs in a dose-dependent way or by a hypersensitivity reaction. Pathological changes consist of a permeability pulmonary edema, an alveolar hemorrhage, an alveolitis and finally the formation of pulmonary fibrosis. Ingestion of the weed killer paraquat may induce a rapidly progressive and lethal form of fibrosing alveolitis, the inhalation of nitrous oxides may elicit lung edema. The most common drugs causing lung damage are cytotoxic agents, often used in combination, and the noncytotoxic drugs amiodarone and nitrofurantoin. PMID:1589677

  2. Wide complex tachycardia after bupropion overdose.

    Science.gov (United States)

    Franco, Vanessa

    2015-10-01

    Here we describe a wide complex tachycardia after bupropion overdose that was responsive to sodium bicarbonate. This rhythm was likely secondary to bupropion-induced sodium channel blockade and corrected QT interval (QTc) prolongation. It is critical for the emergency medicine physician to recognize that a wide complex rhythm in a patient with bupropion overdose may be secondary to sodium channel toxicity and prolonged QTc as this rhythm may be responsive to sodium bicarbonate. Identifying this rhythm as purely ventricular tachycardia can lead to the administration of medications such as amiodarone that may further prolong QTc and contribute to sodium channel blockade, exacerbating bupropion-induced cardiotoxicity. PMID:26311156

  3. Protective Effect of Wenxin Granula on Heart from Myocardial Infarction through Regulating Intracellular Ca2+

    Institute of Scientific and Technical Information of China (English)

    LI Xiao-xue; YANG Bao-feng; LI Xue-lian; CHU Wen-feng; CAI Rui-jun; SHI Yong-fang; XU Chao-qian; SHAN Hong-li; WANG Xing-yang; LU Yan-jie

    2011-01-01

    Objective To assess the anti-arrhythmic activity and cardioprotective effects of Wenxin Granula, a traditional Chinese formula (consisting of Salviae Miltiorrhizae Radix, Polygonati Rhizoma, Notoginseng Radix et Rhizoma, Nardostachyos Radix et Rhizoma, Angelicae Sinensis Radix, and Succinum), on heart in ischemic-induced myocardial infarction (MI) rats and compare with those of Amiodarone which have been demonstrated in clinic. Methods Rats were randomly divided into Sham-operated (control), Ml + Amiodarone [5 mg/(kg·d)] (MI), and MI + Wenxin Granula [10 mg/(kg·d)] groups and left anterior descending coronary artery was occluded in each group. After left anterior descending for 12 h, standard lead Ⅱ of administration electrocardiogram was recorded in order to analyze the occurrence of arrhythmia. After one month, the size of the infarct area of heart was evaluated by TTC staining method and haemodynamic function was assessed to detect the heart function. Laser scanning confocal microscope and the technique of patch clamp were used to detect the intracellular Ca2+ ([Ca2+]j) and L-type calcium current (ICa-L), respectively. Results Both Wenxin Granula [10 mg/(kg·d)] and Amiodarone [5 mg/(kg·d)] could markedly decrease the incidence of arrhythmia in heart of rats which were subjected to ischemic injury. After one month, Wenxin Granula could significantly decrease mortality to 22.22% and reduce the infarct area (P < 0.05), but Amiodarone did not. The mechanism may involve that Wenxin Granula attenuated [Ca2+]j decreasing in MI rats. Additionally, Wenxin Granula could obviously ameliorate the impaired heart function of MI rats by decreasing the elevated left ventricular end-diastolic pressure and increasing the attenuated maximum change velocity of left ventricular pressure in the isovolumic contraction or relaxation period. On the other hand, electrophysiological experiment results revealed that Wenxin Granula administration one month later also increased the

  4. Interest of the free T3 and T4 assays

    International Nuclear Information System (INIS)

    This study has been carried out on 234 eu-hyper- or hypothyroid subjects for whom complete thyroid balances have been realized. These tests include the total T3 and T4 assays: the free T3 and free T4 assays, the TSH when necessary and, finally, the free thyroxine index calculation (IT4L). The fiability of the free hormones assays has been studied on various patients groups, all of them being clinically euthyroid but, either carrying various pathologies or taking medication modifying their thyroid hormone metabolism (Amiodarone). Results show: - the extremely good sensibility of the FT3 and FT4 assays concerning the diagnostic of hyperthyroid subjects, and, more over, reveal a very good specificity of the FT3 parameter; - that the basic TSH or stimulating test assays still remain reference tests in the diagnostic of hypothyroidy. The FT4 assay reveals a rather good specificity too; - the good stability of the FT3 parameter when applied on subjects carrying various pathologies or taking ''Amiodarone''. One notices that any diagnostic taken off from the alone FT4 assay would be, more or less, doubtfull

  5. Cationic amphiphilic drugs enhance entry of lentiviral particles pseudotyped with rabies virus glycoprotein into non-neuronal cells.

    Science.gov (United States)

    Klintworth, Anneke; Nolden, Tobias; Westhaus, Sandra; Rohrmann, Katrin; David, Sascha; Manns, Michael P; Finke, Stefan; Ciesek, Sandra; von Hahn, Thomas

    2015-12-01

    Amiodarone and other cationic amphiphilic drugs (CADs) inhibit cell entry by diverse human pathogenic viruses including Filoviruses, Dengue virus and Japanese encephalitis virus. They are thus considered potential broad spectrum antiviral agents. Here we report the unexpected finding that amiodarone and other CADs markedly enhance rabies virus (RABV) glycoprotein- (GP-) mediated cell entry of pseudotyped lentiviruses into non-neuronal cells but not in neuronal cells. Increased cell entry can also be elicited when CADs are added several hours after pseudoviral attachment. Perturbing endosomal processing with phosphoinosite-3-kinase inhibitors wortmannin and LY294002 mimics the effects of CADs on RABV GP-mediated cell entry. Thus, CADs may enhance RABV GP-mediated cell entry of pseudotyped lentiviruses by promoting a late step of the pseudoviral cell entry process, possibly release from an endosomal compartment into the cytosol. In contrast to the pseudotyped lentiviruses, infection by fully infectious RABV was not enhanced by CADs, indicating, that the observed stimulation of RABV GP mediated lentivirus entry also depended on the used lentivirus vector backbone. In conclusion, we show that while CADs inhibit cell entry of diverse viruses they can also have a paradoxical enhancing effect on the ability of a viral glycoprotein to mediate cell entry depending on the cellular and viral context. Although, we show CAD-mediated enhancement of entry only for pseudoviruses, but not fully infectious RABV, the potential to unexpectedly enhance viral entry should be taken into account when considering use of CADs as antiviral agents. PMID:26542648

  6. Atrial fibrillation after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Nair Suresh

    2010-01-01

    Full Text Available Once considered as nothing more than a nuisance after cardiac surgery, the importance of postoperative atrial fibrillation (POAF has been realized in the last decade, primarily because of the morbidity associated with the condition. Numerous causative factors have been described without any single factor being singled out as the cause of this complication. POAF has been associated with stroke, renal failure and congestive heart failure, although it is difficult to state whether POAF is directly responsible for these complications. Guidelines have been formulated for prevention of POAF. However, very few cardiothoracic centers follow any form of protocol to prevent POAF. Routine use of prophylaxis would subject all patients to the side effects of anti-arrhythmic drugs, while only a minority of the patients do actually develop this problem postoperatively. Withdrawal of beta blockers in the postoperative period has been implicated as one of the major causes of POAF. Amiodarone, calcium channel blockers and a variety of other pharmacological agents have been used for the prevention of POAF. Atrial pacing is a non-pharmacological measure which has gained popularity in the prevention of POAF. There is considerable controversy regarding whether rate control is superior to rhythm control in the treatment of established atrial fibrillation (AF. Amiodarone plays a central role in both rate control and rhythm control in postoperative AF. Newer drugs like dronedarone and ranazoline are likely to come into the market in the coming years.

  7. November 2015 Tucson critical care journal club: atrial fibrillation in sepsis

    Directory of Open Access Journals (Sweden)

    Nahapetian RR

    2015-12-01

    Full Text Available No abstract available. Article truncated at 150 words. Sepsis is a major public health concern in the United States (1. Nearly one-third of in-hospital deaths are the result of sepsis (2. Atrial fibrillation (A-fib is the most common arrhythmia in sepsis and its development portends worse outcomes (3. Current guidelines recommend cardioversion in hemodynamically unstable patients with sepsis; however, there is scant evidence to guide the choice between amiodarone, beta-blockers, calcium-channel blockers, and digoxin (4. In patients with decompensated heart failure, digoxin and amiodarone are preferred over beta-blockers and calcium channel blockers (4. In patients with multiple organ failure there is no evidence to suggest any one agent is superior to the others. This study by Walkey et al. sought to identify current practice patterns in the pharmacologic treatment of A-fib among hospitalized patients with sepsis and to compare outcomes after controlling for potential confounding variables. This retrospective cohort study used a nationally representative source of hospital billing ...

  8. Management of atrial fibrillation: focus on the role of dronedarone

    Directory of Open Access Journals (Sweden)

    Cheng JW

    2011-09-01

    Full Text Available Judy WM Cheng1,2 1Massachusetts College of Pharmacy and Health Sciences, Boston, MA, USA; 2Brigham and Women's Hospital, Boston, MA, USA Background: Dronedarone is an amiodarone derivative that was approved in the US in July 2009 to reduce the risk of cardiovascular hospitalization in patients with paroxysmal or persistent atrial fibrillation (AF, who are in sinus rhythm (SR, or who will be cardioverted. Objective: This article reviews the pharmacology, adverse effects, and clinical evidence available to date on the use of dronedarone in the management of AF and its potential role in the emergency department setting. Results: In the EURIDIS and ADONIS studies evaluating the efficacy of dronedarone in maintaining SR, dronedarone significantly reduced the risk of recurrence of AF compared to placebo, by 22% and 27%, respectively. The ERATO study examined the ability of dronedarone to control ventricular rate in permanent AF. The DIONYSOS study demonstrated that recurrences of AF were more frequent with dronedarone. However, discontinuation of therapy due to intolerance was more frequent with amiodarone. Furthermore, the ATHENA study demonstrated that dronedarone reduced mortality and cardiovascular hospitalization by 24% (P < 0.05 in patients in SR but with other associated risks and a history of AF. However, the ANDROMEDA study, evaluating the use of dronedarone in patients with recent decompensated heart failure, and the PALLAS study, evaluating the use of dronedarone in patients with chronic AF, were both terminated prematurely due to a trend toward an increased risk of cardiovascular events. Conclusion: Dronedarone has been demonstrated to be effective in reducing the incidence of AF recurrence. It appears to be less effective but better tolerated than amiodarone. Dronedarone appears to have a low proarrhythmic risk and is the first anti-arrhythmic that has been demonstrated to reduce cardiovascular mortality and cardiovascular hospitalization

  9. Treating critical supraventricular and ventricular arrhythmias

    Directory of Open Access Journals (Sweden)

    Trappe Hans-Joachim

    2010-01-01

    Full Text Available Atrial fibrillation (AF, atrial flutter, AV-nodal reentry tachycardia with rapid ventricular response, atrial ectopic tachycardia and preexcitation syndromes combined with AF or ventricular tachyarrhythmias (VTA are typical arrhythmias in intensive care patients (pts. Most frequently, the diagnosis of the underlying arrhythmia is possible from the physical examination (PE, the response to maneuvers or drugs and the 12-lead surface electrocardiogram. In unstable hemodynamics, immediate DC-cardioversion is indicated. Conversion of AF to sinus rhythm (SR is possible using antiarrhythmic drugs. Amiodarone has a conversion rate in AF of up to 80%. Ibutilide represents a class III antiarrhythmic agent that has been reported to have conversion rates of 50-70%. Acute therapy of atrial flutter (Aflut in intensive care pts depends on the clinical presentation. Atrial flutter can most often be successfully cardioverted to SR with DC-energies < 50 joules. Ibutilide trials showed efficacy rates of 38-76% for conversion of Aflut to SR compared to conversion rates of 5-13% when intravenous flecainide, propafenone or verapamil was administered. In addition, high dose (2 mg of ibutilide was more effective than sotalol (1.5 mg/kg in conversion of Aflut to SR (70 versus 19%. Drugs like procainamide, sotalol, amiodarone or magnesium were recommended for treatment of VTA in intensive care pts. However, only amiodarone is today the drug of choice in VTA pts and also highly effective even in pts with defibrillation-resistant out-of-hospital cardiac arrest (CA. There is a general agreement that bystander first aid, defibrillation and advanced life support is essential for neurologic outcome in pts after cardiac arrest due to VTA. Public access defibrillation in the hands of trained laypersons seems to be an ideal approach in the treatment of ventricular fibrillation (VF. The use of automatic external defibrillators (AEDs by basic life support ambulance providers or

  10. 影响电击除颤效果的因素分析%Influential Factors of Defibrillation in Patients with Ventricular Fibrillation

    Institute of Scientific and Technical Information of China (English)

    马承君; 马哲; 马永才; 白岩松; 韩图亚

    2011-01-01

    目的 分析影响心室颤动(VF)电击除颤效果的因素,提高VF的救治质量.方法 对本院2001年1月至2010年1月收治的VF患者206例进行分析,比较电击除颤成功组与失败组年龄、VF持续时间、VF振幅、VF频率、除颤次数、胺碘酮用量、肾上腺素用量.结果 VF电击除颤成功组与失败组在年龄、除颤次数上比较差异无统计学意义(P>0.05).在VF振幅、VF 频率、VF持续时间、胺碘酮、肾上腺素用量方面比较差异有统计学意义(P<0.05).结论 VF振幅、频率及持续时间决定电击除颤时机,正确把握才能保证电击除颤效果.合理应用胺碘酮、肾上腺素可以提高电击除颤成功率.%Objective To analyze several factors of defibrillation in the patients with ventricular fibrillation ( VF ). Methods 206 VF cases on our hospital from Janaury 2001 to Janaury 2010 were analyzed. VF duration, VF amplitude, VF frequency, the number of defibrillation, dosage of amiodarone and adrenaline was compared between success and failure group of VF. Results There was no significant difference in age and number of previous defibrillation between the two groups ( P > 0.05 ). There was significant difference in VF amplitude, VF frequency, VF duration, dosage of amiodarone and adrenaline ( P < 0.05 ). Conclusions The achievement of defibrillation was related to amplitude ,frequency and duration of VF. The using of amiodarone and epinephrine properly can improve the success rate of defibrillation.

  11. Impact of dronedarone in atrial fibrillation and flutter on stroke reduction

    Directory of Open Access Journals (Sweden)

    Christine Benn Christiansen

    2010-03-01

    Full Text Available Christine Benn Christiansen1, Christian Torp-Pedersen1, Lars Køber21Department of Cardiology, Gentofte Hospital, University of Copenhagen, Hellerup, Denmark; 2Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, DenmarkBackground: Dronedarone has been developed for treatment of atrial fibrillation (AF or atrial flutter (AFL. It is an amiodarone analogue but noniodinized and without the same adverse effects as amiodarone.Objective and methods: This is a review of 7 studies (DAFNE, ADONIS, EURIDIS, ATHENA, ANDROMEDA, ERATO and DIONYSOS on dronedarone focusing on efficacy, safety and prevention of stroke. There was a dose-finding study (DAFNE, 3 studies focusing on maintenance of sinus rhythm (ADONIS, EURIDIS and DIONYSOS, 1 study focusing on rate control (ERATO and 2 studies investigating mortality and morbidity (ANDROMEDA and ATHENA.Results: The target dose for dronedarone was established in the DAFNE study to be 400 mg twice daily. Both EURIDIS and ADONIS studies demonstrated that dronedarone was superior to placebo for maintaining sinus rhythm. However, DIONYSOS found that dronedarone is less efficient at maintaining sinus rhythm than amiodarone. ERATO concluded that dronedarone reduces ventricular rate in patients with chronic AF. The ANDROMEDA study in patients with severe heart failure was discontinued because of increased mortality in dronedarone group. Dronedarone reduced cardiovascular hospitalizations and mortality in patients with AF or AFL in the ATHENA trial. Secondly, according to a post hoc analysis a significant reduction in stroke was observed (annual rate 1.2% on dronedarone vs 1.8% on placebo, respectively [hazard ratio 0.66, confidence interval 0.46 to 0.96, P = 0.027]. In total, 54 cases of stroke occurred in 3439 patients (crude rate 1.6% receiving dronedarone compared to 76 strokes in 3048 patients on placebo (crude rate 2.5%, respectively.Conclusion: Dronedarone can be used for maintenance of

  12. 缬沙坦预防阵发性房颤复发的临床研究%Clinical Study of Prevention of Recurrence of Paroxysmal Atrial Fibrillation with Valsartan

    Institute of Scientific and Technical Information of China (English)

    黄国定

    2011-01-01

    Objective.To evaluate the valsartan in the prevention of recurrence of paroxysmal atrial fibrillation efficacy.Methods: Paroxysmal,91 patients with symptomatic atrial fibrillation and restore sinus rhythem were randomly divided into control group,45 patients of oral amiodarone in the treatement group 46 patients with additional service on this basis, a daily valsartan 80 mg, were followed up for one year.Results:The treatment group was significantly higher than the maintenance of sinus rhythm(81.8%VS62.8%,P<0.05),left the room by significantly less than the control gropu[(35.10±10.21)mmVS(41.82±11.60)mm ].There were significant differences.Conclusion.Valsartan combined effect of amiodarone on atrial fibrillation after cardioversion of atrial fibrillation to prevent recurrence of the role of maintenance of sinus rhythem significantly better than treatment with amiodarone,which inhibit the renin-angiotensin system with valsartan, reduced cardiac stress,inhibition of atrial electrical remodeling and structural remodeling related, and no obvious adverse reactions.%目的:评价缬沙坦在预防阵发性房颤复发中的疗效.方法:阵发性、症状性房颤患者91例.恢复窦性心律后,随机分为对照组45例,单纯口服胺碘酮;治疗组46例,在此基础上加服缬沙坦每天80mg,随访观察1年.结果:治疗组窦性心律维持率明显高于对照组(81.8%VS62.8%,P<0.05),左房内经明显小于对照组[(35.10±10.21)mmVS(41.82±11.60)mm],差异均有显著意义.结论:缬沙坦联合胺碘酮对阵发性房颤复律后预防房颤复发维持窦性心律作用明显优于单用胺碘酮治疗,这与缬沙坦抑制肾素血管紧张素系统,降低心脏负荷,抑制心房电重构及结构重构有关,且无明显不良反应.

  13. Brain natriuretic peptide and optimal management of heart failure

    Institute of Scientific and Technical Information of China (English)

    LI Nan; WANG Jian-an

    2005-01-01

    Aside from the important role of brain natriuretic peptide (BNP) in diagnosis, and differential diagnosis of heart failure, this biological peptide has proved to be an independent surrogate marker of rehospitalization and death of the fatal disease.Several randomized clinical trials demonstrated that drugs such as beta blocker, angiotensin converting enzyme inhibitor, spironolactone and amiodarone have beneficial effects in decreasing circulating BNP level during the management of chronic heart failure. The optimization of clinical decision-making appeals for a representative surrogate marker for heart failure prognosis. The serial point-of-care assessments of BNP concentration provide a therapeutic goal of clinical multi-therapy and an objective guidance for optimal treatment of heart failure. Nevertheless new questions and problems in this area remain to be clarified. On the basis of current research advances, this article gives an overview of BNP peptide and its property and role in the management of heart failure.

  14. Electrocution-induced atrial fibrillation: a novel cause of a familiar arrhythmia.

    Science.gov (United States)

    Langford, Alex; Dayer, Mark

    2012-01-01

    A previously fit and well 40-year-old man presented to the emergency department with palpitations after suffering an 11 000 volt electrical shock from overhead power cables through a mobile crane which he was operating. His ECG demonstrated the presence of new atrial fibrillation at a rate of 80 beats per min. He was haemodynamically stable, and had otherwise only sustained a small exit burn to his left great toe. Routine blood tests including creatine kinase and troponin T were normal. A bolus of intravenous flecainide failed to restore sinus rhythm, but an amiodarone infusion was successful. An electrical shock is a rare cause of atrial fibrillation. There is no consensus over optimal medical management. Numerous treatment plans have been previously employed with varying degrees of success. PMID:22604201

  15. Atrial fibrillation in rats induced by rapid transesophageal atrial pacing during brief episodes of asphyxia: A new in vivo model

    DEFF Research Database (Denmark)

    Haugan, K.; Lam, Henrik Rye; Knudsen, C. B.;

    2004-01-01

    anesthetized male Sprague-Dawley rats. AF was reproducibly induced in 81% of the rats. The presence of AF was associated with an increased heart rate, and a decreased blood pressure. Treatment with amiodarone, D,L-sotalol, flecainide, and propranolol all reduced duration of AF, whereas verapamil treatment was...... associated with a marked profibrillatory effect. Increasing gap junction intracellular communication using the antiarrhythmic peptide analogue AAP 10 did not affect AF duration. Basal plasma level of epinephrine and norepinephrine were increased 5- to 20-fold relative to values reported by others, but...... unchanged following 35 seconds of asphyxia. The results from our study demonstrate that the rat model shares several clinical key characteristics with human AF: (1) hemodynamic response to AF; (2) increased autonomic tone; (3) antiarrhythmic effects of clinically used drugs; (4) profibrillatory effect of...

  16. The duration of pacing-induced atrial fibrillation is reduced in vivo by inhibition of small conductance Ca2+-activated K+ channels

    DEFF Research Database (Denmark)

    Skibsbye, Lasse; Diness, Jonas; Sørensen, Ulrik S;

    2011-01-01

    , whereas newer multichannel blockers such as amiodarone and ranolazine have been introduced later. This study was devoted to the evaluation of an acute pacing-induced in vivo model of AF in rats. Antiarrhythmic effects of well-known compounds such as lidocaine, dofetilide, and ranolazine were confirmed in...... this model. In addition, antiarrhythmic effects of different inhibitors of Ca2+-activated small conductance K+ (SK) channels were demonstrated. Intravenous application of 5 mg/kg of the negative SK channel modulator NS8593 reduced AF duration by 64.5%, and the lowest significantly effective dose was 1.......5 mg/kg. A dose-effect relationship was established based on 6 different dose groups. Furthermore, it was demonstrated that the antiarrhythmic effect of NS8593 and other tested drugs was associated with an increase in atrial effective refractory period. The functional role of SK channels was confirmed...

  17. THE POSSIBILITIES OF ANTIARRHYTHMIC THERAPY IN PRIMARY PREVENTION OF DEATH IN PATIENTS WITH VENTRICULAR ARRHYTHMIAS

    Directory of Open Access Journals (Sweden)

    Yu. A. Bunin

    2016-01-01

    Full Text Available Highlights of primary prevention of death in patients with ventricular arrhythmias (VA are discussed. Overview of all main clinical trials exploring various anti-arrhythmic drugs in prevention of death in patients with VA is presented. It is emphasized that in patients with organic heart disease and VA only beta-blockers and amiodarone are able to reduce mortality, while other drugs have no effect on mortality, or they even increase mortality mainly due to arrhythmogenic effect. Recent clinical studies of the cardioverter-defibrillators efficacy in these patients are presented. It is shown that the use of cardioverter defibrillators compared with pharmacotherapy is more effective in prevention of fatal outcomes.

  18. Sotalol: a rescue drug in the face of life-threatening refractory ventricular tachycardia.

    Science.gov (United States)

    Kandasamy, Ashok; Arumugham, Sukumar; Krupanandha, Harshavardhan; Reddy, Bhaktavatsala

    2014-01-01

    We describe postoperative refractory ventricular tachycardia (VT) in a patient following aortic and mitral valve replacement. Following an uneventful separation from cardiopulmonary bypass with dobutamine, the patient developed recurrent VT, 4 hours into the postoperative period. The VT did not respond to standard doses of xylocard, magnesium and amiodarone. Electrolyte and acid base parameters were normal. Multiple cardioversions failed to revert back to a stable rhythm. Intra-aortic balloon pumping was instituted and overdrive right ventricular pacing was unsuccessful. Following intravenous sotalol 80 mg, the VT came under control and reverted to a nodal rhythm, which required atrial pacing for the next 8 hours. Oral sotalol therapy was continued at 40 mg daily. The VT did not recur. PMID:24732625

  19. Ventricular fibrillation after bortezomib therapy in a patient with systemic amyloidosis

    Directory of Open Access Journals (Sweden)

    Satoshi Yamasaki

    2013-09-01

    Full Text Available A 64-year-old female was diagnosed with systemic amyloidosis associated with multiple myeloma. Bortezomib and dexamethasone-therapy was initiated; however, she developed lethal ventricular fibrillation (VF and cardiac arrest after 84 hours of therapy. Cardiopulmonary resuscitation using direct current shocks with epinephrine and amiodarone was initiated but failed to receive cardiac function. Although her arterial pulsations recovered immediately after the injection of vasopressin, she died of heart failure 8 hours after the onset of VF. Cardiac amyloidosis was verified by autopsy. Although the direct association of bortezomib with lethal VF remained to be clarified in our patient, the current report emphasizes on bortezomib as a substantial risk factor for cardiomyocyte damage. The potential risk of lethal events associated with cardiac amyloidosis should be carefully considered during bortezomib treatment for patients with AL amyloidosis.

  20. [Resuscitation - Adult advanced life support].

    Science.gov (United States)

    Gräsner, Jan-Thorsten; Bein, Berthold

    2016-03-01

    Enhanced measures for resuscitation of adults are based on basic measures of resuscitation. The central elements are highly effective chest compressions and avoidance of disruptions that are associated with poor patient outcomes that occur within seconds. The universal algorithm distinguishes the therapy for ventricular fibrillation from the therapy in asystole or pulseless electrical activity (PEA) by the need of defibrillation, and amiodarone administration in the former. Defibrillation is biphasic. In all other aspects, there are no differences in therapy. In each episode of cardiac arrest, reversible causes should be excluded or treated. For the diagnosis during resuscitation, sonography can be helpful. What is new in the 2015 ERC recommendations is the use of capnography, which can be used for the assessment of ROSC (return of spontaneous circulation), ventilation, resuscitation and intubation quality. Mechanical resuscitation devices can be used in selected situations. Successful primary resuscitation should be directly followed by measures of the post-resuscitation care. PMID:27022698

  1. Taquicardia ectópica congénita de la unión: Tratamiento farmacológico en el primer año de vida Congenital junctional ectopic tachycardia: Pharmacologic management during infancy

    Directory of Open Access Journals (Sweden)

    Mónica N. Benjamín

    2011-12-01

    Full Text Available La forma congénita de la taquicardia ectópica de la unión (TEU es una arritmia poco frecuente que suele presentar dificultades en su manejo farmacológico, con altas tasas de morbilidad y mortalidad. El objetivo de este trabajo fue informar la experiencia en el seguimiento y el tratamiento de esta forma de taquicardia supraventricular en pacientes menores de un año. Se identificaron siete pacientes con TEU congénita en 28 meses de seguimiento entre 2008 y 2010. El diagnóstico fue realizado en el primer día de vida en cuatro pacientes y dentro de los 150 días de vida en los 3 restantes. Sólo dos presentaron miocardiopatía dilatada. Ninguno presentó cardiopatía estructural. Se utilizó amiodarona en todos los pacientes, en un caso como única droga, asociándose a propanolol en cuatro. En un paciente se asoció flecainida a estos dos fármacos y en otro se la combinó con amiodarona. En un tiempo de seguimiento con un rango de 1-28 meses (media 12.2 meses, mediana 9.75 meses en tres de los pacientes se consiguió obtener ritmo sinusal alternante con taquicardia nodal lenta; ninguno presentó efectos adversos secundarios a la medicación, ni deterioro de la función ventricular. Hubo sólo una muerte en el grupo estudiado. En conclusión, la combinaci��n de fármacos antiarrítmicos (amiodarona más propranolol y eventualmente flecainida constituye una alternativa válida para un adecuado control de la TEU congénita en pacientes menores de un año de edad.Congenital junctional ectopic tachycardia (JET is a rare arrhythmia that can be refractory to medical therapy with high morbidity and mortality rates. The aim of this study was to report our experience with pharmacologic management of congenital JET in infants. Seven patients with congenital JET were identified between 2008 and 2010. Only two of them presented dilated cardiomyopathy. There were no congenital structural defects. Amiodarone was given to all the patients, as single

  2. Increased mortality after dronedarone therapy for severe heart failure

    DEFF Research Database (Denmark)

    Køber, Lars; Torp-Pedersen, Christian; McMurray, John J V; Gøtzsche, Ole; Lévy, Samuel; Crijns, Harry; Amlie, Jan; Carlsen, Jan

    2008-01-01

    BACKGROUND: Dronedarone is a novel antiarrhythmic drug with electrophysiological properties that are similar to those of amiodarone, but it does not contain iodine and thus does not cause iodine-related adverse reactions. Therefore, it may be of value in the treatment of patients with heart failure....... METHODS: In a multicenter study with a double-blind design, we planned to randomly assign 1000 patients who were hospitalized with symptomatic heart failure and severe left ventricular systolic dysfunction to receive 400 mg of dronedarone twice a day or placebo. The primary end point was the composite of...... death from any cause or hospitalization for heart failure. RESULTS: After inclusion of 627 patients (310 in the dronedarone group and 317 in the placebo group), the trial was prematurely terminated for safety reasons, at the recommendation of the data and safety monitoring board, in accordance with the...

  3. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy

    Energy Technology Data Exchange (ETDEWEB)

    Okishige, Kaoru; Sasano, Tetsuo; Yano, Kei; Azegami, Kouji; Suzuki, Kou; Itoh, Kuniyasu [Yokohama Red Cross Hospital (Japan)

    2001-05-01

    We report cases of serious arrhythmias associated with apical hypertrophic cardiomyopathy (AHCM). Thirty-one patients were referred to our institute to undergo further assessment of their AHCM from 1988 to 1999. Three patients with nonsustained ventricular tachycardia demonstrated an {sup 123}I-MIBG regional reduction in the tracer uptake. In two patients with ventricular fibrillation (VF), the findings from {sup 123}I-MIBG imaging revealed regional sympathetic denervation in the inferior and lateral regions. Electrophysiologic study demonstrated reproducible induction of VF in aborted sudden death and presyncopal patients, resulting in the need for an implantable defibrillator device and amiodarone in each patient. Patients with refractory atrial fibrillation with a rapid ventricular response suffered from serious congestive heart failure. A prudent assessment and strategy in patients with this disease would be indispensable in avoiding a disastrous outcome. (author)

  4. Dronedarone (Sanofi-Synthélabo).

    Science.gov (United States)

    Le Grand, B

    2001-05-01

    Sanofi-Synthelabo (formerly Sanofi) is developing the class III antiarrhythmic agent, dronedarone, for the potential treatment of atrial fibrillation and ventricular tachycardia [157842]. Phase III trials for the treatment of arrhythmia are planned for 2001 [399945]. By December 1998, phase IIb trials for the treatment of cardiac arrhythmia had been initiated [295681,320585], and the compound was shown to have the same efficacy as, and better tolerability than amiodarone [330073]. By 1997, the compound had entered phase IIa trials in Europe [219077,295681]. In November 1997, Sanofi expected to file for marketing in 2001/2 [270242]. ABN Amro predicted sales of FFR 50 million in 2001, rising to FFR 150 million in 2002 [317536]. Lehman Brothers predicted a 20% chance of the compound reaching market, with a launch anticipated in 2003 and potential peak sales of $200 million in 2011 [346267]. PMID:16012904

  5. The Expanding Role of NMR in Drug Discovery and Development

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    @@ The role of NMR in the pharmaceutical industry has changed dramatically over the last decade. Once thought of as an analytical technique used primarily to support synthetic chemistry, NMR now has an important role in the investigation of biochemical changes involved in clinical diseases and drug toxicity. It is also used extensively to elucidate the structures of drug metabolites. Data obtained using LC NMR MS and 19F NMR will be used to illustrate the utility of hyphenated methods in identifying xenobiotic metabolites as part of a drug development program. The application of NMR to the study of potential drug toxicity will also be described using the cationic, amphiphilic drugs chloroquine and amiodarone. These drugs are known to induce phospholipidosis characterized by lysosomal lamellar bodies and drug accumulation. Using a metabonomic approach, NMR spectroscopy of urine allowed the identification of a combination of urinary biomarkers of phospholipidosis.

  6. Serious arrhythmias in patients with apical hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    We report cases of serious arrhythmias associated with apical hypertrophic cardiomyopathy (AHCM). Thirty-one patients were referred to our institute to undergo further assessment of their AHCM from 1988 to 1999. Three patients with nonsustained ventricular tachycardia demonstrated an 123I-MIBG regional reduction in the tracer uptake. In two patients with ventricular fibrillation (VF), the findings from 123I-MIBG imaging revealed regional sympathetic denervation in the inferior and lateral regions. Electrophysiologic study demonstrated reproducible induction of VF in aborted sudden death and presyncopal patients, resulting in the need for an implantable defibrillator device and amiodarone in each patient. Patients with refractory atrial fibrillation with a rapid ventricular response suffered from serious congestive heart failure. A prudent assessment and strategy in patients with this disease would be indispensable in avoiding a disastrous outcome. (author)

  7. Sotalol: A rescue drug in the face of life-threatening refractory ventricular tachycardia

    Directory of Open Access Journals (Sweden)

    Ashok Kandasamy

    2014-01-01

    Full Text Available We describe postoperative refractory ventricular tachycardia (VT in a patient following aortic and mitral valve replacement. Following an uneventful separation from cardiopulmonary bypass with dobutamine, the patient developed recurrent VT, 4 hours into the postoperative period. The VT did not respond to standard doses of xylocard, magnesium and amiodarone. Electrolyte and acid base parameters were normal. Multiple cardioversions failed to revert back to a stable rhythm. Intra-aortic balloon pumping was instituted and overdrive right ventricular pacing was unsuccessful. Following intravenous sotalol 80 mg, the VT came under control and reverted to a nodal rhythm, which required atrial pacing for the next 8 hours. Oral sotalol therapy was continued at 40 mg daily. The VT did not recur.

  8. Practical aspects of apixaban use in clinical practice: continuing the theme

    Directory of Open Access Journals (Sweden)

    S. N. Bel'diev

    2015-11-01

    Full Text Available Currently there are no generally accepted guidelines for the use of apixaban together with CYP3A4 and/or P-glycoprotein (P-gp inhibitors. Analysis of clinical and pharmacological studies suggests that apixaban dose should be reduced to 2.5 mg twice daily when co-administered with a strong CYP3A4 and P-gp inhibitors, such as azole antimycotics, HIV protease inhibitors and clarithromycin. However, it is preferred to avoid apixaban combination with strong CYP3A4 and P-gp inhibitors in patients with a creatinine clearance (CrCl <30 mL/min. According to preliminary calculations, apixaban dose should also be adjusted in patients with CrCl <70-80 ml/min, receiving less potent inhibitors of CYP3A4 and/or P-gp, such as diltiazem, naproxen, verapamil, amiodarone and quinidine. 

  9. Drugs in breastfeeding.

    Science.gov (United States)

    Hotham, Neil; Hotham, Elizabeth

    2015-10-01

    Most commonly used drugs are relatively safe for breastfed babies. The dose received via milk is generally small and much less than the known safe doses of the same drug given directly to neonates and infants. Drugs contraindicated during breastfeeding include anticancer drugs, lithium, oral retinoids, iodine, amiodarone and gold salts. An understanding of the principles underlying the transfer into breast milk is important, as is an awareness of the potential adverse effects on the infant. Discussion with the mother about the possibility of either negative product information or ill-informed advice from others will reduce the confusion and anxiety that may be generated. Good resources about medicines and breastfeeding are available and include state-based medicines information services. PMID:26648652

  10. Administration of a probiotic can change drug pharmacokinetics: effect of E. coli Nissle 1917 on amidarone absorption in rats.

    Science.gov (United States)

    Matuskova, Zuzana; Anzenbacherova, Eva; Vecera, Rostislav; Tlaskalova-Hogenova, Helena; Kolar, Milan; Anzenbacher, Pavel

    2014-01-01

    The growing interest in the composition and effects of microbiota raised the question how drug pharmacokinetics could be influenced by concomitant application of probiotics. The aim of this study was to find whether probiotic E. coli strain Nissle 1917 (EcN) influences the pharmacokinetics of concomitantly taken antiarrhythmic drug amiodarone (AMI). Live bacterial suspension of probiotic EcN (or non-probiotic E. coli strain ATCC 25922) was applied orally to male Wistar rats for seven days, while a control group of rats was treated with a saline solution. On the eighth day, the amiodarone hydrochloride was administered as one single oral dose (50 mg/kg) to all rats (N = 60). After 0, 1, 2, 3, 4, 5.5, 7, 9, 14, 22, and 30 hours, blood samples were taken from the rat abdominal aorta. The plasma level of AMI and its metabolite N-desethylamiodarone (DEA) was determined using the HPLC with UV detection. Administration of EcN led to a 43% increase of AMI AUC0-30 in comparison with control samples. However, this effect was not observed if EcN was replaced by a reference non-probiotic E. coli strain. Thus, EcN administration was most probably responsible for better drug absorption from the gastrointestinal tract. Plasma levels of DEA were also increased in plasma samples from animals treated with EcN. This change was again not found in the experiment with the reference non-probiotic strain. Higher DEA levels in samples from EcN-treated rats may be explained either by better absorption of AMI and/or by an increased activity of CYP2C forms, known to participate in metabolism of this drug, after EcN administration. In this paper, it is documented that concomitantly taken probiotic EcN may modulate pharmacokinetics of a drug; in this case, it led to an increased bioavailability of AMI. PMID:24505278

  11. Behaviour of five pharmaceuticals with high baseline toxicity in wastewater treatment

    Science.gov (United States)

    van Driezum, Inge; McArdell, Christa; Fenner, Kathrin; Helbling, Damian; van Breukelen, Boris

    2013-04-01

    Many pharmaceuticals enter the aquatic environment through sewer systems and are partially removed in wastewater treatment plants (WWTP) by sorption to sludge biomass or biodegradation. Biodegradation often does not lead to complete mineralization but to the formation of stable transformation products (TPs), which might still be harmful to the environment. Recently, a study was undertaken to assess the risk of the top 100 pharmaceuticals from wastewater of a hospital in Switzerland. The predicted toxicity was linked to the predicted environmental concentration in order to assess overall risk potential. In this study, biodegradation and sorption studies were carried out on the top five selected pharmaceuticals (amiodarone, atorvastatin, clotrimazole, meclozine and ritonavir). Potential TPs that are formed during activated sludge treatment were identified and concentrations of both the parent compounds and TPs were measured in the WWTP. With this data, the fate of these compounds was modeled in a WWTP system using a multi-reactor steady-state WWTP model. This study showed that sorption was the most important loss process for amiodarone and meclozine. They had an elimination of more than 99%. Sorption was also the main loss process for clotrimazole, but it was combined with some biodegradation. For ritonavir, both biodegradation and sorption played a role in the loss of this compound. The most important removal process for atorvastatin was biodegradation. Four TPs, formed through β-oxidation and monohydroxilation, were identified in both the activated sludge batch reactors and the WWTP effluent. In the WWTP effluent, only atorvastatin, clotrimazole and ritonavir were found. All identified TPs of atorvastatin were detected in the effluent. Risk quotients (RQ) of all five pharmaceuticals were estimated based on effluent concentration and baseline toxicity and ranged from zero to 2.14. Only ritonavir potentially poses an ecotoxicological risk for the aquatic environment.

  12. In vivo hepatotoxicity study of rats in comparison with in vitro hepatotoxicity screening system.

    Science.gov (United States)

    Kikkawa, Rie; Fujikawa, Masaaki; Yamamoto, Toshinori; Hamada, Yoshimasa; Yamada, Hiroshi; Horii, Ikuo

    2006-02-01

    For the establishment of a high throughput screening system using primary cell cultures, investigation of elucidated toxicities to assess the correlation between in vitro and in vivo hepatotoxicity is necessary in the safety evaluation of the compound. In the previous study, we reported the usability of rat primary cultured hepatocytes for establishment of high throughput screening system. To confirm the reliability of rat primary hepatocytes culture screening system, we conducted a single-dose in vivo study with relatively high dose of hepatotoxicant in rats using 4 reference compounds (acetaminophen, amiodarone, tetracycline, carbon tetrachloride), and investigated histopathological changes and expression of oxidative stress-related proteins by immunohistochemistry. We also carried out a proteomics analysis for estimating the reliable and sensitive biomarkers. Histopathologically, compound-specific hepatotoxicity was detected at 24 hr after administration in all compounds except amiodarone, which is known to induce phospholipidosis. Immunohistochemically, oxidative stress-related proteins were increased within 6 hr after administration in all treated groups. Proteomics analysis revealed several protein biomarkers related to oxidative stress and mitochondrial metabolism-regulation, which had been previously detected by proteomics analysis in in vitro screening system. Oxidative stress-related proteins were considered as useful biomarkers of hepatotoxicity; since they were detected by immunohistochemistry and proteomics analysis prior to appearance of compound-specific histopathological changes detected by light microscopy. Considering the relevance of in vitro system to in vivo system from the aspect of new biomarkers related to the toxicogenomics/toxicoproteomics, in vitro primary cell culture system would be sufficient to detect hepatotoxicity in the early stage of drug discovery. PMID:16538041

  13. Drug therapy in cardiac arrest: a review of the literature.

    Science.gov (United States)

    Lundin, Andreas; Djärv, Therese; Engdahl, Johan; Hollenberg, Jacob; Nordberg, Per; Ravn-Fischer, Annika; Ringh, Mattias; Rysz, Susanne; Svensson, Leif; Herlitz, Johan; Lundgren, Peter

    2016-01-01

    The aim of this study was to review the literature on human studies of drug therapy in cardiac arrest during the last 25 years. In May 2015, a systematic literature search was performed in PubMed, Embase, the Cochrane Library, and CRD databases. Prospective interventional and observational studies evaluating a specified drug therapy in human cardiac arrest reporting a clinical endpoint [i.e. return of spontaneous circulation (ROSC) or survival] and published in English 1990 or later were included, whereas animal studies, case series and reports, studies of drug administration, drug pharmacology, non-specified drug therapies, preventive drug therapy, drug administration after ROSC, studies with primarily physiological endpoints, and studies of traumatic cardiac arrest were excluded. The literature search identified a total of 8936 articles. Eighty-eight articles met our inclusion criteria and were included in the review. We identified no human study in which drug therapy, compared with placebo, improved long-term survival. Regarding adrenaline and amiodarone, the drugs currently recommended in cardiac arrest, two prospective randomized placebo-controlled trials, were identified for adrenaline, and one for amiodarone, but they were all underpowered to detect differences in survival to hospital discharge. Of all reviewed studies, only one recent prospective study demonstrated improved neurological outcome with one therapy over another using a combination of vasopressin, steroids, and adrenaline as the intervention compared with standard adrenaline administration. The evidence base for drug therapy in cardiac arrest is scarce. However, many human studies on drug therapy in cardiac arrest have not been powered to identify differences in important clinical outcomes such as survival to hospital discharge and favourable neurological outcome. Efforts are needed to initiate large multicentre prospective randomized clinical trials to evaluate both currently recommended and

  14. Pre-injury beta blocker use does not affect the hyperdynamic response in older trauma patients

    Directory of Open Access Journals (Sweden)

    David C Evans

    2014-01-01

    Full Text Available Purpose: Trauma dogma dictates that the physiologic response to injury is blunted by beta-blockers and other cardiac medications. We sought to determine how the pre-injury cardiac medication profile influences admission physiology and post-injury outcomes. Materials and Methods: Trauma patients older than 45 evaluated at our center were retrospectively studied. Pre-injury medication profiles were evaluated for angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACE-I/ARB, beta-blockers, calcium channel blockers, amiodarone, or a combination of the above mentioned agents. Multivariable logistic regression or linear regression analyses were used to identify relationships between pre-injury medications, vital signs on presentation, post-injury complications, length of hospital stay, and mortality. Results: Records of 645 patients were reviewed (mean age 62.9 years, Injury Severity Score >10, 23%. Our analysis demonstrated no effect on systolic and diastolic blood pressures from beta-blocker, ACE-I/ARB, calcium channel blocker, and amiodarone use. The triple therapy (combined beta-blocker, calcium channel blocker, and ACE-I/ARB patient group had significantly lower heart rate than the no cardiac medication group. No other groups were statistically different for heart rate, systolic, and diastolic blood pressure. Conclusions: Pre-injury use of cardiac medication lowered heart rate in the triple-agent group (beta-blocker, calcium channel blocker, and ACEi/ARB when compared the no cardiac medication group. While most combinations of cardiac medications do not blunt the hyperdynamic response in trauma cases, patients on combined beta-blocker, calcium channel blocker, and ACE-I/ARB therapy had higher mortality and more in-hospital complications despite only mild attenuation of the hyperdynamic response.

  15. Administration of a probiotic can change drug pharmacokinetics: effect of E. coli Nissle 1917 on amidarone absorption in rats.

    Directory of Open Access Journals (Sweden)

    Zuzana Matuskova

    Full Text Available The growing interest in the composition and effects of microbiota raised the question how drug pharmacokinetics could be influenced by concomitant application of probiotics. The aim of this study was to find whether probiotic E. coli strain Nissle 1917 (EcN influences the pharmacokinetics of concomitantly taken antiarrhythmic drug amiodarone (AMI. Live bacterial suspension of probiotic EcN (or non-probiotic E. coli strain ATCC 25922 was applied orally to male Wistar rats for seven days, while a control group of rats was treated with a saline solution. On the eighth day, the amiodarone hydrochloride was administered as one single oral dose (50 mg/kg to all rats (N = 60. After 0, 1, 2, 3, 4, 5.5, 7, 9, 14, 22, and 30 hours, blood samples were taken from the rat abdominal aorta. The plasma level of AMI and its metabolite N-desethylamiodarone (DEA was determined using the HPLC with UV detection. Administration of EcN led to a 43% increase of AMI AUC0-30 in comparison with control samples. However, this effect was not observed if EcN was replaced by a reference non-probiotic E. coli strain. Thus, EcN administration was most probably responsible for better drug absorption from the gastrointestinal tract. Plasma levels of DEA were also increased in plasma samples from animals treated with EcN. This change was again not found in the experiment with the reference non-probiotic strain. Higher DEA levels in samples from EcN-treated rats may be explained either by better absorption of AMI and/or by an increased activity of CYP2C forms, known to participate in metabolism of this drug, after EcN administration. In this paper, it is documented that concomitantly taken probiotic EcN may modulate pharmacokinetics of a drug; in this case, it led to an increased bioavailability of AMI.

  16. Variation in Antiarrhythmic Management of Infants Hospitalized with Supraventricular Tachycardia: A Multi-Institutional Analysis.

    Science.gov (United States)

    Guerrier, Karine; Shamszad, Pirouz; Czosek, Richard J; Spar, David S; Knilans, Timothy K; Anderson, Jeffrey B

    2016-06-01

    Supraventricular tachycardia (SVT) is the most frequent form of symptomatic tachyarrhythmia in infants. The purposes of this study were to describe practice patterns of the management of infants hospitalized with SVT and factors associated with 30-day hospital readmission. This was a multi-institutional, retrospective review of the pediatric health information system database of SVT hospitalizations from 2003 to 2013. High-volume centers (HVC) were defined as those at the upper quartile of admissions. Infants with an ICD-9 code of paroxysmal SVT were included. Antiarrhythmics investigated included amiodarone, atenolol, digoxin, esmolol, flecainide, procainamide, propafenone, propranolol, and sotalol. Frequency of antiarrhythmic use based on center volume was the primary end point. Rate of 30-day SVT readmission was the secondary end point. Analysis of factors associated with readmission was assessed by Chi-square analysis and expressed as odds ratio and 95 % confidence interval. A total of 851 patients (60 % male, 44 % neonates) were hospitalized at 43 hospitals. Propranolol, digoxin, and amiodarone were the most frequently utilized antiarrhythmics. HVCs represented 12 hospitals comprising 494 (58 %) patients. Although HVCs were more likely to utilize propranolol (OR 2.5, CI 1.5-4.1), there was no significant difference in the 30-day readmission rate between patients treated at HVCs versus non-HVCs (p = 0.9). The majority of infants with SVT are treated with a small number of antiarrhythmic medications during index hospitalization. Although hospital-to-hospital variation in antiarrhythmic choice exists, there appears to be no difference in readmission. The remaining practice variation may be related to intrinsic patient characteristics. PMID:27033244

  17. Factors affecting the quality of anticoagulation with warfarin: experience of one cardiac centre

    Science.gov (United States)

    Ciurus, Tomasz; Cichocka-Radwan, Anna

    2015-01-01

    Introduction The risk of complications in anticoagulation therapy can be reduced by maximising the percentage of time spent by the patient in the optimal therapeutic range (TTR). However, little is known about the predictors of anticoagulation control. The aim of this paper was to assess the quality of anticoagulant therapy in patients on warfarin and to identify the factors affecting its deterioration. Material and methods We studied 149 patients who required anticoagulant therapy with warfarin due to non-valvular atrial fibrillation and/or venous thromboembolism. Each patient underwent proper training regarding the implemented treatment and remained under constant medical care. Results The mean age of the patients was 68.8 ± 12.6 years, and 59% were male. A total of 2460 international normalised ratio (INR) measurements were collected during the 18-month period. The mean TTR in the studied cohort was 76 ± 21%, and the median was 80%. The level at which high-quality anticoagulation was recorded for this study was based on TTR values above 80%. Seventy-five patients with TTR ≥ 80% were included in the stable anticoagulation group (TTR ≥ 80%); the remaining 74 patients constituted the unstable anticoagulation group (TTR < 80%). According to multivariate stepwise regression analysis, the independent variables increasing the risk of deterioration of anticoagulation quality were: arterial hypertension (OR 2.74 [CI 95%: 1.06-7.10]; p = 0.038), amiodarone therapy (OR 4.22 [CI 95%: 1.30-13.70]; p = 0.017), and obesity (OR 1.11 [CI 95%: 1.02-1.21]; p = 0.013). Conclusions The presence of obesity, hypertension, or amiodarone therapy decreases the quality of anticoagulation with warfarin. High quality of anticoagulation can be achieved through proper monitoring and education of patients. PMID:26855650

  18. Widely used pharmaceuticals present in the environment revealed as in vitro antagonists for human estrogen and androgen receptors.

    Science.gov (United States)

    Ezechiáš, Martin; Janochová, Jana; Filipová, Alena; Křesinová, Zdena; Cajthaml, Tomáš

    2016-06-01

    A considerable amount of scientific evidence indicates that a number of pharmaceuticals that could be detected in the environment can contribute towards the development of problems associated with human reproductive systems, as well as those of wildlife. We investigated the estrogenic and androgenic effects of select pharmaceuticals with high production volume and environmental relevance. We examined the receptor-binding activities of these pharmaceuticals in the T47D human cell line using altered secretion of cytokine CXCL12. Functional yeast-luciferase reporter gene assays were also employed to confirm the mechanism of receptor binding by estrogen and androgen. Non-steroidal anti-inflammatory drugs, namely ibuprofen, diclofenac and antiarrhythmic agent amiodarone showed strong anti-estrogenic effects in the T47D cell line. In the yeast-luciferase assay, these anti-inflammatory drugs also demonstrated anti-estrogenic potency and inhibited the E2 response in a concentration-dependent manner. Amiodarone did not exhibit any response in the yeast-luciferase assay; therefore, the endocrine disruption presumably occurred at a different level without directly involving the receptor. All the anti-inflammatory drugs considered in this study, including ketoprofen, naproxen and clofibrate, exhibited a dose-dependent antagonism towards the androgen receptor in the yeast-luciferase assays. Several other drugs, including the stimulant caffeine, did not show any response in the tests that were employed. A risk assessment analysis using 'Hazard Quotient' suggested a potential risk, especially in the cases of ibuprofen, ketoprofen, diclofenac and clofibrate. The results reveal the intrinsic endocrine disrupting nature of several pharmaceuticals and thus could contribute towards explaining a number of adverse health effects on humans and wildlife. PMID:26978704

  19. Potential proarrhythmic effect of cardiac resynchronization therapy during perioperative period: data from a single cardiac center

    Institute of Scientific and Technical Information of China (English)

    LUO Nian-sang; YUAN Wo-liang; LIN Yong-qing; CHEN Yang-xin; MAO Xiao-qun; XIE Shuang-lun; KONG Min-yi; ZHOU Shu-xian; WANG Jing-feng

    2010-01-01

    Background Cardiac resynchronization therapy (CRT) could improve heart function, symptom status, quality of life and reduce hospitalization and mortality in patients with severe heart failure (HF) with optimal medical management. However,the possible adverse effects of CRT are often ignored by clinicians.Method A retrospective analysis of CRT over a 6-year period was made in a single cardiac center.Results Fifty-four patients were treated with CRT(D) device, aged (57±11) years, with left ventricular ejection fraction of (32.1±9.8)%, of which 4 (7%) developed ventricular tachycardia/ventricular fibrillation (VT/VF) or junctional tachycardia after operation. Except for one with frequent ventricular premature beat before operation, the others had no previous history of ventricular arrhythmia. Of the 4 patients, 3 had dilated cardiomyopathy and 1 had ischemic cardiomyopathy,and tachycardia occurred within 3 days after operation. Sustained, refractory VT and subsequent VF occurred in one patient, frequent nonsustained VT in two patients and nonparoxysmal atrioventricular junctional tachycardia in one patient. VT was managed by amiodarone in two patients, amiodarone together with beta-blocker in one patient, and junctional tachycardia was terminated by overdrive pacing. During over 12-month follow-up, except for one patient's death due to refractory heart and respiratory failure in hospital, the others remain alive and arrhythmia-free.Conclusions New-onset VT/VF or junctional tachycardia may occur in a minority of patients with or without prior history of tachycardia after biventricular pacing. Arrhythmia can be managed by conventional therapy, but may require temporary discontinuation of pacing. More observational studies should be performed to determine the potential proarrhythmic effect of CRT.

  20. Comparative study between the protective effects of Saudi and Egyptian antivenoms, alone or in combination with ion channel modulators, against deleterious actions of Leiurus quinquestriatus scorpion venom.

    Science.gov (United States)

    Fatani, Amal J; Ahmed, Amany A E; Abdel-Halim, Rabab M; Abdoon, Nozha A; Darweesh, Amal Q

    2010-04-01

    This study compared efficacy of two polyvalent antivenoms (Saudi Arabian and Egyptian), against lethality and pathophysiological changes of Leiurus quinquestriatus quinquestriatus (LQQ) scorpion venom in mice. Additionally, the study examined whether treatment with selected ion channel modulators, lidocaine, nimodipine or amiodarone would be effective, alone or combined with the antivenoms. The protein concentration of the Saudi antivenom was 1/3 of Egyptian, indicating lesser immunogenicity, while both preservative contents were within limits. In immunodiffusion experiments, both exhibited prominent precipitin bands indicating high concentrations of specific antibodies. Neutralizing capacities (60-70 LD(50)) stated on labels were confirmed. Both antivenoms significantly (P < 0.001) prolonged survival time (from 26.9 +/- 1.18 min, 100% dead with venom to 224-300 min, 0-30% dead) of envenomed mice, whether injected iv before or 5 min after venom. Injection of either antivenom plus ion channel modulators, gave comparable results to that observed in mice treated with antivenoms alone. The Na(+) channel blocker lidocaine and the Ca(2+) channel blocker nimodipine on their own significantly protected the animals (P < 0.05), but to a lesser extent. The two antivenoms, significantly ameliorated the venom-evoked changes in serum LDH (P < 0.001) and CKMB (P < 0.01) plus cardiac TNFalpha and nitrate/nitrite levels (P < 0.001). When combined with lidocaine or nimodipine, the effects were not greater than antivenom alone. Moreover, the antivenoms ameliorated characteristic venom-evoked changes in the isolated perfused Langendorff hearts. Lidocaine and amiodarone were more effective than nimodipine. In Conclusion both Saudi and Egyptian antivenoms protected mice from the pathological and lethal effects of LQQ scorpion. Sodium and calcium channel blockers, lidocaine and nimodipine, may be useful when antivenoms are not available. PMID:19931297

  1. Early life-stage toxicity of eight pharmaceuticals to the fathead minnow, Pimephales promelas.

    Science.gov (United States)

    Overturf, M D; Overturf, C L; Baxter, D; Hala, D N; Constantine, L; Venables, B; Huggett, D B

    2012-04-01

    Human pharmaceuticals are routinely being detected in the environment, and there is growing concern about whether these drugs could elicit effects on aquatic organisms. Regulatory paradigms have shifted accordingly, with a greater emphasis on chronic toxicity data compared with acute data. The Organisation for Economic Co-operation and Development 210 Early Life Stage Test has been proposed as a good measure of the potential for pharmaceuticals to elicit chronic toxicity. To begin building a data set regarding the early life-stage toxicity of pharmaceuticals to fish, fathead minnows (FHM) were exposed to amiodarone, carbamazepine, clozapine, dexamethasone, fenofibrate, ibuprofen, norethindrone, or verapamil. Survival and growth were used to assess chronic toxicity in FHM at 28 days posthatch. Exposure of FHM to carbamazepine, fenofibrate, and ibuprofen resulted in no significant adverse effects at the concentrations tested. FHM survival was not impacted by verapamil exposure; however, growth was significantly decreased at 600 μg/L. Dexamethasone-exposed FHM showed a significant decrease in survival at a concentration of 577 μg/L; however, growth was not impacted at the concentration tested. Norethindrone exposure resulted in a significant decrease in survival and dry weight at 14.8 and 0.74 μg/L, respectively. Exposure to amiodarone and clozapine resulted in a significant decrease in survival and a significant increase in growth at concentrations of 1020 and 30.8 μg/L, respectively. Although the effect levels derived in this study are greater then concentrations observed in the environment, these data suggest that synthetic progestins may require additional research. PMID:22048524

  2. 胺碘酮对老年人急性心肌梗死合并快速心室率心房颤动的疗效观察%The effects of amiodrone on rapid ventricle rate atrial fibrillation in elder patients with acute myocardial infarction

    Institute of Scientific and Technical Information of China (English)

    李慧

    2015-01-01

    Objective:To assess the effects of amiodarone on rapid ventrile rate in elderly atrial fibrillation(Af)patients with acute myocardial infarction.Method:Forty-eight elderly Af patients(from 65 to 85 years old),who experienced >120 times/min rapid ventrile rate within 24 hours with acute myocardial infarction during recent 1month were prescribed vein plus oral application of amiodarone.Observing index included the condition of converting and maintaining of atrial fibrillation,ventricular rate controlling,blood pressure changing,mortality in 30 days,and negative effects.Result:In 48 cases of acute myocardial infarction with rapid atrial fibrillation,41 cases (85.4%) restored sinus rhythm within 48 hours.3 cases died.In 45 out of 48 cases,the ventricular rate were significantly reduced(P<0.01),and appeared no significant changes in blood pressure (P>0.05).One of 45 cases appeared to be sinus bradycardia.Three cases appeared long R-R intermittent pause.One case showed hypotension.Another 2 cases appeared phlebitis.During 30 days of follow-up,all of 45 patients were survived,with no other adverse reactions.Conclusion:In acute myocardial infarction,vein plus oral application amiodarone is effective and safe in controling fast ventriculer rate of elderly patients with Af.%目的:观察胺碘酮治疗老年人急性心肌梗死合并快速心室率心房颤动的安全性及疗效.方法:选取48例近1个月内发生心肌梗死,入院后24 h内并发的心室率>120次/min快速心室率心房颤动的老年患者,年龄65~85岁,给予胺碘酮静脉加口服治疗,观察心房颤动转复及维持情况、心室率控制情况、血压变化情况、30 d病死率及不良反应.结果:48例患者中41例(85.4%)在48 h内恢复窦性心律,3例死亡,4例未转复.转复与未转复的45例患者用药后心室率明显下降(P<0.01),用药前后血压无明显变化(P>0.05).1例出现窦性心动过缓,3例出现长R-R间歇,1例血压出现下降,2

  3. Patient and medication-related factors associated with hospital-acquired hyponatremia in patients hospitalized from heart failure.

    Science.gov (United States)

    Saepudin, S; Ball, Patrick A; Morrissey, Hana

    2016-08-01

    Background Hyponatremia has been known as an important predictor of clinical outcomes in patients with heart failure (HF). While information on hyponatremia in patients with HF has been available abundantly, information on factors associated with increased risk of developing hospital-acquired hyponatremia (HAH) is still limited. Objective To identify patients and medication-related factors associated with HAH in patients hospitalized from HF. Setting Fatmawati Hospital in Jakarta, Indonesia. Methods This is a nested case-control study with patients developing HAH served as case group and each patient in case group was matched by age and gender to three patients in control group. Patients included in this study are patients hospitalized from HF, and coded with I.50 according to ICD-10, during 2011-2013 at Fatmawati Hospital in Jakarta, Indonesia. Information retrieved from patients' medical records included demographic profiles, vital signs and symptoms at admission, past medical history, medication during hospitalization and clinical chemistry laboratory records. Multivariable logistic regression analysis was performed to find out patient and treatment-related factors associated with the development of HAH. Main outcome measures Patients and medication related factors having significant association with HAH. Results Four hundreds sixty-four patients were included in this study and 45 of them (9.7 %) met criteria of developing HAH so then, accordingly, 135 patients were selected as controls. 36 patient- and 22 treatment-related factors were analyzed in univariate logistic regression resulted in 20 factors having p value <0.2 and were included in multivariable logistic regression analysis. Final factors showing significant association with HAH are presence of ascites at admission (odds ratio = 4.7; 95 % confidence interval 1.9-11.5) and administration of amiodarone (3.2; 1.3-7.4) and heparin (3.1; 1.2-7.3) during hospital stay. Conclusion Presence of ascites at

  4. Serious drug interactions.

    Science.gov (United States)

    Aronson, J

    1993-10-01

    Of the many varieties of drug interactions, which occur when the disposition or actions of one drug are changed by another, only a few are serious or potentially fatal. A representative outline of some of these illustrates the problem. Precipitant drugs are those which produce the interaction, and object drugs are those whose effects are changed. The interactions which are usually significant are those which alter the metabolism, involve renal excretion, or change the effects of the object drug, especially when the object drug has a low therapeutic index (cardiovascular drugs, anticoagulants, drugs acting on the brain, hypoglycemic drugs, hormones, and cytotoxic drugs). Warfarin toxicity, for example, is produced by aspirin, phenylbutazone, and azapropazone. The dosage requirements of warfarin are reduced by chloramphenicol, ciprofloxacin and other quinolones, erythromycin and some of the other macrolides, metronidazole and other imidazoles, tetracyclines, amiodarone, cimetidine (but not ranitidine), and fibrates. Potassium-depleting drugs can potentiate the action of digoxin, and the elimination of digoxin can be reduced by amiodarone, propafenone, quinidine, and verapamil. Combined oral contraceptives can lose effectiveness through the interaction of carbamazepine, griseofulvin, phenytoin, or rifampicin, which increase estrogen metabolism. In addition, broad-spectrum antibiotics such as ampicillin or tetracyclines also reduce contraceptive effectiveness by altering gut absorption. Even a single drink of an alcoholic beverage may be dangerous to people taking antidepressants, antihistamines, antipsychotic drugs, benzodiazepines, or lithium. Antihistamines suffer inhibited metabolism in the liver if taken in conjunction with the antifungal imidazoles and some of the macrolide antibiotics. Cardiotoxicity of antihistamines is also enhanced by drugs with similar cardiotoxic effects. Lithium potentiation is enhanced by the new serotonin-reuptake inhibitors, and lithium

  5. Drug-induced interstitial lung diseases. Often forgotten; Medikamenteninduzierte interstitielle Lungenerkrankungen. Haeufig vergessen

    Energy Technology Data Exchange (ETDEWEB)

    Poschenrieder, F.; Stroszczynski, C. [Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg (Germany); Hamer, O.W. [Universitaetsklinikum Regensburg, Institut fuer Roentgendiagnostik, Regensburg (Germany); Lungenfachklinik Donaustauf, Donaustauf (Germany)

    2014-12-15

    Drug-induced interstitial lung diseases (DILD) are probably more common than diagnosed. Due to their potential reversibility, increased vigilance towards DILD is appropriate also from the radiologist's point of view, particularly as these diseases regularly exhibit radiological correlates in high-resolution computed tomography (HRCT) of the lungs. Based on personal experience typical relatively common manifestations of DILD are diffuse alveolar damage (DAD), eosinophilic pneumonia (EP), hypersensitivity pneumonitis (HP), organizing pneumonia (OP), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). These patterns are presented based on case studies, whereby emphasis is placed on the clinical context. This is to highlight the relevance of interdisciplinary communication and discussion in the diagnostic field of DILD as it is a diagnosis of exclusion or of probability in most cases. Helpful differential diagnostic indications for the presence of DILD, such as an accompanying eosinophilia or increased attenuation of pulmonary consolidations in amiodarone-induced pneumopathy are mentioned and the freely available online database http://www.pneumotox.com is presented. (orig.) [German] Medikamenteninduzierte interstitielle Lungenerkrankungen (engl. ''drug-induced interstitial lung diseases'', DILD) sind wahrscheinlich haeufiger, als sie diagnostiziert werden. Aufgrund ihrer potenziellen Reversibilitaet ist eine erhoehte Vigilanz gegenueber DILD auch seitens der Radiologie angebracht, da diese regelmaessig ein radiomorphologisches Korrelat in der hochaufloesenden Computertomographie (''high-resolution CT'', HRCT) der Lunge aufweisen. Typische, nach eigener Erfahrung relativ haeufige Manifestationsformen von DILD sind der diffuse Alveolarschaden (engl. ''diffuse alveolar damage'', DAD), die eosinophile Pneumonie (EP), die Hypersensitivitaetspneumonitis (HP), die organisierende

  6. 心力衰竭合并心房纤颤患者60例的临床治疗研究%Clinical treatment research of 60 cases of patients with heart failure combined with atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    张治凯

    2015-01-01

    目的:探讨心力衰竭合并心房纤颤的临床治疗方法及治疗效果。方法:收治心力衰竭合并心房纤颤患者60例,随机分成观察组和对照组,每组30例。两组患者均进行常规基础治疗,观察组在常规基础治疗的同时,给予胺碘酮联合美托洛尔进行治疗。结果:观察组临床治疗总有效率96.6%高于对照组的83.3%。观察组5 d内症状改善率高于对照组。结论:针对心力衰竭合并心房纤颤疾病采用胺碘酮联合美托洛尔能够收到较好的治疗效果,患者临床症状改善快。%Objective:To investigate the clinical treatment methods and effect of patients with heart failure combined with atrial fibrillation.Methods:60 patients with heart failure combined with atrial fibrillation were selected.They were randomly divided into the observation group and the control group,30 casesin each group.Two groups of patients were treated with routine therapy. Patients of the observation group were given amiodarone combined with metoprolol for treatment on the basis of routine treatment. Results:The clinical treatment efficiency of observation group of 96.6% was higher than the control group of 83.3%.The symptom improvement rate within 5 days of the observation group was higher than the control group.Conclusion: For patients with heart failure combined with atrial fibrillation disease using amiodarone combined with metoprolol can receive better treatment effect, and the clinical symptoms improved rapidly.

  7. Epidemiology of thyroid diseases in Africa

    Directory of Open Access Journals (Sweden)

    Anthonia Okeoghene Ogbera

    2011-01-01

    Full Text Available Background: Thyroid disorders are common endocrine disorders encountered in the African continent. Environmental and nutritional factors are often implicated in the occurrence of some thyroid disorders that occur in this part of the world. This is a narrative review that seeks to document the pattern, prevalence, and management of thyroid disorders in the continent. Materials and Methods: The search engine used for this review were PubMed and Google scholar. All available articles on thyroid disorders from the sub-African continent, published until May 2011, were included. Results: Iodine deficiency disorders (IDD which top the list of thyroid disorders and remain the commonest cause of thyroid disorders in the continent is often affected not only by the iodine status in the region but sometimes also by selenium deficiency and thiocyanate toxicity. The reported prevalence rates of endemic goiter range from 1% to 90% depending on the area of study with myxedematous cretinism still a prominent feature of IDD in only a few regions of the continent. The extent of autoimmune thyroid disorders remains unknown because of underdiagnosis and underreporting but the few available studies note a prevalence rate of 1.2% to 9.9% of which Graves diseases is the commonest of these groups of disorders. Rarer causes of thyroid dysfunction such as thyroid tuberculosis and amiodarone related causes are also documented in this review. The onset of new thyroid diseases following amiodarone usage was documented in 27.6% of persons treated for arrhythmia. Reports on thyroid malignancies (CA in Africa abound and differentiated thyroid malignancies are noted to occur more commonly than the other forms of thyroid CA. The documented prevalence rates of thyroid CA in the African continent are as follows (papillary: 6.7-72.1%, follicular: 4.9-68%, anaplastic: 5-21.4%, and medullary: 2.6%-13.8%. For the differentiated thyroid CA, there is a changing trend toward the more

  8. Blinded Evaluation of Combination Drug Therapy for Prolonged Ventricular Fibrillation Using a Swine Model of Sudden Cardiac Arrest.

    Science.gov (United States)

    Mader, Timothy J; Coute, Ryan A; Kellogg, Adam R; Nathanson, Brian H

    2016-01-01

    Despite experimental evidence supporting the use of resuscitation drugs in the treatment of sudden cardiac arrest (CA), there are no good human clinical data to support the decades-old practice of giving these medications during out-of-hospital CA resuscitation. We hypothesized that the lack of efficacy in clinical practice in ventricular fibrillation (VF) is the failure-based manner in which resuscitation drugs have historically been administered (one at a time interspersed with chest compressions and a defibrillation attempt, giving the next only if the previous one was ineffective). The aim of this study was to determine if giving and circulating a combination of commonly available, historically used resuscitation drugs together, prior to the first defibrillation attempt after prolonged VF, might improve short-term outcomes compared with the failure-based serial drug approach used in the past. We used a well-established swine model of sudden prolonged untreated VF. Animals were randomized to receive epinephrine (0.01 mg/kg), vasopressin (0.5 U/kg), amiodarone (4 mg/kg), and sodium bicarbonate (1.0 mEq/kg) in series (SERIES group [n = 53]) or a combination of epinephrine (0.01 mg/kg), vasopressin (0.5 U/kg), amiodarone (4 mg/kg), sodium bicarbonate (1.0 mEq/kg), and metoprolol (0.2 mg/kg) (COCKTAIL group) delivered in rapid succession at the beginning of the attempted resuscitation (n = 27). Data were analyzed descriptively. Baseline characteristics and chemistries between the two groups were the same. Termination of VF was statistically similar in the two groups: 88.7% (47/53) versus 85.2% (23/27) p = 0.66, with an adjusted relative risk ratio (RRR) of 0.94 (0.37, 1.15). However, ROSC was higher in the SERIES group (56.6% [30/53] versus 22.2% [6/27], adjusted RRR = 2.83; [1.16, 3.84] p = 0.029) as was 20-minute survival (52.8% [28/53] versus 18.5% [5/27], adjusted RRR = 3.15 [1.14, 4.54] p = 0.032). The combination of drugs studied, at these dosages

  9. Markers of endothelial dysfunction in patients with iodine induced hyperthyroidism

    International Nuclear Information System (INIS)

    Introduction: It has been reported that hyperthyroidism is associated with an altered endothelial function and increased risk of arterial thromboembolism. The aim of our study was to estimate chosen markers of endothelial dysfunction in iodine-induced thyrotoxicosis (IIT). Materials and methods: The groups studied consisted of 41 hyperthyroid subjects, who had been treated with amiodarone (n = 6) or vitamin preparations supplemented with iodine (n = 35) and 40 persons with normal thyroid function. The following parameters were measured: thyroglobulin antibodies (TG Ab), thyroid peroxidase antibodies (TPO Ab), THS receptor antibodies (TR Ab), soluble adhesion molecules: sVCAM-1 and sICAM-1, von Willebrand factor (vWF), plasminogen activator inhibitor-1 (PAI-1), C-reactive protein (CRP), fibrinogen and urine iodine concentration. Results: Patients with IIT had significantly higher levels of sVCAM-1 (p < 0.01), IL-6 (p < 0.005), fibrinogen (p < 0.005) and CRP (p < 0.05) in comparison to healthy subjects, whereas sICAM-1, PAI-1 and vWF concentrations did not differ between the groups studied. The highest sVCAM-1 levels were observed in patients with amiodarone induced thyrotoxicosis, and fibrinogen and CRP - in subjects receiving vitamin preparations. There were significant correlations between sVCAM-1 concentration and the levels of sICAM-1 (r = 0.341; p = 0.029) and PAI-1 (r = 0.347; p = 0.026), as well as with urine iodine concentration (r 0.448; p = 0.004). IL-6 concentration correlated with vWF (r = 0.456; p 0.003), TPO Ab (r = 0.328; p = 0.036) and PAI-1 level (r = 0.319; p = 0.042). Conclusion: Iodine induced thyrotoxicosis is associated with an increase of sVCAM-1 and IL-6 levels, possibly reflecting inflammatory and destructive processes in the thyroid gland. However, increased procoagulant activity was not found in patients with IIT. (author)

  10. Refractory status epilepticus after inadvertent intrathecal injection of tranexamic acid treated by magnesium sulfate.

    Science.gov (United States)

    Hatch, D M; Atito-Narh, E; Herschmiller, E J; Olufolabi, A J; Owen, M D

    2016-05-01

    We present a case of accidental injection of tranexamic acid during spinal anesthesia for an elective cesarean delivery. Immediately following intrathecal injection of 2mL of solution, the patient complained of severe back pain, followed by muscle spasm and tetany. As there was no evidence of spinal block, the medications given were checked and a 'used' ampoule of tranexamic acid was found on the spinal tray. General anesthesia was induced but muscle spasm and tetany persisted despite administration of a non-depolarizing muscle relaxant. Hemodynamic instability, ventricular tachycardia, and status epilepticus developed, which were refractory to phenytoin, diazepam, and infusions of thiopental, midazolam and amiodarone. Magnesium sulfate was administered postoperatively in the intensive care unit, following which the frequency of seizures decreased, eventually stopping. Unfortunately, on postoperative day three the patient died from cardiopulmonary arrest after an oxygen supply failure that was not associated with the initial event. This report underlines the importance of double-checking medications before injection in order to avoid a drug error. As well, it suggests that magnesium sulfate may be useful in stopping seizures caused by the intrathecal injection of tranexamic acid. PMID:26775897

  11. Postoperative Intensive Care Treatment after Esophageal Resection

    Institute of Scientific and Technical Information of China (English)

    DirkL.Stippel; K.TobiasE.Beckurts

    2004-01-01

    The aim of this article is to give a short review of problems associated with the intensive care treatment of patients after esophageal resection. Pulmonary dysfunction, supraventricular tachyarrhythmia, anastomotic leakage and mental disorders are the topics covered. Systemic inflammatory reaction and sepsis is the linking topic between these specific complications. Pulmonary dysfunction having an incidence of up to 40% is the most important complication. Low tidal volume ventilation, pain management including epidural analgesia and early tracheostomy are the mainstay of therapy. Supraventricular tachyarrhythmia is an early indicator of emerging complications. Its symptomatic treatment is standardized using electric cardioversion, beta-blockers and amiodarone. Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis. Interventional endoscopy is increasingly successful in the therapy of these leakages. Microbiological surveillance and specific antibiotic therapy ensure that a complication does not cause a septic cascade leading to multiorgan failure. The workload on ICU caused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinal surgery.

  12. The impact of interacting drugs on dispensed doses of warfarin in the Swedish population: A novel use of population based drug registers.

    Science.gov (United States)

    Andersson, M L; Lindh, J D; Mannheimer, B

    2013-12-01

    To investigate the impact of interacting drugs on the dispensed doses of warfarin in the Swedish population. This was a retrospective, cross-sectional population based register study of patients being dispensed warfarin. Warfarin doses were estimated in different age groups, in men and women, and in patients using interacting drugs. The influence of interacting drugs on the dispensed warfarin dose was analyzed using multiple regression. All 143,729 patients dispensed warfarin were analyzed. The dispensed dose of warfarin was highest in patients 30-39 years old and decreased with age. Co-medication with carbamazepine, simvastatin, paracetamol, amiodarone, fluconazole, lactulose, or bezafibrate was associated with significant changes in dispensed warfarin doses, by +40%, -3.4%, -7.3%, -8.2%, -8.8%, -9.0%, and -9.7%, respectively. After adjustment for age and gender, sulfamethoxazole was also found to significantly alter the dispensed warfarin dose (-6.1%). We provide new support for the previous scarce evidence of interactions between warfarin and carbamazepine, bezafibrate, and lactulose. Initiation or discontinuation of bezafibrate or lactulose in a patient on warfarin should warrant close clinical monitoring. The marked increased warfarin requirement associated with carbamazepine use supports moving from a more conservative reactive towards a proactive strategy including preventive warfarin dose adjustments to avoid potential adverse effects. PMID:24038065

  13. Drug-induced interstitial lung diseases. Often forgotten

    International Nuclear Information System (INIS)

    Drug-induced interstitial lung diseases (DILD) are probably more common than diagnosed. Due to their potential reversibility, increased vigilance towards DILD is appropriate also from the radiologist's point of view, particularly as these diseases regularly exhibit radiological correlates in high-resolution computed tomography (HRCT) of the lungs. Based on personal experience typical relatively common manifestations of DILD are diffuse alveolar damage (DAD), eosinophilic pneumonia (EP), hypersensitivity pneumonitis (HP), organizing pneumonia (OP), non-specific interstitial pneumonia (NSIP) and usual interstitial pneumonia (UIP). These patterns are presented based on case studies, whereby emphasis is placed on the clinical context. This is to highlight the relevance of interdisciplinary communication and discussion in the diagnostic field of DILD as it is a diagnosis of exclusion or of probability in most cases. Helpful differential diagnostic indications for the presence of DILD, such as an accompanying eosinophilia or increased attenuation of pulmonary consolidations in amiodarone-induced pneumopathy are mentioned and the freely available online database http://www.pneumotox.com is presented. (orig.)

  14. Serum cytokine levels in autoimmune and non-autoimmune hyperthyroid states

    Directory of Open Access Journals (Sweden)

    L.S. Ward

    2000-01-01

    Full Text Available Although the role of interleukin-2 (IL-2 and interferon gamma (gIFN is still poorly understood in hyperthyroid diseases, it is reasonable to assume that these cytokines may be present at higher levels in Graves' disease (GD than in other primarily non-autoimmune thyroid diseases. In order to look for an easy method to distinguish GD from primarily non-autoimmune causes of hyperthyroidism, we compared 13 healthy individuals with 21 treated and untreated hyperthyroid GD patients and with 19 patients with hyperthyroidism due to other etiologies: 7 cases of multinodular goiter, 5 cases of excessive hormone replacement and 7 cases of amiodarone-associated hyperthyroidism. All patients presented low TSH levels and a dubious clinical thyroid state. We found a good correlation between TSH and serum IL-2 levels (r = 0.56; PgIFN (P<0.01 levels were lower in the hyperthyroid group of patients than in control subjects, suggesting a depressed TH1 pattern in the T-cell subset of hyperthyroid patients. GD had normal IL-2 levels, while patients with other forms of thyrotoxicosis presented decreased IL-2 levels (P<0.05. There was no difference between treated and untreated GD patients. We suggest that the direct measurement of serum IL-2 level may help to confirm hyperthyroidism caused by GD.

  15. Pitfalls in the measurement and interpretation of thyroid function tests.

    Science.gov (United States)

    Koulouri, Olympia; Moran, Carla; Halsall, David; Chatterjee, Krishna; Gurnell, Mark

    2013-12-01

    Thyroid function tests (TFTs) are amongst the most commonly requested laboratory investigations in both primary and secondary care. Fortunately, most TFTs are straightforward to interpret and confirm the clinical impression of euthyroidism, hypothyroidism or hyperthyroidism. However, in an important subgroup of patients the results of TFTs can seem confusing, either by virtue of being discordant with the clinical picture or because they appear incongruent with each other [e.g. raised thyroid hormones (TH), but with non-suppressed thyrotropin (TSH); raised TSH, but with normal TH]. In such cases, it is important first to revisit the clinical context, and to consider potential confounding factors, including alterations in normal physiology (e.g. pregnancy), intercurrent (non-thyroidal) illness, and medication usage (e.g. thyroxine, amiodarone, heparin). Once these have been excluded, laboratory artefacts in commonly used TSH or TH immunoassays should be screened for, thus avoiding unnecessary further investigation and/or treatment in cases where there is assay interference. In the remainder, consideration should be given to screening for rare genetic and acquired disorders of the hypothalamic-pituitary-thyroid (HPT) axis [e.g. resistance to thyroid hormone (RTH), thyrotropinoma (TSHoma)]. Here, we discuss the main pitfalls in the measurement and interpretation of TFTs, and propose a structured algorithm for the investigation and management of patients with anomalous/discordant TFTs. PMID:24275187

  16. Rational design, synthesis and 2D-QSAR study of novel vasorelaxant active benzofuran-pyridine hybrids.

    Science.gov (United States)

    Srour, Aladdin M; Abd El-Karim, Somaia S; Saleh, Dalia O; El-Eraky, Wafaa I; Nofal, Zeinab M

    2016-05-15

    Reaction of 3-aryl-1-(benzofuran-2-yl)-2-propen-1-ones 3a-c with malononitrile in the presence of sufficient amount of sodium alkoxide in the corresponding alcohol proceeds in a regioselective manner to afford 2-alkoxy-4-aryl-6-(benzofuran-2-yl)-3-pyridinecarbonitriles 4-37, which also obtained by treating ylidenemalononitriles 6a-q with 2-acetylbenzofuran 1 in the presence of sufficient amount of sodium alkoxide in the corresponding alcohol. The new chemical entities showed significant vasodilation properties using isolated thoracic aortic rings of rats pre-contracted with norepinephrine hydrochloride standard technique. Compounds 11, 16, 21, 24 and 30 exhibited remarkable activity compared with amiodarone hydrochloride the reference standard used in the present study. CODESSA-Pro software was employing to obtain a statistically significant QSAR model describing the bioactivity of the newly synthesized analogs (N=31, n=5, R(2)=0.846, R(2)cvOO=0.765, R(2)cvMO=0.778, F=27.540. s(2)=0.002). PMID:27048942

  17. Appropriate evaluation and treatment of heart failure patients after implantable cardioverter-defibrillator discharge: time to go beyond the initial shock.

    Science.gov (United States)

    Mishkin, Joseph D; Saxonhouse, Sherry J; Woo, Gregory W; Burkart, Thomas A; Miles, William M; Conti, Jamie B; Schofield, Richard S; Sears, Samuel F; Aranda, Juan M

    2009-11-24

    Multiple clinical trials support the use of implantable cardioverter-defibrillators (ICDs) for prevention of sudden cardiac death in patients with heart failure (HF). Unfortunately, several complicating issues have arisen from the universal use of ICDs in HF patients. An estimated 20% to 35% of HF patients who receive an ICD for primary prevention will experience an appropriate shock within 1 to 3 years of implant, and one-third of patients will experience an inappropriate shock. An ICD shock is associated with a 2- to 5-fold increase in mortality, with the most common cause being progressive HF. The median time from initial ICD shock to death ranges from 168 to 294 days depending on HF etiology and the appropriateness of the ICD therapy. Despite this prognosis, current guidelines do not provide a clear stepwise approach to managing these high-risk patients. An ICD shock increases HF event risk and should trigger a thorough evaluation to determine the etiology of the shock and guide subsequent therapeutic interventions. Several combinations of pharmacologic and device-based interventions such as adding amiodarone to baseline beta-blocker therapy, adjusting ICD sensitivity, and employing antitachycardia pacing may reduce future appropriate and inappropriate shocks. Aggressive HF surveillance and management is required after an ICD shock, as the risk of sudden cardiac death is transformed to an increased HF event risk. PMID:19926003

  18. Gene expression profiling in rat liver treated with compounds inducing phospholipidosis

    International Nuclear Information System (INIS)

    We have constructed a large-scale transcriptome database of rat liver treated with various drugs. In an effort to identify a biomarker for diagnosis of hepatic phospholipidosis, we extracted 78 probe sets of rat hepatic genes from data of 5 drugs, amiodarone, amitriptyline, clomipramine, imipramine, and ketoconazole, which actually induced this phenotype. Principal component analysis (PCA) using these probes clearly separated dose- and time-dependent clusters of treated groups from their controls. Moreover, 6 drugs (chloramphenicol, chlorpromazine, gentamicin, perhexiline, promethazine, and tamoxifen), which were reported to cause phospholipidosis but judged as negative by histopathological examination, were designated as positive by PCA using these probe sets. Eight drugs (carbon tetrachloride, coumarin, tetracycline, metformin, hydroxyzine, diltiazem, 2-bromoethylamine, and ethionamide), which showed phospholipidosis-like vacuolar formation in the histopathology, could be distinguished from the typical drugs causing phospholipidosis. Moreover, the possible induction of phospholipidosis was predictable by the expression of these genes 24 h after single administration in some of the drugs. We conclude that these identified 78 probe sets could be useful for diagnosis of phospholipidosis, and that toxicogenomics would be a promising approach for prediction of this type of toxicity

  19. Cytochrome P450 inhibition potential of new psychoactive substances of the tryptamine class.

    Science.gov (United States)

    Dinger, Julia; Woods, Campbell; Brandt, Simon D; Meyer, Markus R; Maurer, Hans H

    2016-01-22

    New psychoactive substances (NPS) are not tested for their cytochrome P450 (CYP) inhibition potential before consumption. Therefore, this potential was explored for tryptamine-derived NPS (TDNPS) including alpha-methyl tryptamines (AMTs), dimethyl tryptamines (DMTs), diallyl tryptamines (DALTs), and diisopropyl tryptamines (DiPTs) using test substrates preferred by the Food and Drug Administration in a cocktail assay. All tested TDNPS with the exception of DMT inhibited CYP2D6 activity with IC50 values below 100μM. DALTs inhibited CYP2D6 activity similar to paroxetine and quinidine and CYP1A2 activity comparable to fluvoxamine. 5-Methoxy-N,N-diallyltryptamine reduced in vivo the caffeine metabolism in rats consistent with in vitro results. Five of the AMTs also inhibited CYP1A2 activity comparable to amiodarone. AMT and 6-F-AMT inhibited CYP2A6 activity in the range of the test inhibitor tranylcypromine. CYP2B6 activity was inhibited by 19 tryptamines, but weakly compared to efavirenz. CYP2C8 activity was inhibited by five of the tested TDNPS and three showed values comparable to trimethoprim and gemfibrozil. Six tryptamines inhibited CYP2C9 and seven CYP2C19 activities comparable to fluconazole and chloramphenicol, respectively. Nineteen compounds showed inhibition of CYP2E1 and 18 of CYP3A activity, respectively. These results showed that the CYP inhibition by TDNPS might be clinically relevant, but clinical studies are needed to explore this further. PMID:26599973

  20. Gene expression profiling in rat liver treated with compounds inducing phospholipidosis.

    Science.gov (United States)

    Hirode, Mitsuhiro; Ono, Atsushi; Miyagishima, Toshikazu; Nagao, Taku; Ohno, Yasuo; Urushidani, Tetsuro

    2008-06-15

    We have constructed a large-scale transcriptome database of rat liver treated with various drugs. In an effort to identify a biomarker for diagnosis of hepatic phospholipidosis, we extracted 78 probe sets of rat hepatic genes from data of 5 drugs, amiodarone, amitriptyline, clomipramine, imipramine, and ketoconazole, which actually induced this phenotype. Principal component analysis (PCA) using these probes clearly separated dose- and time-dependent clusters of treated groups from their controls. Moreover, 6 drugs (chloramphenicol, chlorpromazine, gentamicin, perhexiline, promethazine, and tamoxifen), which were reported to cause phospholipidosis but judged as negative by histopathological examination, were designated as positive by PCA using these probe sets. Eight drugs (carbon tetrachloride, coumarin, tetracycline, metformin, hydroxyzine, diltiazem, 2-bromoethylamine, and ethionamide), which showed phospholipidosis-like vacuolar formation in the histopathology, could be distinguished from the typical drugs causing phospholipidosis. Moreover, the possible induction of phospholipidosis was predictable by the expression of these genes 24 h after single administration in some of the drugs. We conclude that these identified 78 probe sets could be useful for diagnosis of phospholipidosis, and that toxicogenomics would be a promising approach for prediction of this type of toxicity. PMID:18355885

  1. Identification of oxidative stress-related proteins for predictive screening of hepatotoxicity using a proteomic approach.

    Science.gov (United States)

    Yamamoto, Toshinori; Kikkawa, Rie; Yamada, Hiroshi; Horii, Ikuo

    2005-08-01

    We investigated the effects of three hepatotoxicants, acetaminophen (APAP), amiodarone (AD) and tetracycline (TC), on protein expression in primary cultured rat hepatocytes with toxicoproteomic approach, which is two-dimensional gel electrophoresis (2DE) and mass spectrometry. The objectives of this study were to search for alternative toxicity biomarkers which could be detected with high sensitivity prior to the appearance of morphological changes or alterations of analytical conventional biomarkers. The related proteins in the process of cell degeneration/necrosis such as cell death, lipid metabolism and lipid/carbohydrate metabolism were mainly affected under exposure to APAP, AD and TC, respectively. Among the differentially expressed proteins, several oxidative stress-related proteins were clearly identified after 24-hr exposure, even though they were not affected for 6-hr exposure. They were glutathione peroxidase (GPX) as a down-regulated protein as well as peroxiredoxin 1 (PRX1) and peroxiredoxin 2 (PRX2) as up-regulated proteins, which are known to serve as antioxidative enzymes in cells. These findings suggested that the focused proteins, GPX and PRXs, could be utilized as biomarkers of hepatotoxicity, and they were useful for setting high throughput screening methods to assess hepatotoxicity in the early stage of drug discovery. PMID:16141655

  2. Investigation of proteomic biomarkers in in vivo hepatotoxicity study of rat liver: toxicity differentiation in hepatotoxicants.

    Science.gov (United States)

    Yamamoto, Toshinori; Kikkawa, Rie; Yamada, Hiroshi; Horii, Ikuo

    2006-02-01

    We investigated the overall protein expression profiles in the in vivo hepatotoxicity of rats induced by four well-recognized hepatotoxicants. Acetaminophen (APAP), amiodarone (AMD), tetracycline (TC) and carbon tetrachloride (CTC) were administered to male rats by gavages and the liver at 24 hr post-dosing was applied to the proteomic experiment. Blood biochemistry and histopathology were examined to identify specific changes related to the compounds given. Protein expression in the liver was investigated by 2-dimensional gel electrophoresis (2DE), and spots showing a significantly different expression in treated versus control group were excised from gels and identified by Q-Tof mass spectrometer. They were well characterized based on their functions related to the mechanisms of toxicity of the compounds. Among them, we focused on the 8 proteins that were affected by all 4 compounds examined. Proteins related to oxidative stress response such as carbonic anhydrase III (CA3) and 60kDa heat shock protein (HSP60), and energy metabolism such as adenylate kinase 4 (AK4) were found. Moreover, hierarchical clustering analysis using 2D-gel spots information revealed the possibility to differentiate the groups based on their toxicity levels such as severity of liver damage. These results suggested that assessing the effects of hepatotoxicants on protein expression is worth trying to screen candidate compounds at the developmental stage of drugs. PMID:16538043

  3. Optimal tachycardia programming in ICDs : Recommendations in the post-MADIT-RIT era.

    Science.gov (United States)

    Israel, Carsten W; Burmistrava, Tatsiana

    2016-09-01

    Optimal implantable cardioverter-defibrillator (ICD) programming can reduce the incidence of inappropriate shock therapy and improve prognosis in patients with an ICD. Only after results from randomized trials became available was the "safety first" feeling overcome that mandated early shock therapy, waived the use of antitachycardia pacing and forced shock therapy after a time of 30 s expired, even if tachycardia discriminators would have withheld the therapy. The strong evidence to limit ICD therapy to longer ventricular tachycardia (VT) should not result in individually dangerous ICD programming, particularly in patients with a high risk of slow VT (known monomorphic VT, post VT ablation, during treatment with amiodarone, very dilated left ventricle). Monitoring zones may aid to detect unexpected slow VT and to explain symptoms such as presyncope without exposing the patient to an unnecessary risk of inappropriate therapy. This review summarizes our current knowledge on optimal ICD programming and explains exactly how we should program device parameters in practice in single- or dual-chamber ICDs by different manufacturers and in different groups of patients. PMID:27624808

  4. Calcium dependence of eugenol tolerance and toxicity in Saccharomyces cerevisiae.

    Directory of Open Access Journals (Sweden)

    Stephen K Roberts

    Full Text Available Eugenol is a plant-derived phenolic compound which has recognised therapeutical potential as an antifungal agent. However little is known of either its fungicidal activity or the mechanisms employed by fungi to tolerate eugenol toxicity. A better exploitation of eugenol as a therapeutic agent will therefore depend on addressing this knowledge gap. Eugenol initiates increases in cytosolic Ca2+ in Saccharomyces cerevisiae which is partly dependent on the plasma membrane calcium channel, Cch1p. However, it is unclear whether a toxic cytosolic Ca2+elevation mediates the fungicidal activity of eugenol. In the present study, no significant difference in yeast survival was observed following transient eugenol treatment in the presence or absence of extracellular Ca2+. Furthermore, using yeast expressing apoaequorin to report cytosolic Ca2+ and a range of eugenol derivatives, antifungal activity did not appear to be coupled to Ca2+ influx or cytosolic Ca2+ elevation. Taken together, these results suggest that eugenol toxicity is not dependent on a toxic influx of Ca2+. In contrast, careful control of extracellular Ca2+ (using EGTA or BAPTA revealed that tolerance of yeast to eugenol depended on Ca2+ influx via Cch1p. These findings expose significant differences between the antifungal activity of eugenol and that of azoles, amiodarone and carvacrol. This study highlights the potential to use eugenol in combination with other antifungal agents that exhibit differing modes of action as antifungal agents to combat drug resistant infections.

  5. Effect of Taurine on The Respiratory System of Rats

    Directory of Open Access Journals (Sweden)

    Ammer E.M

    2013-08-01

    Full Text Available The present study was designed to investigate the effect of taurine on isolated trachea and pulmonary artery of rats and the possible mechanism(s of action. The possible antioxidant effect of taurine was also studied by measuring its protective effect against cyclophosphamide induced lung injuiry. Taurine produced a concentration dependent relaxation in the isolated tracheal strips and pulmonary arterial rings precontracted by serotonin (2x10-4 mM. The relaxing effect of taurine was not influenced by pretreatment with nitric oxide synthase inhibitor (L-NAME , cysteinyl leukotreines receptor 1 blocker (montelukast , H1 receptor blocker (chlorpheniramine , β-adrenoceptor blocker (propranolol, potassium channel blocker (amiodarone , cyclo-oxygenase inhibitor (indomethacin or muscarinic receptor blocker (atropine. Preincubation with adenosine receptor blocker (aminophylline significantly potentiated the relaxing effect of taurine in the tracheal strips and pulmonary arterial rings. Cyclophosphamide (CYP, 150 mg/kg administerated i.p. in a single dose was used to produce lung injuiry in rats. CYP caused marked increase in lung lipid peroxides (MDA and decrease in lung reduced glutathione (GSH. Administration of taurine (1% in drinking water starting 7 days before CYP and continuing throughout the duration of the experiment (24 hours improved significantly the lung GSH and MDA. It can be concluded that taurine relaxes precontracted rat tracheal strips and pulmonary arterial rings probably by direct effect on the smooth muscles. Also, the observed antioxidant activity of taurine which may contribute to its relaxant effect suggesting the usefulness of turine in pulmonary hypertension.

  6. Interaction of metaiodobenzylguanidine with cardioactive drugs: an in vitro study

    Energy Technology Data Exchange (ETDEWEB)

    Huguet, F. [INSERM, Tours Univ. Hospital (France)]|[Inst. of Xenobiotic Studies, Poitiers Univ. Hospital (France); Fagret, D. [URA, CNRS, Grenoble Univ. Hospital (France); Caillet, M. [INSERM, Tours Univ. Hospital (France); Piriou, A. [Inst. of Xenobiotic Studies, Poitiers Univ. Hospital (France); Besnard, J.C. [INSERM, Tours Univ. Hospital (France); Guilloteau, D. [INSERM, Tours Univ. Hospital (France)

    1996-05-01

    Metaiodobenzylguanidine (MIBG), an analogue of noradrenaline, is used to explore the functional integrity of sympathetic nerve endings in the human heart. Various drugs inhibit noradrenaline transport systems and may block the uptake of MIBG. As in vivo studies of the effect of these drugs on myocardial [{sup 123}]MIBG uptake are often difficult to perform, we used an in vitro human blood platelet model for this purpose. A platelet preparation from healthy volunteers was incubated with [{sup 125}I]MIBG alone or different concentrations of drugs currently used in cardiology. Labetalol and propranolol inhibited [{sup 125}I]MIGB uptake, whereas all other drugs tested (other {beta}-blockers, calcium inhibitors, digoxin and amiodarone) had no effecft even at doses exceeding 50 {mu}M. The labetalol dose inhibiting 50% of [{sup 125}I]MIBG uptake was lower than the plasma concentration of this drug in treated patients, whereas the propranolol dose was higher. This in vitro study of the effect of drugs on MIBG uptake by human blood platelets is predictive of their in vivo effect on myocardial uptake of [{sup 123}I]MIBG in treated patients, provided that plasma concentration is taken into account. (orig.)

  7. Beeinflussung der Schilddrüsenfunktion durch Medikamente

    Directory of Open Access Journals (Sweden)

    Wolf P

    2014-01-01

    Full Text Available Die Funktion der Schilddrüse unterliegt einem strengen Regelkreis, der zahlreiche Angriffspunkte für unerwünschte Wechselwirkungen mit verschiedenen Medikamenten und Wirkstoffklassen bietet, teilweise mit klinisch relevanten Folgen. In dieser Übersichtsarbeit sollen daher einerseits die häufigsten Medikamentenwirkungen auf die Schilddrüsenfunktion beschrieben sowie andererseits auch auf die Folgen einer gestörten Resorption bei bereits bestehender Schilddrüsenhormonsubstitutionstherapie hingewiesen werden. Während diese Wechselwirkungen beispielsweise für Amiodaron oder Lithium schon lange bekannt sind, kommt es vor allem durch die Entwicklung neuer immunmodulierender Wirkstoffklassen, wie Tyrosinkinaseinhibitoren und monoklonaler Autoantikörper, zu gehäuften Beobachtungen von Schilddrüsenfunktionsbeeinträchtigungen. Neben Lithium wird auch auf die Wechselwirkung anderer Psychopharmaka eingegangen sowie der Einfluss von Wirkstoffklassen wie Gallensäurebinder, Antazida und Phosphatbinder auf die Resorption von Levothyroxin bei bestehender Schilddrüsenhormonsubstitutionstherapie näher beschrieben. Das Ziel dieser Arbeit ist es daher, einen für den praktisch tätigen Arzt tauglichen Überblick über Medikamentenwirkungen auf die Schilddrüse zu schaffen.

  8. A pharmacogenetics-based warfarin maintenance dosing algorithm from Northern Chinese patients.

    Directory of Open Access Journals (Sweden)

    Jinxing Chen

    Full Text Available Inconsistent associations with warfarin dose were observed in genetic variants except VKORC1 haplotype and CYP2C9*3 in Chinese people, and few studies on warfarin dose algorithm was performed in a large Chinese Han population lived in Northern China. Of 787 consenting patients with heart-valve replacements who were receiving long-term warfarin maintenance therapy, 20 related Single nucleotide polymorphisms were genotyped. Only VKORC1 and CYP2C9 SNPs were observed to be significantly associated with warfarin dose. In the derivation cohort (n = 551, warfarin dose variability was influenced, in decreasing order, by VKORC1 rs7294 (27.3%, CYP2C9*3(7.0%, body surface area(4.2%, age(2.7%, target INR(1.4%, CYP4F2 rs2108622 (0.7%, amiodarone use(0.6%, diabetes mellitus(0.6%, and digoxin use(0.5%, which account for 45.1% of the warfarin dose variability. In the validation cohort (n = 236, the actual maintenance dose was significantly correlated with predicted dose (r = 0.609, P<0.001. Our algorithm could improve the personalized management of warfarin use in Northern Chinese patients.

  9. January 2014 Tucson critical care journal club: esmolol in septic shock

    Directory of Open Access Journals (Sweden)

    Strawter C

    2014-02-01

    Full Text Available No abstract available. Article truncated at 150 words. An 86-year old man had a non-contrast thoracic CT for evaluation of a chest x-ray abnormality. Incidentally, the CT scan showed diffuse increase in liver density with Hounsfield units of 105. The normal unenhanced attenuation value is between 55-65 Hounsfield units in a normal liver on CT scan without contrast (1. Hepatic attenuation is reflected in Hounsfield values and depends on combinations of factors including the presence or absence (as well as phase of IV contrast administration. The patient had no known underlying liver disease and liver function studies were within normal limits. Figure 1 shows coronal and axial views of the CT scan of the patient. There are several intrinsic liver pathologies leading to diffuse changes in liver attenuation including (2: Deposits of certain metals seen in hemochromatosis, hemosiderosis, and Wilson’s disease; Glycogen storage disease(es; Medications/drugs including amiodarone and gold therapy (3-7; Previous Thorotrast administration ...

  10. Management of Atrial Fibrillation in Critically Ill Patients

    Directory of Open Access Journals (Sweden)

    Mattia Arrigo

    2014-01-01

    Full Text Available Atrial fibrillation (AF is common in ICU patients and is associated with a two- to fivefold increase in mortality. This paper provides a reappraisal of the management of AF with a special focus on critically ill patients with haemodynamic instability. AF can cause hypotension and heart failure with subsequent organ dysfunction. The underlying mechanisms are the loss of atrial contraction and the high ventricular rate. In unstable patients, sinus rhythm must be rapidly restored by synchronised electrical cardioversion (ECV. If pharmacological treatment is indicated, clinicians can choose between the rate control and the rhythm control strategy. The optimal substance should be selected depending on its potential adverse effects. A beta-1 antagonist with a very short half-life (e.g., esmolol is an advantage for ICU patients because the effect of beta-blockade on cardiovascular stability is unpredictable in those patients. Amiodarone is commonly used in the ICU setting but has potentially severe cardiac and noncardiac side effects. Digoxin controls the ventricular response at rest, but its benefit decreases in the presence of adrenergic stress. Vernakalant converts new-onset AF to sinus rhythm in approximately 50% of patients, but data on its efficacy and safety in critically ill patients are lacking.

  11. Heart Surgery Experience in Hitit University Faculty of Medicine Corum Research and Training Hospital: First Year Results

    Directory of Open Access Journals (Sweden)

    Adem Diken

    2014-03-01

    Full Text Available Aim: We aimed to assess the clinical outcomes of our department of cardiac surgery which was newly introduced in Hitit University Corum Education and Research Hospital. Material and Method: Between November 2012 and November 2013, a total of 110 open-heart surgeries were performed. Ten out of these (9.1% were emergency operations for acute ST elevation myocardial infarction Off-pump technique was used in 31 (29.2% patients and cardiopulmonary bypass was used in 75 (70.8%. A total of 106 patients received coronary artery bypass grafting, 1 received mitral reconstruction, 1 received Bentall procedure, 1 received tricuspid valve repair, 1 received mitral valve replacement, 1 received aortic valve replacement with aortic root enlargement and 1 received aortic supracoronary graft replacement. Results: Hospital mortality occurred in 1 (0.9% patient. Four patients (3.6% who were on dual antiaggregants underwent a revision for bleeding on the day of the operation. Morbidities occurred in 3 (2.7% patients. Atrial fibrillation occurred in 11 (10% patients and the normal sinus rhythm was achieved by amiodarone. Intraaortic balloon counterpulsation was used in 5 (4.5% patients. Discussion: The newly introduced cardiac surgery department of the Hitit University Corum Education and Research Hospital, which provides tertiary care to a wide rural community, serves with low morbidity and mortality.

  12. Prediction of positive food effect: Bioavailability enhancement of BCS class II drugs.

    Science.gov (United States)

    Raman, Siddarth; Polli, James E

    2016-06-15

    High-throughput screening methods have increased the number of poorly water-soluble, highly permeable drug candidates. Many of these candidates have increased bioavailability when administered with food (i.e., exhibit a positive food effect). Food is known to impact drug bioavailability through a variety of mechanisms, including drug solubilization and prolonged gastric residence time. In vitro dissolution media that aim to mimic in vivo gastrointestinal (GI) conditions have been developed to lessen the need for fed human bioequivalence studies. The objective of this work was to develop an in vitro lipolysis model to predict positive food effect of three BCS Class II drugs (i.e., danazol, amiodarone and ivermectin) in previously developed lipolysis media. This in vitro lipolysis model was comparatively benchmarked against FeSSIF and FaSSIF media that were modified for an in vitro lipolysis approach, as FeSSIF and FaSSIF are widely used in in vitro dissolution studies. The in vitro lipolysis model accurately predicted the in vivo positive food effect for three model BCS class II drugs. The in vitro lipolysis model has potential use as a screening test of drug candidates in early development to assess positive food effect. PMID:27067239

  13. Traumatic Tension Pneumothorax as a Cause of ICD Failure: A Case Report and Review of the Literature.

    Science.gov (United States)

    Ul Haq, Ehtesham; Omar, Bassam

    2014-01-01

    Background. Tension pneumothorax can infrequently cause ventricular arrhythmias and increase the threshold of defibrillation. It should be suspected whenever there is difficulty in defibrillation for a ventricular arrhythmia. Purpose. To report a case of traumatic tension pneumothorax leading to ventricular tachycardia and causing defibrillator failure. Case. A 65-year-old African-American female was brought in to our emergency department complaining of dyspnea after being forced down by cops. She had history of mitral valve replacement for severe mitral regurgitation and biventricular implantable cardioverter defibrillator inserted for nonischemic cardiomyopathy. Shortly after arrival, she developed sustained ventricular tachycardia, causing repetitive unsuccessful ICD shocks. She was intubated and ventricular tachycardia resolved with amiodarone. Chest radiograph revealed large left sided tension pneumothorax which was promptly drained. The patient was treated for congestive heart failure; she was extubated on the third day of admission, and the chest tube was removed. Conclusion. Prompt recognition of tension pneumothorax is essential, by maintaining a high index of suspicion in patients with an increased defibrillation threshold causing ineffective defibrillations. PMID:25400953

  14. The role of TSH receptor antibodies in the management of Graves' disease.

    Science.gov (United States)

    Matthews, David C; Syed, Akheel A

    2011-06-01

    The central role of thyrotropin receptor antibodies (TRAbs) in the pathogenesis of Graves' disease has been recognised for several decades. However, the practical application of testing for TRAbs in clinical decision making remains the subject of controversy. The diagnosis of Graves' disease can be made in most cases simply based on a patient's clinical presentation. The TRAb test is therefore of most value in ambiguous clinical scenarios such as in the differential diagnosis of unilateral exophthalmos, euthyroid Graves' ophthalmopathy, subclinical hyperthyroidism, thyrotoxicosis associated with hyperemesis gravidarum, amiodarone-induced thyrotoxicosis and painless thyroiditis. It may also have a role in predicting the risk of a recurrence of Graves' disease following a course of antithyroid drug treatment. One further clinical utility of the TRAb test is in pregnancy where antibody titre measured during the third trimester is used to predict the risk of neonatal thyroid dysfunction. The TRAb titre not only aids in clinching a difficult diagnosis but can also help guide treatment in some patients. Although the TRAb assay has become more affordable in recent years, cost remains an important factor when considering its use routinely. Nonetheless, this is an underutilised blood test that could augment standard endocrine investigations in the differential diagnosis of hyperthyroidism. PMID:21570635

  15. Conversion of recent-onset atrial fibrillation: Which drug is the best?

    Directory of Open Access Journals (Sweden)

    Diego Conde; Pablo Elissamburu; Nicolas Lalor Leandro Rodriguez; Martin Aragon; Juan Pablo Costabel; Florencia Lambardi; Marcelo Trivi

    2013-08-01

    Full Text Available Introduction: Vernakalant is a new, safe and effective drug used intravenously, which has proved to be more rapid in converting recent onset AF to sinus rhythm compared to placebo, amiodarone, propafenone and flecainide in clinical studies with few patients. Up to the present no study has been conducted comparing these three drugs with a substantial number of patients. The aim of our study is to compare the time to conversion to sinus rhythm, hospital stay and adverse events between vernakalant or flecainide and propafenone in patients with a recent-onset atrial fibrillation. Materials and Methods: 150 hemodynamically stable patients with recent onset AF without structural heart disease were prospectively included. A single oral dose of propafenone 600 mg was administered to 50 patients, 50 patients received intravenous vernakalant and other 50 patients received a single oral dose of flecainide 300 mg. Clinical and laboratory variables were recorded. Results: Baseline characteristics were similar in the three groups. Time to conversion to sinus rhythm was 12 minutes in the vernakalant group versus 151 minutes in the propafenone group and 162 minutes in flecainide group (p< 0.01. The hospital stay was 243 minutes in the vernakalant group versus 422 minutes in the propafenone group and 410 minutes in flecainide group (p< 0.01 (Figure 2. No adverse events were reported. Conclusion: The time to conversion to sinus rhythm and hospital stay were statistical shorter in vernakalant group compared with flecainide and propafenone. There were no adverse events in the three groups.

  16. Digoxin Therapy of Fetal Superior Ventricular Tachycardia: Are Digoxin Serum Levels Reliable?

    Science.gov (United States)

    Saad, Antonio F.; Monsivais, Luis; Pacheco, Luis D.

    2016-01-01

    Background  Despite its seldom occurrence, fetal tachycardia can lead to poor fetal outcomes including hydrops and fetal death. Management can be challenging and result in maternal adverse effects secondary to high serum drug levels required to achieve effective transplacental antiarrhythmic drug therapy. Case  A 33-year-old woman at 33 weeks of gestation with a diagnosis of a fetal sustained superior ventricular tachycardia developed chest pain, shortness of breath, and bigeminy on electrocardiogram secondary to digoxin toxicity despite subtherapeutic serum drug levels. She required supportive care with repletion of corresponding electrolyte abnormalities. After resolution of cardiac manifestations of digoxin toxicity, the patient was discharged home. The newborn was discharged at day 9 of life on maintenance amiodarone. Conclusion  We describe an interesting case of digoxin toxicity with cardiac manifestations of digoxin toxicity despite subtherapeutic serum drug levels. This case report emphasizes the significance of instituting an early diagnosis of digoxin toxicity during pregnancy, based not only on serum drug levels but also on clinical presentation. In cases of refractory supportive care, digoxin Fab fragment antibody administration should be considered. With timely diagnosis and treatment, excellent maternal and perinatal outcomes can be achieved.

  17. Insights into the mechanism of idiopathic left ventricular tachycardia: a case report and literature review.

    Science.gov (United States)

    Puie, Paul; Cismaru, Gabriel; Muresan, Lucian; Rosu, Radu; Puiu, Mihai; Andronache, Marius; Gusetu, Gabriel; Matuz, Roxana; Mircea, Petru-Adrian; Pop, Dana; Zdrenghea, Dumitru

    2015-01-01

    Left ventricular posterior fascicular tachycardia (LVPFT) is an idiopathic form of VT characterized by right bundle branch block morphology and left axis deviation. The mechanism of LPFVT is thought to be localized reentry close to the posterior fascicle. We present the case of a 24-year-old medical student who was admitted to the emergency department complaining of palpitations. The ECG showed an aspect suggestive of LVPFT. Vagal maneuvers, adenosine and i.v. Metoprolol were ineffective in terminating the arrhythmia. Conversion to sinus rhythm was obtained 10 h later, with i.v Amiodarone. The ECG in sinus rhythm showed left posterior fascicular block. Because antiarrhythmic drugs were not desired by the patient, VT ablation was proposed. The electrophysiological study identified the mechanism of arrhythmia to be reentry using the slowly conducting verapamil-sensitive fibers as the antegrade limb and the posterior fascicle as the retrograde limb. Radiofrequency applications near the posterior fascicle, in the lower half of the interventricular septum, at the junction of the two proximal thirds with the distal third interrupted the tachycardia and made it non-inducible at programmed stimulation. The case is unusual as the patient had a left posterior fascicular block during sinus rhythm before ablation. This demonstrates that the reentry circuit of VT does not need antegrade conduction through the posterior fascicle for perpetuation. PMID:26381389

  18. Pearls and perils of an implantable defibrillator trial using a common control: implications for the design of future studies

    Directory of Open Access Journals (Sweden)

    Hallstrom Alfred P

    2008-05-01

    Full Text Available Abstract Aims Implantable defibrillators are considered life-saving therapy in heart failure (CHF patients. Surprisingly, the recent Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT reached an opposing conclusion from that of numerous other trials about their survival benefit in patients with advanced CHF. A critical analysis of common control trial design may explain this paradoxical finding, with important implications for future studies. Methods and Results Common control trials compare several intervention groups to a single rather than separate control groups. Though potentially requiring fewer patients than trials using separate controls, variation in the common control group will influence all comparisons and creates correlations between findings. During subgroup analyses, this dependency of outcomes may increase belief in the presence of a real subgroup effect when, in fact, it should increase skepticism. For example, a high (r = 0.92, statistically unlikely (p = 0.052 correlation between comparisons was observed across the subgroups reported in SCD-HeFT. Such concordance between amiodarone and a defibrillator across subgroups was unexpected, given how much the effects of these treatments significantly differed from one another in the main study. This suggests the study's subgroup findings (specifically the absence of benefit from defibrillators in advanced CHF were not necessarily a consequence of treatment; more likely, they resulted from variation in what the treatments were compared against, the common control. Conclusion Common control trials can be more efficient than other designs, but induce dependence between treatment comparisons and require cautious interpretation.

  19. Effects of drugs on defibrillation threshold%药物对除颤阈值的影响

    Institute of Scientific and Technical Information of China (English)

    黄震华

    2009-01-01

    Implantable cardioverter-defibrillator possesses vital value for preventing sudden cardiac death. For patients with already implantable cardioverter-defibrillator, some cardiovascular drugs especially the anti-arrhythmic ones are still inevitably needed. Some evidences showed that sotalol, and β-adrenergic receptor antagonists may decrease defibrillation threshold, and amiodarone, lidocaine, mexiletine, moracizine, verapamil may increase defibrillation threshold.%埋藏式心脏复律除颤器对于预防心源性猝死具有重要价值.对于已安装埋藏式心脏复律除颤器的病人,不可避免地仍需使用一些心血管药物,特别是抗心律失常药物.一些证据表明,索他洛尔、肾上腺素β受体阻滞药可降低除颤阈值,而胺碘酮、利多卡因、美西律、莫雷西嗪、维拉帕米等可提高除颤阈值.

  20. Evaluation of drug-induced neurotoxicity based on metabolomics, proteomics and electrical activity measurements in complementary CNS in vitro models.

    Science.gov (United States)

    Schultz, Luise; Zurich, Marie-Gabrielle; Culot, Maxime; da Costa, Anaelle; Landry, Christophe; Bellwon, Patricia; Kristl, Theresa; Hörmann, Katrin; Ruzek, Silke; Aiche, Stephan; Reinert, Knut; Bielow, Chris; Gosselet, Fabien; Cecchelli, Romeo; Huber, Christian G; Schroeder, Olaf H-U; Gramowski-Voss, Alexandra; Weiss, Dieter G; Bal-Price, Anna

    2015-12-25

    The present study was performed in an attempt to develop an in vitro integrated testing strategy (ITS) to evaluate drug-induced neurotoxicity. A number of endpoints were analyzed using two complementary brain cell culture models and an in vitro blood-brain barrier (BBB) model after single and repeated exposure treatments with selected drugs that covered the major biological, pharmacological and neuro-toxicological responses. Furthermore, four drugs (diazepam, cyclosporine A, chlorpromazine and amiodarone) were tested more in depth as representatives of different classes of neurotoxicants, inducing toxicity through different pathways of toxicity. The developed in vitro BBB model allowed detection of toxic effects at the level of BBB and evaluation of drug transport through the barrier for predicting free brain concentrations of the studied drugs. The measurement of neuronal electrical activity was found to be a sensitive tool to predict the neuroactivity and neurotoxicity of drugs after acute exposure. The histotypic 3D re-aggregating brain cell cultures, containing all brain cell types, were found to be well suited for OMICs analyses after both acute and long term treatment. The obtained data suggest that an in vitro ITS based on the information obtained from BBB studies and combined with metabolomics, proteomics and neuronal electrical activity measurements performed in stable in vitro neuronal cell culture systems, has high potential to improve current in vitro drug-induced neurotoxicity evaluation. PMID:26026931

  1. 食管切除术后的重症监护治疗%Postoperative Intensive Care Treatment after Esophageal Resection

    Institute of Scientific and Technical Information of China (English)

    Dirk L.Stippel; K.Tobias E.Beckurts

    2004-01-01

    The aim of this article is to give a short review of problems associated with the intensive care treatment of patients after esophageal resection. Pulmonary dysfunction, supraventricular tachyarrhythmia, anastomotic leakage and mental disorders are the topics covered. Systemic inflammatory reaction and sepsis is the linking topic between these specific complications. Pulmonary dysfunction having an incidence of up to 40% is the most important complication. Low tidal volume ventilation, pain management including epidural analgesia and early tracheostomy are the mainstay of therapy. Supraventricular tachyarrhythmia is an early indicator of emerging complications. Its symptomatic treatment is standardized using electric cardioversion, beta-blockers and amiodarone. Anastomotic leakage must be suspect in any septic episode.Endoscopy and contrast studies allow for precise diagnosis. Interventional endoscopy is increasingly successful in the therapy of these leakages. Microbiological surveillance and specific antibiotic therapy ensure that a complication does not cause a septic cascade leading to multiorgan failure. The workload on ICU caused by a patient after esophageal resection still exceeds that of most other patients with gastrointestinal surgery.

  2. In vitro detection of cardiotoxins or neurotoxins affecting ion channels or pumps using beating cardiomyocytes as alternative for animal testing.

    Science.gov (United States)

    Nicolas, Jonathan; Hendriksen, Peter J M; de Haan, Laura H J; Koning, Rosella; Rietjens, Ivonne M C M; Bovee, Toine F H

    2015-03-01

    The present study investigated if and to what extent murine stem cell-derived beating cardiomyocytes within embryoid bodies can be used as a broad screening in vitro assay for neurotoxicity testing, replacing for example in vivo tests for marine neurotoxins. Effect of nine model compounds, acting on either the Na(+), K(+), or Ca(2+) channels or the Na(+)/K(+) ATP-ase pump, on the beating was assessed. Diphenhydramine, veratridine, isradipine, verapamil and ouabain induced specific beating arrests that were reversible and none of the concentrations tested induced cytotoxicity. Three K(+) channel blockers, amiodarone, clofilium and sematilide, and the Na(+)/K(+) ATPase pump inhibitor digoxin had no specific effect on the beating. In addition, two marine neurotoxins i.e. saxitoxin and tetrodotoxin elicited specific beating arrests in cardiomyocytes. Comparison of the results obtained with cardiomyocytes to those obtained with the neuroblastoma neuro-2a assay revealed that the cardiomyocytes were generally somewhat more sensitive for the model compounds affecting Na(+) and Ca(2+) channels, but less sensitive for the compounds affecting K(+) channels. The stem cell-derived cardiomyocytes were not as sensitive as the neuroblastoma neuro-2a assay for saxitoxin and tetrodotoxin. It is concluded that the murine stem cell-derived beating cardiomyocytes provide a sensitive model for detection of specific neurotoxins and that the neuroblastoma neuro-2a assay may be a more promising cell-based assay for the screening of marine biotoxins. PMID:25479353

  3. Permanent and temporary pacemaker implantation after orthotopic heart transplantation

    Directory of Open Access Journals (Sweden)

    Bacal Fernando

    2000-01-01

    Full Text Available PURPOSE:To determine the indication for and incidence and evolution of temporary and permanent pacemaker implantation in cardiac transplant recipients. METHODS: A retrospective review of 114 patients who underwent orthotopic heart transplantation InCor (Heart Institute USP BR between March 1985 and May 1993. We studied the incidence of and indication for temporary pacing, the relationship between pacing and rejection, the need for pemanent pacing and the clinical follow-up. RESULTS: Fourteen of 114 (12%heart transplant recipients required temporary pacing and 4 of 114 (3.5% patients required permanent pacing. The indication for temporary pacing was sinus node dysfunction in 11 patients (78.5% and atrioventricular (AV block in 3 patients (21.4%. The indication for permanent pacemaker implantation was sinus node dysfunction in 3 patients (75% and atrioventricular (AV block in 1 patient (25%. We observed rejection in 3 patients (21.4% who required temporary pacing and in 2 patients (50% who required permanent pacing. The previous use of amiodarone was observed in 10 patients (71.4% with temporary pacing. Seven of the 14 patients (50% died during follow-up. CONCLUSION: Sinus node dysfunction was the principal indication for temporary and permanent pacemaker implantation in cardiac transplant recipients. The need for pacing was related to worse prognosis after cardiac transplantation.

  4. Ranolazine for Atrial Fibrillation: Too Good to be True?

    Directory of Open Access Journals (Sweden)

    Joseph J. Gard, MD

    2010-08-01

    Full Text Available Several management options for patients with symptomatic atrial fibrillation (AF available today were not even in the realm of discussion two decades ago. These advances, however, have primarily involved invasive management options for patients with drug refractory arrhythmia.1-3 After the recognition that electrical isolation of the thoracic veins benefits patients with paroxysmal AF, a slew of more involved ablative techniques evolved.4-8 Major breakthroughs in antiarrhythmic therapy, however, have not paralleled this meteoric development of invasive techniques. The drive for invasive procedures has, in fact, been widely based on the lack of availability of simple, effective, and safe pharmacological options for AF.9-11 The introduction of dronedarone into clinical practice represented a recent addition to antiarrhythmic therapy options for use in the management of patients with AF. This agent is an analogue of amiodarone but devoid of the iodine moiety which allows its use without the well-recognized and dreaded organ toxicity associated with long-term use. Nevertheless, a significant need exists for a drug with limited side effects that can be used for symptomatic intermittent AF without the need for daily chronic use, fear of organ toxicity, and concern regarding proarrhythmia in patients with structural heart disease.

  5. TR{alpha}- and TSH-mRNA levels after temporal exposition with methimazole in zebrafish, Danio rerio

    Energy Technology Data Exchange (ETDEWEB)

    Schulz, A.E.I.; Stocker, A.; Hollosi, L.; Schramm, K.W. [Inst. of Ecological Chemistry, GSF - National Research Center for Environment and Health (Germany)

    2004-09-15

    The group of dioxin and dioxin-like substances are highly persistent in the environment. There are evidences from present investigations that a variety of substances are capable of disrupting the endocrine system in the aquatic environment. These substances are called endocrine disruptors. Dioxin and related compounds can act as endocrine disruptors. Aquatic animals like amphibian and fish are especially affected of the impact of these compounds. Investigations concerned so far in particular the domain of reproduction biology and the thyroid axis especially. Recent investigations showed that the TR{alpha}-mRNA level change after a short temporal expression with T3, methimazole and amiodarone. The objective of the project is to identify effects of thyroid endocrine disruptors on the regulation of gene expression of the thyroid receptors TR{alpha}a, TR{beta} and thyroid stimulating hormone TSH and associated effects on other system. In preliminary studies the effects of the drug methimazole as model substance on gene expression of TR{alpha} and TSH were investigated. Methimazole is an inhibitor of the thyroid peroxidase so that the formation of thyroid hormones is disrupted.

  6. March 2016 critical care case of the month

    Directory of Open Access Journals (Sweden)

    Loftsgard T

    2016-03-01

    Full Text Available No abstract available. Article truncated at 150 words. History of Present Illness: A 58-year-old man was admitted to the ICU in stable condition after an aortic valve replacement with a mechanical valve. Past Medical History: He had with past medical history significant for endocarditis, severe aortic regurgitation related to aortic valve perforation, mild to moderate mitral valve regurgitation, atrial fibrillation, depression, hypertension, hyperlipidemia, obesity, and previous cervical spine surgery. As part of his preop workup, he had a cardiac catheterization performed which showed no significant coronary artery disease. Pulmonary function tests showed an FEV1 of 55% predicted and a FEV1/FVC ratio of 65% consistent with moderate obstruction. Medications: Amiodarone 400 mg bid, digoxin 250 mcg, furosemide 20 mg IV bid, metoprolol 12.5 mg bid. Heparin nomogram since arrival in the ICU. Physical Examination: He was extubated shortly after arrival in the ICU. Vitals signs were stable. His weight had increased 3 Kg compared to admission. He was awake ...

  7. The implantable defibrillator and antiarrhythmic drugs--competitive and complementary treatment for severe ventricular arrhythmia.

    Science.gov (United States)

    Dorian, P; Newman, D

    1993-11-01

    Most patients with a history of sustained ventricular tachycardia (VT) or ventricular fibrillation (VF) are at high risk of recurrence. Implanted defibrillators (ICDs) are highly effective in sensing and converting VT or VF to a perfusing rhythm. "Conventional" antiarrhythmic agents, which primarily block cardiac sodium channels, are relatively ineffective in preventing arrhythmia recurrence; amiodarone and sotalol appear to be effective in reducing recurrence and mortality rates, although the extent of benefit is not well understood. Despite the apparent advantage of ICDs, they have short- and long-term complications, are costly, and their benefit in prolonging the quantity or quality of life remains unproven. Randomized clinical trials which compare the effect of ICDs with that of antiarrhythmic drugs on mortality, cost, and quality of life will be necessary to understand how patients with malignant arrhythmias ought to be treated. If an ICD is implanted, adjunctive therapies need to be considered to treat the underlying heart disease and to derive optimum benefit from the device. Drugs may have beneficial or adverse interactions with devices, and the full understanding of these interactions requires further study. PMID:8269662

  8. An integrated approach to improved toxicity prediction for the safety assessment during preclinical drug development using Hep G2 cells.

    Science.gov (United States)

    Noor, Fozia; Niklas, Jens; Müller-Vieira, Ursula; Heinzle, Elmar

    2009-06-01

    Efficient and accurate safety assessment of compounds is extremely important in the preclinical development of drugs especially when hepatotoxicity is in question. Multiparameter and time resolved assays are expected to greatly improve the prediction of toxicity by assessing complex mechanisms of toxicity. An integrated approach is presented in which Hep G2 cells and primary rat hepatocytes are compared in frequently used cytotoxicity assays for parent compound toxicity. The interassay variability was determined. The cytotoxicity assays were also compared with a reliable alternative time resolved respirometric assay. The set of training compounds consisted of well known hepatotoxins; amiodarone, carbamazepine, clozapine, diclofenac, tacrine, troglitazone and verapamil. The sensitivity of both cell systems in each tested assay was determined. Results show that careful selection of assay parameters and inclusion of a kinetic time resolved assay improves prediction for non-metabolism mediated toxicity using Hep G2 cells as indicated by a sensitivity ratio of 1. The drugs with EC(50) values 100 microM or lower were considered toxic. The difference in the sensitivity of the two cell systems to carbamazepine which causes toxicity via reactive metabolites emphasizes the importance of human cell based in-vitro assays. Using the described system, primary rat hepatocytes do not offer advantage over the Hep G2 cells in parent compound toxicity evaluation. Moreover, respiration method is non invasive, highly sensitive and allows following the time course of toxicity. Respiration assay could serve as early indicator of changes that subsequently lead to toxicity. PMID:19332084

  9. Targeted toxicological screening for acidic, neutral and basic substances in postmortem and antemortem whole blood using simple protein precipitation and UPLC-HR-TOF-MS

    DEFF Research Database (Denmark)

    Telving, Rasmus; Hasselstrøm, Jørgen Bo; Andreasen, Mette Findal

    2016-01-01

    -HR-TOF-MS was achieved in one injection. This method covered basic substances, substances traditionally analyzed in negative ESI (e.g., salicylic acid), small highly polar substances such as beta- and gamma-hydroxybutyric acid (BHB and GHB, respectively) and highly non-polar substances such as amiodarone. The new method......A broad targeted screening method based on broadband collision-induced dissociation (bbCID) ultra-performance liquid chromatography high-resolution time-of-flight mass spectrometry (UPLC-HR-TOF-MS) was developed and evaluated for toxicological screening of whole blood samples. The acidic, neutral...... was performed on spiked whole blood samples and authentic postmortem and antemortem whole blood samples. For most of the basic drugs, the established cut-off limits were very low, ranging from 0.25ng/g to 50ng/g. The established cut-off limits for most neutral and acidic drugs, were in the range from 50ng...

  10. Three Vessel Coronary Cameral Fistulae Associated with New Onset Atrial Fibrillation and Angina Pectoris

    Directory of Open Access Journals (Sweden)

    Murat Yuksel

    2014-01-01

    Full Text Available Coronary cameral fistulas are abnormal communications between a coronary artery and a heart chamber or a great vessel which are reported in less than 0.1% of patients undergoing diagnostic coronary angiography. All three major coronary arteries are even less frequently involved in fistula formation as it is the case in our patient. A 68-year-old woman was admitted to cardiology clinic with complaints of exertional dyspnea and angina for two years and a new onset palpitation. Standard 12-lead electrocardiogram revealed atrial fibrillation (AF with a ventricular rate of 114 beat/minute and accompanying T wave abnormalities and minimal ST-depression on lateral derivations. Transthoracic echocardiographic examination was normal except for diastolic dysfunction, minimally mitral regurgitation, and mild to moderate enlargement of the left atrium. Sinus rhythm was achieved by medical cardioversion with amiodarone infusion. Coronary angiography revealed diffuse and multiple coronary-left ventricle fistulas originating from the distal segments of both left and right coronary arterial systems without any stenosis in epicardial coronary arteries. The patient’s symptoms resolved almost completely with medical therapy. High volume shunts via coronary artery to left ventricular microfistulas may lead to increased volume overload and subsequent increase in end-diastolic pressure of the left ventricle and may cause left atrial enlargement.

  11. Assessment of pathophysiology based on the left ventricular shape in five patients with midventricular obstructive hypertrophic cardiomyopathy

    International Nuclear Information System (INIS)

    The pathophysiology of midventricular obstructive hypertrophic cardiomyopathy (MVO) is unknown. Patients with MVO and MVO-like cardiomyopathy were classified into three groups based on the cardioimaging morphological characteristics of the left ventricle to investigate their complications and treatment. Four patients with MVO and one patient with disease-like MVO were admitted in our hospital from 1999 to 2005. Group A consisted of one patient with indications of pressure gradient at mid-ventricle without apical aneurysm, Group B consisted of three patients with indications of pressure gradient and apical aneurysm, and Group C consisted of one patient with hour-glass appearance with apical aneurysm and decreased left ventricular systolic function without pressure gradient. The diagnosis was established during examination for sustained ventricular tachycardia (SVT, three patients), paroxysmal atrial fibrillation (one patient), and coronary artery disease (one patient). Cardiogenic embolization was observed in all cases which originated from atrial fibrillation (one case) and apical aneurysm (two cases). No embolic event occurred in any patient after warfarin therapy. SVT occurred in patients in Groups B and C. SVT refractory to beta-blocker and mexiletine was treated by amiodarone. Apical aneurysmectomy and cryoablation could prevent recurrent SVT with drug resistance. Four of the five patients with MVO had arrhythmia (atrial fibrillation, SVT) and three had cardiogenic embolization. MVO could be classified into three groups depending on the morphological characteristics and complications. Treatment of MVO should be based on these characteristics. (author)

  12. [Atrial fibrillation. New views on an old disease].

    Science.gov (United States)

    Asensio-Lafuente, E; Alvarez-Mosquera, J B; Lozano-Díaz, J E; Farías-Vega, A; Narváez-David, R; Dorantes-García, J; Orea-Tejeda, A; Rebollar-González, V; Portos-Silva, J M; Oseguera-Moguel, J

    2001-01-01

    Atrial fibrillation (Afib) is clinically the most common arrhythmia. Its main complications are recurrent embolic events and a variable deterioration of functional class. Atrial fibrillation induces changes in cellular ionic channels that self-perpetuate the arrhythmia. The pharmacologic treatment of Afib is directed toward correction of those changes and return to sinus rhythm. It is also intended to maintain adequate heart rates and prevent embolic events through anticoagulation or platelet antiagregation. There are presently several class IC or class III antiarrhythmics available for attempting a return to sinus rhythm. The success rates are irregular, the best achieved with flecainide or propafenone among patients without structural heart disease. Amiodarone is the best choice when there is such a problem. The combination possibilities are huge, so that each case must be individualized. The new class III antiarrhythmics are very effective, but have a relatively high rate of side effects including torsade de pointes. Anticoagulation should be the preferred treatment among the majority of patients, but each case should be individually evaluated. New therapies such as focal or linear catheter ablation techniques, atrial or biatrial programmed stimulation, and atrial cardioverter-defibrillator need longer follow-up and experience to be objectively evaluated, although there are reasons to be optimistic in the future, even if patients need antiarrhythmic support at present. Surgery has high morbi-mortality rates, so it is not the preferred approach. PMID:11692812

  13. High-throughput cardiac safety evaluation and multi-parameter arrhythmia profiling of cardiomyocytes using microelectrode arrays.

    Science.gov (United States)

    Gilchrist, Kristin H; Lewis, Gregory F; Gay, Elaine A; Sellgren, Katelyn L; Grego, Sonia

    2015-10-15

    Microelectrode arrays (MEAs) recording extracellular field potentials of human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) provide a rich data set for functional assessment of drug response. The aim of this work is the development of a method for a systematic analysis of arrhythmia using MEAs, with emphasis on the development of six parameters accounting for different types of cardiomyocyte signal irregularities. We describe a software approach to carry out such analysis automatically including generation of a heat map that enables quick visualization of arrhythmic liability of compounds. We also implemented signal processing techniques for reliable extraction of the repolarization peak for field potential duration (FPD) measurement even from recordings with low signal to noise ratios. We measured hiPS-CM's on a 48 well MEA system with 5minute recordings at multiple time points (0.5, 1, 2 and 4h) after drug exposure. We evaluated concentration responses for seven compounds with a combination of hERG, QT and clinical proarrhythmia properties: Verapamil, Ranolazine, Flecainide, Amiodarone, Ouabain, Cisapride, and Terfenadine. The predictive utility of MEA parameters as surrogates of these clinical effects were examined. The beat rate and FPD results exhibited good correlations with previous MEA studies in stem cell derived cardiomyocytes and clinical data. The six-parameter arrhythmia assessment exhibited excellent predictive agreement with the known arrhythmogenic potential of the tested compounds, and holds promise as a new method to predict arrhythmic liability. PMID:26232523

  14. An integrated approach to improved toxicity prediction for the safety assessment during preclinical drug development using Hep G2 cells

    International Nuclear Information System (INIS)

    Efficient and accurate safety assessment of compounds is extremely important in the preclinical development of drugs especially when hepatotoxicty is in question. Multiparameter and time resolved assays are expected to greatly improve the prediction of toxicity by assessing complex mechanisms of toxicity. An integrated approach is presented in which Hep G2 cells and primary rat hepatocytes are compared in frequently used cytotoxicity assays for parent compound toxicity. The interassay variability was determined. The cytotoxicity assays were also compared with a reliable alternative time resolved respirometric assay. The set of training compounds consisted of well known hepatotoxins; amiodarone, carbamazepine, clozapine, diclofenac, tacrine, troglitazone and verapamil. The sensitivity of both cell systems in each tested assay was determined. Results show that careful selection of assay parameters and inclusion of a kinetic time resolved assay improves prediction for non-metabolism mediated toxicity using Hep G2 cells as indicated by a sensitivity ratio of 1. The drugs with EC50 values 100 μM or lower were considered toxic. The difference in the sensitivity of the two cell systems to carbamazepine which causes toxicity via reactive metabolites emphasizes the importance of human cell based in-vitro assays. Using the described system, primary rat hepatocytes do not offer advantage over the Hep G2 cells in parent compound toxicity evaluation. Moreover, respiration method is non invasive, highly sensitive and allows following the time course of toxicity. Respiration assay could serve as early indicator of changes that subsequently lead to toxicity.

  15. 53例药源性间质性肺炎的文献分析%Literature Analysis of 53 Reports of Drug-induced Interstitial Pneumonia

    Institute of Scientific and Technical Information of China (English)

    胡美绘; 孙安修

    2014-01-01

    目的:探讨引起间质性肺炎的药品种类及其临床表现特点。方法检索中国医院数字图书馆、中国知网、万方数据库中1994~2013年,关键词为“间质性肺炎”的相关文献,进行归纳总结。结果共检索出相关文献74篇,报道53例药源性间质性肺炎,涉及15种药物,包括吉非替尼(15例)、利妥西单抗(9例)、来氟米特(8例)、胺碘酮(8例)、厄洛替尼(5例)、干扰素(2例)、5-氟尿嘧啶(1例)、粒细胞集落刺激因子(1例)、吉西他滨(1例)、卡莫司汀(1例)、麻疹疫苗(1例)、百草枯(1例)等。53例患者中,2例治疗结果不详;治愈17例(33.33%),好转19例(37.26%),死亡15例(29.41%)。结论各药品引起间质性肺炎发病机制尚不明确,临床表现相似。发病率较高的药物有吉非替尼、利妥西单抗、来氟米特、胺碘酮、厄洛替尼。%Objective To study the drugs leading to interstitial pneumonia and analyze their clinical characteristics. Methods We searched the literatures from 1994 to 2013 by key words of "interstitial pneumonia" in China Digital Library, China National Knowledge Infrastructure, Wanfang Database, and summarized them. Results A total of 74 relevant articles were identified, which reported 53 cases of drug-induced interstitial neumonia, involving 15 kinds of drugs. The drugs included gefitinib(15), rituximab(9), leflunomide(8), amiodarone(8), erlotinib(5), interferon(2), 5-fluorouracil(1), granulocyte colony-stimulating factor(1), gemcitabine(1), carmustine (1), measles vaccine (1), paraquat(1), et al.The result showed that 53 cases contained 17 cases(33.33%) cured, 19 cases(37.26%) improved , 15 cases(29.41%) died and 2 cases unclear. Conclusion The clinical manifestations of interstitial pneumonia induced by drugs were similar, but the pathogenesis was unknown. The drugs leading to higher incidence were gefitinib, rituximab

  16. Evaluation of the Therapeutic Effect of Bisoprolol on Heart Failure Patients with Persistent Atrial Fibrillation%评价比索洛尔对心力衰竭合并持续性房颤的疗效

    Institute of Scientific and Technical Information of China (English)

    王琴; 袁文

    2015-01-01

    Objective To evaluate the therapeutic ef ect of Bisoprolol on heart failure patients with persistent atrial fibril ation . Methods 76 heart failure patients with persistent atrial fibril ation were randomly divided into observation group and control group with 38 cases in each group, two groups were given conventional treatment of the primary disease in Department of internal medicine. The observation group in the conventional treatment were treated on the basis of using bisoprolol tablets from 0.25 to 10mg, 1 times/day, lasting for 4 weeks;the control group was treated on the basis of oral Amiodarone pieces of at least 200mg, 1 times/ day, for 4 weeks. Results The cardiac function of two groups after treatment significantly improved, compared with that before treatment, there were statistical significance ( <0.05);comparison of the two groups after treatment in control ing ventricular rate , the observation group was significantly bet er than the cont group( <0.05); observation of adverse reactions to drugs, Amiodarone group was higher than that of Bisoprolol group. Conclusion Bisoprolol in treatment of congestive heart failure with persistent atrial fibril ation has good curative ef ect, less side reaction, is a first-line refined conventional drug to optimizing control of heart failure complicated with atrial fibril ation.%目的评价比索洛尔对心力衰竭合并持续性房颤的疗效。方法选取心力衰竭合并持续性房颤患者76例,随机分为观察组与对照组各38例,两组均给予原发病内科的常规治疗。观察组在常规治疗基础上采用比索洛尔片0.25~10mg,1次/d;对照组在常规治疗基础上口服胺碘酮片至少200mg,1次/d,维持4w。结果两组患者治疗后的心功能明显改善,与治疗前比较,均有统计学意义(<0.05);治疗后两组心室率控制比较,观察组明显优于对照组(<0.05);观察药物不良反应,胺碘酮组高于比索洛尔组。结论比索洛尔治

  17. Brugada syndrome: A brand new case

    Directory of Open Access Journals (Sweden)

    Jurčević Ružica

    2009-01-01

    Full Text Available Background: Brugada syndrome (BS is a disorder characterized by syncope or sudden death associated with one of several electrocardiographic (ECG patterns characterized by incomplete right bundle branch block and ST elevation in the anterior precordial leads. Patients with BS are prone to develop ventricular tachyarrhythmias that may lead to syncope, cardiac arrest, or sudden cardiac death. Case report. A 58-year-old woman is the first described case of Brugada syndrome in Serbia with intermittent typical changes in basic electrocardiography (ECG: ST segment elevation in the precordial chest leads like dome or coved - major form or type I. For the last 27 years the patient had suffered of palpitations and dizziness, without syncopal events. Her sister had died suddenly during the night in sleep. During 24-hour Holter monitoring the patient had ventricular premature beats during the night with R/T phenomenon and during the recovery phase of exercise testing had rare premature ventricular beats as the consequence of parasympatethic stimulation. Late potentials were positive. Echocardiography revealed left ventricular ejection fraction of 60%. We performed coronary angiography and epicardial coronary arteries were without significant stenosis and structural heart disease was excluded. In the bigining of the electrophysiological study ECG was normal, and after administration of Propaphenon i.v. Brugada syndrome unmasked with appearance of type I ECG pattern. A programed ventricular stimulation induced non sustained ventricular tachycardia. One-chamber implantable cardioverter defibrillator was implanted and the patient was treated with a combination od amiodarone and metoprolol per os. After one-year follow-up, there were no episodes of ventricular tachycardia and ventricular fibrillation. Conclusion. Brugada syndrome is a myocardial disorder which prognosis and therapy are related to presence of ventricular fibrillation or ventricular tachycardia

  18. RADIOFREQUENCY CATHETER ABLATION OF PERMANENT ATRIAL FIBRILLATION UNDER GUIDANCE OF CARTO-MERGE TECHNIQUE

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    Objective To investigate the feasibility and effectiveness of radiofrequency catheter ablation (RFCA) to treat permanent atrial fibrillation (AF) under the guidance of Carto-Merge technique.Methods Fifteen male patients with permanent AF underwent RFCA under the guidance of Carto-Merge technique. The mean age was 54. 00 ± 10. 44 years, and duration of AF was 23.66 ± 14. 93 months. Cardiac magnetic resonance angiography (MRA) was performed to obtain pre-procedural three-dimensional (3D) images on the anatomy of left atrium (LA) and pulmonary veins (PVs) before RFCA procedure. Then the electroanatomical map was integrated with 3D images of MRA to form Carto-Merge map that guided step-by-step ablation strategy of permanent AF. Circumferential PV ablation was performed first until complete PVs electric isolation confirmed by Lasso catheter. If AF was not terminated, lesion lines on roof of LA, mitral isthmus, and tricuspid isthmus were produced.Results The episodes of AF were terminated during RFCA in 2 patients, by direct current cardioversion in the remaining 13 patients. Transient AF occurred in 2 patients after ablation on 1st day and 1st week respectively, AF terminated spontaneously not long after taking metoprolol. One patient developed persistent atrial flutter (AFL) in 2 months after procedure and AFL was eliminated by the second ablation. Persistent AF recurred on 1st day, 1st and 5th week respectively in 3 patients, and did not terminate after 3 months even though amiodarone was given The remaining 12 patients were all free of AF during 2-11 months of follow-up. The recent success rate for RFCA of permanent AF was 80%.Conclusions Carto-Merge technique can effectively guide RFCA of permanent AF. When combined with single Lasso mapping, it can simplify the mapping, lower expenses, and enhance the success rate of RFCA of permanent AF.

  19. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

    Directory of Open Access Journals (Sweden)

    Karvounis Charalambos

    2009-07-01

    Full Text Available Abstract Background The percentage of hypertrophic cardiomyopathy (HCM patients who are in high risk for Sudden Death (SD constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually. The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients. Methods Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR during upright exercise testing and Maximum left ventricular Wall Thickness (MWT ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece. Results Fifteen patients (12.2% of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4% had an ABPR to exercise, 17 patients (13.8% had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8% suffered from syncope, and 8 patients (6.5% had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1% had none risk factor. Twenty four patients (19.5% had 1 risk factor, 17 patients (13.8% had 2 risk factors, 4 patients (3.25% had 3 risk factors, and 4 patients (3.25% had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3% had 2 or more risk factors. Conclusion This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20% carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.

  20. Investigation of a hepatotoxicity screening system in primary cell cultures --"what biomarkers would need to be addressed to estimate toxicity in conventional and new approaches?".

    Science.gov (United States)

    Kikkawa, Rie; Yamamoto, Toshinori; Fukushima, Tamio; Yamada, Hiroshi; Horii, Ikuo

    2005-02-01

    High throughput toxicological estimation is required for safety evaluation in the early stage of drug discovery. In this context, establishment of an in vitro screening system reflecting in vivo toxicity is demanded for earlier safety assessment. We investigated LDH release and mitochondrial respiration (WST-1 reduction assay; WST-1) to detect cytotoxicity, morphological evaluation, and proteomics for estimating the reliable and sensitive biomarkers by using rat primary hepatocytes exposed to the compounds (acetaminophen, amiodarone, tetracycline and carbon tetrachloride) that are known to induce hepatotoxicity. In LDH release, no significant difference was detected between the control and compound exposed cells after exposure for 3 or 6 hr, but a dose-dependent increase was observed after exposure for 24 hr. Regarding the WST-1 assay, a dose-dependent reduction was detected after exposure for 6 and 24 hr to all of the compounds evaluated. In the proteomics analysis, 31 candidate proteins were identified from among the 103 demonstrating altered expression spots after exposure to acetaminophen. It was concluded that the cytotoxicity was detected earlier by measuring WST-1 than by measuring LDH release because the reduction of mitochondrial respiration is an expressions of earlier toxicity for cellular function, while the measured increase in the LDH release occurs after the failure of the cell membrane. Mitochondrial respiration ability was a useful parameter for cytotoxicity in in vitro hepato-toxicity screening, as cytotoxicity can be detected during the early stage of exposure. In addition to the conventional biomarkers, several protein biomarkers which relate to oxidative stress and metabolism-regulation were detected. Further comprehensive analysis of defined proteins would be necessary to estimate the more sensitive toxicology biomarker. PMID:15800402

  1. Use of a low-density microarray for studying gene expression patterns induced by hepatotoxicants on primary cultures of rat hepatocytes.

    Science.gov (United States)

    de Longueville, Francoise; Atienzar, Franck A; Marcq, Laurence; Dufrane, Simon; Evrard, Stéphanie; Wouters, Lydia; Leroux, Florence; Bertholet, Vincent; Gerin, Brigitte; Whomsley, Rhys; Arnould, Thierry; Remacle, José; Canning, Mickael

    2003-10-01

    In the field of gene expression analysis, DNA microarray technology is having a major impact on many different areas including toxicology. For instance, a number of studies have shown that transcription profiling can generate the information needed to assign a compound to a mode-of-action class. In this study, we investigated whether compounds inducing similar toxicological endpoints produce similar changes in gene expression. In vitro primary rat hepatocytes were exposed to 11 different hepatotoxicants: acetaminophen, amiodarone, clofibrate, erythromycin estolate, isoniazid, alpha-naphtylylisothiocyanate, beta-naphtoflavone, 4-pentenoic acid, phenobarbital, tetracycline, and zileuton. These molecules were selected on the basis of their variety of hepatocellular effects observed such as necrosis, cholestasis, steatosis, and induction of CYP P450 enzymes. We used a low-density DNA microarray containing 59 genes chosen as relevant toxic and metabolic markers. The in vitro gene expression data generated in this study were generally in good agreement with the literature, which mainly concerns in vivo data. Furthermore, gene expression profiles observed in this study have been confirmed for several genes by real-time PCR assays. All the tested drugs generated a specific gene expression profile. Our results show that even with a relatively limited gene set, gene expression profiling allows a certain degree of classification of compounds with similar hepatocellular toxicities such as cholestasis, necrosis. The clustering analysis revealed that the compounds known to cause steatosis were linked, suggesting that they functionally regulate similar genes and possibly act through the same mechanisms of action. On the other hand, the drugs inducing necrosis and cholestasis were pooled in the same cluster. The drugs arbitrarily classified as the CYP450 inducers formed individual clusters. In conclusion, this study suggests that low-density microarrays could be useful in

  2. Genomic cluster and network analysis for predictive screening for hepatotoxicity.

    Science.gov (United States)

    Fukushima, Tamio; Kikkawa, Rie; Hamada, Yoshimasa; Horii, Ikuo

    2006-12-01

    The present study was undertaken to estimate the usefulness of genomic approaches to predict hepatotoxicity. Male rats were treated with acetaminophen (APAP), carbon tetrachloride (CCL), amiodarone (AD) or tetracycline (TC) at toxic doses. Their livers were extracted 6 or 24 hr after the dosings and were used for subsequent examinations. At 6 hr there were no histological changes noted in any of the groups except for the CCL group, but at 24 hr, such changes were noted in all but the AD group. Regarding genomic analysis, we performed hierarchical cluster analysis using S-plus software. The individual microarray data were clearly classified into 5 treatment-related clusters at 24 hr as well as at 6 hr, even though no morphological changes were noted at 6 hr. In the gene expression analysis using GeneSpring, transcription factor and oxidative stress- and lipid metabolism-related genes were markedly affected in all treatment groups at both time points when compared with the corresponding control values. Finally, we investigated gene networks in the above-affected genes by using Ingenuity Pathway Analysis software. Down-regulation of lipid metabolism-related genes regulated by SREBP1 was observed in all treatment groups at both time points, and up-regulation of oxidative stress-related genes regulated by Nrf2 was observed in the APAP and CCL treatment groups. From the above findings, for the application of genomic approaches to predict hepatotoxicity, we considered that cluster analysis for classification and early prediction of hepatotoxicity and network analysis for investigation of toxicological biomarkers would be useful. PMID:17202758

  3. 注射剂溶媒选择与说明书不符致医患矛盾3例分析%Analysis of doctor-patient contradictions induced by drug solvents inconsistent with drug package insert

    Institute of Scientific and Technical Information of China (English)

    司继刚

    2015-01-01

    Objective To explore how to handle doctor-patient contradictions induced by drug solvents incon-sistent with drug package insert,to provide references for solving the doctor-patient contradictions by multidisciplinar-y. Methods Pharmacist participated in solving the doctor-patient contradictions caused by injective omeprazole sodi-um,injective alanyl glutamine and amiodarone injection for dilution solvent inconsistent with drug instructions. Results By pharmacy service and pharmacy education,doctor-patient contradictions resolved. Conclusion Hospital should develop pharmacists professional technical service,carry out rational drug use,reduce medical contradictions and dis-putes caused by improper irrational drug use and drug incompatibility.%目的:探讨药物溶媒选择与药品说明书不符致医患矛盾的处理,为医院多学科处理医患矛盾提供参考。方法对于注射用奥美拉唑钠、注射用丙氨酰谷氨酰胺及胺碘酮注射液3种药物因为稀释溶媒与药品说明书不符所引起医患矛盾进行了分析,药师发挥了在处理此类纠纷方面的积极作用。结果通过药师的药学服务和用药宣教工作,医患矛盾得以化解。结论医院应发挥药师专业技术特长,开展合理用药的药学服务工作,减少因不合理用药和药物配伍不当引起的医患矛盾和医患纠纷。

  4. Case Analysis and Intervention of Warfarin Drug Interactions by Clinical Pharmacist%临床药师对华法林药物相互作用的病例分析和干预

    Institute of Scientific and Technical Information of China (English)

    杨周生; 郑萍

    2014-01-01

    Objective: To explore the role of clinical pharmacists in the treatment based on one case analysis and intervention of warfarin drug interactions . Methods: In view of the patient medication and the drug interaction , the mechanism affecting warfarin anticoagulation by combined drug use was explored . Results: Amiodarone was one of the main factors enhancing the effect of warfarin anticoagulation . With the assistance of clinical pharmacist a safe and effective treatment plan for the patient was made . Conclusion: Clinical pharmacist ’ s participating in making therapeutic regimen can provide a safe and effective medication plan for both doctors and patients .%目的:通过临床药师对1例华法林药物相互作用的病例分析和干预,探讨药师在临床治疗中发挥的作用。方法:针对病例的用药情况,从药物相互作用角度,探讨分析合并用药对华法林抗凝作用影响的机制。结果:胺碘酮是增强华法林抗凝作用的主要因素,临床药师协助医师为患者制定了安全、有效的治疗方案。结论:临床药师参与药物治疗方案的制定,可为医师、患者双方提供安全、有效的用药方案。

  5. Survive On Call - A QI Project to Improve Access to Hospital Clinical Guidelines.

    Science.gov (United States)

    Penders, Robert; Mallet, Mark

    2016-01-01

    Accessing clinical guidelines and telephone numbers can be time consuming for junior doctors, particularly during a busy on-call shift. Smartphones allow instant access to this information, without leaving a patient's bedside. This overcomes the relative paucity of fixed desktop computers available in most clinical areas. In this project, a trainee doctor developed a clinical smartphone app to improve the access of clinical and hospital-specific information. A representative sample of ten junior doctors were recruited to quantify the amount of time spent accessing guidelines using desktop computers, versus the App. The average time to access a common guideline (Hypokalaemia management) with the App was 12.4 seconds (95% CI 2.3), versus 76.8 seconds (95% CI 30.6) using a computer. A difference of 64.4 seconds (p access an Amiodarone prescribing guideline with the App was 25.9 seconds (95% CI 12.9), versus 142.0 seconds (95% CI 44.8) using a computer. A difference of 116.1 seconds (p access clinical guidelines and telephone numbers. They clearly feel it has improved their working efficiency. This has been supported by quantitative measures of actual time saved using the App. The ability to access such information in as little time as possible may be even more pertinent where decision-making is time-critical - for example in Anaesthesia and Emergency Medicine. Further study into these specialties is warranted to determine whether mobile information can impact upon patient safety and clinical outcomes. PMID:27239310

  6. Drug-induced QT interval prolongation and torsades de pointes: Role of the pharmacist in risk assessment, prevention and management.

    Science.gov (United States)

    Tisdale, James E

    2016-05-01

    Torsades de pointes (TdP) is a life-threatening arrhythmia associated with prolongation of the corrected QT (QTc) interval on the electrocardiogram. More than 100 drugs available in Canada, including widely used antibiotics, antidepressants, cardiovascular drugs and many others, may cause QTc interval prolongation and TdP. Risk factors for TdP include QTc interval >500 ms, increase in QTc interval ≥60 ms from the pretreatment value, advanced age, female sex, acute myocardial infarction, heart failure with reduced ejection fraction, hypokalemia, hypomagnesemia, hypocalcemia, bradycardia, treatment with diuretics and elevated plasma concentrations of QTc interval-prolonging drugs due to drug interactions, inadequate dose adjustment of renally eliminated drugs in patients with kidney disease and rapid intravenous administration. Pharmacokinetic drug interactions associated with the highest risk of TdP include antifungal agents, macrolide antibiotics (except azithromycin) and drugs to treat human immunodeficiency virus interacting with amiodarone, disopyramide, dofetilide or pimozide. Other important pharmacokinetic interactions include antidepressants (bupropion, duloxetine, fluoxetine, paroxetine) interacting with flecainide, quinidine or thioridazine. Pharmacists play an important role in minimizing the risk of drug-induced QTc interval prolongation and TdP through knowledge of drugs that are associated with a known or possible risk of TdP, individualized assessment of risk of drug-induced QTc interval prolongation, awareness of drug interactions most likely to result in TdP and attention to dose reduction of renally eliminated QTc interval-prolonging drugs in patients with kidney disease. Treatment of hemodynamically stable TdP consists of discontinuation of the offending drug(s), correction of electrolyte abnormalities and administration of intravenous magnesium sulfate 1 to 2 g. PMID:27212965

  7. Development of a mitochondria-based centrifugal ultrafiltration/liquid chromatography/mass spectrometry method for screening mitochondria-targeted bioactive constituents from complex matrixes: Herbal medicines as a case study.

    Science.gov (United States)

    Yang, Xing-Xin; Xu, Feng; Wang, Dan; Yang, Zhi-Wei; Tan, Huan-Ran; Shang, Ming-Ying; Wang, Xuan; Cai, Shao-Qing

    2015-09-25

    Mitochondria are an important intracellular pharmacological target because damage to this organelle results in a variety of human disorders and because mitochondria are involved in complex processes such as energy generation, apoptosis and lipid metabolism. To expedite the search for natural bioactive compounds targeting mitochondria, we initially developed an efficient mitochondria-based screening method by combining centrifugal ultrafiltration (CU) with liquid chromatography/mass spectrometry (LC/MS), which is called screening method for mitochondria-targeted bioactive constituents (SM-MBC) and is compatible with the search of mitochondria-targeted compounds from complex matrixes such as herbal medicines extracts. Functionally active, structurally intact and pure mitochondria were obtained from rat myocardium using an optimized protocol for mitochondrial isolation comprising organelle release followed by differential and Nycodenz density gradient centrifugation. After evaluating the reliability of the method using thiabendazole (TZ), rotenone (RN), amiodarone (AR) and trimetazidine (TD) as positive controls, this method was successfully applied to screen bioactive constituents from extracts of Polygoni Cuspidati Rhizoma et Radix (PCRR) and Scutellariae Radix (SR). Nineteen active compounds were detected and identified by LC/MS, of which 17 were new mitochondria-targeted compounds. The activity of 9 of the 19 hit compounds was confirmed by in vitro pharmacological trials. These results demonstrate that SM-MBC can be used for the efficient screening of mitochondria-targeted constituents in complex preparations used to treat mitochondrial disorders, such as PCRR and SR. The results may be meaningful for an in-depth understanding of drug mechanism of action and drug discovery from medicinal herbs. PMID:26306914

  8. Herzbeteiligung bei Myopathien

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    Finsterer J

    2001-01-01

    Full Text Available Herzbeteiligung bei Patienten mit Myopathien wird zunehmend häufiger diagnostiziert. Sie manifestiert sich bei diesen Patienten als Störung der Erregungsbildung und -ausbreitung, Wandverdickung, abnorme Textur des Myokards, linksventrikuläre Hypertrabekulierung, Dilatation der Herzhöhlen mit/ohne sekundärer Klappeninsuffizienz, Reduktion der Koronarreserve, intrakardiale Thrombusbildung, Endo-/Myokardfibrose, regionale Wandbewegungsstörung und systolische und/oder diastolische Funktionsstörung mit/ohne Herzinsuffizienz. Herzbeteiligung wurde bisher bei Dystrophinopathien, Emery-Dreifuss-Muskeldystrophie, fazioskapulohumeraler Muskeldystrophie, Sarcoglycanopathien, kongenitaler Muskeldystrophie Fukuyama, myotoner Dystrophie Typ 1 und 2, proximal myotoner Myopathie, Glykogenose Typ II, III, IV, VII und IX, Carnitinmangel, Myoadenylat-Deaminase-Mangel, Acyl-CoA-Dehydrogenase-Mangel, lysosomaler Glykogen-Speicherkrankheit, Mitochondriopathien, Desmin-Myopathie, Nemalin-Myopathie, Central Core-Krankheit, kongenitaler Fasertypen-Dysproportion, Barth-Syndrom, McLeod-Syndrom und Bethlem-Myopathie beschrieben. Herzbeteiligung bei Myopathien kann über Monate oder Jahre progredient verlaufen oder auch akut auftreten bzw. sich bis hin zum kardialen Notfall verschlechtern. Die Therapie der Herzbeteiligung richtet sich nach den spezifischen kardialen Abnormitäten und umfaßt Digitalis, Diuretika, ACE-Hemmer, Kalziumantagonisten, Amiodaron, Betablocker, L-Carnitin, Antikoagulation, Kardioversion, Schrittmacher, Defibrillator, Hochfrequenz-Katheter-Ablation und die Herztransplantation. Generell sollten Myopathie-Patienten kardiologisch untersucht werden, sobald die neurologische Diagnose feststeht, da eine suffiziente kardiale Therapie die Herzbeteiligung bei Myopathien positiv beeinflußt. Ein kardiologisches Follow-up ist angezeigt, wenn die Herzbeteiligung klinisch manifest wird bzw. bei rascher Progredienz.

  9. Safety and efficacy of vernakalant for acute cardioversion of atrial fibrillation: an update

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    Dobrev D

    2013-04-01

    Full Text Available Yukiomi Tsuji,1 Dobromir Dobrev1–3 1Institute of Pharmacology, Faculty of Medicine, University Duisburg-Essen, Essen, 2Division of Experimental Cardiology, Medical Faculty Mannheim, Heidelberg University, Mannheim, 3Deutsches Zentrum für Herz-Kreislauf-Forshcung [German Center for Cardiovascular Research], partner site Heidelberg/Mannheim, Mannheim, Germany Abstract: Intravenous vernakalant has recently been approved in Europe as an atrial-selective antiarrhythmic drug for the conversion of recent-onset atrial fibrillation (AF. It inhibits atrial-selective K+ currents (IK,ACh and IKur and causes rate-dependent atrial-predominant Na+ channel block, with only a small inhibitory effect on the rapid delayed rectifier K+ current (IKr in the ventricle. Due to its atrial-selective properties, vernakalant prolongs the effective refractory period of the atria with minimal effects on the ventricles, being associated with a low proarrhythmic risk for torsades de pointes arrhythmias. Five pivotal clinical trials consistently demonstrated that vernakalant rapidly terminates AF with stable maintenance of sinus rhythm for up to 24 hours. A head-to-head comparative trial showed that the 90-minute conversion rate of vernakalant was substantially higher than that of amiodarone. Initially, a longer-acting oral formulation of vernakalant was shown to be effective and safe in preventing AF recurrence after cardioversion in a Phase IIb study. However, the clinical studies testing oral vernakalant for maintenance of sinus rhythm after AF cardioversion were prematurely halted for undisclosed reasons. This review article provides an update on the safety and efficacy of intravenous vernakalant for the rapid cardioversion of AF. Keywords: atrial fibrillation, antiarrhythmic drug, atrial-selective K+ currents, Na+ channel block, ventricles

  10. Approach to the treatment of atrial fibrillation in patients with cardiovascular risk profile: Multicentric international study

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    Pavlović Siniša U.

    2015-01-01

    Full Text Available Introduction. Atrial fibrillation (AF, the most common arrhythmia that requires treatment, does not come out of the focus of researchers. Monitoring its prevalence and effects of therapy is a good guideline approach to the growing population of patients in which this arrhythmia occurs. Objective. The aim of the study was to evaluate the efficacy of treatment of AF and cardiovascular profiles in the observed population. Methods. In this observational, cross-sectional, multicenter, international study, 584 patients in 30 centers in Serbia and Slovenia, older than 18 years and with AF or in sinus rhythm with a history of AF, were included. The assessment of the efficacy of treatment of AF was performed by analyzing the frequency of adequate therapeutic effect of medication in rhythm or frequency control in patients with AF. Results. The results confirmed that the highest incidence of AF duration is more than seven days, and is accompanied by symptoms. Inadequate frequency regulation was registered at 8.9% of patients. Hypertension was registered in two-thirds of all patients, while other cardiovascular risk factors were registered in about one-third of patients. An echocardiographic finding in the group of patients with AF confirms generally adequate left ventricular function with a slightly enlarged left atrium (4.6±0.8 cm. Increasing age and time from the first episode of AF decreases the probability of maintaining sinus rhythm, while symptomatic AF had a positive impact on the presence of sinus rhythm. Propafenone, sotalol and amiodarone showed a statistically significant connection with a positive therapeutic response, while β-blockers had a negative impact on the probability of establishing and maintaining sinus rhythm. Conclusion. Characteristics of therapeutic approaches, risks, comorbidity of patient populations in Slovenia and Serbia correspond to the fullest extent with the recommendations for good clinical practice, which further

  11. How Do Atrial-Selective Drugs Differ From Antiarrhythmic Drugs Currently Used in the Treatment of Atrial Fibrillation?

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    Alexander Burashnikov

    2008-07-01

    Full Text Available Current pharmacologic strategies for the management of atrial fibrillation (AF include use of 1 sodium channel blockers, which are contraindicated in patients with coronary artery or structural heart disease because of their potent effect to slow conduction in the ventricles, 2 potassium channel blockers, which predispose to acquired long QT and Torsade de Pointes arrhythmias because of their potent effect to prolong ventricular repolarization, and 3 mixed ion channel blockers such as amiodarone, which are associated with multi-organ toxicity. Accordingly, recent studies have focused on agents that selectively affect the atria but not the ventricles. Several atrial-selective approaches have been proposed for the management of AF, including inhibition of the atrial-specific ultrarapid delayed rectified potassium current (IKur, acetylcholine-regulated inward rectifying potassium current (IK-ACh, or connexin-40 (Cx40. All three are largely exclusive to atria. Recent studies have proposed that an atrial-selective depression of sodium channel-dependent parameters with agents such as ranolazine may be an alternative approach capable of effectively suppressing AF without increasing susceptibility to ventricular arrhythmias. Clinical evidence for Cx40 modulation or IK-ACh inhibition are lacking at this time. The available data suggest that atrial-selective approaches involving a combination of INa, IKur, IKr, and, perhaps, Ito block may be more effective in the management of AF than pure IKur or INa block. The anti-AF efficacy of the atrial-selective/predominant agents appears to be similar to that of conventionally used anti-AF agents, with the major apparent difference being that the latter are associated with ventricular arrhythmogenesis and extracardiac toxicity.

  12. Preoperative Statin use is not Associated with a Reduced Risk of Atrial Fibrillation After Cardiac Surgery

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    Brian J Barnes PharmD

    2011-05-01

    Full Text Available Introduction Postoperative atrial fibrillation (POAF is prevalent after cardiac surgery and associated with significant morbidity and costs. Statins are commonly used in this population and may be a preventative strategy for PAOF. We wished to examine the effect of preoperative statin use on the risk of POAF after cardiac surgery. Methods A retrospective, observational study was conducted using data from 489 adult patients who underwent cardiac surgery at a single institution. Univariate analyses and unconditional logistic regression were used to determine the impact of preoperative statin use on the probability of developing POAF, while controlling for the baseline risk of POAF and the use of amiodarone prophylaxis (AMP. A baseline risk index was calculated for each patient using a previously validated model. Patients with chronic atrial fibrillation or missing data were excluded. Results Mean patient age was 63 (SD=13 years, 73% were male, 68% underwent isolated coronary artery bypass grafting, 16% underwent isolated valve surgery, with 13% underwent combined CABG and valve surgeries, and 3% underwent other forms of cardiac surgery. POAF occurred in 27% of patients receiving statins and 24% of those not receiving statins (p=0.3792. After controlling for baseline risk of POAF and the use of AMP, we found that preoperative statins were not associated with reductions in POAF (OR=1.19, 95%CI=0.782-1.822, p=0.4118. Conclusions Multiple factors impact the development of POAF after cardiac surgery including patient demographics, comorbidities, surgical type, and concomitant medications. In this study, after adjustment for these factors the preoperative use of statins did not significantly influence the development of POAF.

  13. How Do Atrial-Selective Drugs Differ From Antiarrhythmic Drugs Currently Used in the Treatment of Atrial Fibrillation?

    Directory of Open Access Journals (Sweden)

    Charles Antzelevitch

    2008-07-01

    Full Text Available Current pharmacologic strategies for the management of atrial fibrillation (AF include use of 1 sodium channel blockers, which are contraindicated in patients with coronary artery or structural heart disease because of their potent effect to slow conduction in the ventricles, 2 potassium channel blockers, which predispose to acquired long QT and Torsade de Pointes arrhythmias because of their potent effect to prolong ventricular repolarization, and 3 mixed ion channel blockers such as amiodarone, which are associated with multi-organ toxicity. Accordingly, recent studies have focused on agents that selectively affect the atria but not the ventricles. Several atrial-selective approaches have been proposed for the management of AF, including inhibition of the atrial-specific ultrarapid delayed rectified potassium current (IKur, acetylcholine-regulated inward rectifying potassium current (IK-ACh, or connexin-40 (Cx40. All three are largely exclusive to atria. Recent studies have proposed that an atrial-selective depression of sodium channel-dependent parameters with agents such as ranolazine may be an alternative approach capable of effectively suppressing AF without increasing susceptibility to ventricular arrhythmias. Clinical evidence for Cx40 modulation or IK-ACh inhibition are lacking at this time. The available data suggest that atrial-selective approaches involving a combination of INa, IKur, IKr, and, perhaps, Ito block may be more effective in the management of AF than pure IKur or INa block. The anti-AF efficacy of the atrial-selective/predominant agents appears to be similar to that of conventionally used anti-AF agents, with the major difference being that the latter are associated with ventricular arrhythmogenesis and extracardiac toxicity.

  14. Paroxysmal supraventricular tachycardia: physiopathology and management

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    Paola Neroni

    2014-06-01

    Full Text Available Paroxysmal supraventricular tachycardia (PSVT is the most frequent arrhythmia in newborns and infants. Most supraventricular tachycardias affect structurally healthy hearts. Apart from occasional detection by parents, most tachycardias in this age group are revealed by heart failure signs, such as poor feeding, sweating and shortness of breath. The main symptom reported by school-age children is palpitations. The chronic tachycardia causes a secondary form of dilative cardiomyopathy. Treatment of acute episode usually has an excellent outcome. Vagal manoeuvres are effective in patients with atrioventricular reentrant tachycardia. Adenosine is the drug of choice at all ages for tachycardias involving the atrioventricular node. Its key advantage is its short half life and minimum or no negative inotropic effects. Verapamil is not indicated in newborns and children as it poses a high risk of electromechanical dissociation. Antiarrhythmic prophylaxis of PSVT recurrence is usually recommended in the first year of life, because the diagnosis of tachycardia may be delayed up to the appearance of symptoms. Digoxin can be administered in all forms of PSVT involving the atrioventricular node, except for patients with Wolff-Parkinson-White syndrome below one year of age. Patients with atrioventricular reentrant PSVT can be treated effectively by class Ic drugs, such as propaphenone and flecainide. Amiodarone has the greatest antiarrhythmic effect, but should be used with caution owing to the high incidence of side effects. Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgiou

  15. Atrial Fibrillation Ablation in Systolic Dysfunction: Clinical and Echocardiographic Outcomes

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    Tasso Julio Lobo

    2015-01-01

    Full Text Available Background: Heart failure and atrial fibrillation (AF often coexist in a deleterious cycle. Objective: To evaluate the clinical and echocardiographic outcomes of patients with ventricular systolic dysfunction and AF treated with radiofrequency (RF ablation. Methods: Patients with ventricular systolic dysfunction [ejection fraction (EF <50%] and AF refractory to drug therapy underwent stepwise RF ablation in the same session with pulmonary vein isolation, ablation of AF nests and of residual atrial tachycardia, named "background tachycardia". Clinical (NYHA functional class and echocardiographic (EF, left atrial diameter data were compared (McNemar test and t test before and after ablation. Results: 31 patients (6 women, 25 men, aged 37 to 77 years (mean, 59.8±10.6, underwent RF ablation. The etiology was mainly idiopathic (19 p, 61%. During a mean follow-up of 20.3±17 months, 24 patients (77% were in sinus rhythm, 11 (35% being on amiodarone. Eight patients (26% underwent more than one procedure (6 underwent 2 procedures, and 2 underwent 3 procedures. Significant NYHA functional class improvement was observed (pre-ablation: 2.23±0.56; postablation: 1.13±0.35; p<0.0001. The echocardiographic outcome also showed significant ventricular function improvement (EF pre: 44.68%±6.02%, post: 59%±13.2%, p=0.0005 and a significant left atrial diameter reduction (pre: 46.61±7.3 mm; post: 43.59±6.6 mm; p=0.026. No major complications occurred. Conclusion: Our findings suggest that AF ablation in patients with ventricular systolic dysfunction is a safe and highly effective procedure. Arrhythmia control has a great impact on ventricular function recovery and functional class improvement.

  16. Evaluating the Safety of Intraoperative Antiarrhythmics in Pediatric Cardiac Surgery Patients.

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    Beaty, Rachel S; Moffett, Brady S; Hall, Stuart; Kim, Jeffrey

    2015-10-01

    Cardiac arrhythmias occurring during the intraoperative period for cardiac surgery have been associated with excess morbidity and mortality. Several antiarrhythmics have been utilized for the management of intraoperative arrhythmias. These antiarrhythmic medications can cause undesirable adverse outcomes in the intensive care setting. The incidence and treatment of adult intraoperative arrhythmias have been studied. In addition, the prevalence, risk factors, and optimal treatment of pediatric postoperative arrhythmias have also been studied. However, the literature has not been published on intraoperative antiarrhythmia treatment during pediatric cardiac surgery. The purpose of this study was to determine the safety of intraoperative antiarrhythmic medications utilized in pediatric cardiac surgery patients. This was a retrospective review of all patients who received an intraoperative antiarrhythmic in the cardiovascular operating room at Texas Children's Hospital. Patients were included if they underwent cardiovascular surgery from November 2008 to July 2013 and were excluded if antiarrhythmics were given intraoperatively for other indications (i.e., esmolol for hypertension) or if patients were older than 18 years of age. Safety of antiarrhythmic treatment was determined by the absence or presence of adverse events. Control or recurrence of the arrhythmia was analyzed as a secondary measure to help determine antiarrhythmic efficacy. A total of 45 patients were identified (53.3 % male). Patients were a median of 0.52 years at the time of surgery. Primary surgery types were tetralogy of Fallot repair (n = 6; 13.3 %) and ventricular septal defect closure (n = 5, 11.1 %). Thirty-one patients (68.9 %) had documented adverse events after the administration of antiarrhythmics. Most of these adverse events occurred after the administration of amiodarone (n = 16; 51.6 %) followed by esmolol (n = 15; 48.4 %). Fifty-one percent of the arrhythmias resolved in the operating

  17. Anesthesia Approach in Endovascular Aortic Reconstruction

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    Ayşin Alagöl

    2013-03-01

    Full Text Available Introduction: We have analyzed our initial results of our anesthesia techniques in our new-onset endovascular aortic reconstruction cases.Patients and Methods: The perioperative data of 15 elective and emergent endovascular aortic reconstruction cases that were operated in 2010-2011 were collected in a database. The choice of anesthesia was made by the risk factors, surgical team’s preferences, type and location of the aortic pathology and by the predicted operation duration. The data of local and general anesthesia cases were compared.Results: Thirteen (86.7% cases were male and 2 (13.3% female. Eleven patients were in ASA Class III. The demographic parameters, ASA classifications, concurrent diseases were similar in both groups. Thirteen (86.7% cases had infrarenal abdominal aortic aneurysm and 2 (13.3% had Type III aortic dissection. The diastolic arterial pressures were lower in general anesthesia group in 20th and 40th minutes’ measurements just like the mean arterial pressure measurements at the 40th, 100th minutes and during the deployment of the graft. Postoperative mortality occurred in 3 (20.0% patients and they all had general anesthesia and they were operated on emergency basis. Postoperative morbidity occurred in four patients that had general anesthesia (acute renal failure, multi-organ failure and pneumonia. The other patient had atrial fibrillation on the 1st postoperative day and was converted to sinus rhythm with amiodarone infusion.Conclusion: Edovascular aortic reconstruction procedures can safely be performed with both general and local anesthesia less invasively compared to open surgery. General anesthesia may be preferred for the better hemodynamic control.

  18. Increased Mortality Associated with Digoxin in Contemporary Patients with Atrial Fibrillation: Findings from the TREAT-AF Study

    Science.gov (United States)

    Turakhia, Mintu P.; Santangeli, Pasquale; Winkelmayer, Wolfgang C.; Xu, Xiangyan; Ullal, Aditya J.; Than, Claire T.; Schmitt, Susan; Holmes, Tyson H.; Frayne, Susan M.; Phibbs, Ciaran S.; Yang, Felix; Hoang, Donald D.; Ho, P. Michael; Heidenreich, Paul A.

    2014-01-01

    Objectives To evaluate the association of digoxin with mortality in atrial fibrillation. Background Despite endorsement of digoxin in clinical practice guidelines, there exist limited data on its safety in atrial fibrillation and flutter (AF). Methods Using complete data from the US Department of Veterans Administration (VA) Health Care System, we identified patients with newly-diagnosed, non-valvular AF seen within 90 days in an outpatient setting between VA fiscal years 2004-2008. We used multivariate and propensity-matched Cox proportional hazards to evaluate the association of digoxin use to death. Residual confounding was assessed by sensitivity analysis. Results Of 122,465 patients with 353,168 person-years of follow-up (age 72.1±10.3 years, 98.4% males), 28,679 (23.4%) patients received digoxin. Cumulative mortality rates were higher for digoxin-treated patients than for untreated patients (95 vs. 67 per 1,000 person-years; P<0.001). Digoxin use was independently associated with mortality after multivariate adjustment (HR: 1.26, 95%CI: 1.23-1.29, P<0.001) and propensity matching (HR: 1.21, 95%CI: 1.17-1.25, P<0.001), even after adjustment for drug adherence. The risk of death was not modified by age, sex, heart failure, kidney function, or concomitant use of beta blockers, amiodarone, or warfarin. Conclusion Digoxin was associated with increased risk of death in patients with newly-diagnosed AF, independent of drug adherence, kidney function, cardiovascular comorbidities, and concomitant therapies. These findings challenge current cardiovascular society recommendations on use of digoxin in AF. PMID:25125296

  19. Quality of the cardiovascular drugs prescribing in Zagreb during the period 2001- 2004

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    Dražen Stojanović

    2009-02-01

    Full Text Available Aim To investigate the outpatient utilisation of cardiovasculardrugs in Zagreb, during the 2001-2004 period, and to identify thepossible association between the increase in the utilisation of particulardrug groups and decrease in the number of hospital admissions.Methods The number of DDD per thousand inhabitants per day(DDDs/TID was calculated from data on the number and size ofdispensed drug packages, obtained from the Zagreb Pharmacies.Drug Utilisation 90% (DU90% method was used on assessmentof drug prescribing quality.Results Total utilisation of the cardiovascular drugs was high inZagreb during the 2001-2004 period (between 402.9 DDDs/TIDand 406.9 DDDs/TID. Agents acting on the renin-angiotensinsystem (C09 (121.3 DDDs/TID and calcium channel blockers(C08 (87.5 DDDs/TID accounted for more than 50% of drugsused for the treatment of hypertension in 2004. The greatest utilisationincrease was observed for statins (78.3%. Comparison ofDU90% segment between 2001 and 2004 revealed pentoxifyllineand amiodarone to be absent, whereas cilazapril and ramipril intheir combination with HCTZ, bisoprolol, valsartan and losartanalone or in their combination with HCTZ were added in 2004,DU90% segment still contain doxazosin and propafenone, whichhad no grounds in therapeutic guidelines.Conclusion The outpatient utilisation of cardiovascular drugs washigh during the 2001-2004 period. The utilization pattern was improved.The result was a decrease in the number of hospital admissionsfor main cardiovascular events.

  20. TO DETERMINE THE FREQUENCY OF UNDIAGNOSED HYPERTHYROIDISM IN PATIENTS PRESENTING WITH GENERAL IZED ANXIETY DISORDER

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    Shahid

    2013-02-01

    Full Text Available ABSTRACT: OBJECTIVE: To determine the frequency of hyperthyroidism in p atients presenting with generalized anxiety disorder. MATERIAL AND METHODS: This prospective analytical study was carried out on 150 patients presenting with Generalized Anxiety disorder following the criteria of DSM-IV-TR presenting to the Medical OPD of Sri Aurobindo Institute of Medical S ciences, Indore (M.P from Jan 2011 to Nov 2012 with symptoms of anxiety, worry, p alpitations, sweating, tremors, anorexia, hot flushes, restlessness, difficulty in concentrating and weight loss and those experiencing periods of intense fear were enr olled. All those patients who had been diagnosed or were being treated for thyroid d isease or had undergone thyroid surgery or radioablation of thyroid gland were excl uded. In addition patients who had anxiety with concomitant medical disease as tubercu losis, hepatitis, diabetes or hypertension etc and those on anti-arrhythmic drug amiodarone and interferon therapy for hepatitis were also excluded from the s tudy. After a detailed history and clinical examination, thyroid function tests, E.C.G was performed in all patients and those found thyrotoxic were subjected to thyroid sc an and Thyroid Peroxidase antibodies (TPOAb test to know cause of thyrotoxic osis. Results: Out of 150 patients, 108 (72% were females and 42 (28% were males. They were between 18 to 48 years of age. Mean age was 28.5 ± 4.2 years. Out of 150 patients, 19 patients (12.7% were found to have elevated total and unbou nd thyroid hormone and low thyroid stimulating hormone levels and the rest 131 (87.3% patients had normal thyroid function test. All of 19 thyrotoxic patient s (15 females and 4 males in thyroid scan showed increased tracer uptake. Out of 19 thyr otoxic patients six had Graves' disease, ten had toxic multinodular goiter and thre e had toxic thyroid adenoma.

  1. Detection of metabolic activation leading to drug-induced phospholipidosis in rat hepatocyte spheroids.

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    Takagi, Masashi; Sanoh, Seigo; Santoh, Masataka; Ejiri, Yoko; Kotake, Yaichiro; Ohta, Shigeru

    2016-02-01

    Drug-induced phospholipidosis (PLD) is one of the adverse reactions to treatment with cationic amphiphilic drugs. Recently, simple and reliable evaluation methods for PLD have been reported. However, the predictive power of these methods for in vivo PLD induction is insufficient in some cases. To accurately predict PLD, we focused on drug metabolism and used three-dimensional cultures of hepatocytes known as spheroids. Here we used the fluorescent phospholipid dye N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)-1,2-dihexadecanoyl-sn-glycero-3-phosphoethanolamine (NBD-PE) to detect PLD induction. After 48 hr exposure to 20 µM amiodarone and amitriptyline, PLD inducers, NBD-PE fluorescence in the spheroids was significantly higher than that in the control. In contrast, 1 mM acetaminophen, as a negative control, did not increase fluorescence. Furthermore, the combination of NBD-PE fluorescence and LysoTracker Red fluorescence and the accumulation of intrinsic phospholipids reflected PLD induction in spheroids. To evaluate metabolic activation, we assessed PLD induction by loratadine. NBD-PE fluorescence intensity was significantly increased by 50 µM loratadine treatment. However, the fluorescence was markedly decreased by co-treatment with 500 µM 1-aminobenzotriazole, a broad cytochrome P450 inhibitor. The formation of desloratadine, a metabolite of loratadine, was observed in spheroids after treatment with loratadine alone. These results showed that metabolic activation is the key factor in PLD induction by treatment with loratadine. We demonstrated that rat primary hepatocyte spheroid culture is a useful model for evaluating drug-induced PLD induction mediated by metabolic activation of the drug using the fluorescence probe technique. PMID:26763403

  2. Matrix solid-phase dispersion followed by liquid chromatography tandem mass spectrometry for the determination of selective ciclooxygenase-2 inhibitors in sewage sludge samples.

    Science.gov (United States)

    Triñanes, Sara; Casais, M Carmen; Mejuto, M Carmen; Cela, Rafael

    2016-09-01

    A straightforward single-step extraction method based on matrix solid-phase dispersion (MSPD), followed by high-performance liquid chromatography with hybrid quadrupole time of flight mass spectrometry (LC-QTOF-MS), was developed and optimized to determine five non-steroidal anti-inflammatory drugs (Valdecoxib, Etoricoxib, Parecoxib, Celecoxib and 2,5-Dimethylcelecoxib) in sewage sludge samples. The influence of different operational parameters on the extraction efficiency a well as in the matrix effects of the produced extracts was evaluated in detail. Under final working conditions, freeze dried samples (0.2g) were first soaked with 100μL of aqueous potassium hydroxide solution (60%, w/v), mixed with 1g of anhydrous sodium sulfate and dispersed with 1g of Florisil. This blend was transferred to the top of a polypropylene column cartridge containing 3g of silica. Analytes were recovered using 15mL of hexane/acetone (1:2, v/v) mixture. The extracts were concentrated by evaporation and reconstituted with 1mL of methanol/water (1:1, v/v), filtered and injected in the LC system. Quantification limits from 0.005 and 0.05ngg(-1) and absolute recoveries between 86 and 105% were achieved. Results indicated the presence of two of the targeted COXIBs in real samples of sewage sludge, the highest average concentration (22ngg(-1)) corresponding to celecoxib. Moreover, the screening capabilities of the LC-QTOF-MS system demonstrated that the developed MSPD extraction procedure might be useful for the selective extraction of some other pharmaceuticals (e.g. amiodarone and their metabolite N-desethylamiodarone, miconazole, clotrimazole and ketoprofen) from sludge samples. PMID:27521258

  3. Availability of human induced pluripotent stem cell-derived cardiomyocytes in assessment of drug potential for QT prolongation

    Energy Technology Data Exchange (ETDEWEB)

    Nozaki, Yumiko, E-mail: yumiko-nozaki@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Honda, Yayoi, E-mail: yayoi-honda@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Tsujimoto, Shinji, E-mail: shinji-tsujimoto@ds-pharma.co.jp [Regenerative and Cellular Medicine Office, Dainippon Sumitomo Pharma. Co., Ltd., Chuo-ku, Tokyo 104-0031 (Japan); Watanabe, Hitoshi, E-mail: hitoshi-1-watanabe@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Kunimatsu, Takeshi, E-mail: takeshi-kunimatsu@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan); Funabashi, Hitoshi, E-mail: hitoshi-funabashi@ds-pharma.co.jp [Preclinical Research Laboratories, Dainippon Sumitomo Pharma. Co., Ltd., Suita, Osaka 564-0053 (Japan)

    2014-07-01

    Field potential duration (FPD) in human-induced pluripotent stem cell-derived cardiomyocytes (hiPS-CMs), which can express QT interval in an electrocardiogram, is reported to be a useful tool to predict K{sup +} channel and Ca{sup 2+} channel blocker effects on QT interval. However, there is no report showing that this technique can be used to predict multichannel blocker potential for QT prolongation. The aim of this study is to show that FPD from MEA (Multielectrode array) of hiPS-CMs can detect QT prolongation induced by multichannel blockers. hiPS-CMs were seeded onto MEA and FPD was measured for 2 min every 10 min for 30 min after drug exposure for the vehicle and each drug concentration. I{sub Kr} and I{sub Ks} blockers concentration-dependently prolonged corrected FPD (FPDc), whereas Ca{sup 2+} channel blockers concentration-dependently shortened FPDc. Also, the multichannel blockers Amiodarone, Paroxetine, Terfenadine and Citalopram prolonged FPDc in a concentration dependent manner. Finally, the I{sub Kr} blockers, Terfenadine and Citalopram, which are reported to cause Torsade de Pointes (TdP) in clinical practice, produced early afterdepolarization (EAD). hiPS-CMs using MEA system and FPDc can predict the effects of drug candidates on QT interval. This study also shows that this assay can help detect EAD for drugs with TdP potential. - Highlights: • We focused on hiPS-CMs to replace in vitro assays in preclinical screening studies. • hiPS-CMs FPD is useful as an indicator to predict drug potential for QT prolongation. • MEA assay can help detect EAD for drugs with TdP potentials. • MEA assay in hiPS-CMs is useful for accurately predicting drug TdP risk in humans.

  4. Ocular and systemic adverse effects of ophthalmic and non ophthalmic medications.

    Science.gov (United States)

    Izazola-Conde, C; Zamora-de la Cruz, D; Tenorio-Guajardo, G

    2011-01-01

    Information related to adverse drug effects caused by ocular medications and ocular adverse effects of systemically administered drugs has increased over the last several decades. Here we review the medical literature over the last four decades to both quantitatively and qualitatively determine the adverse effects of ocular drugs and ocular toxicity of non-ocular drugs. A systematic bibliographic review of the literature was performed with the following terms: "drug treatment", "drug therapy", "ocular adverse effects", "ocular side effects", "ocular toxicity", "systemic side effects", "systemic adverse effects", "systemic toxicity", "ocular drug" and "ophthalmic drug" using the Boolean operators or, and, not. Searches focused on: (1) Ocular side/adverse effects of ophthalmic drugs; (2) Ocular side/adverse effects of systemic drugs; (3) Systemic side/adverse effects of ophthalmic drugs. PubMed was used to perform searches. Limits included: species, human and field tag, abstract/title, dates from 01/01/1971 to 31/12/2010. A sub-selection of references was made by discarding articles that were irrelevant for the topics listed above. Adverse effects of alpha2-adrenergic agonists, beta-adrenergic antagonists, quinine derivatives and antituberculosis agents appear in the literature throughout the period of the review. Adverse effects of newer drugs such as amiodarone, phosphodiesterase 5 inhibitors, antiepileptics, tamoxifen, and its interactions have been published principally in the last two decades. It is imperative for patient safety that knowledge of the adverse effects of drugs on the eye whether topically or systemically administered, and the possible systemic effects of drugs given as ophthalmic medications be emphasized to clinicians. PMID:22423585

  5. INVESTIGATION OF SEIZURE ACTIVITY AFTER CYCLIC NUCLEOTIDE PHOSPHODIESTERASE INHIBITION WITH SECOND MESSENGER AND CALCIUM ION CHANNEL INHIBITION IN MICE

    Directory of Open Access Journals (Sweden)

    J Nandhakumar

    2012-03-01

    Full Text Available The role of PDE-4 inhibitor etazolate, was evaluated in the presence of PDE-7 inhibitor, BRL-50481, in animal models of epilepsy. Seizures were induced in the animals by subjecting them to injection of chemical convulsants, Pilocarpine, Kainic acid (KA and maximal electroshock (MES. The combination of etazolate and BRL50481 treated mice showed a significant (P<0.001 quick onset of action, jerky movements and convulsion when compared to gabapentin. The combination of etazolate and sGC inhibitor, methylene blue (MB treated mice showed a significant (P<0.001 delay in onset of action, jerky movements and convulsion when compare to gabapentin as well as against the combination of etazolate with BRL 50481.The present study mainly highlights the individual effects of etazolate and combination with BRL-50481 potentiates (P<0.001 the onset of seizure activity against all models of convulsion. The study mainly comprises the onset of seizures, mortality/recovery, percentage of prevention of seizures (anticonvulsant and total duration of convulsive time. The total convulsive time was prolonged significantly (P<0.05 and P<0.01 in combination of methylene blue with etazolate treated (28.59% and 35.15 % groups, compared to DMSO received group (100% in the MES model. In the same way, the combination of calcium channel modulator (CCM and calcium channel blocker (CCB amiodarone and nifedipine respectively, with etazolate showed a significant (P<0.001 delay in onset of seizures, compared to DMSO and etazolate treated groups in all models of epilepsy. This confirms that both CCM and CCB possess anticonvulsant activity. Finally, the study reveals that identification of new cAMP mediated phosphodiesterases family members offers a potential new therapy for epilepsy management in future.

  6. Successful management of anticoagulation therapy during international travel.

    Science.gov (United States)

    Truong, Teresa; Armor, Becky L

    2012-03-01

    Warfarin is considered a high-risk drug because of its narrow therapeutic window, variability in dose response, and multitude of drug and food interactions. Although travel advice is available for patients who are taking warfarin, it is geared toward patients who are traveling to developed countries and tends to be lacking in detail. We describe a 53-year-old woman with two mechanical heart valves and chronic atrial fibrillation who was taking warfarin for thromboembolism prophylaxis and had plans to travel to Vietnam for 10 weeks. Three days before her departure, she was prescribed amiodarone for long-term use. As a result of the extended duration of her travel and the complexities of warfarin use, the pharmacists who managed the patient's anticoagulation reviewed several aspects of a comprehensive management approach with the patient for a safe international trip. They assessed the patient's thromboembolic and hemorrhagic risks, and determined which other drugs (e.g., enoxaparin, phytonadione), dosages, and adequate supplies would be required along with warfarin, as well as how to safely transport these drugs during travel. In addition, the logistics of effectively monitoring international normalized ratio (INR) levels were evaluated, and methods of managing multiple potential scenarios were carefully planned out. Contact with the patient was made through pharmacist-directed telephone visits throughout the travel period. A total of 12 telephone visits were conducted with the patient during the 10 weeks of travel. Her INR was supratherapeutic on three occasions and was subtherapeutic once; however, neither enoxaparin nor phytonadione were needed during the travel period, and the patient returned safely to the United States. Effective and safe use of high-risk drugs for patients leaving the United States requires extensive pretravel planning, and pharmacists can play a central role in optimizing therapeutic outcomes for these patients during international travel

  7. [Heart rate and outcome in patients with acute and chronic heart failure].

    Science.gov (United States)

    Oliva, Fabrizio; Ammirati, Enrico; Campana, Carlo; Carubelli, Valentina; Cirò, Antonio; Di Tano, Giuseppe; Mortara, Andrea; Senni, Michele; Morandi, Fabrizio; Metra, Marco

    2016-03-01

    Heart rate (HR) is not only a physical sign but also a biomarker. High HR in several cardiac disorders is associated with increased mortality. In heart failure (HF), HR represents an important therapeutic target, both in the acute and chronic phase. Beta-blockers are a milestone of recommended treatments in HF patients with reduced ejection fraction. However, hemodynamic profile or intolerance may limit the use or the optimization of beta-blocker treatment, both during hospitalization and outpatient follow-up. More recently, ivabradine has become available, a drug that lowers HR by blocking the I(f) current in the pacemaker cells at the sinoatrial node level. In the SHIFT trial, ivabradine was shown to improve the outcome of patients with chronic HF, in sinus rhythm, with HR >70 b/min while on beta-blockers. Preliminary data have shown that this drug has a good safety profile and lowers effectively HR even during hospitalization due to worsening HF. However, further studies are warranted to understand if an earlier administration of ivabradine can lead to a better prognosis beyond symptom control and improved hemodynamics. In patients with atrial fibrillation and HF, the target is the restoration of sinus rhythm, alternatively rate control should be pursued with beta-blockers, amiodarone or digitalis, even if there is no clear evidence of an association between ventricular rate response in patients with atrial fibrillation at discharge after an HF hospitalization and major cardiovascular events. In this review, the studies that point to a role of HR both as a biomarker and a therapeutic target in patients with acute and chronic HF are described. In addition, the proportions of patients who do not reach target HR values at discharge after an acute decompensated HF episode or in the chronic phase are evaluated based on the Italian registries. PMID:27030005

  8. Ablation of atrial fibrillation with the Epicor system: a prospective observational trial to evaluate safety and efficacy and predictors of success

    Directory of Open Access Journals (Sweden)

    Diez Claudius

    2010-05-01

    Full Text Available Abstract Background High intensity focused ultrasound (HIFU energy has evolved as a new surgical tool to treat atrial fibrillation (AF. We evaluated safety and efficacy of AF ablation with HIFU and analyzed predictors of success in a prospective clinical study. Methods From January 2007 to June 2008, 110 patients with AF and concomitant open heart surgery were enrolled into the study. Main underlying heart diseases were aortic valve disease (50%, ischemic heart disease (48%, and mitral valve disease (18%. AF was paroxysmal in 29%, persistent in 31%, and long standing persistent in 40% of patients, lasting for 1 to 240 months (mean 24 months. Mean left atrial diameter was 50 ± 7 mm. Each patient underwent left atrial ablation with the Epicor system prior to open heart surgery. After surgery, the patients were treated with amiodarone and coumadin for 6 months. Follow-up studies including resting ECG, 24 h Holter ECG, and echocardiography were obtained at 6 and 12 months. Results All patients had successful application of the system on the beating heart prior to initiation of extracorporeal circulation. On average, 11 ± 1 ultrasound transducer elements were used to create the box lesion. The hand-held probe for additional linear lesions was employed in 83 cases. No device-related deaths occurred. Postoperative pacemaker insertion was necessary in 4 patients. At 6 months, 62% of patients presented with sinus rhythm. No significant changes were noted at 12 months. Type of AF and a left atrial diameter > 50 mm were predictors for failure of AF ablation. Conclusion AF ablation with the Epicor system as a concomitant procedure during open heart surgery is safe and acceptably effective. Our overall conversion rate was lower than in previously published reports, which may be related to the lower proportion of isolated mitral valve disease in our study population. Left atrial size may be useful to determine patients who are most likely to benefit from

  9. Drug-induced liver injury: results from the hospital-based Berlin Case–Control Surveillance Study

    Science.gov (United States)

    Douros, Antonios; Bronder, Elisabeth; Andersohn, Frank; Klimpel, Andreas; Thomae, Michael; Sarganas, Giselle; Kreutz, Reinhold; Garbe, Edeltraut

    2015-01-01

    Aim Drug-induced liver injury (DILI) is often responsible for acute liver failure, drug withdrawal, boxed warnings or drug non-approval. Therefore, we conducted a case–control study to determine the hepatotoxic risk of a wide range of drugs. Methods The Berlin Case–Control Surveillance Study FAKOS included all 51 Berlin hospitals in a hospital network. Between 2002 and 2011, 198 patients with acute idiopathic hepatitis, 377 inpatient controls and 708 outpatient controls were ascertained. Case patients were thoroughly validated using anamnestic, clinical, laboratory and histological data. Drug exposure was obtained in a face-to-face interview. A possible drug aetiology was assessed in individual patients by applying the updated Council for International Organizations of Medical Sciences (CIOMS) scale. Drug risks were further quantified [odds ratios (OR) with 95% confidence intervals (CI)] in a case–control design with unconditional logistic regression analysis. Drug intake in the last 28 days before index date was considered for the analysis. Results The study corroborated hepatotoxic risks for a number of drugs, including phenprocoumon (OR 3.3, 95% CI 1.5, 6.7), amiodarone (OR 5.5, 95% CI 1.3, 21.2), clozapine (OR 34.6, 95% CI 2.8, 824.9) and flupirtine (OR 40.2, 95% CI 5.5, 856.9). Increased risks were also suggested for less commonly reported substances such as angiotensin II receptor blockers, atypical antipsychotics and for biperiden, a drug never before reported to be hepatotoxic. Conclusions Our study identified a large number of drugs as possible causes of hepatotoxicity. The observed risk for seldom reported substances highlights the need for further post-authorization safety studies not exclusively focusing on drugs already labelled as potentially hepatotoxic. PMID:25444550

  10. Hepatocyte-based in vitro model for assessment of drug-induced cholestasis

    Energy Technology Data Exchange (ETDEWEB)

    Chatterjee, Sagnik, E-mail: Sagnik.Chatterjee@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium); Richert, Lysiane, E-mail: l.richert@kaly-cell.com [KaLy-Cell, 20A rue du Général Leclerc, 67115 Plobsheim (France); Augustijns, Patrick, E-mail: Patrick.Augustijns@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium); Annaert, Pieter, E-mail: Pieter.Annaert@pharm.kuleuven.be [Drug Delivery and Disposition, KU Leuven Department of Pharmaceutical and Pharmacological Sciences, O and N2, Herestraat 49 — bus 921, 3000 Leuven (Belgium)

    2014-01-01

    Early detection of drug-induced cholestasis remains a challenge during drug development. We have developed and validated a biorelevant sandwich-cultured hepatocytes- (SCH) based model that can identify compounds causing cholestasis by altering bile acid disposition. Human and rat SCH were exposed (24–48 h) to known cholestatic and/or hepatotoxic compounds, in the presence or in the absence of a concentrated mixture of bile acids (BAs). Urea assay was used to assess (compromised) hepatocyte functionality at the end of the incubations. The cholestatic potential of the compounds was expressed by calculating a drug-induced cholestasis index (DICI), reflecting the relative residual urea formation by hepatocytes co-incubated with BAs and test compound as compared to hepatocytes treated with test compound alone. Compounds with clinical reports of cholestasis, including cyclosporin A, troglitazone, chlorpromazine, bosentan, ticlopidine, ritonavir, and midecamycin showed enhanced toxicity in the presence of BAs (DICI ≤ 0.8) for at least one of the tested concentrations. In contrast, the in vitro toxicity of compounds causing hepatotoxicity by other mechanisms (including diclofenac, valproic acid, amiodarone and acetaminophen), remained unchanged in the presence of BAs. A safety margin (SM) for drug-induced cholestasis was calculated as the ratio of lowest in vitro concentration for which was DICI ≤ 0.8, to the reported mean peak therapeutic plasma concentration. SM values obtained in human SCH correlated well with reported % incidence of clinical drug-induced cholestasis, while no correlation was observed in rat SCH. This in vitro model enables early identification of drug candidates causing cholestasis by disturbed BA handling. - Highlights: • Novel in vitro assay to detect drug-induced cholestasis • Rat and human sandwich-cultured hepatocytes (SCH) as in vitro models • Cholestatic compounds sensitize SCH to toxic effects of accumulating bile acids • Drug

  11. Meta-analysis of randomized controlled trials on magnesium in addition to beta-blocker for prevention of postoperative atrial arrhythmias after coronary artery bypass grafting

    Directory of Open Access Journals (Sweden)

    Wu Xiaosan

    2013-01-01

    Full Text Available Abstract Background Atrial arrhythmia (AA is the most common complication after coronary artery bypass grafting (CABG. Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG. Methods We searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible. Results Five randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR 1.12, 95% confidence interval (CI 0.86-1.47, P = 0.40. Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24 or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62. However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001. Conclusions This meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium.

  12. Herzbeteiligung bei Myopathien

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    Finsterer J

    2001-01-01

    Full Text Available Herzbeteiligung bei Patienten mit Myopathien wird zunehmend häufiger diagnostiziert. Sie manifestiert sich bei diesen Patienten als Störung der Erregungsbildung und -ausbreitung, Wandverdickung, abnorme Textur des Myokards, linksventrikuläre Hypertrabekulierung, Dilatation der Herzhöhlen mit/ohne sekundärer Klappeninsuffizienz, Reduktion der Koronarreserve, intrakardiale Thrombusbildung, Endo-/Myokardfibrose, regionale Wandbewegungsstörung und systolische und/oder diastolische Funktionsstörung mit/ohne Herzinsuffizienz. Herzbeteiligung wurde bisher bei Dystrophinopathien, Emery-Dreifuss-Muskeldystrophie, fazioskapulohumeraler Muskeldystrophie, Sarcoglycanopathien, kongenitaler Muskeldystrophie Fukuyama, myotoner Dystrophie Typ 1 und 2, Glykogenose Typ II, III, IV, VII und IX, Carnitinmangel, Myoadenylat-Deaminase-Mangel, Acyl-CoA-Dehydrogenase-Mangel, lysosomaler Glykogen-Speicherkrankheit, Mitochondriopathien, Desmin-Myopathie, Nemalin-Myopathie, Central Core-Krankheit, kongenitaler Fasertypen-Dysproportion, Barth-Syndrom, McLeod-Syndrom und Bethlem-Myopathie beschrieben. Herzbeteiligung bei Myopathien kann über Monate oder Jahre progredient verlaufen oder auch akut auftreten bzw. sich bis hin zum kardialen Notfall verschlechtern. Die Therapie der Herzbeteiligung richtet sich nach den spezifischen kardialen Abnormitäten und umfaßt Digitalis, Diuretika, ACE-Hemmer, Kalziumantagonisten, Amiodaron, Betablocker, L-Carnitin, Antikoagulation, Kardioversion, Schrittmacher, Defibrillator, Hochfrequenz-Katheter-Ablation und die Herztransplantation. Generell sollten Myopathie-Patienten kardiologisch untersucht werden, sobald die neurologische Diagnose feststeht, da eine suffiziente kardiale Therapie die Herzbeteiligung bei Myopathien positiv beeinflußt. Ein kardiologisches Follow-up ist angezeigt, wenn die Herzbeteiligung klinisch manifest wird bzw. bei rascher Progredienz.

  13. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective: to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods: The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF). The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃. The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132±68 min for our patients. The average fluoroscopy time was 33±17 min. With a mean follow-up of 16±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion: Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  14. Ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation

    Institute of Scientific and Technical Information of China (English)

    王建安; 孙勇; 何红

    2003-01-01

    Objective : to evaluate the efficacy and safety of ultrasound ablation of pulmonary veins for treatment of paroxysmal atrial fibrillation. Methods : The study population consisted of 9 patients with 5 males and 4 females enrolled consecutively who had idiopathic paroxysmal atrial fibrillation(AF) . The ultrasound balloon was positioned through a special sheath to the orifice of the target vein by a transseptal procedure. The balloon was inflated with contrast-mixed saline (contrast: saline = 1:4) whose volume was decided by the diameter of the target pulmonary vein. The ablation energy was usually set up at 35 to 40 watts with temperature controlled at 60℃ . The duration of each ablation was about 120 seconds which was repeated not over 10 times. Results: The average duration of the total procedure was 132± 68 min for our patients. The average fluoroscopy time was 33 ±17 min. With a mean follow-up of 16 ±8 months after the procedure, AF was completely eliminated in 4 patients without antiarrhythmic drugs. The episodes of atrial fibrillation were eliminated in 2 patients with low dosage of oral amiodarone (0.1, once daily) which was ineffective before the procedure. The frequency of episodes was similar to that before the procedure in 3 patients. There were no complications such as hemopericardium, air embolism and stenosis of the pulmonary veins by angiography, related to the procedure. Conclusion : Ultrasound ablation of the pulmonary veins is a new approach to treat paroxysmal atrial fibrillation. Before we determined its value, we need to do more researches with bigger sample, randomization and comparison design.

  15. Clinical application of low energy intracardiac cardioversion of atrial fibrillation

    International Nuclear Information System (INIS)

    Objective: To evaluate the efficacy and safety of low energy intracardiac cardioversion in persistent atria fibrillation. Methods: Low energy intracardiac cardioversion was performed by delivering R wave-synchronized biphasic shocks in 7 patients (4 men, 3 women) with persistent atrial fibrillation. Prior to the procedure, all patients underwent transesophageal echocardiographic examinations to rule out the presence of intracardiac thrombus and received subcutaneous injection of low molecular weight heparin for 3-5 days. Two custom-made 6 Fr catheters (Rhythm Technologies of Getz, USA) were used for de-fibrillation shock delivery. One catheter was positioned in the lower right atrium so that the majority of the catheter electrodes had firm contact with the right atrial free wall. The second catheter was placed randomly either in coronary sinus through right internal jugular vein or in the left pulmonary artery through femoral vein. In addition, a standard diagnostic 6-F quadrupolar catheter was placed at the right ventricular apex for ventricular synchronization and postshock ventricular pacing. Shocks were delivered by Implant Support Device (Model 4510, Teleceronics). After conversion, all patients were treated with intravenous amiodarone in the first 24 hours followed by oral administration. Results: In all 7 patients cardioversion of atrial fibrillation to sinus rhythm was successfully obtained. A mean of 2 ± 1 shocks per patient has been delivered with a total amount of 13 shocks. The average delivered energy was 7.8 ± 2.2 Joules. No complication occurred. At a mean follow-up of 18 ± 9 months, 4 of the 7 patients treated successfully showed sinus rhythm there after. Atrial fibrillation recurred in 3 patients at the second, fifth day and eighth month after cardioversion. Conclusions: Low energy intracardiac cardioversion is effective and safe, and can be easily performed in patients without general anesthesia. It offers a new option for restoring sinus

  16. Development of HepG2-derived cells expressing cytochrome P450s for assessing metabolism-associated drug-induced liver toxicity.

    Science.gov (United States)

    Xuan, Jiekun; Chen, Si; Ning, Baitang; Tolleson, William H; Guo, Lei

    2016-08-01

    The generation of reactive metabolites from therapeutic agents is one of the major mechanisms of drug-induced liver injury (DILI). In order to evaluate metabolism-related toxicity and improve drug efficacy and safety, we generated a battery of HepG2-derived cell lines that express 14 cytochrome P450s (CYPs) (1A1, 1A2, 1B1, 2A6, 2B6, 2C8, 2C9, 2C18, 2C19, 2D6, 2E1, 3A4, 3A5 and 3A7) individually using a lentiviral expression system. The expression/production of a specific CYP in each cell line was confirmed by an increased abundance of the CYP at both mRNA and protein levels. Moreover, the enzymatic activities of representative CYPs in the corresponding cell lines were also measured. Using our CYP-expressed HepG2 cells, the toxicity of three drugs that could induce DILI (amiodarone, chlorpromazine and primaquine) was assessed, and all of them showed altered (increased or decreased) toxicity compared to the toxicity in drug-treated wild-type HepG2 cells. CYP-mediated drug toxicity examined in our cell system is consistent with previous reports, demonstrating the potential of these cells for assessing metabolism-related drug toxicity. This cell system provides a practical in vitro approach for drug metabolism screening and for early detection of drug toxicity. It is also a surrogate enzyme source for the enzymatic characterization of a particular CYP that contributes to drug-induced liver toxicity. PMID:26477383

  17. Bridging Functional and Structural Cardiotoxicity Assays Using Human Embryonic Stem Cell-Derived Cardiomyocytes for a More Comprehensive Risk Assessment.

    Science.gov (United States)

    Clements, Mike; Millar, Val; Williams, Angela S; Kalinka, Sian

    2015-11-01

    More relevant and reliable preclinical cardiotoxicity tests are required to improve drug safety and reduce the cost of drug development. Current in vitro testing strategies predominantly take the form of functional assays to predict the potential for drug-induced ECG abnormalities in vivo. Cardiotoxicity can also be structural in nature, so a full and efficient assessment of cardiac liabilities for new chemical entities should account for both these phenomena. As well as providing a more appropriate nonclinical model for in vitro cardiotoxicity testing, human stem cell-derived cardiomyocytes offer an integrated system to study drug impact on cardiomyocyte structure as well as function. Employing human embryonic stem cell-derived cardiacmyocytes (hESC-CMs) on 3 assay platforms with complementary insights into cardiac biology (multielectrode array assay, electrophysiology; impedance assay, cell movement/beating; and high content analysis assay, subcellular structure) we profiled a panel of 13 drugs with well characterized cardiac liabilities (Amiodarone, Aspirin, Astemizole, Axitinib, AZT, Bepridil, Doxorubicin, E-4031, Mexiletine, Rosiglitazone, Sunitinib, Sibutramine, and Verapamil). Our data show good correlations with previous studies and reported clinical observations. Using multiparameter phenotypic profiling techniques we demonstrate the dynamic relationship that exists between functional and structural toxicity, and the benefits of this more holistic approach to risk assessment. We conclude by showing for the first time how the advent of transparent MEA plate technology enables functional and structural cardiotoxic responses to be recorded from the same cell population. This approach more directly links changes in morphology of the hESC-CMs with recorded electrophysiology signatures, offering even greater insight into the wide range of potential drug impacts on cardiac physiology, with a throughput that is more amenable to early drug discovery. PMID:26259608

  18. Tachyarrhythmias, bradyarrhythmias and acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Trappe Hans-Joachim

    2010-01-01

    Full Text Available The incidence of bradyarrhythmias in patients with acute coronary syndrome (ACS is 0.3% to 18%. It is caused by sinus node dysfunction (SND, high-degree atrioventricular (AV block, or bundle branch blocks. SND presents as sinus bradycardia or sinus arrest. First-degree AV block occurs in 4% to 13% of patients with ACS and is caused by rhythm disturbances in the atrium, AV node, bundle of His, or the Tawara system. First- or second-degree AV block is seen very frequently within 24 h of the beginning of ACS; these arrhythmias are frequently transient and usually disappear after 72 h. Third-degree AV blocks are also frequently transient in patients with infero-posterior myocardial infarction (MI and permanent in anterior MI patients. Left anterior fascicular block occurs in 5% of ACS; left posterior fascicular block is observed less frequently (incidence < 0.5%. Complete bundle branch block is present in 10% to 15% of ACS patients; right bundle branch block is more common (2/3 than left bundle branch block (1/3. In patients with bradyarrhythmia, intravenous (IV atropine (1-3 mg is helpful in 70% to 80% of ACS patients and will lead to an increased heart rate. The need for pacemaker stimulation (PS is different in patients with inferior MI (IMI and anterior MI (AMI. Whereas bradyarrhythmias are frequently transient in patients with IMI and therefore do not need permanent PS, there is usually a need for permanent PS in patients with AMI. In these patients bradyarrhythmias are mainly caused by septal necrosis. In patients with ACS and ventricular arrhythmias (VTA amiodarone is the drug of choice; this drug is highly effective even in patients with defibrillation-resistant out-of-hospital cardiac arrest. There is general agreement that defibrillation and advanced life support is essential and is the treatment of choice for patients with ventricular flutter/fibrillation. If defibrillation is not available in patients with cardiac arrest due to VTA

  19. Occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy at the Cantonal Hospital Zenica

    Directory of Open Access Journals (Sweden)

    Jasmin Zvorničanin

    2015-02-01

    Full Text Available Dear Editor, We read with interest the article by Čerim et al. regarding the occurrence and morphological characteristics of cataracts in patients treated with general steroid therapy (1. Similar to the results of previous studies, the authors found that the use of corticosteroids is associated with a higher incidence of cataract development and posterior subcapsular (PSC cataract as most prevalent morphological type (2. Older age and heredity are the most important risk factors associated with different types of cataracts and females are at increased risk of cortical cataract (2,3. Myopia (≤ −1.0 D and elevated intraocular pressure are also associated with an increased risk of nuclear and PSC cataracts (3. The major causal external risk factors influencing cataract formation include: smoking, excessive UV-B exposure, diabetes mellitus (DM and steroidal treatment (2,3. There is also a significant relationship between the risk of cataracts and delivered corticosteroid dose (4. Lower monthly household income, lower education, hypercholesterolemia, hypertension and DM are independent risk factors for the development of any cataract type, while older age and DM are independent risk factors for the development of pure PSC (5. Elevated body mass index (BMI and rapid weight gain may also increase the risk for age related cataract, especially PSC cataract (3,6. Other risk factors for PSC development also include hypertension, the use of amiodarone, thiazide diuretics, aspirin and vitamin E (2. For these reasons, we would kindly ask the authors to perform the correlations for age, gender, BMI, length and regimen of steroid use, cumulative steroid dose, the use of other systemic drugs, DM duration, spherical equivalent and intraocular pressure changes, with cataract occurrence and morphology between the groups. Without this information it would be difficult to hypothesize the direct steroid induced cataractogenesis, especially in the group on the

  20. Mode of death on Chagas heart disease: comparison with other etiologies. a subanalysis of the REMADHE prospective trial.

    Directory of Open Access Journals (Sweden)

    Silvia M Ayub-Ferreira

    Full Text Available Sudden death has been considered the main cause of death in patients with Chagas heart disease. Nevertheless, this information comes from a period before the introduction of drugs that changed the natural history of heart failure. We sought to study the mode of death of patients with heart failure caused by Chagas heart disease, comparing with non-Chagas cardiomyopathy.We examined the REMADHE trial and grouped patients according to etiology (Chagas vs non-Chagas and mode of death. The primary end-point was all-cause, heart failure and sudden death mortality; 342 patients were analyzed and 185 (54.1% died. Death occurred in 56.4% Chagas patients and 53.7% non-Chagas patients. The cumulative incidence of all-cause mortality and heart failure mortality was significantly higher in Chagas patients compared to non-Chagas. There was no difference in the cumulative incidence of sudden death mortality between the two groups. In the Cox regression model, Chagas etiology (HR 2.76; CI 1.34-5.69; p = 0.006, LVEDD (left ventricular end diastolic diameter (HR 1.07; CI 1.04-1.10; p<0.001, creatinine clearance (HR 0.98; CI 0.97-0.99; p = 0.006 and use of amiodarone (HR 3.05; CI 1.47-6.34; p = 0.003 were independently associated with heart failure mortality. LVEDD (HR 1.04; CI 1.01-1.07; p = 0.005 and use of beta-blocker (HR 0.52; CI 0.34-0.94; p = 0.014 were independently associated with sudden death mortality.In severe Chagas heart disease, progressive heart failure is the most important mode of death. These data challenge the current understanding of Chagas heart disease and may have implications in the selection of treatment choices, considering the mode of death.ClinicalTrials.gov NCT00505050 (REMADHE.

  1. Aluminum Phosphide; the Most Fatal Rodenticide and Fungicide

    International Nuclear Information System (INIS)

    ; Chronic administration may lead to significant decreases in Na-K-ATPase activities in renal, hepatic and cardiac tissues, decreases of Ca-ATPase and Mg-ATPase in liver, and decreases in hematocrit, red blood cell count, hemoglobin and platelets. Prognosis: The mortality rate is high. The prognostic factors were shock, ECG abnormalities, using of vasoactive drugs, use of mechanical ventilation, and haemodynamic disturbances. Treatment: No specific antidote is known, but it is dose dependent and time dependent to stomach wash. In vitro, use of vegetable oils, coconut oil, and liquid paraffin and were effective in inhibiting release of phosphine from AP. Intravenous amiodarone/xylocard have successfully used to revert dangerous ventricular arrhythmias. Conclusion: Potential hazards associated with phosphide fumigants should be recognized. Minimizing the use of this fumigant improves worker safety, reduces both control costs and harm to the environment and potential duel use.(author)

  2. Comparative Analysis of Methods to Induce Myocardial Infarction in a Closed-Chest Rabbit Model

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    Marc-Antoine Isorni

    2015-01-01

    Full Text Available Objective. To develop a rabbit model of closed-chest catheter-induced myocardial infarction. Background. Limitations of rodent and large animal models justify the search for clinically relevant alternatives. Methods. Microcatheterization of the heart was performed in 47 anesthetized 3-4 kg New Zealand rabbits to test five techniques of myocardial ischemia: free coils (n=4, interlocking coils (n=4, thrombogenic gelatin sponge (n=4, balloon occlusion (n=4, and alcohol injection (n=8. In order to limit ventricular fibrillation, an antiarrhythmic protocol was implemented, with beta-blockers/amiodarone before and xylocaine infusion during the procedure. Clinical, angiographic, and echographic data were gathered. End points included demonstration of vessel occlusion (TIMI flow grades 0 and 1 on the angiogram, impairment of left ventricular function at 2 weeks after procedure (by echocardiography, and pathologically confirmed myocardial infarction. Results. The best arterial access was determined to be through the right carotid artery. The internal mammary guiding catheter 4-Fr was selected as the optimal device for selective intracoronary injection. Free coils deployed prematurely and tended to prolapse into the aorta. Interlocking coils did not deploy completely and failed to provide reliable results. Gelatin sponge was difficult to handle, adhered to the catheter, and could not be clearly visualized by fluoroscopy. Balloon occlusion yielded inconsistent results. Alcohol injection was the most efficient and reproducible method for inducing myocardial infarction (4 out of 6 animals, the extent of which could be fine-tuned by using a coaxial balloon catheter as a microcatheter (0.52 mm to achieve a superselective injection of 0.2 mL of alcohol. This approach resulted in a 20% decrease in LVEF and infarcted myocardium was confirmed histologically. Conclusions. By following a stepwise approach, a minimally invasive, effective, and reproducible

  3. 艾司洛尔治疗急性心肌梗死心室电风暴的疗效观察%Clinic Effect of Esmolol on Ventricular Electrical Storm in Patients After Myocardial Infarction

    Institute of Scientific and Technical Information of China (English)

    孙珺

    2015-01-01

    目的:观察艾司洛尔治疗急性心肌梗死患者发生心室电风暴的临床疗效。方法选取心肌梗死后心室电风暴患者共56例。24例为对照组,治疗采用胺碘酮或利多卡因及电复律;32例为观察组,治疗采用除对照组方法外,加用艾司洛尔。观察艾司洛尔终止心室电风暴,协助转复的成功率。结果观察组应用艾司洛尔后转复成功率显著高于对照组,需要电除颤复律的次数明显减少。结论静脉应用艾司洛尔治疗心肌梗死后心室电风暴效果显著,临床应尽早使用。%Objective To observe clinic effect of esmolol injection on ventricular electrical storm (VES) in patients after myocardi⁃al infarction. Methods We collected 56 patients with VES after myocardial infarction. As control group, 24 cases were treated with ami⁃odarone or lidocaine and electroversion. Besides, as observe group 32 cases were treated with amiodarone or lidocaine and electrover⁃sion, Immediately were given esmolol injection when patients were diagnosed VES. The success rate of terminating VES and using elec⁃troversion were compared in two groups. Results The success rate of terminating VES using esmolol group were significantly higher than control group .Using electroversion were reduced significantly in esmolol group. Conclusions The injection of esmolol is an effec⁃tive treatment on VES after myocardial infarction and using esmolol should be earlier.

  4. Appropriateness of administration of nasogastric medication and preliminary intervention

    Directory of Open Access Journals (Sweden)

    Zhou Q

    2012-11-01

    Full Text Available Ling-Ling Zhu,1 Ling-Cheng Xu,2 Hui-Qin Wang,3 Jing-Fen Jin,3 Hua-Fen Wang,3 Quan Zhou21Cadre Department, 2Department of Pharmacy, 3Division of Nursing, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, ChinaAbstract: A utilization study was performed in a 2200-bed tertiary care teaching hospital. Data mining was performed on all nasogastric medication prescriptions for patients hospitalized in 2011. Nurses were interviewed by questionnaire. A PDCA (Plan-Do-Check-Act cycle was used for continuous quality improvement. The proportion of patients with nasogastric tubes (NGT was 3.2%. A large number of medical orders (n  6261 involved nasogastric medications with a package insert particularly noting that they should not be crushed or opened (group 1 or medications without a specific formulation recommendation in the package insert but having evidence discouraging NGT dosing (group 2. Of the nasogastrically administered sustained-release or controlled-release formulations, a sustained-release sodium valproate tablet formulation was the most prescribed drug and a sustained-release 2.5 mg felodipine tablet was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral  12.3%]. Among the nasogastrically administered enteric-coated formulations, a myrtol-standardized enteric-coated capsule formulation was the most prescribed drug and a pantoprazole tablet formulation was prescribed with the highest proportion of NGT dosing [NGT/(NGT  oral  19.3%]. Proportions of NGT dosing for amiodarone and carbamazepine (group 2 were 4.8% and 6.3%, respectively. The percentage of nurses with adequate knowledge about pharmaceutical dosage formulations was 60%. The rate of answering correctly as to whether medications in group 1 could be crushed or opened was only 30%. Awareness of evidence discouraging NGT dosing of medications in group 2 was zero. Most nurses (90% left physicians and

  5. Clinical Observation of Metacentric Particles Treatment of Elderly Heart Failure Combined Atrial Fibrillation%稳心颗粒治疗老年心力衰竭合并房颤患者临床观察

    Institute of Scientific and Technical Information of China (English)

    王忠林; 章可谓; 章先锋

    2015-01-01

    Objective To explore the metacentre grain of atrial fibril ation (af) in the treatment of senile heart failure combined clinical curative ef ect. Methods Select a center, 149 cases of senile heart failure with atrial fibril ation patients. 73 cases were randomly divided into control group, taking amiodarone 0.2 g/time, 3 times/d, to 0.2 g/time after 1 week, 2 times/d, after 2 weeks to 0.2 g/times, 1/d. The treatment group 76 examples, take metacentre grain 9 g/time, 3 times/d. Results Two groups of clinical curative ef ect comparison of the control group was 61.0%, the treatment group was 82.4%, the treatment group is bet er than that of control group ( 0.05). Conclusion Metacentric granule on senile heart failure with ventricular rate control in patients with atrial fibril ation, curative ef ect and good safety is worth clinical application.%目的观察稳心颗粒治疗老年心力衰竭合并心房颤动患者的临床疗效。方法选择某中心老年心力衰竭合并房颤患者149例。随机分为对照组73例,服用胺碘酮0.2g/次,3次/d,1w后改为0.2g/次,2次/d,2w后改为0.2g/次,1次/d。治疗组76例,服用稳心颗粒9g/次,3次/d。结果两组临床疗效比较,对照组为61.0%,治疗组为82.4%,治疗组优于对照组(0.05)。结论稳心颗粒对老年心力衰竭合并房颤患者控制心室率疗效确切、安全性好,值得临床应用。

  6. Effects of n-3 polyunsaturated fatty acids on cardiac ion channels

    Directory of Open Access Journals (Sweden)

    CarmenValenzuela

    2012-07-01

    Full Text Available Dietary n-3 polyunsaturated fatty acids (PUFAs have been reported to exhibit antiarrhythmic properties, attributed to their capability to modulate ion channels. In the present review, we will focus on the effects of PUFAs on cardiac sodium channel (Nav1.5 and two potassium channels (Kv (Kv1.5 and Kv11.1. n-3 marine (docohexaenoic and eicohexapentaenoic acid and plant origin (alpha-linolenic acid PUFAs block Kv1.5 and Kv11.1 channels at physiological concentrations. Also, DHA and EPA decreased Nav1.5 and calcium channels. These effects on Na and Ca channels theoretically should shorten the cardiac APD, whereas the blocking actions of n-3 PUFAs of Kv channels should lengthen the cardiac action potential. Experiments performed in female rabbits fed with a diet rich in n-3 PUFAs show a longer cardiac action potential and effective refractory period. This study was performed to analyze if their antiarrhythmic effects are due to a reduction of triangulation, reverse use-dependence, instability and dispersion of the cardiac action potential (TRIaD as a measure of proarrhythmic effects. Dietary n-3 PUFAs supplementation markedly reduced dofetilide-induced TRIaD and abolished dofetilide-induced torsades de pointes (TdP. Ultrafast sodium channel block by DHA may account for the antiarrhythmic protection of dietary supplements of n-3 PUFAs against dofetilide induced proarrhythmia observed in this animal model. The cardiac effects of n-3 PUFAs resemble those of amiodarone: both block sodium, calcium and potassium channels, have anti-adrenergic properties, can prolong the cardiac action potential, reverse TRIaD and suppress TdP. The main difference is that sodium channel block by n-3 PUFAs has a much faster onset and offset kinetics. Therefore, the electrophysiological profile of n-3 PUFAs appears more desirable: the duration of reduced sodium current (facilitates re-entry is much shorter. The n-3 PUFAs appear as a safer alternative to other antiarrhythmic

  7. 光敏性药疹68例临床分析%Clinical analysis of 68 patients with photosensitization drug eruption

    Institute of Scientific and Technical Information of China (English)

    朱敏刚; 魏盛; 王音; 胡晓波; 刘卫

    2015-01-01

    目的::明确光敏性药疹的临床特征及相关药物。方法:对我院门诊诊断为光敏性药疹患者的临床资料进行回顾性分析。结果:68例患者中,噻嗪类药物所致37例,喹诺酮类19例,多西环素3例,维胺酯、辛伐他丁及秋水仙碱各2例,氯丙嗪、地尔硫卓及乙胺碘呋酮各1例。皮损仅局限于曝光部位的62例,主要表现为水肿性红斑;皮损同时累及非曝光部位的有6例,表现为湿疹样皮损等多形性损害。患者停用可疑药物及避光,口服抗组胺药、烟酰胺或中小剂量糖皮质激素,外用炉甘石洗剂或糖皮质激素乳膏。65例患者皮损于4周内基本消退。结论:噻嗪类利尿剂及喹诺酮类是引起光敏性药疹最常见的药物。%Objective:To determine the types of drugs which caused photosensitization drug eruption and the clinical features of the patients. Methods: The data of patients with photosensitization drug eruption was analyzed retrospectively. Results: Out of 68 patients, 37 patients were caused by thiazine diuretics, 19 by quinolones, 3 by doxycycline, 2 by viaminate, 2 by Simvastatin, 2 by colchicine, 1 by chlorpromazine, 1 by diltiazem and 1 by amiodarone. The lesions were located on exposed area only and mainly manifested as edem-atous erythema in 62 patients. The lesions were located on both exposed and unexposed areas and manifested as various lesions in 6 patients. All patients stopped the suspicious drugs, kept away from the sun exposure and were given oral antihistamines, nicotinamide, low-medium doses of glucocorticoid and topical calamine lotion and corticosteroids cream. Six five patients were cured after the treatment of 4 weeks. Conclusion:Thia-zine diuretics and quinolones are the most common drugs inducing the photosensitization drug eruption in our patients.

  8. Hepatic toxicity of dronedarone in mice: Role of mitochondrial β-oxidation

    International Nuclear Information System (INIS)

    Highlights: • Dronedarone is not hepatotoxic to mice up to 200 mg/kg/day. • At 400 mg/kg/day dronedarone decreases food intake and inhibits hepatic fatty acid metabolism. • Impaired hepatic fatty acid metabolism is associated with increased hepatocyte apoptosis and serum transaminases. • Mice with subclinical impairment of β-oxidation are slightly more susceptible to dronaderone than wild type mice. - Abstract: Dronedarone is an amiodarone-like antiarrhythmic drug associated with severe liver injury. Since dronedarone inhibits mitochondrial respiration and β-oxidation in vitro, mitochondrial toxicity may also explain dronedarone-associated hepatotoxicity in vivo. We therefore studied hepatotoxicity of dronedarone (200 mg/kg/day for 2 weeks or 400 mg/kg/day for 1 week by intragastric gavage) in heterozygous juvenile visceral steatosis (jvs+/−) and wild-type mice. Jvs+/− mice have reduced carnitine stores and are sensitive for mitochondrial β-oxidation inhibitors. Treatment with dronedarone 200 mg/kg/day had no effect on body weight, serum transaminases and bilirubin, and hepatic mitochondrial function in both wild-type and jvs+/− mice. In contrast, dronedarone 400 mg/kg/day was associated with a 10–15% drop in body weight, and a 3–5-fold increase in transaminases and bilirubin in wild-type mice and, more accentuated, in jvs+/− mice. In vivo metabolism of intraperitoneal 14C-palmitate was impaired in wild-type, and, more accentuated, in jvs+/− mice treated with 400 mg/kg/day dronedarone compared to vehicle-treated mice. Impaired β-oxidation was also found in isolated mitochondria ex vivo. A likely explanation for these findings was a reduced activity of carnitine palmitoyltransferase 1a in liver mitochondria from dronedarone-treated mice. In contrast, dronedarone did not affect the activity of the respiratory chain ex vivo. We conclude that dronedarone inhibits mitochondrial β-oxidation in and ex vivo, but not the respiratory chain. Jvs

  9. 丹参酮II-A磺酸钠对房颤大鼠模型心房肌细胞Kv1.5钾通道表达影响的研究%The research of the tanshinone II-A sulfonate on the expression of the rat model of atrial fibrillation atrial myocytes Kv1.5

    Institute of Scientific and Technical Information of China (English)

    刘维琴; 杨娟; 李卫松

    2013-01-01

      Objective:To observed the tanshinone II-A sulfonate atrial fibrillation rat atrial myocytes electrical remodeling and cell membrane potassium ion channels. Methods: Preparation of atrial fibrillation animal models, quantitative PCR determination of atrial myocytes Kv1.5 potassium channel gene expression, HE staining atrial myocytes ultrastructural changes. Results: Tanshinone II-A sulfonate, amiodarone significantly improved atrial fibrillation rat atrial myocytes potassium channel Kv1.5 gene expression level reduction (P<0.05) and atrial muscle cell ultrastructure. Conclusion:Tanshinone II-A sulfonate by improving atrial fibrillation rats potassium channel Kv1.5 gene expression caused by atrial electrical remodeling cut to the prevention and treatment of atrial fibrillation.%  目的:观察丹参酮 II-A 磺酸钠对房颤大鼠心房肌细胞电重构及细胞膜钾离子通道的影响。方法:制备房颤动物模型,荧光定量 PCR 技术测定心房肌细胞 Kv1.5钾通道基因表达,HE 染色观察心房肌细胞超微结构变化。结果:丹参酮 II-A磺酸钠、胺碘酮能明显改善房颤大鼠心房肌细胞钾通道Kv1.5基因表达减低水平(P<0.05)及心房肌细胞组织超微结构。结论:丹参酮II-A磺酸钠能够通过改善房颤大鼠钾通道Kv1.5基因表达下调所引发的心房电重构,从而预防和治疗房颤。

  10. Measurement of Regional and Global Pulmonary Clearance of 99mTc-DTPA (Demethylamitriptylene-Acetate): An Index of Alveolar Epithelial Permeability

    International Nuclear Information System (INIS)

    normals reported by many authors. Standardizing the procedures and establishing the normal range we started to use already proven method in different groups of subjects exposed to harmful agents supposed that alter epithelial integrity. Increased lung clearance of inhaled aerosols were obtained in non-symptomatic smokers, asbestosis suffering patients, and in non-smokers exposed to asbestos with normal lung ventilation studies. Faster clearance was also found in the patients with chronic renal failure on regular haemodialysis program using bio incompatible membrane, longer than 5 years. At the same time normal values were obtained in the group on short term haemodialysis. Abnormal clearance rate was shown in patients with malignant disease, exposed to external and internal lung radiation, and in subjects on long term amiodarone treatment, as well. In patients with cardiac heart failure and lung edema, and first stage of sarcoidosis, lung clearance was normal. It remains now as further challenge comparison of there values with some other investigations, expectantly it would contribute in elucidation of different mechanisms in pulmonary pathology. Assessment of 99mTc-DTPA lung clearance is a very attractive method, non-invasive, cheap, and widely available. Until now there is no an other alternative procedure that would be able to give us more information about epithelial permeability. (Author)

  11. Clinical observation of esmolol for the treatment of acute myocardial infarction with sympathetic storm%艾司洛尔治疗急性心肌梗死后交感风暴的临床观察

    Institute of Scientific and Technical Information of China (English)

    李垚; 陈万林

    2015-01-01

    Objective To explore the efficacy and safety of esmolol for the treatment of acute myocardial infarction patients with sympathetic storm.Methods Sixty acute myocardial infarction patients who suffered from sympathetic storm during the hospitalization from January 2013 to January 2015 in the People's Hospital of Baoji City.The patients were randomly divided into two groups : esmolol group(patients were treated with cardioversion or electric defibrillation and esmolol, n =30) and control group (patients were treated with cardioversion or electric defibrillation and amiodarone, n =30).Results The effective rate of esmolol group was 93.33% (28/30), of control group was 70.00% (21/30), and the difference was significant (x2 =5.455, P =0.020).The success rate of esmolol group which terminated sympathetic storm was significantly higher than control group (28% vs.20%, P =0.020).Recurrence of ventricular tachycardia or ventricular fibrillation after esmolol treatment was significantly lower, the corresponding were less (3.30± 2.76 vs.6.83 ± 4.58, P =0.001).Esmolol group was no occurrence of hypotension that could not be corrected or severe slow arrhythmia.NTproBNP level between the two groups was not statistically significant observation (P > 0.05).Conclusion Esmolol treatment of sympathetic storm is better efficacy, safety and be worthy of clinical application.%目的 探讨艾司洛尔治疗急性心肌梗死后交感风暴的效果及安全性.方法 选择60例在我院住院期间发生交感电风暴的急性心肌梗死患者60例.随机分为两组,艾司洛尔组:电复律或电除颤+艾司洛尔组30例;对照组:电复律或电除颤+胺碘酮组30例.结果 艾司洛尔组有效率为93.33%(28/30),胺碘酮组有效率70.00% (21/30),差异有统计学意义(x2=5.455,P=0.020).静脉使用艾司洛尔治疗组成功终止交感风暴的比率要显著高于胺碘酮治疗组(28%与21%),两组比较差异有统计学意义(P=0.020).艾司洛

  12. Insulin resistance and clinical aspects of non-alcoholic steatohepatitis (NASH).

    Science.gov (United States)

    Agarwal, Naresh; Sharma, Barjesh Chander

    2005-10-01

    Non-alcoholic steatohepatitis (NASH) is one of the most common liver disorders. This is highly prevalent in obese and diabetic subjects. Persons with central obesity are at particular risk. Other clinical predictors are age more than 40-50 years and hyperlipidemias, but none of these factors is invariable for causation of NASH. Other reported associations are, celiac disease, Wilson's Disease and few other metabolic diseases. Drugs, particularly amiodarone, tamoxifen, nucleoside analogues and methotrxate have also been linked to NASH. The disease is evenly distributed in both sexes but advanced disease is more common in women. Ethnic variation exists and African Americans are less affected than Hispanic Americans. Specific clinical features of NASH are infrequent. Patients usually come to clinical attention by elevated liver enzymes found on routine evaluation but on history, about two third of patients will admit to have mild fatigue and about half will report right upper quadrant pain. Rarely, patient may present with a complication of cirrhosis. Physical examination may reveal hepatomegaly and splenomegaly. Research in last few years has stressed that development of steatosis, stetohepatitis, fibrosis with subsequent cirrhosis are most probably the result of insulin resistance. Therefore, clinical features may reflect existence of insulin resistance. Obesity, particularly central obesity is most important of these. Patients may have sleep apnea syndrome. Hypertension and manifestations of diabetes mellitus like polyuria, polydypsia, and neurological deficits may occur. Patients may have varying combination of obesity, diabetes, hyperlipidemia, hypertension and impaired fibrinolysis (syndrome X). Children with insulin resistance may show acanthosis nigricance. Patients with polycystic ovary syndrome, which consists of insulin resistance, diabetes, obesity, hirsutism, oligo or polymenorrha and hyperlipidemia may have NASH. Other rare manifestations of insulin

  13. 30例房颤射频消融术的临床研究%Clinical study of 30 cases of atrial fibrillation ablation

    Institute of Scientific and Technical Information of China (English)

    郑元喜; 辜和平; 程静芳

    2014-01-01

    cases of atrial fibrillation patients, atropine injection after the return to normal. Among the 26 cases of patients with paroxysmal atrial fibrillation ablation conversion to sinus rhythm in 16 cases, all patients after 3 months of stopping amiodarone and propafenone antiarrhythmic drugs. Conclusion Transcatheter radiofrequency ablation of atrial fibrillation can reduce heart failure and thrombosis and other complications, minimally invasive, and it has advantages of short operation time, good effect, which is worthy of promotion and application.

  14. 冠心病伴心力衰竭合并心房颤动的心室率控制研究%Heart Rate Control in Coronary Heart Disease with Heart Failure and Chronic Permanent Atrial Fibrillation

    Institute of Scientific and Technical Information of China (English)

    岑明秋; 陆明; 胡鹏飞; 吴迦勒; 马旭辉; 陈超; 黄抒伟

    2015-01-01

    目的 探讨心室率控制对冠心病伴心力衰竭合并心房颤动(以下简称房颤)患者