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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 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

  5. 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/amiodaron...e.Human.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vitro/amiodaron...e.Rat.in_vitro.Liver.zip ftp://ftp.biosciencedbc.jp/archive/open-tggates/LATEST/Rat/in_vivo/Liver/Single/amiodaron...ve/open-tggates/LATEST/Rat/in_vivo/Liver/Repeat/amiodarone.Rat.in_vivo.Liver.Repeat.zip ...

  6. Bronchiolitis obliterans organizing pneumonia during low-dose amiodarone therapy

    NARCIS (Netherlands)

    Jessurun, GAJ; Hoogenberg, K; Crijns, HJGM

    1997-01-01

    Two cases of amiodarone-induced pulmonary toxicity during a relatively short period of low-dose amiodarone treatment are reported. The toxicity risk of amiodarone is determined by cumulative factors in individual patients.

  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. 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

  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. 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.

  11. 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.

  12. Cytotoxicity effects of amiodarone on cultured cells.

    Science.gov (United States)

    Golli-Bennour, Emna El; Bouslimi, Amel; Zouaoui, Olfa; Nouira, Safa; Achour, Abdellatif; Bacha, Hassen

    2012-07-01

    Amiodarone is a potent anti-arrhythmic drug used for the treatment of cardiac arrhythmias. Although, the effects of amiodarone are well characterized on post-ischemic heart and cardiomyocytes, its toxicity on extra-cardiac tissues is still poorly understood. To this aim, we have monitored the cytotoxicity effects of this drug on three cultured cell lines including hepatocytes (HepG2), epithelial cells (EAhy 926) and renal cells (Vero). We have investigated the effects of amiodarone on (i) cell viabilities, (ii) heat shock protein expressions (Hsp 70) as a parameter of protective and adaptive response and (iii) oxidative damage.Our results clearly showed that amiodarone inhibits cell proliferation, induces an over-expression of Hsp 70 and generates significant amount of reactive oxygen species as measured by lipid peroxidation occurrence. However, toxicity of amiodarone was significantly higher in renal and epithelial cells than in hepatocytes. Vitamin E supplement restores the major part of cell mortalities induced by amiodarone showing that oxidative damage is the predominant toxic effect of the drug.Except its toxicity for the cardiac system, our findings demonstrated that amiodarone can target other tissues. Therefore, kidneys present a high sensibility to this drug which may limit its use with subjects suffering from renal disorders.

  13. Amiodarone

    Science.gov (United States)

    ... ventricular arrhythmias (a certain type of abnormal heart rhythm when other medications did not help or could ... that you cannot control poor coordination or trouble walking numbness or tingling in the hands, legs, and ...

  14. 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.

  15. 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.

  16. 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

  17. Continuous vs episodic prophylactic treatment with amiodarone for the prevention of atrial fibrillation : a randomized trial

    NARCIS (Netherlands)

    Ahmed, Sheba; Rienstra, Michiel; Crijns, Harry J. G. M.; Links, Thera P.; Wiesfeld, Ans C. P.; Hillege, Hans L.; Bosker, Hans A.; Lok, Dirk J. A.; Van Veldhuisen, Dirk J.; Van Gelder, Isabelle C.

    2008-01-01

    Context Amiodarone effectively suppresses atrial fibrillation but causes many adverse events. Objective To compare major events in patients randomized to receive episodic amiodarone treatment with those who received continuous amiodarone treatment while still aiming to prevent atrial fibrillation. D

  18. 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

  19. The Incidence and Risk of Inducing Hyperthyroidism Following Amiodarone Treatment

    Directory of Open Access Journals (Sweden)

    Cozlea D L

    2013-06-01

    Full Text Available Introduction: Amiodarone, a frequently used antiarrhythmic drug in cardiology, is very efficient in the treatment of ventricular and supraventricular tachiarrithmyas. The iodine content of amiodarone is 39%. Its chemical structure is similar to tyrosine. It is estimated that 1-23% of patients treated with amiodarone can develop hyperthyroidism. The purpose of this study is to assess and monitor the incidence of hyperthyroidism induced by amiodarone in patients admitted for various types of cardiac dysrhythmias, considering that most of the patients included in the study came from an endemic goitre area.

  20. 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

  1. 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%.

  2. 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

  3. 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.

  4. Increased Density of the Liver and Amiodarone-Associated Phospholipidosis

    Directory of Open Access Journals (Sweden)

    Sunao Kojima

    2009-01-01

    Full Text Available This is a case report in which a 60-year-old man who suffered from ventricular tachycardia with dilated cardiomyopathy was prescribed amiodarone. After taking amiodarone, liver enzymes were increased and computed tomographic (CT scanning of the abdomen showed a significant increase in the density of the liver without contrast medium. He was suspected as hemochromatosis and liver biopsy was performed. An abnormal high density of liver tissue may be observed in an unenhanced CT in patients treated with amiodarone and we suggest that periodic monitoring of liver function and/or liver biopsy is warranted before an irreversible stage is reached.

  5. 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...

  6. 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

  7. 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

  8. 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).

  9. 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.

  10. 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-

  11. Amiodarone-Induced Pulmonary Toxicity – A Frequently Missed Complication

    Science.gov (United States)

    Sweidan, Alexander J.; Singh, Navneet K.; Dang, Natasha; Lam, Vinh; Datta, Jyoti

    2016-01-01

    INTRODUCTION Amiodarone is often used in the suppression of tachyarrhythmias. One of the more serious adverse effects includes amiodarone pulmonary toxicity (APT). Several pulmonary diseases can manifest including interstitial pneumonitis, organizing pneumonia, acute respiratory distress syndrome, diffuse alveolar hemorrhage, pulmonary nodules or masses, and pleural effusion. Incidence of APT varies from 5–15% and is correlated to dosage, age of the patient, and preexisting lung disease. DESCRIPTION A 56-year-old male with a past medical history of coronary artery disease and chronic obstructive pulmonary disease was admitted for a coronary artery bypass graft. Post-operatively, the patient was admitted to the ICU for ventilator management and continued to receive his home dose of amiodarone 400 mg orally twice daily, which he had been taking for the past 3 months. The patient was found to be hypoxemic with a PaO2 52 mmHg and bilateral infiltrates on chest x-ray. Patient also complained of new onset dyspnea. Physical exam found bilateral rhonchi with bibasilar crackles and subcutaneous emphysema along the left anterior chest wall. Daily chest x-rays showed worsening of bilateral interstitial infiltrates and pleural effusions. A chest high-resolution computed tomography on post-operative day 3 showed extensive and severe bilateral ground glass opacities. APT was suspected and amiodarone was discontinued. A course of oral prednisone without antibiotics was initiated, and after one week of treatment the chest film cleared, the PaO2 value normalized and dyspnea resolved. DISCUSSION APT occurs via cytotoxic T cells and indirectly by immunological reaction. Typically the lungs manifest a diffuse interstitial pneumonitis with varying degrees of fibrosis. Infiltrates with a ‘ground-glass’ appearance appreciated on HRCT are more definitive than chest x-ray. Pulmonary nodules can be seen, frequently in the upper lobes. These are postulated to be accumulations of

  12. Effects of amiodarone on the pharmacokinetics and toxicity of digoxin in laboratory animals.

    Science.gov (United States)

    Staneva-Stoytcheva, D; Kristeva, E

    1992-04-01

    Some pharmacokinetic interactions between digoxin and amiodarone were studied in experiments on rabbits. An increase of digoxin serum levels was established in amiodarone-treated rabbits (amiodarone 30 mg/kg s.c. for five days alone or together with digoxin). The calculated elimination half-life (t 1/2) and the area under the curve (AUC) of digoxin were increased and the digoxin clearance was decreased, being most pronounced in animals receiving amiodarone-digoxin combination for five days. There were no changes either in digoxin toxicity in amiodarone-treated guinea pigs or in serum levels of T4, T3 and TTH. The possible mechanisms of digoxin-amiodarone interactions are discussed.

  13. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    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 ...

  16. 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

  17. 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

  18. 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

  19. Effect of amiodarone therapy on mortality in patients with left ventricular dysfunction and asymptomatic complex ventricular arrhythmias: Argentine Pilot Study of Sudden Death and Amiodarone (EPAMSA).

    Science.gov (United States)

    Garguichevich, J J; Ramos, J L; Gambarte, A; Gentile, A; Hauad, S; Scapin, O; Sirena, J; Tibaldi, M; Toplikar, J

    1995-09-01

    The efficiency of prophylactic antiarrhythmic treatment with amiodarone in reducing 1-year mortality in patients with reduced left ventricular ejection fraction ( < 35%) and asymptomatic ventricular arrhythmias (Lown classes 2 and 4) was investigated in a prospective, multicenter, randomized, controlled study. Among 127 patients who entered the study, 61 were assigned to no antiarrhythmic therapy (control group [CG] and 66 to amiodarone treatment (amiodarone group [AG]). Amiodarone was administered at a dosage of 800 mg/day for 2 weeks followed by 400 mg/day thereafter. A 12-month follow-up was completed for 106 patients (57 in the AG and 49 in the CG). Amiodarone reduced the overall mortality rate, which was 10.5% in the AG versus 28.6% in the CG (odds ratio [OR] 0.29; 95% confidence interval [CI] 0.10 to 0.84; log-rank test 0.02) and sudden death rate, which was 7.0% in the AG versus 20.4% in the CG (OR 0.29; 95% CI 0.08 to 1.00; log-rank test 0.04). Side effects were rare, and in only three patients did amiodarone treatment have to be discontinued.

  20. Amiodarone and metabolite MDEA inhibit Ebola virus infection by interfering with the viral entry process.

    Science.gov (United States)

    Salata, Cristiano; Baritussio, Aldo; Munegato, Denis; Calistri, Arianna; Ha, Huy Riem; Bigler, Laurent; Fabris, Fabrizio; Parolin, Cristina; Palù, Giorgio; Mirazimi, Ali

    2015-07-01

    Ebola virus disease (EVD) is one of the most lethal transmissible infections characterized by a high fatality rate, and a treatment has not been developed yet. Recently, it has been shown that cationic amphiphiles, among them the antiarrhythmic drug amiodarone, inhibit filovirus infection. In the present work, we investigated how amiodarone interferes with Ebola virus infection. Wild-type Sudan ebolavirus and recombinant vesicular stomatitis virus, pseudotyped with the Zaire ebolavirus glycoprotein, were used to gain further insight into the ability of amiodarone to affect Ebola virus infection. We show that amiodarone decreases Ebola virus infection at concentrations close to those found in the sera of patients treated for arrhythmias. The drug acts by interfering with the fusion of the viral envelope with the endosomal membrane. We also show that MDEA, the main amiodarone metabolite, contributes to the antiviral activity. Finally, studies with amiodarone analogues indicate that the antiviral activity is correlated with drug ability to accumulate into and interfere with the endocytic pathway. Considering that it is well tolerated, especially in the acute setting, amiodarone appears to deserve consideration for clinical use in EVD.

  1. 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

  2. Acute Amiodarone Pulmonary Toxicity after Drug Holiday: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Ahmed Abuzaid

    2015-01-01

    Full Text Available Amiodarone is reported to cause a wide continuum of serious clinical effects. It is often challenging to detect Amiodarone-induced pulmonary toxicity (AIPT. Typically, the diagnosis is made based on the clinical settings and may be supported by histopathology results, if available. We describe a 57-year-old patient who developed severe rapidly progressive respiratory failure secondary to AIPT with acute bilateral infiltrates and nodular opacities on chest imaging. Interestingly, Amiodarone was discontinued 3 weeks prior to his presentation. He had normal cardiac filling pressures confirmed by echocardiography. To our knowledge, this is the first case of isolated acute lung injury induced by Amiodarone, three weeks after therapy cessation, with adequate clinical improvement after supportive management and high dose steroid therapy.

  3. 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

    was based on a randomized, controlled, double-blind trial (the RASCABG study) using avoidance of atrial fibrillation as the measure of benefit at the Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Skejby, Denmark. Two hundred and fifty eligible consecutively enrolled CABG......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...... 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...

  4. 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 study was prospective, controlled, and randomized and was performed in a tertiary health care center associated with a university. PARTICIPANTS: One hundred sixty-three patients scheduled for coronary artery bypass graft surgery. INTERVENTIONS: In this 2 x 2 factorial-designed study the patients were...... 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...

  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 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

  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. 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.

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

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    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.

  10. 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

  11. 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

  12. 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

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

    Directory of Open Access Journals (Sweden)

    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. 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

  15. 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.

  16. 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

  17. 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

    Directory of Open Access Journals (Sweden)

    K. G. Adamyan

    2015-01-01

    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.

  18. SEVERE AMIODARONE-INDUCED BRADICARDIA CONCEALES SICK SINUS SYNDROME: CASE REPORT.

    Science.gov (United States)

    Crăcană, Irina; Vasilcu, T F; Mardare, Alexandra; Alexa, Ioana Dana; Marcu, D T M

    2016-01-01

    Sinus node dysfunction is one of the most common arrhythmias in elderly patients; it is usually associated with intermittent and variable symptoms, thus making it difficult to diagnose. We present the case of an elderly female patient with a personal history of atrial fibrillation treated for the last three years with amiodarone; she was admitted to the Geriatric Clinic for non-specific symptoms with onset two months previously for which she had already sought care in different medical services. Clinical examination showed severe bradycardia; ECG and Holter ECG on admission confirmed severe bradycardia, with a heart rate between 29 and 50 beats/min (bpm). Given her long-term treatment with amiodarone we looked for and found hyperthyroidism; the endocrine examination led to the diagnosis of mixed type Amiodarone-induced thyrotoxicosis and initiation of corticosteroid and antithyroid treatment. The evolution of cardiac arrhythmia was monitored with the help of several Holter ECGs performed after amiodarone washout and return to the euthyroid state, which revealed a tachycardia-bradycardia syndrome initially masked by the side effects of the unsupervised therapy with amiodarone, and properly treated by the implantation of a pacemaker.

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

    Science.gov (United States)

    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

  20. [Successful treatment of fetal supraventricular tachycardia with a combination of digoxin and amiodarone].

    Science.gov (United States)

    Hajdú, J; Szabó, I; Német, J

    1996-10-01

    The supraventricular tachycardia is a life threatening state in the intrauterine life. It can cause non-immune hydrops fetalis, intrauterine death or complications during the delivery. The unexplained tachycardia can cause fetal distress and premature delivery. Usually the digoxin is the first drug of choice for transplacental cardioversion. If digitalisation does not achieve cardioversion, the second line antiarrhythmic drugs should be instituted. Amiodarone has been suggested as a therapeutic alternative after failure of digoxin-verapamil combination. We give a drug in standard therapeutic doses for four-five days and after it we determine whether it is effective or not. We should determine the newer therapy or termination of pregnancy. The transplacental administration of amiodarone may be dangerous because of fetal cretinism. Our case is the first in Hungary-in our best knowledge- and we suggest the amiodarone for transplacental therapy. PMID:8927371

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

    Directory of Open Access Journals (Sweden)

    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.

  2. 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.

  3. 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.

  4. 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.

  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...... period. CONCLUSION: Short-term oral amiodarone treatment following ablation for paroxysmal or persistent AF did not significantly reduce recurrence of atrial tachyarrhythmias at the 6-month follow-up, but it more than halved atrial arrhythmia related hospitalization and cardioversion rates during...

  6. 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.

  7. 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.

  8. 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 rando......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 randomized, controlled, double-blinded PASCART study, using avoidance of atrial fibrillation as the measure of benefit. Two hundred and fifty-four eligible, consecutively enrolled patients, undergoing surgery for lung cancer at the department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital.......23). There were no signs of adverse developments referable to amiodarone in this prophylactic regime. CONCLUSIONS: For patients undergoing surgery for lung cancer, routine use of postoperative prophylactic intravenous bolus and five subsequent days of oral amiodarone therapy reduces the risk of atrial...

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. Acute epigastric and low back pain during amiodarone infusion; is it the drug or the vehicle to blame?

    Science.gov (United States)

    Petrou, Emmanouil; Iakovou, Ioannis; Boutsikou, Maria; Girasis, Chrysafios; Mavrogeni, Sophie; Pavlides, Gregory

    2014-01-01

    Amiodarone is a Class III antiarrhythmic agent used for cardioversion and prevention of recurrences of atrial fibrillation. However, its use is limited due to its side-effects resulting from the drug's long-term administration. We have described acute epigastric pain following treatment with intravenous amiodarone for atrial fibrillation in a previous report. Hereby, we describe a second patient who suffered acute epigastric pain, as well as one who suffered acute low back pain. Intravenous amiodarone has been related to a series of minor and major adverse reactions, indicating other constituents of the intravenous solution as the possible cause, possibly polysorbate-80. A possible correlation between acute epigastric and low back pain after intravenous amiodarone loading is unproven; however it is of crucial importance for clinicians to be aware of this phenomenon, and especially since an acute epigastric pain is implicated in the differential diagnosis of cardiac ischemia. PMID:24239300

  14. Amiodarone inhibits the mitochondrial beta-oxidation of fatty acids and produces microvesicular steatosis of the liver in mice

    Energy Technology Data Exchange (ETDEWEB)

    Fromenty, B.; Fisch, C.; Labbe, G.; Degott, C.; Deschamps, D.; Berson, A.; Letteron, P.; Pessayre, D. (Institut National de la Sante et de la Recherche Medicale U24, Clichy (France))

    1990-12-01

    Amiodarone has been shown to produce microvesicular steatosis of the liver in some recipients. We have determined the effects of amiodarone on the mitochondrial oxidation of fatty acids in mice. In vitro, the formation of 14C-acid-soluble beta-oxidation products from (U-14C)palmitic acid by mouse liver mitochondria was decreased by 92% in the presence of 125 microM amiodarone and by 94% in the presence of 125 microM N-desethylamiodarone. Inhibition due to 100 or 150 microM amiodarone persisted in the presence of 5 mM acetoacetate, whereas acetoacetate totally relieved inhibition due to 15 microM rotenone. In vivo, exhalation of (14C)CO2 from (U-14C)palmitic acid was decreased by 31, 40, 58 and 78%, respectively, in mice receiving 19, 25, 50 and 100 mg.kg-1 of amiodarone hydrochloride 1 hr before the administration of (U-14C)palmitic acid. One hour after 100 mg.kg-1, the exhalation of (14C)CO2 from (1-14C)palmitic acid, (1-14C)octanoic acid or (1-14C)butyric acid was decreased by 78, 72 and 53%, respectively. Exhalation of (14C)CO2 from (1-14C)palmitic acid was normal between 6 and 9 hr after administration of 100 mg.kg-1 of amiodarone hydrochloride, but was still inhibited by 71 and 37%, 24 and 48 hr after 600 mg.kg-1. Twenty four hours after the latter dose of amiodarone, hepatic triglycerides were increased by 150%, and there was microvesicular steatosis of the liver. We conclude that amiodarone inhibits the mitochondrial beta-oxidation of fatty acids and produces microvesicular steatosis of the liver in mice.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. 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...

  18. 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

  19. 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)

  20. [Amiodaron neuropathy: clinical and pathological study of a new drug induced lipidosis (author's transl)].

    Science.gov (United States)

    Dudognon, P; Hauw, J J; de Baecque, C; Derrida, J P; Escourolle, R; Nick, E J

    1979-01-01

    The authors report a case of amiodaron-induced neuropathy in a seventy one years old man. First signs appeared seventeen months after the treatment was started with 400 mg/day for one year and continued with 200 mg/day. Examination on the 29th month disclosed a severe sensory and motor deficit of the limbs with distal predominancy. Motor nerve conduction velocity was strongly impaired without modification of distal latencies. Fundi were normal. The patient improved quickly after drug withdrawal. The authors review the rare similar cases reported in the literature and attempt to describe the clinical caracteristics of amiodaron neuropathy. Qualitative and quantitative light and electron microscopical studies of nerve, muscle and skin biopsies, including teased fibers preparations were performed and they disclosed a marked reduction of the number of myelinated fibers. Wallerian degeneration predominated (31 p. 100) other segmental demyalination (25 p. 100). Numerous polymorphous lipid-laden lysosomes were present in Schwann cells, fibrocytes, pericytes, endothelial and muscle cells. These previously undescribed morphological findings are similar to those present in perhexiline maleate intoxications. We believe amiodaron neuropathy is a new neuropathy with drug-induced lipidosis. PMID:531409

  1. 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

  2. Effect of Stem Cell Therapy on Amiodarone Induced Fibrosing Interstitial Lung Disease in Albino Rat

    Science.gov (United States)

    Zaglool, Somaya Saad; Zickri, Maha Baligh; Abd El Aziz, Dalia Hussein; Mabrouk, Doaa; Metwally, Hala Gabr

    2011-01-01

    Background and Objectives: The fibrosing forms of interstitial lung disease (ILD) are associated with significant morbidity and mortality. ILD may be idiopathic, secondary to occupational, infection, complicate rheumatic diseases or drug induced. Efficacy of antifibrotic agents is as far as, limited and uncertain. No effective treatment was confirmed for pulmonary fibrosis except lung transplantation. The present study aimed at investigating the possible effect of human cord blood mesenchymal stem cell (MSC) therapy on fibrosing ILD. This was accomplished by using amiodarone as a model of induced lung damage in albino rat. Methods and Results: Seventeen adult male albino rats were divided into 3 groups. Rats of amiodarone group were given 30 mg/kg of amiodarone orally 6 days/ week for 6 weeks. Rats of stem cell therapy group were injected with stem cells in the tail vein following confirmation of lung damage and left for 4 weeks before sacrifice. Obstructed bronchioles, thickened interalveolar septa and thickened wall of pulmonary vessels were found and proved morphometrically. Reduced type I pneumocytes and increased area% of collagen fibers were recorded. All findings regressed on stem cell therapy. Conclusions: Cord blood MSC therapy proved definite amelioration of fibrosing interstitial lung disease provided therapy starts early in the development of the pathogenesis. PMID:24298346

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

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    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.

  4. 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

  5. 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

  6. Correlation of Biomicroscopic Findings with Confocal Microscopy in Eyes with Amiodarone-Induced Cornea Verticillata

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    Emine Kaya

    2014-01-01

    Full Text Available Objectives: To investigate the correlation between biomicroscopic and confocal microscopic findings in eyes with amiodarone-induced cornea verticillata. Materials and Methods: Sixteen eyes of 8 patients with amiodarone-induced cornea verticillata were evaluated. Eyes with keratopathy were staged according to Orlando slit-lamp microscopy classification. Confocal laser-scanning microscopy was performed by Rostock cornea modulated to HRT II (Heidelberg Engineering GmbH, Heidelberg, Germany, and staging was done according to Falke’s classification that is based on the degree of epithelial basal cell deposit accumulation. The relation between biomicroscopic staging and corneal involvement detected on confocal microscopy was assessed by Spearman correlation analysis. Results: The mean age of the 8 patients (5 male, 3 female was 63.1±7.2 (50 to 69 years. The mean duration of drug treatment was 12.1±11.8 (3 to 36 months, and the mean drug treatment dose was 312.5±223.2 (100 to 800 mg/day. At the time of examination, 50% of the patients had already given up the treatment at a mean of 29.5±15.8 (6 to 40 months ago, whereas the other 50% were still on amiodarone therapy. Hyper-reflecting deposits were observed in the basal epithelium, anterior-, mid-and deep-stroma, and in the endothelium on confocal microscopic examination. Correlation was detected between biomicroscopic and confocal microscopic stages (r=0.770, p<0.001. Frequency of detecting deposits in the stroma and endothelium was found to be increasing as the biomicroscopic stage increased (r=0.844; p<0.001 and r=0.551; p<0.01, respectively. Conclusion: In amiodarone-induced cornea verticillata, correlated results were detected between biomicroscopic and confocal microscopic staging. Therefore, in clinics where confocal microscopy is not available, biomicroscopic staging can be used as a guiding parameter in eyes with amiodarone-induced cornea verticillata. (Turk J Ophthalmol 2014; 44: 63-67

  7. Mexiletine as an adjunctive therapy to amiodarone reduces the frequency of ventricular tachyarrhythmia events in patients with an implantable defibrillator.

    Science.gov (United States)

    Gao, Dongsheng; Van Herendael, Hugo; Alshengeiti, Lamia; Dorian, Paul; Mangat, Iqwal; Korley, Victoria; Ahmad, Kamran; Golovchiner, Gregory; Aves, Theresa; Pinter, Arnold

    2013-08-01

    The most effective pharmacological management of frequent ventricular tachyarrhythmia events in patients with an implantable defibrillator who failed or did not tolerate amiodarone is unknown. The aim of this retrospective cohort study was to assess the efficacy and tolerability of mexiletine in such patients. The patients served as self-controls. The number of treated ventricular tachyarrhythmia episodes (primary outcome); mortality, shocks from the defibrillator, and electrical storm events (secondary outcomes) during mexiletine therapy was compared with a matched duration of observation just before initiating mexiletine in 29 patients who were treated with a median dose of 300 mg/d of mexiletine and were followed for a median of 12 months. None of the patients had to stop mexiletine due to side effect. There was a significant reduction in the incidence of ventricular tachycardia/fibrillation episodes (median 2 vs. 12 events, P = 0.001) and shocks (median 0 vs. 2 events, P = 0.003) in the first 3 months of treatment, but long-term efficacy was only observed among patients who continued amiodarone therapy. In conclusion, mexiletine, when added to amiodarone in case of amiodarone inefficacy, reduces ventricular tachycardia/fibrillation events and appropriate therapies in patients with an implantable cardioverter defibrillator. A randomized trial should validate the efficacy and safety of mexiletine as an adjunctive therapy to amiodarone. PMID:23609328

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. Effects of amiodarone therapy on thyroid iodine content as measured by x-ray fluorescence

    Energy Technology Data Exchange (ETDEWEB)

    Fragu, P.; Schlumberger, M.; Davy, J.M.; Slama, M.; Berdeaux, A.

    1988-04-01

    Thyroid iodine content (TIC) was measured by x-ray fluorescence in 68 patients who had received amiodarone treatment for varying intervals (1 g/week for 1-120 months). Thirty-six patients were euthyroid; the mean TIC of the patients (n = 15), who had been treated for less than 12 months was 30 +/- 19 (+/- SD) mg, twice the normal mean value (14.6 +/- 5.0 mg), and it was 39 +/- 17 mg in those (n = 16) who had been treated for 12-60 months and 29 +/- 6 mg in those (n = 5) who had been treated longer (greater than 60 months). Nineteen patients were hyperthyroid and had elevated TIC values. Of them, 6 patients had a goiter; their TIC (50 +/- 19 mg) was not significantly different from that of the hyperthyroid patients with no goiter (55 +/- 29 mg), but they became hyperthyroid more rapidly. Thirteen patients were hypothyroid; none had TIC values above the normal range, and it was below 2.5 mg in 5 patients. A sequential study was undertaken in 11 euthyroid patients who had no detectable antithyroid antibodies. TIC did not increase during treatment in 2 patients; both developed hypothyroidism, which was transient in 1 despite continuation of amiodarone treatment. The TIC initially increased during amiodarone treatment in the other 9 patients, leveling off at the end of the first year. The TIC rose well above the upper limit of the normal range in 4 patients, of whom 2 became hyperthyroid during the second year of treatment. TIC remained within the normal range in the other 5 patients, of whom 3 became hypothyroid after 12-24 months of treatment (1 subclinical, 2 overt). Although the TIC was significantly higher in the patients with hyperthyroidism than in the patients who remained euthyroid, the TIC test cannot be used to predict the occurrence of hyperthyroidism.

  13. Cardiac arrest provoked by itraconazole and amiodarone interaction: a case report

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    Betrosian Alex

    2011-07-01

    Full Text Available Abstract Introduction Azoles, and specifically itraconazole, are often prescribed for the treatment of fungal diseases or empirically for persistent sepsis in patients who are neutropenic or in intensive care. Occasional cardiovascular adverse events have been associated with itraconazole use, and are usually attributed to the interaction of itraconazole with cisapride, terfenadine or digoxin. Its interaction with amiodarone has not been previously described. Case presentation A 65-year-old Caucasian man was admitted to the Intensive Care Unit at our facility for an extensive ischemic stroke associated with atrial fibrillation. Due to rapid ventricular response he was started on intravenous amiodarone and few days later itraconazole was also prescribed for presumed candidemia. After receiving the first dose our patient became profoundly hypotensive but responded rapidly to fluids and adrenaline. Then, two months later, itraconazole was again prescribed for confirmed fungemia. After receiving the first dose via a central venous catheter our patient became hypotensive and subsequently arrested. He was resuscitated successfully, and as no other cause was identified the arrest was attributed to septic shock and his antifungal treatment was changed to caspofungin. When sensitivity test results became available, antifungal treatment was down-staged to itraconazole and immediately after drug administration our patient suffered another arrest and was once again resuscitated successfully. This time the arrest was related to itraconazole, which was discontinued, and from then on our patient remained stable until his discharge to our neurology ward. Conclusions Itraconazole and amiodarone coadministration can lead to serious cardiovascular adverse events in patients who are critically ill. Intensivists, pharmacists and medical physicians should be aware of the interaction of these two commonly used drugs.

  14. 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)

  15. 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.

  16. 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...

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

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    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.

  18. Comparative Study of Nifekalant Versus Amiodarone for Shock-Resistant Ventricular Fibrillation in Out-of-Hospital Cardiopulmonary Arrest Patients

    NARCIS (Netherlands)

    M. Amino; K. Yoshioka; T. Opthof; S. Morita; S. Uemura; K. Tamura; T. Fukushima; S. Higami; H. Otsuka; K. Akieda; M. Shima; D. Fujibayashi; T. Hashida; S. Inokuchi; I. Kodama; T. Tanabe

    2010-01-01

    Background: In Japan, intravenous nifekalant ( NIF) was often used for direct current cardioversion-resistant ventricular fibrillation (VF), until the use of intravenous amiodarone (AMD) was approved in 2007. The defibrillatory efficacy of NIF and AMD has thus far not been compared for resuscitation

  19. 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

  20. 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.

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

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    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.

  2. Total Thyroidectomy for Amiodarone-induced Thyrotoxicosis in the Hyperthyroid State.

    Science.gov (United States)

    Kaderli, R M; Fahrner, R; Christ, E R; Stettler, C; Fuhrer, J; Martinelli, M; Vogt, A; Seiler, C A

    2016-01-01

    Amiodarone is a potent antiarrhythmic agent, indicated for the treatment of refractory arrhythmias, which may lead to thyrotoxicosis. In these patients, thyroidectomy is a valid therapeutic option. Antithyroid therapy in the immediate preoperative setting and the subsequently accepted minimal delay until thyroidectomy have not been clearly defined yet. The aim of the present study was to show, that total thyroidectomy under general anaesthesia in patients with amiodarone-induced thyrotoxicosis (AIT) is safe without necessarily obtaining an euthyroid state preoperatively.We conducted a retrospective cohort study of prospectively gathered data on 11 patients undergoing total thyroidectomy under general anaesthesia between January 2008 and December 2013 for AIT at our University Hospital.All patients were preoperatively treated with carbimazole, steroids and β-receptor antagonists. Additionally, 3 patients received potassium perchlorate and in one patient carbimazole was changed to propylthiouracil. Plasmapheresis was performed in 3 patients. Only one patient was euthyroid at the time of operation. There were no significant intra- and postoperative complications, especially no signs of thyroid storm. One patient could postoperatively be removed from the cardiac transplant waiting list due to improved cardiac function.Improvements in the interdisciplinary surgical management for AIT between cardiologists, endocrinologists, anaesthetists and endocrine surgeons provide the basis of safe total thyroidectomy under general anaesthesia in hyperthyroid state. Early surgery without long delay for medical antithyroid treatment (with its potential negative side effects) is recommended. PMID:26575117

  3. Amiodarone-induced pulmonary toxicity. Immunoallergologic tests and bronchoalveolar lavage phospholipid content.

    Science.gov (United States)

    Nicolet-Chatelain, G; Prevost, M C; Escamilla, R; Migueres, J

    1991-02-01

    Amiodarone (A) is a widely-used antiarrhythmic drug. Pulmonary toxicity is the most serious adverse effect with an estimated mortality of 1 to 33 percent. In order to determine an element helpful for diagnosis, we examined four patients with amiodarone-induced pulmonary toxicity, three patients treated with A, without evidence of pulmonary toxicity but with a main underlying pulmonary disease, and four healthy volunteers. Daily and cumulative doses or duration of treatment were similar in the first two groups. Pulmonary function tests (spirometry, CO-diffusing capacity, arterial blood gases), roentgenographic examinations, pulmonary biopsies or immunoallergologic tests (skin reaction, lymphoblastic transformation test and human basophile degranulation test) did not provide any discriminatory element. In APT+, we observed an increased cellularity of the bronchoalveolar lavage. Neither the differential cell count nor the presence of foamy macrophages were distinguishable between APT+ and APT-. The phospholipid composition of BAL fluid showed a decreased total phospholipid and phospholipid/protein ratio in all patients compared to normal subjects. These changes reflect more the severity of pulmonary disease than the specificity of the causative agent. However, we observed that the unique PL which decreases in APT- and remains normal in APT+ is phosphatidyl-serine + phosphatidylinositol (PS + PI). This has to be confirmed and should be evaluated at different stages of the disease to determine an eventual specific element. We conclude that there are no data currently available to establish the diagnosis of APT except perhaps for the analysis of BAL PL content.

  4. Randomised trial of low-dose amiodarone in severe congestive heart failure. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA)

    Science.gov (United States)

    Doval, H C; Nul, D R; Grancelli, H O; Perrone, S V; Bortman, G R; Curiel, R

    1994-08-20

    In severe heart failure many deaths are sudden and are presumed to be due to ventricular arrhythmias. The GESICA trial evaluated the effect of low-dose amiodarone on two-year mortality in patients with severe heart failure. Our prospective multicentre trial included 516 patients on optimal standard treatment for heart failure. Patients were randomised to 300 mg/day amiodarone (260) or to standard treatment (256). Intention-to-treat analysis showed 87 deaths in the amiodarone group (33.5%) compared with 106 in the control group (41.4%) (risk reduction 28%; 95% CI 4%-45%; log rank test p = 0.024). There were reductions in both sudden death (risk reduction 27%; p = 0.16) and death due to progressive heart failure (risk reduction 23%; p = 0.16). Fewer patients in the amiodarone group died or were admitted to hospital due to worsening heart failure (119 versus 149 in the control group; risk reduction 31%; 95% CI 13-46%; p = 0.0024). The decrease in mortality and hospital admission was present in all subgroups examined and independent of the presence of non-sustained ventricular tachycardia. Side-effects were reported in 17 patients (6.1%); amiodarone was withdrawn in 12. Low-dose amiodarone proved to be an effective and reliable treatment, reducing mortality and hospital admission in patients with severe heart failure independently of the presence of complex ventricular arrhythmias.

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

    Energy Technology Data Exchange (ETDEWEB)

    Martino, E.; Aghini-Lombardi, F.; Lippi, F.; Baschieri, L.; Safran, M.; Braverman, L.E.; Pinchera, A.

    1985-12-01

    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.

  6. 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

  7. Long-term use of amiodarone before heart transplantation significantly reduces early post-transplant atrial fibrillation and is not associated with increased mortality after heart transplantation

    Directory of Open Access Journals (Sweden)

    Rivinius R

    2016-02-01

    Full Text Available Rasmus Rivinius,1 Matthias Helmschrott,1 Arjang Ruhparwar,2 Bastian Schmack,2 Christian Erbel,1 Christian A Gleissner,1 Mohammadreza Akhavanpoor,1 Lutz Frankenstein,1 Fabrice F Darche,1 Patrick A Schweizer,1 Dierk Thomas,1 Philipp Ehlermann,1 Tom Bruckner,3 Hugo A Katus,1 Andreas O Doesch1 1Department of Cardiology, Angiology and Pneumology, 2Department of Cardiac Surgery, Heidelberg University Hospital, 3Institute for Medical Biometry and Informatics, University of Heidelberg, Heidelberg, Germany Background: Amiodarone is a frequently used antiarrhythmic drug in patients with end-stage heart failure. Given its long half-life, pre-transplant use of amiodarone has been controversially discussed, with divergent results regarding morbidity and mortality after heart transplantation (HTX.Aim: The aim of this study was to investigate the effects of long-term use of amiodarone before HTX on early post-transplant atrial fibrillation (AF and mortality after HTX.Methods: Five hundred and thirty patients (age ≥18 years receiving HTX between June 1989 and December 2012 were included in this retrospective single-center study. Patients with long-term use of amiodarone before HTX (≥1 year were compared to those without long-term use (none or <1 year of amiodarone. Primary outcomes were early post-transplant AF and mortality after HTX. The Kaplan–Meier estimator using log-rank tests was applied for freedom from early post-transplant AF and survival.Results: Of the 530 patients, 74 (14.0% received long-term amiodarone therapy, with a mean duration of 32.3±26.3 months. Mean daily dose was 223.0±75.0 mg. Indications included AF, Wolff–Parkinson–White syndrome, ventricular tachycardia, and ventricular fibrillation. Patients with long-term use of amiodarone before HTX had significantly lower rates of early post-transplant AF (P=0.0105. Further, Kaplan–Meier analysis of freedom from early post-transplant AF showed significantly lower rates of AF in this

  8. 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.

  9. 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.

  10. 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

  11. 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

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

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    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.

  13. 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

  14. 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

  15. 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

  16. 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

  17. 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

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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

  20. 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 VALIAN...

  1. 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

  2. Amiodarone therapy in chronic heart failure and myocardial infarction: a review of the mortality trials with special attention to STAT-CHF and the GESICA trials. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina.

    Science.gov (United States)

    Pinto, J V; Ramani, K; Neelagaru, S; Kown, M; Gheorghiade, M

    1997-01-01

    Amiodarone appears to reduce sudden death in patients with left ventricular dysfunction resulting from an acute MI or a primary dilated cardiomyopathy, particularly if complex ventricular arrhythmias are present. Amiodarone's beneficial effect on mortality in these patients could be unrelated to its antiarrhythmic effects. Multiple factors could account for the improvement in mortality such as the drug's antiischemic effects, neuromodulating effects, its effect on left ventricular function and on heart rate. Moreover, patients with LV dysfunction who have survived an episode of sudden death would potentially benefit from amiodarone therapy. Future trials are needed to determine the precise subsets(s) of patients who would benefit from the drug and the most efficacious dosing regimen for the drug. Based on available data, amiodarone is the only antiarrhythmic agent which has not been shown to increase mortality in patients with chronic heart failure.

  3. 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

  4. 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

  5. Comparison of use and role of adrenaline and amiodarone in cardiac arrest:Case of emergency center in Kosovo

    Institute of Scientific and Technical Information of China (English)

    Basri Lenjani; Nehat Baftiu; Ilaz Bunjaku; Kadir Hyseni; Arianit Jakupi

    2013-01-01

    Objective: To investigate application of cardiopulmonary resuscitation (CPR) measures within the golden minutes in Europe. Methods: The collected data belong to the patients with cardiac arrest that have been recorded in patients’ protocol logbook at the Emergency Clinic. During the 2010-2011 in the Emergency Center of the CUCK in Prishtina have been treated a total of 269 patients with cardiac arrest, of whom 159 or 59.1% have been treated in 2010, and 110 patients or 40.9% in 2011. Cardiac arrest cases were present during all days of the week, but most frequently cases have been reported on Monday with 32.0% of cases, and on Friday with 24.5% of cases. All patients with cardiac arrest have been treated with physiological solution. Results: In 245 or 91.1% patients adrenaline has been applied; in 64 or 23.8% amiodarone has been applied; in 12 or 4.5% cases atropine has been applied, 11 or 4.1% of cases were treated with NaHCO3; 7 or 2.6% of cases were treated with lidocaine; and 6 or 2.2% of cases were treated with dopamine. All survivors from cardiac arrest have received appropriate medical assistance within 10 minutes from attack, which implies that if cardiac arrest occurs near an health care institution (with an opportunity to provide the emergent health care) the rate of survival is higher. Conclusions: Anti-arrhythmic drugs as with vasopressors, the evidence that anti-arrhythmic drugs are of benefit in cardiac is limited. No anti-arrhythmic drug given during human cardiac arrest has been shown to increase survival to hospital discharge, although amiodarone has been shown to increase survival to hospital admission after shock-refractory VF/VT. There are no data on the use of amiodarone for shock-refractory VF/VT when single shocks are used. Despite the lack of human long-term outcome data, the balance of evidence is in favour of the use of some anti-arrhythmic drugs for the management of arrhythmias in cardiac arrest.

  6. 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

  7. 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.

  8. 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...... with 32.8% of amiodarone patients; p = 0.0012). Serious adverse events or events leading to discontinuation of study drug were uncommon. There were no cases of torsades de pointes, ventricular fibrillation, or polymorphic or sustained ventricular tachycardia. Conclusions Vernakalant demonstrated efficacy......-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...

  9. Adaptation of the QT interval to heart rate changes in isolated perfused guinea pig heart: influence of amiodarone and D-sotalol.

    Science.gov (United States)

    Padrini, R; Speranza, G; Nollo, G; Bova, S; Piovan, D; Antolini, R; Ferrari, M

    1997-05-01

    The inadequacy of the QT interval to shorten following heart rate increase is a feature of the inherited long QT syndrome and may have a role in the genesis of the typical arrhythmias associated with this syndrome (torsade des pointes). The aim of our study was to evaluate whether drugs that prolong the QT interval, such as amiodarone and D-sotalol, may also impair the ability of the QT interval to adapt to sudden heart rate changes. Experiments were carried out on isolated perfused guinea pig hearts (Langendorff preparation). Driving frequency was changed, in steps, every two minutes (Hz: 2.5-3-2.5-3.75-2.5-5-2.5), while epicardial ECG was continuously recorded on magnetic tape. QT interval was automatically measured by means of a beat-by-beat analysis program. D-sotalol was added to the perfusion medium at a concentration of 4 micrograms ml-1, while amiodarone was administered, before in vitro evaluation, for seven days (50 mg kg-1 per day, intraperitoneally). In control experiments two phases of QT adaptation were identified: an abrupt QT shortening at the first beat after frequency change (QT1), followed by a gradual, exponential QT shortening that reached a new steady state in about 1 min (half life: 13 sec). The electrical restitution curve (the relation between QT1 and the corresponding diastolic interval) had a rate constant of 57 +/- 8 ms. Neither drug changed the slow component of QT adaptation. However, both drugs increased the ability of QT to shorten upon premature stimulation: D-sotalol by increasing the rate constant of the restitution curve and amiodarone by decreasing the y-intercept. Our results indicate that D-sotalol and amiodarone do not impair QT shortening during tachycardia but, on the contrary, they may favour QT adaptation, thus reducing the likelihood of the potentially lethal 'R on T phenomenon'. This may be an additional mechanism by which these drugs can exert their antifibrillatory action.

  10. 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.

  11. 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

  12. 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.

  13. 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

  14. In vitro kinetics of amiodarone and its major metabolite in two human liver cell models after acute and repeated treatments.

    Science.gov (United States)

    Pomponio, Giuliana; Savary, Camille C; Parmentier, Céline; Bois, Frederic; Guillouzo, André; Romanelli, Luca; Richert, Lysiane; Di Consiglio, Emma; Testai, Emanuela

    2015-12-25

    The limited value of in vitro toxicity data for the in vivo extrapolation has been often attributed to the lack of kinetic data. Here the in vitro kinetics of amiodarone (AMI) and its mono-N-desethyl (MDEA) metabolite was determined and modelled in primary human hepatocytes (PHH) and HepaRG cells, after single and repeated administration of clinically relevant concentrations. AMI bioavailability was influenced by adsorption to the plastic and the presence of protein in the medium (e.g. 10% serum protein reduced the uptake by half in HepaRG cells). The cell uptake was quick (within 3h), AMI metabolism was efficient and a dynamic equilibrium was reached in about a week after multiple dosing. In HepaRG cells the metabolic clearance was higher than in PHH and increased over time, as well as CYP3A4. The interindividual variability in MDEA production in PHHs was not proportional to the differences in CYP3A4 activities, suggesting the involvement of other CYPs and/or AMI-related CYP inhibition. After repeated treatment AMI showed a slight potential for bioaccumulation, whereas much higher intracellular MDEA levels accumulated over time, especially in the HepaRG cells, associated with occurrence of phospholipidosis. The knowledge of in vitro biokinetics is important to transform an actual in vitro concentration-effect into an in vivo dose-effect relationship by using appropriate modelling, thus improving the in vitro-to-in vivo extrapolation.

  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. 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。

  17. Quantitation of Flecainide, Mexiletine, Propafenone, and Amiodarone in Serum or Plasma Using Liquid Chromatography-Tandem Mass Spectrometry (LC-MS/MS).

    Science.gov (United States)

    Slawson, Matthew H; Johnson-Davis, Kamisha L

    2016-01-01

    Flecainide, mexiletine, propafenone, and amiodarone are antiarrhythmic drugs that are used primarily in the treatment of cardiac arrhythmias. The monitoring of the use of these drugs has applications in therapeutic drug monitoring and overdose situations. LC-MS/MS is used to analyze plasma/serum extracts with loxapine as the internal standard to ensure accurate quantitation and control for any potential matrix effects. Positive ion electrospray is used to introduce the analytes into the mass spectrometer. Selected reaction monitoring of two product ions for each analyte allows for the calculation of ion ratios which ensures correct identification of each analyte, while a matrix matched calibration curve is used for quantitation. PMID:26660169

  18. Microscopia confocal in vivo nos depósitos corneanos por amiodarona In vivo confocal microscopy in amiodarone corneal deposits

    Directory of Open Access Journals (Sweden)

    Gustavo Victor

    2007-02-01

    Full Text Available OBJETIVO: Descrever os achados da microscopia confocal in vivo em pacientes nos diversos estágios de ceratopatia induzida por amiodarona, e correlacionar o estadiamento biomicroscópico com o estadiamento confocal. MÉTODOS: Vinte olhos de 10 pacientes (6 homens e 4 mulheres em tratamento com amiodarona, que apresentavam ceratopatia induzida pela droga, foram selecionados para o estudo, com a microscopia confocal (MC. RESULTADOS: A média de idade foi 58 ± 6,2 anos (50-66 anos e o tempo de uso da droga foi de 6 ± 3,2 anos (2-11 anos. Todos pacientes tinham acuidade visual com correção melhor ou igual a 20/40. A biomicroscopia evidenciou ceratopatia por amiodarona: dois pacientes no estágio 1, quatro no estágio 2 e quatro no estágio 3. Todas as córneas apresentaram inclusões intracelulares brilhantes e de alta refletividade na camada epitelial basal. A partir dos estágios 2 e 3, foram encontrados microdepósitos em todas camadas corneanas. Foram observados afilamento e aumento da tortuosidade dos nervos corneanos nos estágios 2 e 3 da ceratopatia. A contagem endotelial média foi de 2.524 ± 150,3 células/mm². CONCLUSÃO: O epitélio basal foi o mais acometido nos diferentes estágios da ceratopatia. Nos pacientes do estágio 1 a biomicroscopia, os microdepósitos subepiteliais são restritos ao epitélio superficial e basal, ao passo que nos pacientes dos estágios 2 e 3, os microdepósitos afetam todas camadas corneanas. À medida que a ceratopatia avança, os nervos corneanos ficam mais afilados e tortuosos.PURPOSE: To describe in vivo confocal microscopy findings in patients with different stages of amiodarone-induced keratopathy, and correlate biomicroscopy stages with confocal stages. METHODS: Twenty eyes of 10 patients (6 men and 4 women, who receive treatment with amiodarone were selected for the study with confocal microscopy (MC. RESULTS: The average age was 58 ± 6.2 years (50-66 years and time of use of the drug was 6

  19. 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

  20. 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.

  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. 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.

  3. 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

  4. 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.

  5. 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。

  6. 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.

  7. 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.

  8. 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.

  9. 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。

  10. 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

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. 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.

  16. 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

  17. 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。

  18. 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.

  19. 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.

  20. 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。

  1. 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

  2. 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

  3. 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

  4. 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。

  5. 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.

  6. 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.

  7. 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.

  8. 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..

  9. 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.

  10. 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.

  11. 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.

  12. 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.

  13. 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。

  14. 去乙基胺碘酮--容易被忽视的影响胺碘酮临床使用质量的因素%Desethylamiodarone-an Neglected Factor Affecting the Clinical Use of Amiodarone

    Institute of Scientific and Technical Information of China (English)

    谭蓉; 杨继红; 孙为民

    2014-01-01

    Drugs could affect the activity of CYP450 isoenzyme, which would influence drug safety and efficacy of the substrates of CYP450 isoenzyme. Desethylamiodarone, an in vivo metabolite of amiodarone, not only contributes to its therapeutic effect, at the same time, also plays great role in the side effects of amiodarone by influencing the CYP450 isoenzyme system. Therefore, neglecting the influence factors of desethylamiodarone will affect the safety and efficacy evaluation of amiodarone.%药物可通过CYP450同工酶途径影响其底物药物临床使用的安全性和有效性。胺碘酮体内代谢产物去乙基胺碘酮不仅对其治疗作用贡献较大,同时,对CYP450同工酶系的影响也较为广泛,作用也更强。因此,对胺碘酮临床使用的评估,忽视去乙基胺碘酮的影响因素,将影响胺碘酮临床使用的安全性和有效性。

  15. 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。

  16. 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。

  17. 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。

  18. 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.

  19. 盐酸胺碘酮治疗儿童难治性持续性心动过速%Treatment of intractable incessant tachycardia in children with Amiodarone

    Institute of Scientific and Technical Information of China (English)

    李筠; 周爱卿; 杨健萍; 朱敏; 张海燕

    2009-01-01

    目的 提高对盐酸胺碘酮治疗儿童难治性持续性心动过速的认识.方法 对2006年1月-2007年12月80例应用盐酸胺碘酮治疗的难治性心动过速患儿的资料进行总结.其中男52例,女38例;年龄1个月~14岁(平均2.5岁).结果 盐酸胺碘酮具有良好的控制心室率的作用,总有效率为90%左右;同时它有不同程度转复窦性心律的作用,房性心动过速67%,阵发性室上性心动过速92%,交界逸搏性心动过速89%、室性心动过速56%;小剂量β受体阻滞剂具有协同盐酸胺碘酮抗心动过速的作用.治疗过程中7例出现低血压,4例出现心动过缓.结论 Ⅲ类抗心律失常药盐酸胺碘酮具有广泛的抗心律失常作用,它对治疗血流动力学相对稳定的小儿难治性持续性心动过速是安全有效的.%Objective To improve the understanding of Amiodarone in the treatment of intractable incessant tachycardia in children. Methods Data of 80 patients with intractable incessant tachycardia treated by Amiodarone were summarized. Among them 52 were male, 38 were female, and average age was 2.5 years old. Results Amiodarone reduced heart rate effectively, with about 90% effective. Simultaneously, it could convert tachycardia into sinus rhythm and succeeded 67% in atrial tachycardia, 92% in paroxysmal supraventricular tachycardia, 89% in junctional ectopic tachycardia, 56% in ventricular tachycardia respectively. Use of small dosage of β-receptor blocker together with Amiodarone showed synergy. Hypotension and bradycardia are the main side effects. Conclusions Too rapid and sustained tachycardia can lead, to hemodynamic disorders and cause heart failure, it requires urgent and adequate treatment. Amiodarone can be used to treat different kinds of intractable incessant tachycardia, and is safe and effective in patients with relatively stable hemodynamis.

  20. 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.

  1. 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

  2. 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

  3. 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.

  4. 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.

  5. A transcriptomics-based hepatotoxicity comparison between the zebrafish embryo and established human and rodent in vitro and in vivo models using cyclosporine A, amiodarone and acetaminophen.

    Science.gov (United States)

    Driessen, Marja; Vitins, Alexa P; Pennings, Jeroen L A; Kienhuis, Anne S; Water, Bob van de; van der Ven, Leo T M

    2015-01-22

    The zebrafish embryo (ZFE) is a promising alternative, non-rodent model in toxicology, which has an advantage over the traditionally used models as it contains complete biological complexity and provides a medium to high-throughput setting. Here, we assess how the ZFE compares to the traditionally used models for liver toxicity testing, i.e., in vivo mouse and rat liver, in vitro mouse and rat hepatocytes, and primary human hepatocytes. For this comparison, we analyzed gene expression changes induced by three model compounds for cholestasis, steatosis, and necrosis. The three compounds, cyclosporine A, amiodarone, and acetaminophen, were chosen because of their relevance to human toxicity and these compounds displayed hepatotoxic-specific changes in the mouse in vivo data. Compound induced expression changes in the ZFE model shared similarity with both in vivo and in vitro. Comparison on single gene level revealed the presence of model specific changes and no clear concordance across models. However, concordance was identified on the pathway level. Specifically, the pathway "regulation of metabolism - bile acids regulation of glucose and lipid metabolism via FXR" was affected across all models and compounds. In conclusion, our study with three hepatotoxic model compounds shows that the ZFE model is at least as comparable to traditional models in identifying hepatotoxic activity and has the potential for use as a pre-screen to determine the hepatotoxic potential of compounds.

  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.

  8. 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。

  9. 胺碘酮致飞行员甲状腺功能异常二例并文献复习%Two cases of pilots with amiodarone-induced thyroid dysfunction and literature review

    Institute of Scientific and Technical Information of China (English)

    杨彩哲; 于亚静; 徐先荣; 郑军; 刘红巾; 付兆君; 崔丽; 关小宏; 王建昌

    2015-01-01

    目的 总结飞行人员因心律失常服用胺碘酮而引起甲状腺功能异常的临床特征、诊断、分型、治疗及预后,为以后类似疾病的诊治及航空医学鉴定提供经验. 方法 通过回顾性分析2例飞行员因心房颤动服用胺碘酮而引起甲状腺功能异常的过程,结合文献复习,总结胺碘酮诱发甲状腺功能异常的临床特征、诊断、分型、治疗及转归. 结果 例1飞行员在服用胺碘酮7个月后停药,停药1个月后出现“低T3综合征”.停药2年后再次服用胺碘酮,1个月后出现碘诱导2型甲状腺毒症;停用胺碘酮3个月,甲状腺功能恢复正常.例2飞行员间断服用胺碘酮9年后诊断为碘诱导甲状腺功能减退,停用胺碘酮,并口服左甲状腺素钠75 μg,1次/d,补充治疗,5个月后甲状腺功能恢复正常.应用左甲状腺素钠2年后停药,甲状腺功能完全恢复正常.两例飞行员鉴定结论为暂时飞行不合格. 结论 飞行人员应用胺碘酮前,应完善相关检查.在治疗过程中、停药后6~9月甚至更长时间内,应定期检查甲状腺功能.对服用胺碘酮的飞行员要定期随访,尤其对既往存在甲状腺疾病和存在危险因素者.胺碘酮所引起的甲状腺功能异常有可能恢复正常.鉴定结论要结合心律失常和甲状腺功能情况综合判断.%Objective To summarize the clinic feature,diagnosis,treatment,and prognosis of amiodarone-induced thyroid dysfunction in the pilots with arrhythmia and gather the experiences on treatment and aviation medical assessment.Methods Retrospective analysis was done on the process of 2 cases with amiodarone induced abnormal thyroid function in pilots with atrial fibrillation and on the literatures to summary the clinic feature,diagnosis,treatment,and prognosis were reviewed.Results Case 1 had taken amiodarone for 7 months and low T3 syndrome was diagnosed 1 month later.Two years later,he took amiodarone again for 1 month and was

  10. 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.

  11. 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.

  12. 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

  13. 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。

  14. 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.

  15. 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.

  16. 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。

  17. 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.

  18. 普罗帕酮和胺碘酮治疗阵发性室上性心动过速的临床分析%Clinical analysis of propafenone and amiodarone in the treatment of paroxysmal suproventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    税小波; 高建军; 邹玉刚; 税朝东; 税朝莲

    2015-01-01

    目的:探讨分别运用普罗帕酮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11月-2014年7月收治阵发性室上性心动过速患者64例,随机分为观察组和对照组,各32例。对照组和观察组分别采用普罗帕酮和胺碘酮进行治疗,比较两组的治疗效果。结果:观察组转复时间明显长于对照组,不良反应率明显低于对照组,组间比较差异均具有统计学意义(P<0.05)。观察组临床总有效率(87.50%)同对照组(90.63%)相比差异无统计学意义(P>0.05)。结论:在阵发性室上性心动过速的临床治疗中,普罗帕酮和胺碘酮均有良好的治疗效果,但普罗帕酮起效更快,胺碘酮的安全性更高。%Objective:To explore the clinical effect of propafenone and amiodarone used respectively in the treatment of paroxysmal suproventricular tachycardia.Methods: 64 cases of paroxysmal suproventricular tachycardia were selected from November 2010 to July 2014.They were divided into the observation group and the control group with 32 cases in each.The control group and the observation group were treated with propafenone and amiodarone respectively.We compared the therapeutic effect of the two groups.Results:The converting time of the observation group was obviously higher than that of the control group,and the adverse reaction rate was significantly lower than that of the control group.The differences between the two groups were statistically significant(P0.05).Conclusion:Propafenone and amiodarone in the treatment of paroxysmal suproventricular tachycardia had good treatment effect,but amiodarone had faster effect and higher safety.

  19. 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.

  20. 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

  1. 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

  2. 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.

  3. 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 .

  4. 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.

  5. 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

  6. 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

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    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

  7. 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

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    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

  8. 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

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    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

  9. 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.

  10. 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.

  11. 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

    Institute of Scientific and Technical Information of China (English)

    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.

  12. 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。

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

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    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

  14. 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

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    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

  15. 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.

  16. 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.

  17. 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.

  18. 文献对胺碘酮、利多卡因治疗阵发性室性心动过速预后差异的Meta分析%Research Document of Amiodarone, Lidocaine Treatment of Paroxysmal Supraventricular Tachycardia Meta-analysis of Differences in Prognosis

    Institute of Scientific and Technical Information of China (English)

    陈阵; 刘亚凤; 胡念丹; 苏薇薇; 李文强

    2012-01-01

    目的 评价相关文献中关于使用胺碘酮和利多卡因治疗阵发性室性心动过速(paroxysmal ventricular tachycardia,PVT)的预后差异.方法 检索Cochrane图书馆、EMbase、Pubmed及Medline 1996~ 2011年中采用随机对照试验(RCT)中关于使用胺碘酮、利多卡因治疗PVT预后差异的文献,对纳入文献质量进行评价和资料提取,并进行Meta分析.结果 本研究共纳入5篇文献,均表明使用胺碘酮治疗PVT较利多卡因预后好,差异有统计学意义(P<0.05);两药治疗PVT在复律失败人数、死亡人数、药物不良反应等方面比较差异均有统计学意义(P<0.05).结论 使用胺碘酮治疗PVT可降低患者住院次数,且未增加不良反应,故当PVT症状不严重时,胺碘酮可作为治疗的首选.%Objective To evaluate the pertinent literature of amiodarone, lidocaine treatment in the prognosis of paroxysmal ventricular tachycardia ( PVT). Methods The papers from Cochrane Library, EM base, Pubmed were searched, Medline for RCT of paroxysmal ventricular tachycardia treatment using amiodarone or lidocaine was randomly evalvated, an assessment for the methodology after screening and selecting all the papers with the help of the software of Review manager 5.0 was made, and Meta analysis was conducted. Results A total of 5 literatures were included, all of which results showed that amiodarone had a better prognosis than lidocaine, and the difference was significant (P < 0.05 ) ; the number of successful cardio version, adverse reactions and the number of deaths related to the RCT docamented significant differences between the Amiodarone and Lidocaine treatment of PVT (P <0.05). Conclusion The use of PVT Amiodarone treatment can reduce the rate of hospitalization, without increasing the incidence rate of other adverse reactions. Therefore, in minor cases of PVT, Amiodarone can be the preferred treatment method.

  19. Comparison on Effect of Amiodarone and Propafenone Treating Paroxysmal Supraventricular Tachycardia%胺碘酮和普罗帕酮治疗阵发性室上性心动过速的效果比较

    Institute of Scientific and Technical Information of China (English)

    赵敏

    2014-01-01

    目的:比较胺碘酮和普罗帕酮治疗阵发性室上性心动过速的疗效。方法将88例阵发性室上性心动过速患者随机分为两组,A 组44例患者给予胺碘酮治疗,B 组44例患者给予普罗帕酮治疗。结果两组复律成功率比较,差异无统计学意义(P >0.05);A 组复律时间长于 B 组,复律时间分布较 B 组差,不良反应发生率低于 B 组,差异均有统计学意义(P <0.05)。结论胺碘酮和普罗帕酮对阵发性室上性心动过速的治疗各有利弊,普罗帕酮见效快、患者耐受差,适用于无严重器质性心脏病及心功能正常者;而胺碘酮见效较慢、不良反应少、适应证广,适用于器质性心脏病及心功能不全患者。%Objective To compare the efficacy of amiodarone and propafenone treating paroxysmal supraventricular tachycardia. Methods 88 cases with paroxysmal supraventricular tachycardia were selected and divided into two groups randomly. The A group for 44 cases were treated with amiodarone, and the B group for 44 cases were treated with propafenone. Results The difference for the successful rate of cardioversion between two groups had no statistical significance(P>0.05). The cardioversion time of A group was longer than that of B group, and the cardioversion time distribution of A group was worse than that of B group, the incidence rate of adverse reactions in A group was lower than that of B group ,which had statistical significance (P<0.05). Conclusion Propafenone and propafenone treating paroxysmal supraventricular tachycardia has advantages and disadvantages. Amiodarone has the advantages that the effect is fast, the patients have poor tolerance and it is applied to the patients with normal cardiac function and without organic heart disease, and amiodarone has the advantages that the effect is slow, there are few adverse reactions, there are wide range of indications, and it is applied to patients with organic heart disease

  20. 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.

  1. 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.

  2. 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.

  3. 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.

  4. 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。

  5. 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。

  6. 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.

  7. 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.

  8. 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

  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. 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.

  11. 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。

  12. 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.

  13. 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

  14. 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

  15. Effect of Intravenous Administration of Amiodarone on The Hemodynamics in Rats with Acute Myocardial Ischemic%静脉注射胺碘酮对急性心肌缺血大鼠血流动力学的影响

    Institute of Scientific and Technical Information of China (English)

    徐向钊; 张冬梅; 郎淑慧; 彭亮; 王萌

    2013-01-01

    目的 观察静脉应用胺碘酮对急性心肌缺血大鼠血流动力学的影响.方法 健康雄性SD大鼠40只,体重250~300g,采用随机数字表法,将大鼠随机分为五组:假手术组(S组);缺血再灌注组(I/R组):胺碘酮2.5mg·kg-1+持续泵注组(A1组);胺碘酮5.0mg·kg-1组(A2组),不进行持续泵注;胺碘酮5.0 mg· kg-1组+持续泵注组(A3组)均于缺血前10min静脉注射胺碘酮.分别记录缺血前10min(T0),缺血后30min(T1),再灌注30min(T2),再灌注60min(T3),再灌注120min(T4)大鼠心率(HR),左心室收缩压(LVSP)、左心室终末舒张压(LVEDP)、左心室内压最大上升速率(+dp/dtmax)、左心室内压最大下降率(-dp/dtmax)的变化以及心律失常的分析.结果 各组大鼠在T0时HR、LVSP、LVEDP、+dp/dtmax、-dp/dtmax比较差异无统计学意义(P>0.05);在缺血以后,与S组比较,I/R、A1、A2、A3组大鼠的HR、LVSP、+dp/dtmax、-dp/dtmax降低(P<0.05),LVEDP升高(P<0.05);与I/R组比较,A1、A2、A3组HR、LVSP、+dp/dtmax、-dp/dtmax升高(P<0.05),LVEDP降低(P<0.05);A1组HR、LVSP、+dp/dtmax、-dp/dtmax比A2、A3组降低,LVEDP升高(P<0.05),A3组HR、LVSP、+dp/dtmax、-dp/dtmax比A2组升高,LVEDP降低(P<0.05),组间比较差异有统计学意义(P<0.05).各组大鼠在急性缺血期心律失常的评分显示,I/R、A1、A2、A3组评分均高于S组(P <0.05);A1、A2、A3组评分均低于I/R组(P<0.05);A2、A3组低于A1组,A3组低于A2组,差异均有统计学意义(P<0.05).结论 静脉应用胺碘酮可以改善急性心肌缺血大鼠的血流动力学及减少心律失常的发生率,以5.0mg·kg-1加持续泵注组效果最佳.%Objective To investigate the effect of intravenous administration of amiodarone on the hemodynamics in rats with acute myocardial ischemic. Methods 40 SD rats, weighting 250 ~300g, were randomly divided into 5 groups (n = 8) : sham - operation ( S) , ischemic - reperfusion control group ( I

  16. 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

  17. 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。

  18. 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

  19. 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

  20. 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.

  1. 乙胺碘肤酮用作甲亢术前准备的临床观察%Clinical Observation of Amiodarone Used in the Preoperative Preperation in Grave's Disease

    Institute of Scientific and Technical Information of China (English)

    曾毅克; 黎绍基; 吕诗寿

    2000-01-01

    目的:初步探讨乙胺碘肤酮(Amiodarone)用于甲亢术前准备的可行性.方法:12名患者非随机分为两组,以使其平均年龄、甲亢的严重程度和甲状腺肿大程度相匹配,分别使用Lugol液和Amiodarone作术前准备,比较两组患者切除的腺体质量(m),术中出血量(V),甲状腺组织的碘含量(mI).结果:Amiodarone组m=(89.81±51.41)g,V=(128.16±30.92)ml,mI=(0.033±0.017)%;Lugol液组m=(81.28±39.81)g,V=(194.97±57.77)ml,mI=(0.034±0.013)%;两组对比在切除腺体质量相当时,Amiodarone组的术中出血量较少(t检验P0.05).结论:乙胺碘肤酮用于甲亢术前准备对甲亢控制良好,能达到常规Lugol液的准备效果,而且口服无刺激,较Lugol液优越.

  2. 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。

  3. 静脉注射胺碘酮与普罗帕酮治疗阵发性室上性心动过速疗效的Meta分析%A meta-analysis of amiodarone and propafenone treatment of supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    王少波; 梁锦军; 黄从新

    2013-01-01

    Objective To evaluate the efficacy and safety of intravenous amiodarone and propafenone in treating par-oxysmal supraventricular tachycardia with the meta analysis. Methods Randomized controlled trials ( RCT ) included written in Chinese and English concerned using amiodarone and propafenone in treatment of paroxysmal supraventricular tachycardia were collected from 1999 to 2012 in a meta-analysis. The RevMan 5. 1 software of Cochrane Coordination Net was used for sta-tistical analysis. Results The therapy of amiodarone group and propafenone group in the treatment of paroxysmal supraventric-ular tachycardia effect analysis were: integrated test results was( OR = 1.45, 95% CIO.83 -2.51, P > 0. 05 ). The funnel plot analysis showed no significant bias. The adverse reaction analysis of amiodarone group and propafenone group therapy in the treatment of paroxysmal supraventricular tachycardia as follows: integrated test results was( OR =0.47, 95% CI 0. 29~ 0.77, P >0. 05 ). The funnel plot analysis showed no significant bias. Conclusion The amiodarone group and propafenone group therapy in the treatment of paroxysmal supraventricular tachycardia were showed no obvious differences. The incidence of adverse reactions of the amiodarone were lower than the propafenone.%目的 系统评价静脉注射胺碘酮与普罗帕酮治疗阵发性室上性心动过速的疗效与安全性.方法 计算机检索1999-2012年中英文电子文献数据库,收集有关胺碘酮和普罗帕酮治疗阵发性室上性心动过速的随机对照试验(RCT),应用Cochrane协作网提供的RevMan 5.1软件进行系统评价.结果 最终纳入5篇文献,(1)静脉注射胺碘酮组与普罗帕酮组治疗阵发性室上性心动过速疗效:两药差异无统计学意义(OR=1.45,95%CI 0.83~2.51,P>0.05);漏斗图分析结果未发现显著偏倚.(2)静脉注射胺碘酮组与普罗帕酮组治疗阵发性室上性心动过速不良反应:胺碘酮组不良反应发

  4. Analysis on efficacy and safety of amiodarone combined with dabigatran etexilate in treatment of non-valvular atrial fi-brillation%胺碘酮联合达比加群酯治疗非瓣膜性心房颤动的疗效和安全性分析

    Institute of Scientific and Technical Information of China (English)

    李玲; 罗晓丽; 王红勇

    2015-01-01

    Objective To investigate the efficacy and safety of amiodarone combined with dabigatran etexilate in the treatment of non-valvular atrial fibrillation.Methods 76 cases of non-valvular atrial fibrillation in our hospital from January to July 2014 were randomly divided into the treatment group and the control group.The treatment group was treated with amiodarone combined with dabigatran etexilate,while the control group was treated with ami-odarone combined with warfarin.The changes of electrocardiogram(EKG),blood coagulation indexes and biochemical indexes,and adverse reactions were observed in the two groups.Results Compared with before treatment,PT, APTT,INR and TT after treatment in the two groups were increased (P 0.05),the heart rate in the two groups was signif-icantly decreased (P 0.05).9 cases (23.7%) of gastrointestinal reactions occurred in the treatment group,which were higher than 5.3% in the control group (P 0.05),两组患者心率明显降低(P 0.05)。治疗组发生消化道反应9例(23.7%),高于对照组的5.3%(P <0.05)。而治疗组栓塞或血栓以及出血的发生率均低于对照组(P <0.05)。结论胺碘酮联合达比加群酯治疗非瓣膜性心房颤动安全有效,值得在临床推广。

  5. 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.

  6. 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.

  7. 胺碘酮治疗应用于冠心病急性心肌梗死伴高危快速型心律失常的临床疗效观察%Clinical effect of amiodarone in the treatment of acute myocardial infarction with high risk and rapid arrhythmia

    Institute of Scientific and Technical Information of China (English)

    许雪

    2015-01-01

    目的:研究分析胺碘酮应用于冠心病急性心肌梗死伴高危快速型心律失常的临床疗效.方法:收集我院2013年1月至2014年12月收治的80例冠心病急性心肌梗死伴高危快速型心律失常的患者,将80例患者平均分为观察组与对照组,两组患者均为40例,观察组采用胺碘酮对患者进行治疗,对照组采用利多卡因进行治疗,对两组患者的临床疗效进行对照分析.结果:观察组患者总有效率明显高于对照组(P<0.05).结论:对急性心肌梗死伴高危快速型心律失常的患者静脉注射胺碘酮能有效控制患者病情,胺碘酮治疗急性心肌梗死伴高危快速性心律失常具有良好的疗效,值得在临床上进行推广.%Objective: To study the clinical effect of amiodarone used in coronary heart disease (CHD) with high risk and rapid arrhythmia acute myocardial infarction. Methods: 80 cases of patients with acute myocardial infarction, coronary heart disease associated with high risk of fast arrhythmia patients were collected in our hospital during January 2013 to December 2013. The 80 patients were divided into an observation group and a control group with 40 cases in each group. The observation group was treated with amiodarone and the control group was treated with lidocaine. Analysis on comparison of the clinical curative effect of two groups of patients was conducted. Results: The total effective rate in the observation group was significantly higher than that of the control group (P< 0.05). Conclusion: For the acute myocardial infarction patients with high risk and rapid arrhythmia intravenous, amiodarone is effective to control the patient's condition. Amiodarone in treatment of acute myocardial infarction with high risk and rapid arrhythmia has good curative effect and it is worthy of application in clinical treatment.

  8. 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。

  9. 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.

  10. 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).

  11. 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.

  12. 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.

  13. 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

  14. 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

  15. The amiodarone derivative 2-methyl-3-(3,5-diiodo-4-carboxymethoxybenzyl)benzofuran (KB130015) opens large-conductance Ca2+-activated K+ channels and relaxes vascular smooth muscle.

    Science.gov (United States)

    Gessner, Guido; Heller, Regine; Hoshi, Toshinori; Heinemann, Stefan H

    2007-01-26

    2-methyl-3-(3,5-diiodo-4-carboxymethoxybenzyl)benzofuran (KB130015) has been developed to retain the antiarrhythmic properties of the parent molecule amiodarone but to eliminate its undesired side effects. In patch-clamp experiments, KB130015 activated large-conductance, Ca2+-activated BK(Ca) channels formed by hSlo1 (alpha) subunits in HEK 293 cells. Channels were reversibly activated by shifting the open-probability/voltage (P(o)/V) relationship by about -60 mV in 3 muM intracellular free Ca2+ ([Ca2+]in). No effect on the single-channel conductance was observed. KB130015-mediated activation of BK(Ca) channels was half-maximal at 20 microM with a Hill coefficient of 2.8. BK(Ca) activation by KB130015 did not require the presence of Ca2+ and still occurred with saturating (100 microM) [Ca2+]in. Effects of the prototypic BK(Ca) activator NS1619 (1,3-dihydro-1-[2-hydroxy-5-(trifluoromethyl)phenyl]-5-(trifluoromethyl)-2H-benzimidazol-2-one) and those of KB130015 were not additive suggesting that both activators may at least partially share a common mechanism of action. KB130015-mediated activation was observed also for BK(Ca) channels from insects and for human BK(Ca) channels with already profoundly left-shifted voltage-dependence. In contrast, human intermediate conductance Ca2+-activated channels were inhibited by KB130015. Using segments of porcine pulmonary arteries, KB130015 induced endothelium-independent vasorelaxation, half-maximal at 43 microM KB130015. Relaxation was inhibited by 1 mM tetraethylammonium, suggesting that KB130015 can activate vascular smooth muscle type BK(Ca) channels under physiological conditions. Interestingly, the shift in the P(o)/V relationship was considerably stronger (-90 mV in 3 microM [Ca2+]in) for BK(Ca) channels containing Slo-beta1 subunits. Thus, KB130015 belongs to a novel class of BK(Ca) channel openers that exert an effect depending on the subunit composition of the channel complex.

  16. 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.

  17. 静脉滴注胺碘酮与普罗帕酮治疗阵发性室上性心动过速疗效分析%Analysis of the effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    黄萍

    2015-01-01

    目的:分析对阵发性室上性心动过速行静脉滴注胺碘酮与普罗帕酮治疗的效果。方法:收治阵发性室上性心动过速患者90例,随机分为研究组和对照组,每组45例。对照组行胺碘酮治疗,研究组行普罗帕酮治疗,观察两组疗效。结果:治疗后研究组总有效率95.56%显著高于对照组的71.11%,且转复时间(24.18±18.53)min显著少于对照组的(40.52±18.60)min(P<0.05)。结论:阵发性室上性心动过速患者行静脉滴注普罗帕酮治疗的效果显著。%Objective:To discuss the effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia.Methods:90 patients with paroxysmal supraventricular tachycardia were selected.They were randomly divided into the study group and the control group with 45 cases in each.The control group received amiodarone treatment,and the study group underwent propafenone treatment.We observed the curative effect of two groups.Results:The study group after treatment the total efficiency of 95.56% was significantly higher than the control group of 71.11%,and the reversal time (24.18±18.53)min was less than the control group of(40.52 ± 18.60)min(P<0.05).Conclusion:The effect of intravenous amiodarone and propafenone on paroxysmal supraventricular tachycardia is outstanding.

  18. 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

  19. 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

  20. 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

  1. 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

  2. 胺碘酮和普罗帕酮治疗阵发性室上性心动过速的疗效对照研究%Controlled study on effect of amiodarone and hydrochloric acid propafenone on paroxysmal supraventricular tachycardia

    Institute of Scientific and Technical Information of China (English)

    霍秋玉

    2012-01-01

    Objective To observe the clinical efficacy and safety of intravenous amiodarone and hydrochloric acid propafenone in treating paroxysmal supraventricular tachycardia. Methods Eighty patients with paroxysmal supraventricular tachycardia were divieded into group A and B randomly (40 cases in each group). Group A received amiodarone, while group B received hydrochloric acid propafenone. The effective rate of cardioversion, cardioversion time, adverse reactions and the heart rate change were compared. Results The effective rate in group A was higher than that in group B, but the difference was not statistically significant. The cardioversion time in group A was obviously longer than that in group B (P<0. 01). The heart rates in the two groups after treatment decreased obviously (P<0.01), while the heart rate in group A was obviously lower than that in group B (P<0. 01). The incidence of adverse reactions in group A was lower than that in group B, but the difference was not statistically significant. Conclusion There are advantages of both amiodarone and propafenone in the treatment of paroxysmal supraventricular tachycardia. Propafenone is applicable to acute tachycardia, but adverse reactions should be taken into consideration. The amiodarone is effective in the treatment of paroxysmal supraventricular tachycardia in spite of the slow onset.%目的 比较静脉注射胺碘酮和普罗帕酮治疗阵发性室上心动过速的临床疗效及安全性.方法 将80例室上心动过速患者随机分为A、B 2组,各40例,A组给予胺碘酮注射液治疗,B组给予普岁帕酮注射液治疗,比较2组复律成功率、复律时间、不良反应及用药前后心率的变化.结果 A组复律成功率高于B组,但差异无统计学意义(P>0.05),而复律时间显著长于B组(P<0.01);2组治疗后心率均较治疗前显著下降(P<0.01),但治疗后A组心率显著低于B组(P<0.01).A组不良反应发生率低于B组,但差异无统计学意义.结论

  3. 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

  4. 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.

  5. 碳纳米管存在下盐酸胺碘酮与 BSA 的相互作用%Interaction of amiodarone hydrochloride with BSA in the presence of carbon nanotubes

    Institute of Scientific and Technical Information of China (English)

    马红燕; 辛建伟; 张越诚

    2013-01-01

    Under the pH 7.40 Tris-HCl buffer system , fluorescence spectroscopy was used to investigate the influences of carbon nanotubes(CNTs)on the fluorescence of amiodarone hydrochloride (AD)on bovine serum albumin(BSA)and the influences of AD on that of BSA without CNTs.The experimental results demonstrated that AD could quench the intrinsic fluorescence of BSA ,and the quenching mechanism was dynamic quenching.The fluorescence quenching action of AD on BSA was strengthened in the pres-ence of CNTs.The binding constants KA,binding sites n and the corresponding thermodynamic parameters ΔH,ΔG andΔS at differ-ent temperatures were calculated.Based on the thermodynamic parameters ,it was proved that the major roles of binding force of AD-BSA was the electrostatic.The distance r of AD-BSA was evaluated according to the theory of Föster energy transfer.Moreover,the effect of AD on the conformation of BSA was also analyzed by using synchronous fluorescence spectroscopy .The results showed that AD changed the conformation of BSA during the reaction.But the CNTs could not change the conformation of BSA.The binding con-stants KA ,binding sites n of AD on BSA was increased in the presence of CNTs .The discussion offer a reference study on the action mechanism of CNTs and AD with albumin in vivo .%在pH 7.40的Tris-HCl缓冲体系下,用荧光光谱法研究了碳纳米管( MCNTs)对盐酸胺碘酮( AD)和牛血清白蛋白( BSA)荧光光谱特性的影响以及无碳纳米管共存时盐酸胺碘酮与BSA之间的相互作用。结果表明,AD对BSA的荧光有较强的猝灭作用,其猝灭机理为动态猝灭。碳纳米管的存在使AD对BSA的猝灭作用增强。计算了不同温度下AD与BSA之间的表观结合常数KA ,结合位点数n。相应的热力学参数ΔH、ΔG和ΔS表明,AD与BSA之间主要以静电作用力结合。根据Förster非辐射能量转移理论,确定了AD与BSA之间的结合距离r=3.99 nm。此外,利用同

  6. 氯沙坦联合胺碘酮在阵发性房颤复律及维持复律后窦性心率中的应用效果分析%Application Effect of Losartan Combined with Amiodarone in Patients with Paroxysmal Atrial Fibrillation ;Cardioversion and Maintenance of Sinus Heart Rate after Cardioversion

    Institute of Scientific and Technical Information of China (English)

    姜涛; 王曼; 武孟宇

    2015-01-01

    目的:探讨阵发性房颤患者应用氯沙坦联合胺碘酮的临床复律效果及对患者维持复律后窦性心率的意义。方法:2010年1月-2013年3月将72例非瓣膜病阵发性房颤患者按随机数字表法分为对照组36例和观察组36例,对照组给予胺碘酮治疗,观察组给予氯沙坦+胺碘酮治疗,比较治疗24 h、3 d和7 d时房颤的转复情况。在房颤复律后,继续药物治疗并随访观察1年,评价两组窦性心率的维持效果。结果:对照组治疗24 h、3 d和7 d房颤的转复率分别为72.2%(26/36)、83.3%(30/36)和91.7%(33/36),观察组的转复率分别为69.4%(25/36)、88.9%(32/36)和97.2%(35/36),观察组在7 d时房颤转复率较对照组明显升高(P<0.05)。两组窦性心率在治疗12个月时维持率分别为69.7%(23/33)和88.6%(31/35)(P<0.05),两组左房内径分别为(38.3±1.9)mm和(34.2±2.0)mm(P<0.05)。结论:阵发性房颤患者应用氯沙坦联合胺碘酮复律效果及维持复律后的窦性心率均优于单用胺碘酮治疗,可能与氯沙坦抑制肾素-血管紧张素系统,降低心脏负荷,抑制心房电及结构重构有关。%Objective:To investigate the clinical effect of losartan combined with amiodarone in patients with paroxysmal atrial fibrillation cardioversion and maintenance of sinus heart rate after cardioversion.Method:From January 2010 to March 2013,72 patients with nonvalvular paroxysmal atrial fibrillation randomly were given amiodarone therapy (control group 36 cases)and losartan combined with amiodarone therapy(observation group 36 cases),cardioversion of atrial fibrillation was compared after treatment for 24 h,3 d and 7 d. After cardioversion of atrial fibrillation,patients were continued to give drug treatment and followed up for 1 year,the maintenance effect of sinus heart rate was evaluated of the two groups.Result:The atrial fibrillation cardioversion rate in

  7. 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、

  8. 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。

  9. 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

  10. 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

  11. 胺碘酮治疗慢性心力衰竭并发室性心律失常56例临床分析%Chronic Heart Failure Complicated by Ventricular Arrhythmias Amiodarone Therapy Clinical Analysis of 56 Cases

    Institute of Scientific and Technical Information of China (English)

    金迪

    2015-01-01

    目的:探究胺碘酮治疗慢性心力衰竭并发室性心律失常的疗效,分析其优势。方法将2014年1月~2014年5月到我院诊治的56例慢性心力衰竭并发室性心律失常的患者随机分为对照组(实施常规抗心力衰竭治疗)和实验组(常规抗心力衰竭治疗+胺碘酮治疗)每组28例,观察两组的左心室射血分数(LVEF%)和二尖瓣口舒张早期和舒张晚期血流峰值计算E峰/A峰(E/A),心律失常,心功能改善情况,比较其差异。结果观察组内的治疗前后LVE、E/A资料分析后P0.05;在心功能改善方面差异显著(P 0.05; heart function improvement were significantly different (P <0.05).ConclusionAmiodarone can reduce pain and complications for patients with chronic heart failure complicated by ventricular arrhythmias, but should continue to study the long-term effectiveness.

  12. 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.

  13. Adrenaline and amiodarone dosages in resuscitation: rectifying misinformation.

    Science.gov (United States)

    Botha, Martin; Wells, Mike; Dickerson, Roger; Wallis, Lee; Stander, Melanie

    2013-10-01

    Despite the recognition of specialists in emergency medicine and the professionalisation of prehospital emergency care, international guidelines and consensus are often ignored, and the lag between guideline publication and translation into clinical practice is protracted. South African literature should reflect the latest evidence to guide resuscitation and safe patient care. This article addresses erroneous details regarding life-saving interventions in the South African Medicines Formulary, 10th edition. 

  14. 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.

  15. 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

  16. 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...

  17. 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.

  18. 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

  19. 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

  20. 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

  1. 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....

  2. About PF

    Science.gov (United States)

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

  3. 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....

  4. Dasatinib

    Science.gov (United States)

    ... amiodarone (Cordarone), disopyramide (Norpace),dofetilide (Tikosyn), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), procainamide (Procanbid, Pronestyl), propafenone (Rythmol), ...

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

    NARCIS (Netherlands)

    Vitins, A.P.; Kienhuis, A.S.; Speksnijder, E.N.; Roodbergen, M.; Luijten, M.; Ven, van der L.T.M.

    2014-01-01

    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 re

  6. The therapeutic effect of amiodarone on the elderly with sinus bradycardia and premature ventricular complexes%胺碘酮对老年心动过缓伴室性早搏临床疗效的观察

    Institute of Scientific and Technical Information of China (English)

    邵迴龙; 张红明; 高燕; 卫亚

    2004-01-01

    目的观察胺碘酮对老年心动过缓伴室性早搏的临床疗效.方法选择老年心动过缓伴室性早搏患者29例,入选者均为其它抗心律失常药物治疗效果欠佳或出现明显不良反应,口服胺碘酮4周并复查动态心电图、甲状腺功能、肝功、胸片等.结果显示口服胺碘酮后总有效率86.20%,用药后平均心率减慢,QTc延长,不良反应发生率为20.69%.结论胺碘酮治疗老年心动过缓伴室性早搏相对较安全、有效.

  7. 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...

  8. 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.

  9. Clinical Analysis of Propafenone and Amiodarone Emergency Cardioversion of Pparoxysmal Supraventricular Tachycardia%普罗帕酮和胺碘酮急诊转复阵发性室上性心动过速的临床分析

    Institute of Scientific and Technical Information of China (English)

    廉秀华

    2015-01-01

    目的:对普罗帕酮和胺碘酮治疗转复阵发性室上性心动过速(PSVT)患者的临床疗效进行分析。方法分析80例PSVT患者的临床资料。结果两组总有效率、不良反应率对比(P>0.05);治疗组转复时间短于对照组(P 0.05). The treatment group was significantly shorter than the control group (P < 0.05). Conclusion The clinical efficacy of the treatment of the patients with paroxysmal ventricular tachycardia with the drug treatment of the patients with the treatment of the patients with paroxysmal tachycardia is equivalent to that of Proba.

  10. 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

  11. 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...

  12. 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

  13. 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).

  14. 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), ...

  15. Vardenafil

    Science.gov (United States)

    ... with or without food, 60 minutes before sexual activity. Vardenafil usually should not be taken more often ... Flomax, in Jalyn), and terazosin; amiodarone (Cordarone, Pacerone); antifungals such as fluconazole (Diflucan), itraconazole (Onmel, Sporanox), and ...

  16. Zonisamide

    Science.gov (United States)

    ... called anticonvulsants. It works by decreasing abnormal electrical activity in the brain. ... mention any of the following: amiodarone (Cordarone, Pacerone);antifungals such as itraconazole (Sporanox) and ketoconazole (Nizoral); carbonic ...

  17. Iloperidone

    Science.gov (United States)

    ... called atypical antipsychotics. It works by changing the activity of certain natural substances in the brain. ... any of the following: amiodarone (Cordarone, Pacerone); antidepressants; antifungal medications such as itraconazole (Sporanox) and ketoconazole (Nizoral); ...

  18. Midazolam

    Science.gov (United States)

    ... of medications called benzodiazepines. It works by slowing activity in the brain to allow relaxation and sleep. ... of the following: amiodarone (Cordarone, Pacerone); aminophylline (Truphylline); antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), and ketoconazole ( ...

  19. 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

  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. Use and Outcomes of Antiarrhythmic Therapy in Patients with Atrial Fibrillation Receiving Oral Anticoagulation: Results from the ROCKET AF Trial

    Science.gov (United States)

    Steinberg, Benjamin A.; Hellkamp, Anne S.; Lokhnygina, Yuliya; Halperin, Jonathan L.; Breithardt, Günter; Passman, Rod; Hankey, Graeme J.; Patel, Manesh R.; Becker, Richard C.; Singer, Daniel E.; Hacke, Werner; Berkowitz, Scott D.; Nessel, Christopher C.; Mahaffey, Kenneth W.; Fox, Keith A.A.; Califf, Robert M.; Piccini, Jonathan P.

    2014-01-01

    Background Antiarrhythmic drugs (AAD) and anticoagulation are mainstays of atrial fibrillation (AF) treatment. Objective We aimed to study the use and outcomes of AAD therapy in anticoagulated AF patients. Methods Patients in the ROCKET AF trial (n=14,264) were grouped by AAD use at baseline: amiodarone, other AAD, or no AAD. Multivariable adjustment was performed to compare stroke, bleeding, and death across groups, as well as across treatment assignment (rivaroxaban or warfarin). Results Of 14,264 patients randomized, 1681 (11.8%) were treated with an AAD (1144 [8%] with amiodarone, 537 [3.8%] with other AADs). Amiodarone-treated patients were less-often female (38% vs. 48%), had more persistent AF (64% vs. 40%), and more concomitant heart failure (71% vs. 41%) than patients receiving other AADs. Patients receiving no AAD more closely-resembled amiodarone-treated patients. Time in therapeutic range was significantly lower in warfarin-treated patients receiving amiodarone versus no AAD (50% vs. 58%, p<0.0001). Compared with no AAD, neither amiodarone (adjusted HR 0.98, 95% CI 0.74–1.31, p=0.9) nor other AADs (adjusted HR 0.66, 95% CI 0.37–1.17, p=0.15) were associated with increased mortality. Similar results were observed for embolic and bleeding outcomes. Rivaroxaban treatment effects in patients not on an AAD were consistent with the overall trial (primary endpoint adjusted HR 0.82, 95% CI 0.68–0.98, pinteraction=0.06; safety endpoint adjusted HR 1.12, 95% CI 0.90–1.24, pinteraction=0.33). Conclusion Treatment with AADs was not associated with increased morbidity or mortality in anticoagulated patients with AF. The influence of amiodarone on outcomes in patients receiving rivaroxaban requires further study. PMID:24833235

  3. 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...

  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、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.

  6. Atrial Mapping of Sustained Atrial Fibrillation and Effects of Amiodarone on Electrophysiological Charactaristics in A Rapid Atrial Pacing Canine Model%犬快速心房起搏心房颤动模型全心房心外膜标测以及静脉胺碘酮对其心电的影响

    Institute of Scientific and Technical Information of China (English)

    王健; 刘兴鹏; 刘小青; 龙德勇; 董建增; 马长生

    2005-01-01

    探讨快速心房起搏心房颤动(简称房颤)模型房颤发作时肺静脉、左右心房各部位激动频率的差异以及胺碘酮对其电生理特性的影响.选健康雄性杂种犬10只,以400次/分的固定频率进行右心耳起搏,建立快速心房起搏房颤模型.10周后终止起搏,行64道全心房心外膜标测.标测部位分别为左右心房游离壁、左右心房顶部、左上肺静脉、左下肺静脉、右上肺静脉和右下肺静脉.记录以上部位的心外膜电图,测量各标测部位的平均房颤波周长(AFCL),并对不同部位心外膜标测电图进行频谱分析.静脉注射胺碘酮300 mg,分析胺碘酮治疗前后各部位有效不应期(ERP)和AFCL的变化.结果: 8只犬完成整个实验.在所有8只犬中,最短AFCL/ERP位于Marshall韧带的有2只,位于左下肺静脉的有6只;AFCL/ERP在心房的分布呈明显的梯度分布,自短至长依次为:肺静脉或Marshall韧带、左房游离壁和左侧Bachmann 束、右侧Bachmann束和右房游离壁;频谱分析结果与AFCL分析结果一致;胺碘酮虽然可延长肺静脉和心房各部位ERP和AFCL,但是不能终止房颤的发作.结论:局灶机制可能是快速心房起搏房颤模型的发生和维持机制.

  7. Safety analysis of intravenous amiodarone in wolff-parkinson-white syndrome with atrial fibrillation%预激综合征经旁路前传的心房颤动患者静脉注射胺碘酮的安全性分析

    Institute of Scientific and Technical Information of China (English)

    单兆亮; 王玉堂; 时向民; 闫俊瑾; 赵立朝

    2005-01-01

    目的探讨预激综合征(W-P-W)合并心房颤动(房颤)患者静脉注射胺碘酮的安全性.方法选择接受射频消融治疗的W-P-W患者及同期行隐匿性房室旁路射频消融治疗的患者(对照组)各16例,测量W-P-W组患者预激旁路前传有效不应期(ERPAP)和对照组的房室结有效不应期(ERPAVN).在10min内缓慢静脉注射胺碘酮150mg,10min后重复上述测量,并对结果进行对比分析.结果 W-P-W组用药后ERPAP有轻微延长(P<0.05),其中1例用药后缩短了60ms;对照组ERPAVN用药后明显延长(P<0.05).结论部分W-P-W合并房颤的患者静脉注射胺碘酮时,可能会促进激动经旁路下传,使心室率加快或引发心室颤动,需格外慎重.

  8. 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。

  9. 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

  10. 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。

  11. 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.

  12. 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.

  13. Increased mortality after dronedarone therapy for severe heart failure

    DEFF Research Database (Denmark)

    Køber, Lars; Torp-Pedersen, Christian; McMurray, John J V;

    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 failu...

  14. 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.

  15. Vernakalant. Too dangerous in atrial fibrillation.

    Science.gov (United States)

    2012-05-01

    The usual aim of treatment for patients with symptomatic paroxysmal or recent-onset atrial fibrillation, including after cardiac surgery, is to slow the heart rate. Electrical and drug (amiodarone) cardioversion are other options. Vernakalant, an antiarrhythmic drug, has been authorised in the European Union for rapid reduction of recent-onset atrial fibrillation. It is only available in an injectable form. Vernakalant has not been compared in clinical trials with treatments slowing the heart rate, or with electrical cardioversion. The only available comparison with another antiarrhythmic agent is a clinical pharmacology study versus amiodarone, a slow-acting drug, based on the rate of cardioversion at 90 minutes in 240 patients. As expected, given the brief observation period, the rate was significantly higher with vernakalant (51.7% versus 5.2%). During clinical evaluation, 6 deaths occurred in the vernakalant groups versus none in the other groups (placebo or amiodarone). The main adverse effects of vernakalant are cardiac arrhythmias (ventricular arrhythmia, torsades de pointes, bradycardia) and severe hypotension. Altered taste, sneezing, paraesthesia, nausea and pruritus were frequent, and respiratory and neuropsychological effects were also reported. A trial in atrial flutter was interrupted when cases of cardiogenic shock occurred. Interactions are to be expected with drugs that prolong the QT interval, and also with drugs that lower the heart rate or the blood potassium concentration. In practice, it is better to continue to use amiodarone for drug cardioversion and to avoid using vernakalant. PMID:22827000

  16. 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.

  17. 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.

  18. Microgravity spheroids as a reliable, long-term tool for predictive toxicology

    DEFF Research Database (Denmark)

    Fey, S. J.; Wrzesinski, Krzysztof

    2013-01-01

    those seen in vivo. Studies with 5 common drugs (acetaminophen, amiodarone, metformin, phenformin, and valproic acid) have shown that they are more predictive of lethally-toxic plasma levels in vivo than published studies using primary human hepatocytes. Shotgun proteomics has revealed that the gain...

  19. 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...

  20. Identifying a selective substrate and inhibitor pair for the evaluation of CYP2J2 activity.

    Science.gov (United States)

    Lee, Caroline A; Jones, J P; Katayama, Jonathan; Kaspera, Rüdiger; Jiang, Ying; Freiwald, Sascha; Smith, Evan; Walker, Gregory S; Totah, Rheem A

    2012-05-01

    CYP2J2, an arachidonic acid epoxygenase, is recognized for its role in the first-pass metabolism of astemizole and ebastine. To fully assess the role of CYP2J2 in drug metabolism, a selective substrate and potent specific chemical inhibitor are essential. In this study, we report amiodarone 4-hydoxylation as a specific CYP2J2-catalyzed reaction with no CYP3A4, or other drug-metabolizing enzyme, involvement. Amiodarone 4-hydroxylation enabled the determination of liver relative activity factor and intersystem extrapolation factor for CYP2J2. Amiodarone 4-hydroxylation correlated with astemizole O-demethylation but not with CYP2J2 protein content in a sample of human liver microsomes. To identify a specific CYP2J2 inhibitor, 138 drugs were screened using terfenadine and astemizole as probe substrates with recombinant CYP2J2. Forty-two drugs inhibited CYP2J2 activity by ≥50% at 30 μM, but inhibition was substrate-dependent. Of these, danazol was a potent inhibitor of both hydroxylation of terfenadine (IC(50) = 77 nM) and O-demethylation of astemizole (K(i) = 20 nM), and inhibition was mostly competitive. Danazol inhibited CYP2C9, CYP2C8, and CYP2D6 with IC(50) values of 1.44, 1.95, and 2.74 μM, respectively. Amiodarone or astemizole were included in a seven-probe cocktail for cytochrome P450 (P450) drug-interaction screening potential, and astemizole demonstrated a better profile because it did not appreciably interact with other P450 probes. Thus, danazol, amiodarone, and astemizole will facilitate the ability to determine the metabolic role of CYP2J2 in hepatic and extrahepatic tissues. PMID:22328583

  1. 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。

  2. 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.

  3. Dronedarone: Where Does it Fit in the AF Therapeutic Armamentarium?

    Directory of Open Access Journals (Sweden)

    James A. Reiffel, MD;

    2013-04-01

    Full Text Available Dronedarone, a derivative of amiodarone with similar mechanisms of action (blocking calcium, potassium and sodium channels in addition to having anti-adrenergic effects does not contain iodine and has shown no thyroid toxicity in its clinical trials, has fewer drug interactions than amiodarone, and has rare if any proven pulmonary toxicity.1-8 Very rarely, dronedarone has produced severe hepatic failure – not shown predictable by routine hepatic function test monitoring in its clinical trials (see the package insert for details. Dronedarone’s effects on blocking the L-type calcium current are dose/concentration dependent and require higher levels than its effects on the sodium channel and on potassium channels.1 (and, Belardinalli and Zeng, 2012 personal communication Dronedarone is approved for the treatment of atrial fibrillation (see below; has had limited studies for other arrhythmias; and has no adverse drug-ICD interactions reported.

  4. 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....

  5. 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...

  6. 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.

  7. Acute atrial fibrillation during dengue hemorrhagic fever

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    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.

  8. 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 ...

  9. Class III antiarrhythmic agents in cardiac failure: lessons from clinical trials with a focus on the Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina (GESICA).

    Science.gov (United States)

    Doval, H C

    1999-11-01

    The results of previous clinical trials, in a variety of clinical settings, showed that class I agents may consistently increase mortality in sharp contrast to the effects of beta blockers. Attention has therefore shifted to class III compounds for potential beneficial effects on long-term mortality among patients with underlying cardiac disease. Clinical trials with d-sotalol, the dextro isomer (devoid of beta blockade) of sotalol, showed increased mortality in patients with low ejection fraction after myocardial infarction and in those with heart failure; whereas in the case of dofetilide, the impact on mortality was neutral. Because of the complex effects of its actions as an alpha-adrenergic blocker and a class III agent, the impact on mortality of amiodarone in patients with heart failure is of particular interest. A meta-analysis of 13 clinical trials revealed significant reductions in all-cause and cardiac mortality among patients with heart failure or previous myocardial infarction. Among these were 5 controlled clinical trials that investigated the effects of amiodarone on mortality among patients with heart failure. None of these trials was large relative to the beta-blocker trials in the postinfarction patients. However, the larger 2 of the 5 amiodarone trials produced discordant effects on mortality, neutral in one and significantly positive in the other. Some of the differences may be accounted for by the differences in eligibility criteria and baseline characteristics. Future trials that may be undertaken to resolve the discrepancies may need to allow for the newer findings on the effects of concomitant beta blockers, implantable devices, and possibly, spironolactone. All these modalities of treatment have been shown in controlled clinical trials to augment survival in patients with impaired ventricular function or manifest heart failure. Additional trials, some of which are currently in progress, compare amiodarone with implantable devices and other

  10. Identification of novel substrates for human cytochrome P450 2J2.

    Science.gov (United States)

    Lee, Caroline A; Neul, David; Clouser-Roche, Andrea; Dalvie, Deepak; Wester, Michael R; Jiang, Ying; Jones, J P; Freiwald, Sascha; Zientek, Michael; Totah, Rheem A

    2010-02-01

    Several antihistamine drugs including terfenadine, ebastine, and astemizole have been identified as substrates for CYP2J2. The overall importance of this enzyme in drug metabolism has not been fully explored. In this study, 139 marketed therapeutic agents and compounds were screened as potential CYP2J2 substrates. Eight novel substrates were identified that vary in size and overall topology from relatively rigid structures (amiodarone) to larger complex structures (cyclosporine). The substrates displayed in vitro intrinsic clearance values ranging from 0.06 to 3.98 mul/min/pmol CYP2J2. Substrates identified for CYP2J2 are also metabolized by CYP3A4. Extracted ion chromatograms of metabolites observed for albendazole, amiodarone, astemizole, thioridazine, mesoridazine, and danazol showed marked differences in the regioselectivity of CYP2J2 and CYP3A4. CYP3A4 commonly metabolized compounds at multiple sites, whereas CYP2J2 metabolism was more restrictive and limited, in general, to a single site for large compounds. Although the CYP2J2 active site can accommodate large substrates, it may be more narrow than CYP3A4, limiting metabolism to moieties that can extend closer toward the active heme iron. For albendazole, CYP2J2 forms a unique metabolite compared with CYP3A4. Albendazole and amiodarone were evaluated in various in vitro systems including recombinant CYP2J2 and CYP3A4, pooled human liver microsomes (HLM), and human intestinal microsomes (HIM). The Michaelis-Menten-derived intrinsic clearance of N-desethyl amiodarone was 4.6 greater in HLM than in HIM and 17-fold greater in recombinant CYP3A4 than in recombinant CYP2J2. The resulting data suggest that CYP2J2 may be an unrecognized participant in first-pass metabolism, but its contribution is minor relative to that of CYP3A4. PMID:19923256

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

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    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.

  12. 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“.

  13. Atrial flutter complicating severe leptospirosis: a case report

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    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.

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

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    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.

  15. Dronedarone.

    Science.gov (United States)

    Tamargo, J; López-Farré, A; Caballero, R; Delpón, E

    2011-02-01

    Atrial fibrillation (AF), the most common cardiac arrhythmia, is associated with substantial morbidity and mortality. Dronedarone is an amiodarone-like benzofuran which lacks the iodine moiety and presents a methane sulfonyl group that decreases its lipophilicity, thus shortening the half-life and decreasing tissue accumulation. Like amiodarone, dronedarone blocks multiple cardiac ion channels and β-adrenoceptors, presenting electrophysiological characteristics of all four Vaughan Williams classes of antiarrhythmic drugs. In clinical trials, dronedarone has been found effective for both rhythm and rate control. Dronedarone was more effective than placebo in maintaining sinus rhythm in patients with paroxysmal and/or persistent AF and was also effective for ventricular rate control during AF recurrences, providing incremental rate control on top of standard drugs in permanent AF. Furthermore, in the ATHENA trial, dronedarone reduced the incidence of hospitalization due to cardiovascular events or death in patients with nonpermanent AF. Even when dronedarone was less effective than amiodarone in decreasing AF recurrence, it had a better safety profile, being devoid of thyroid, pulmonary and neurological toxicity. This review analyzes the electrophysiological and pharmacological properties, as well as the efficacy and safety of dronedarone in patients with atrial fibrillation.

  16. 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

  17. 1例房颤合并真菌感染患者室性心动过速诱因分析%Inducement Analysis of 1 Case of Ventricular Tachycardia in Patient with Atrial Fibrillation Complicated with Fungal Infection

    Institute of Scientific and Technical Information of China (English)

    郑重践; 林妙娴

    2014-01-01

    To analyze the cause of ventricular tachycardia in patient with atrial fibrillation complicated with fungal infection during the course of treatment.An increased risk of arrhythmia will be caused by many factors, such as hypokalemia, fluconazole combined with ami-odarone, et al.However, greater risk will be caused by a combination of amiodarone and fluconazole (0.4 g・ d-1 ).Great attention should be paid to the dosage of fluconazole under the necessary combination of fluconazole and amiodarone.%分析1例房颤合并真菌感染患者治疗过程中出现室性心动过速的诱因。可能导致本例室性心律失常发生的因素有低钾血症、氟康唑与胺碘酮联用,但氟康唑加量至0.4 g・ d -1时联合使用胺碘酮风险更大。临床在不可避免将氟康唑与胺碘酮联用时,应注意氟康唑的给药剂量。

  18. 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.

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

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    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.

  20. 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

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. [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

  6. 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

  7. Paroxysmal Supraventricular Tachycardia on Children: Clinical Analysis of 37 cases%小儿阵发性室上性心动过速37例临床分析

    Institute of Scientific and Technical Information of China (English)

    张文祥; 李自普; 聂娜娜; 王思平; 锡洪敏

    2012-01-01

    目的:对比研究和评价不同方法治疗小儿阵发性室上性心动过速(PSVT)的的疗效,提高转复率.方法:回顾性分析2002.04-2011.05我院住院治疗的37例PSVT患儿的临床资料,并分析比较心律平与胺碘酮的药物转复率,构成比采用x2检验,α=0.05.结果:37例患儿中,13例治疗原发病后自动转率,24例患儿给予心律平治疗,其中1例放弃治疗,5例未见效,心律平转复率为69.77%,5例未见效患儿改用胺碘酮治疗,1例死于原发病,1例控制症状后行射频消融术治愈,胺碘酮转复率为75%,二者之间无显著差异性.结论:心律平与胺碘酮均能较好的治疗小儿PSVT,对于反复发作,药物治疗无效的小儿PSVT,射频消融术已成为最佳选择.%To investigate the curative effect of different methods on treating paroxysmal supraventrieular tachycardia of children.Methods:37 cases were retrospective analyzed with regard.The conversion rates of propafenone and amiodarone were analysis by chi-square test,α=0.05.Results:Of 37 children,13 cases had automatic conversion aiter curing the primary desease,24 cases were given propafenone,1 case gave up,5 cases had no effect.The propafenone conversion rate was 69.77%.5 cases with amiodarone,1case died of dilated cardiomyopathy,1 case cured by Radiofrequency ablation after controlling clinical symptoms,the amiodarone conversion rate was 75%.There was no significant difference between them.Conclusion:The propafenone and amiodarone all lad better conversion rate in children with paroxysmal supraventricular tachycardia,For the complexity and intractable paroxysmal supraventricular tachycardia,radiofrequency catheter ablation was become the best choice for the pediatric patients.

  8. [Arrhythmias from swallowing].

    Science.gov (United States)

    Palazzuoli, V; Mondillo, S; Faglia, S; D'Aprile, N; De Luca, G; Kristodhullu, A; Corba, E

    1992-01-01

    We describe the case of a 51-year old, non cardiopathic patient, with recurrent attacks of supraventricular tachycardia induced by swallowing. In the existing literature we found several descriptions of hypokinetic arrhythmias, easily explained by a mechanism of vagal inhibition. The cases of predominantly hyperkinetic arrhythmias, however, are much less common. In these patients the origin of the disease seems to be due to sympathetic oesophageal fibers and superior and medium cardiac nerves. In the present case, as in the others reported in the literature, the drug of choice seems to be Amiodarone which appears to be the most effective in preventing tachyarrhythmias caused by swallowing.

  9. Determination of Drug Toxicity Using 3D Spheroids Constructed From an Immortal Human Hepatocyte Cell Line

    DEFF Research Database (Denmark)

    Fey, S. J.; Wrzesinski, Krzysztof

    2012-01-01

    Numerous publications have documented that the immortal cells grown in three-dimensional (3D) cultures possess physiological behavior, which is more reminiscent of their parental organ than when the same cells are cultivated using classical two-dimensional (2D) culture techniques. The goal...... that a precise dose can be provided in a manner similar to in vivo studies. This avoided correction of the actual dose given based on a protein determination after treatment (when some cells may have lysed). Conversion of published in vitro LC50 data (mM) for six common drugs (acetaminophen, amiodarone...

  10. Delayed ventricular repolarization as an anti-arrhythmic principle.

    Science.gov (United States)

    Vaughan Williams, E M

    1985-11-01

    Depolarization of cardiac muscle is achieved by 'fast inward current' through channels which are inactivated within about 1 ms. When the cells are repolarized the process of inactivation of fast channels is rapidly reversed. The class 1 anti-arrhythmic drugs delay the disappearance of inactivation until long after repolarization is complete. In theory, it should be possible to produce a similar extension of refractory period by delaying the repolarization itself. Quinidine and disopyramide caused minor delays of repolarization, but both were primarily class 1 agents, and in addition had undesirable anticholinergic activity. Amiodarone, already in use for many years as an antianginal drug, prolonged action potential duration (APD) and was shown to have an anti-arrhythmic action in rabbits, dogs and man. Although prolongation of APD lengthens QT, a long QT may be caused by phenomena other than prolonged APD, such as heterogeneity of sympathetic drive. Association of long QT with arrhythmia does not, therefore, invalidate the principle that homogeneously prolonged APD should be anti-arrhythmic. In practice, amiodarone, bretylium, sotalol, thyroidectomy, and long-term beta-blockade prolong APD, and are associated with low incidence of arrhythmia. Many mechanisms controlling cardiac repolarization have been proposed, but how repolarization is delayed by individual agents is not fully elucidated.

  11. Dronedarone: a new antiarrhythmic agent.

    Science.gov (United States)

    Oyetayo, Ola O; Rogers, Carrie E; Hofmann, Prudence O

    2010-09-01

    Dronedarone is an antiarrhythmic agent recently approved by the United States Food and Drug Administration for the reduction of cardiovascular-related hospitalizations in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. The drug is a derivative of amiodarone and has been modified to reduce the organ toxicities frequently encountered with amiodarone. Dronedarone exerts its antiarrhythmic effects through multichannel blockade of the sodium, potassium, and calcium channels and also possesses antiadrenergic activity, thereby exhibiting pharmacologic effects of all four Vaughan Williams classes of antiarrhythmics. The efficacy of dronedarone for the maintenance of sinus rhythm, ventricular rate control, and reduction in cardiovascular-related hospitalizations has been demonstrated in several randomized, placebo-controlled trials. Although a high rate of gastrointestinal events (e.g., nausea, vomiting, and diarrhea) has been associated with dronedarone, more serious adverse events such as thyroid, liver, or pulmonary toxicities have not been observed. Because of a possible increase in mortality, dronedarone should be avoided in patients with New York Heart Association class IV or II-III heart failure with a recent decompensation. Given the efficacy and safety data currently available, dronedarone represents a reasonable alternative for maintenance of sinus rhythm in appropriately selected patients.

  12. 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.

  13. 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 ...

  14. Autophagy-preferential degradation of MIR224 participates in hepatocellular carcinoma tumorigenesis.

    Science.gov (United States)

    Lan, Sheng-Hui; Wu, Shan-Ying; Zuchini, Roberto; Lin, Xi-Zhang; Su, Ih-Jen; Tsai, Ting-Fen; Lin, Yen-Ju; Wu, Cheng-Tao; Liu, Hsiao-Sheng

    2014-09-01

    Autophagy and microRNA (miRNA) are important regulators during cancer cell tumorigenesis. Impaired autophagy and high expression of the oncogenic microRNA MIR224 are prevalent in hepatocellular carcinoma (HCC); however, the relationship between the 2 phenomena remains elusive. In this study, we are the first to reveal that autophagy selectively regulates MIR224 expression through an autophagosome-mediated degradation system. Based on this finding, we further demonstrated that in hepatitis B virus (HBV)-related HCC, aberrant autophagy (low autophagic activity) results in accumulation of MIR224 and decreased expression of the target gene Smad4, which leads to increased cell migration and tumor formation. Preferential recruitment of MIR224 into the autophagosome was clearly demonstrated by a) miRNA in situ hybridization under confocal microscopy, and b) immunogold labeling of MIR224 under electron microscopy compared with a ubiquitously expressed microRNA MIRlet7e/let-7. Furthermore, we found that off-label use of amiodarone, an antiarrhythmic agent, effectively suppressed HCC tumorigenesis through autophagy-mediated MIR224 degradation both in vitro and in vivo. In summary, we identified amiodarone as a new autophagy inducer, which may provide an alternative approach in HCC therapy through a novel tumor suppression mechanism.

  15. Taquiarritmias supraventriculares fetales refractarias al tratamiento inicial Fetal supraventricular tachyarrhythmias refractory to initial therapy

    Directory of Open Access Journals (Sweden)

    Eduardo Malvino

    2005-04-01

    Full Text Available Las arritmias fetales representan un motivo infrecuente de ingreso a la unidad de cuidados intensivos. Se presenta tres casos de gestantes entre 27 y 32 semanas, con el diagnóstico de taquiarri-tmias supraventriculares fetales sostenidas, que exhibían fracaso en el intento inicial de reversión con digoxina. Dos casos con taquicardia supraventricular respondieron favorablemente cuando se asoció flecainida. Un feto hidrópico con aleteo auricular y bloqueo 2:1 no revirtió con la asociación de flecainida ni amiodarona a la digoxina y requirió la interrupción de la gestación en la 30ª semana. El neonato presentó disfunción tiroidea transitoria atribuida a la administración de amiodarona.Fetal arrhythmia is an unusual cause of admission in critical care unit. We report three cases of pregnant patients with gestational age of 27 to 32 weeks, with diagnosis of fetal sustained supraventricular tachyarrhymias; which were resistant to digoxin as first line therapy. Two fetuses had supraventricular tachycardia and were converted with flecainide in association with digoxin. A remaining hydropic fetus suffering atrial flutter with 2:1 auriculo-ventricular conduction, failed to restore sinus rhythm with digoxin alone or in association with flecainide nor amiodarone, and required premature c-section at 30ª week of gestation. Due to amiodarone administration the neonate suffered transient neonatal hypothyroidism.

  16. 1例心力衰竭患者的药学监护%Pharmaceutical care on a patient with heart failure

    Institute of Scientific and Technical Information of China (English)

    白颖; 王家伟

    2016-01-01

    1例58岁女性患者,因心力衰竭加重合并房颤、肺部感染和慢性丙型肝炎入院治疗,给予抗心衰、控制房颤及抗感染等药物治疗。入院后予以托拉塞米(20 mg,iv)、去乙酰毛花苷(0.4 mg,iv)抗心衰治疗,给予莫西沙星(0.4 g,qd,ivgtt)抗感染治疗,给予胺碘酮(150 mg,iv)控制房颤,患者肝功能及凝血功能进一步恶化,ALT 1052 IU·L-1,AST 2784 IU·L-1,INR 13.18。临床药师分析患者所用药物中莫西沙星和胺碘酮可加重肝脏损伤及凝血障碍,此外,胺碘酮还可促进华法林的抗凝作用。临床药师建议停用莫西沙星和胺碘酮,输注新鲜冰冻血浆,抗生素更换为美罗培南,同时给予保肝治疗。停药9 d,INR 1.31。停药13 d,ALT 51 IU·L-1,AST 29 IU·L-1。在此监护过程中,临床药师与医生进行及时的沟通,根据患者情况分析治疗方案并提出个体化治疗方案建议,提高了药物治疗效果,确保了患者的用药安全。%One 58-year-old female patient with atrial fibrillation, pulmonary infection and chronic hepatitis C was hospitalized because of aggravation of heart failure. The patient received torasemide (20 mg, iv) and deslanoside (0.4 mg, iv) for heart failure therapy, moxilfoxacin (0.4 g, qd, ivgtt) for anti-infection and amiodarone (150 mg, iv) for atrial ifbrillation control. But the liver function and coagulative function of patient were aggravated. The alanine aminotransferase (ALT) was 1052 IU·L-1, aspartate aminotransferase (AST) was 2784 IU·L-1 and international normalized ratio (INR) was 13.18. The clinical pharmacists suggested to withdraw the moxifloxacin and amiodarone. Considering that moxifloxacin and amiodarone could lead to the deterioration of liver and coagulative function and amiodarone could promote the anticoagulation of warfarin, clinical pharmacists advised that moxilfoxacin and amiodarone should be stopped, while fresh

  17. Potassium ion channels remodeling in rapid atrial pacing right atrium of rabbits with Microelectrode arrays%钾通道阻断剂对心房快速起搏兔右心耳场电位时限的影响

    Institute of Scientific and Technical Information of China (English)

    孙娟; 侯月梅; 刘政疆; 张玲; 冯艳

    2010-01-01

    目的 应用微电极阵列(MEA)研究钾通道阻断剂对快速起搏(RAP)兔右心耳场电位时限(fAPD)的变化.方法 成年新西兰大白兔40只,体重2.5~3.0 kg,雌雄不拘,由新疆医科大学动物实验中心提供,动物质量属于一级标准.随机分为3组,对照组(non-pace,n=8),起搏+钾通道阻断剂组(TEA、4-AP和BaCl2,每组n=8),起搏+胺碘酮组(n=8).RAP 24 h后,迅速开胸取心脏,剪下右心耳,随即切片(厚度500 μm),将标本固定在MEA记录系统.分别记录正常对照组,给予阻断剂及胺碘酮组MEA形态和fAPD改变.结果 对照组右心耳fAPD为(188.33±18.29)ms,起搏组fAPD为(173.91±6.83)ms.给予20 mmol/L TEA阻断IK,fAPD由(176.67±8.66)ms延长到(196.11±10.76)ms(P=0.012),5 mmol/L 4-AP阻断Ito,fAPD由(169.38±10.56)ms延长到(188.56±13.82)ms(P=0.005).10-4mol/L BaCl2阻断I Kir,fAPD由(182.22±12.87)ms延长到(191.11±13.09)ms(P=0.039).2×10-6mmol/L胺碘酮使fAPD由(167.38±13.67)ms延长到(185.00±15.14)ms(P=0.002).结论 应用MEA技术町真实客观反映心肌组织切片的电生理特性.24 h RAP后,以阻断,Ito,IKur,IK1和IKs为主的钾通道阻断剂延长右心耳fAPD.胺碘酮可有效逆转或阻止右心耳fAPD的延长.%Objective To explore the effects of potassium ion channel blocker on field action potential duration (fAPD) of right atrial appendage (RAA) during rapid atrial pacing (RAP) by Microelectrode arrays.Methods Fourty New Zealand white rabbits of either sex (weight 2.5 to 3.0 kg,n=40)were randomly divided into 3 groups:control groups,potassium ion channel blocker groups(TEA,4-Ap and BaCl2)and amiodarone groups.All animals were anesthetized with pentobarbital(30 ms/kg followed by 5 mg/kg/h,i.v.).The hearts were quickly removed and right atrial appendage (RAA) sliced (slice thickness 500 μm).Each slice was perfused with Tyrode's solution and continuously stimulated about 30 min.Control groups received Tyrode's solution superfusion 10 min,blocker groups and

  18. 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

  19. 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.

  20. Identification by automated screening of a small molecule that selectively eliminates neural stem cells derived from hESCs but not dopamine neurons.

    Directory of Open Access Journals (Sweden)

    Yi Han

    Full Text Available BACKGROUND: We have previously described fundamental differences in the biology of stem cells as compared to other dividing cell populations. We reasoned therefore that a differential screen using US Food and Drug Administration (FDA-approved compounds may identify either selective survival factors or specific toxins and may be useful for the therapeutically-driven manufacturing of cells in vitro and possibly in vivo. METHODOLOGY/PRINCIPAL FINDINGS: In this study we report on optimized methods for feeder-free culture of hESCs and hESC-derived neural stem cells (NSCs to facilitate automated screening. We show that we are able to measure ATP as an indicator of metabolic activity in an automated screening assay. With this optimized platform we screened a collection of FDA-approved drugs to identify compounds that have differential toxicity to hESCs and their neural derivatives. Nine compounds were identified to be specifically toxic for NSCs to a greater extent than for hESCs. Six of these initial hits were retested and verified by large-scale cell culture to determine dose-responsive NSC toxicity. One of the compounds retested, amiodarone HCL, was further tested for possible effects on postmitotic neurons, a likely target for transplant therapy. Amiodarone HCL was found to be selectively toxic to NSCs but not to differentiated neurons or glial cells. Treated and untreated NSCs and neurons were then interrogated with global gene expression analysis to explore the mechanisms of action of amiodarone HCl. The gene expression analysis suggests that activation of cell-type specific cationic channels may underlie the toxicity of the drug. CONCLUSIONS/SIGNIFICANCE: In conclusion, we have developed a screening strategy that allows us to rapidly identify clinically approved drugs for use in a Chemistry, Manufacture and Control protocol that can be safely used to deplete unwanted contaminating precursor cells from a differentiated cell product. Our results

  1. 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.

  2. Drug-induced hepatic steatosis.

    Science.gov (United States)

    Amacher, David E; Chalasani, Naga

    2014-05-01

    Several drugs have been associated with the potential for drug-induced hepatic steatosis (DIHS) and/or phospholipidosis (DIPL), a lysosomal storage disorder. Drug-induced hepatic steatosis is generally a chronic but reversible affliction and may involve drug accumulation in the liver. Fat accumulation may be either macrovesicular or microvesicular in nature. Commonly used medications associated with DIHS include amiodarone, valproate, tamoxifen, methotrexate, and some chemotherapeutic and antiretroviral agents. Two recently approved medications for the treatment of hereditary homozygous hypercholesterolemia have also been noted to cause hepatic steatosis. For some compounds such as methotrexate and tamoxifen, the underlying metabolic risk factors such as obesity and metabolic syndrome may exacerbate their potential to cause DIHS and its progression. In this article, the authors discuss the preclinical screening and mechanisms of DIHS and DIPL, and review specific examples of drugs commonly used in clinical practice that are known to cause DIHS. PMID:24879984

  3. 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.

  4. 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)

  5. 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.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    S. N. Bel'diev

    2015-01-01

    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. 

  8. 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.

  9. An unexpected side-effect of a commonly used drug.

    Science.gov (United States)

    Fernández González, Francisco; Miranda, Samayra; Santiago Casiano, Mónica; Nieves, José; Adorno, Edgardo; Fernández González, Ricardo

    2013-01-01

    We report a case of a 68 year-old-female patient with clinical features of drug-induced lupus erythematosus after five years of treatment with amiodarone. She presented generalized skin rash, arthralgia on upper and lower extremities, associated with difficulty to walk. Remarkable laboratory results revealed a positive antinuclear antibody test and a skin rash biopsy showing a superficial and deep perivascular infiltrate of lymphocytes, histiocytes, and eosinophils. Once the etiology of the patient's symptoms was identified, the culprit drug was removed and she had a complete remission of all signs and symptoms. Early diagnose should be recognized for prompt intervention and avoid further complications associated with this rare side-effect.

  10. 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

  11. 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

  12. [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

  13. 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)

  14. 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.

  15. Permanent junctional reciprocating tachycardia in a dog.

    Science.gov (United States)

    Santilli, Roberto A; Santos, Luis F N; Perego, Manuela

    2013-09-01

    A 5-year-old male English Bulldog was presented with a 1-year history of paroxysmal supraventricular tachycardia (SVT) partially responsive to amiodarone. At admission the surface ECG showed sustained runs of a narrow QRS complex tachycardia, with a ventricular cycle length (R-R interval) of 260 ms, alternating with periods of sinus rhythm. Endocardial mapping identified the electrogenic mechanism of the SVT as a circus movement tachycardia with retrograde and decremental conduction along a concealed postero-septal atrioventricular pathway (AP) and anterograde conduction along the atrioventricular node. These characteristics were indicative of a permanent junctional reciprocating tachycardia (PJRT). Radiofrequency catheter ablation of the AP successfully terminated the PJRT, with no recurrence of tachycardia on Holter monitoring at 12 months follow-up.

  16. La néphrotoxicite secondaire à l'hyperbilribinemie: à propos d'un cas

    Science.gov (United States)

    Jomni, Med Taieb; Largueche, Mouna; Kaab, Badreddine Ben; Abdelaal, Imen; Bellakhal, Syrine; Douggui, Med Hédi

    2015-01-01

    L'hyperbilirubinémie à des taux élevés est nephrotoxique par divers mécanismes allant de la tubulopathie proximale aux dépôts massifs de bilirubine. Cette entité bien que décrite depuis le début du vingtième siècle est souvent méconnue dans la littérature moderne. Nous rapportons le cas d'un patient présentant une cirrhose probablement d'origine médicamenteuse (Amiodarone*), dont la fonction rénale s'est altérée parallèlement à la majoration de l'hyperbilirubinémie. Aucune autre cause de l'insuffisance rénale aigue n'a été retrouvée. PMID:26977222

  17. Antiarrhythmic therapy and risk of death in patients with atrial fibrillation: a nationwide study

    DEFF Research Database (Denmark)

    Andersen, Søren Skøtt; Hansen, Morten Lock; Gislason, Gunnar H;

    2009-01-01

    by individual-level linkage of nationwide registries. Multivariable Cox proportional-hazard models with time-dependent covariates were used to analyse the risk of death associated with AAD therapy. A total of 141,500 patients were included in the study; of these 3356 (2.4%) patients received treatment......AIMS: To examine the risk of death associated with antiarrhythmic drug (AAD) therapy in a nationwide unselected cohort of patients with atrial fibrillation (AF). METHODS AND RESULTS: All patients admitted with AF in Denmark from 1995 to 2004 and their subsequent use of AADs were identified...... increased risk of death associated with any of the AADs. Hazard ratio (95% confidence interval) for flecainide 0.38 (0.32-0.44), propafenone 0.65 (0.58-0.71), sotalol 0.65 (0.63-0.67), and amiodarone 0.94 (0.89-1.00). CONCLUSION: In an unselected cohort of patients with AF, antiarrhythmic treatment...

  18. [Role of surgery in treatment of hyperthyroidism].

    Science.gov (United States)

    Martin, F; Caporal, R; Tran Ba Huy, P

    1999-09-01

    Hyperthyroidism is treated with antithyroid drugs, radioactive iodine or surgery. The aim of surgery is to obtain long-lasting euthyroidism with a minimal risk of recurrence, secondary hypothyroidism, and complications involving the recurrent nerve or the parathyroids. Depending on the etiology, total or partial resection is indicated in light of these objectives. According to the literature, surgery is not used as first intention treatment for Grave's disease, its role and indications remaining a question of debate. However, surgery is the treatment of choice for toxic nodules, current consensus favoring extracapsular total lobectomy. For multinodular toxic goiter, three are several surgical indications: failure of medical treatment, relapse after drug withdrawal, specific clinical or socioeconomic situations requiring rapid efficacy. Total lobectomy associated with subtotal contralateral hemithyroidectomy appears to be the most appropriate procedure. Surgery may also be indicated for treatment of pregnancy-, diabetes-, or amiodarone-induced hyperthyroidism. PMID:10519008

  19. Taquicardia supraventricular en recién nacido: Un reto diagnóstico y terapéutico en la práctica médica / Supraventriculartachycardia in a newborn: A diagnostic and therapeuticchallenge in medical practice

    Directory of Open Access Journals (Sweden)

    Elibet Chávez González

    2015-10-01

    Full Text Available Supraventricular tachycardias in children are the fastest rhythms most frequently reported (70%. Orthodromic tachycardia is that which usually occurs in newborns, and its treatment with amiodarone together with beta blockers has an effectiveness of 63%. However, the combination of antiarrhythmic drugs in children and infants is not recommended because of the proarrhythmic effects. Electrophysiological study and radiofrequency ablation are reserved for older children, where there is less risk of procedures; besides little risk has been reported in children with accessory pathways. The case of an 11-day-old newborn who presented two electrocardiographically different episodes of tachycardia is reported. Those episodes suggested unequal production mechanisms of the arrhythmia, which was difficult to control and needed the combination of three antiarrhythmic drugs for maintaining sinus rhythm.

  20. 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.

  1. Dronedarone: an emerging therapy for atrial fibrillation.

    Science.gov (United States)

    Rosei, Enrico Agabiti; Salvetti, Massimo

    2010-06-01

    Atrial fibrillation (AF) is a common arrhythmia, with a prevalence ranging from 0.1% to 9.0% at different ages, and is associated with increased cardiovascular events and mortality. A significant increase in the prevalence of the disease is expected to occur in the coming years as a consequence of the aging of the population and advances in the management of coronary artery disease and heart failure. Effective rhythm control may be difficult to obtain in a significant proportion of patients with AF. The limited efficacy and the possible adverse effects of antiarrhythmic drugs has led researchers to focus their attention on new molecules, in a search of compounds with antiarrhythmic efficacy and a more favourable safety profile. Among several new drugs developed for the management of AF, dronedarone, a benzofuran derivative that shares many of the antiarrhythmic properties of amiodarone, but with a more favourable safety profile, seems particularly promising. The drug is noniodinated, has less lipophilicity, reaches therapeutic concentrations over a shorter period of time and has lower tissue accumulation. Dronedarone, similarly to amiodarone, exhibits electrophysiologic characteristics of all 4 Vaughan Williams classes. Clinical studies have shown that dronedarone effectively reduces ventricular rate, may prevent or delay the recurrence of AF, and may reduce cardiovascular morbidity and mortality in patients with AF or atrial flutter. The drug has an overall good safety profile, in particular with low pulmonary and thyroid toxicity. An important exception is represented by patients with unstable haemodynamic conditions, in which the use of dronedarone has been found to be associated with an increase in mortality. Dronedarone has been recently approved for clinical use by the Food and Drug Administration and by the European Medicines Agency. Further results from trials and clinical use will better define the efficacy and safety profile of dronedarone in AF compared

  2. 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.

  3. 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

  4. 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

  5. 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

  6. 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.

  7. 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.

  8. 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

  9. CHANGES IN THE LEVEL OF NATRIURETIC PEPTIDES IN PATIENTS WITH ATRIAL FIBRILLATION TREATED WITH ANTIARRHYTHMIC DRUGS

    Directory of Open Access Journals (Sweden)

    V. I. Podzolkov

    2015-09-01

    Full Text Available Aim. To study the changes of plasma levels of NT-proBNP and NT-proANP in patients with persistent atrial fibrillation (AF treated with various antiarrhythmic drugs.Material and methods. Patients with persistent AF (n=123 aged 39-83 years old were included into the study. The patients were divided into 2 groups: group 1 included patients with arterial hypertension (n=61, group 2 - patients with ischemic heart disease (IHD; n=62. After sinus rhythm restoration the patients were divided into 4 subgroups. Patients of 1A subgroup used propafenone to maintain sinus rhythm during the next 6 months, while patients of 2A subgroup used amiodarone. Patients of 1B and 2B subgroups used bisoprolol to control ventricular rate. Plasma natriuretic peptide levels were evaluated in all patients during the first 3 days after the sinus rhythm restoration and 6 months after.Results. Increased levels of NT-proBNP and NT-proANP in the first days after the sinus rhythm restoration were found in patients of both groups and were associated with the episode of AF. After 6 months of treatment the reduction of NT-proBNP and NT-proANP levels was found in patients of 1A subgroup (NT-proBNP: from 160.5±15.2 pg/ml to 130.1±12.2 pg/ml; NT-proANP: from 15.3±6.4 nmol/L to 11.5±5.3 nmol/L, p<0.05 for both and of 2A subgroup (NT-proBNP: from 180.2±12.7 to 120.6±10.9 pg/ml; NT-proANP: from 17.1±7.1 to 11.8±7.2 nmol/L, p<0.05 for both. NT-proBNP and NT-proANP levels were decreasing consistently both in hypertensive patients receiving propafenone and in IHD patients taking amiodarone. No significant changes in NT-proBNP and NT-proANP levels were found in patient of subgroups 1B and 2B during the follow-up.Conclusion. Increased plasma levels of NT-proBNP and NT-proANP were found in the first days after the restoration of sinus rhythm in patients with persistent AF, and after 6 months of sinus rhythm maintenance these levels reduced significantly.

  10. 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

  11. 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

  12. 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.

  13. 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

  14. 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

  15. 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.

  16. 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.

  17. 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)

  18. [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

  19. Calcium dependence of eugenol tolerance and toxicity in Saccharomyces cerevisiae.

    Science.gov (United States)

    Roberts, Stephen K; McAinsh, Martin; Cantopher, Hanna; Sandison, Sean

    2014-01-01

    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.

  20. 静脉用乙胺碘呋酮在心律失常急诊中的应用

    Institute of Scientific and Technical Information of China (English)

    杜军

    2002-01-01

    @@ 乙胺碘呋酮(Amiodarone,简称胺碘酮,AMD)是1962年作为冠状动脉扩张剂开发的.1967年作为治疗心绞痛药物在比利时等国家上市.1974年Rasenbaum等报告作为抗心律失常药物也有效.1985年在美国上市,1992年获得日本厚生省认可[1].以前按Vaughan Williams分类属Ⅲ型药物,其后的研究显示AMD具有类似Ⅰ型和Ⅱ型药物作用,还具有甲状腺修饰,改变膜磷脂代谢,抑制细胞因子产生等作用,其药理作用十分复杂.本文仅就静脉用AMD在心律失常急诊中的应用介绍如下.

  1. A classification of antiarrhythmic actions reassessed after a decade of new drugs.

    Science.gov (United States)

    Vaughan Williams, E M

    1984-04-01

    The past decade has seen the introduction of many new class 1 drugs, restricting fast inward current. Confirmative evidence has been obtained that the antiarrthymic action of lidocaine and diphenylhydantoin is indeed due to their effect as class 1 agents depressing conduction. The original class 3 drug, amiodarone, is increasingly in use as an antiarrhythmic of first choice for WPW and for arrhythmias associated with hypertrophic myopathy, and as a reserve drug in resistant arrhythmias of other types. Other compounds delaying repolarization have proved to be clinically effective as antiarrhythmics. In addition to their class 2 antiarrhythymic action exhibited acutely, on long-term treatment beta blockers have a class 3 action, which might be, at least in part, responsible for the protection of postinfarction patients against sudden death. Recent research suggests that inhibition of slow inward current may lead, as a secondary consequence of lowered [Ca]i, to improved cell-to-cell conduction. Finally, all but one of the new antiarrhythmic drugs, none of which existed in 1972, have turned out to possess one or more of the four classes of action originally described. This can hardly be a coincidence. The single exception, alinidine, a selective bradycardic agent, may restrict anionic currents, which would constitute a fifth class of action, but this is far from proved.

  2. Ventricular ectopy and QTc-interval prolongation associated with dronedarone therapy.

    Science.gov (United States)

    Gonzalez, Jaime E; Sauer, William H; Krantz, Mori J

    2013-10-01

    Amiodarone is an effective treatment for atrial and ventricular arrhythmias, but its use is limited by a toxic adverse-effect profile. Although dronedarone has been touted as an antiarrhythmic agent devoid of both solid organ toxicity and proarrhythmic properties, its potential for prolonging ventricular repolarization may augment triggered ectopy. We describe a 66-year-old man who began dronedarone 400 mg twice/day for new-onset paroxysmal atrial fibrillation; he had no left ventricular dysfunction or clinical heart failure. Three months after starting the drug, he complained of malaise, fatigue, and rare palpitations. Twenty four-hour Holter monitoring revealed increased premature ventricular complexes, and the rate-corrected QT (QTc) interval was prolonged (range 525-760 msec). Dronedarone was discontinued and the patient's symptoms gradually resolved over the next 3 weeks. Holter monitoring revealed a marked reduction in ventricular ectopy burden, and the QTc interval decreased to his baseline values. Even in the absence of documented symptomatic torsade de pointes, this case suggests that caution should be exercised when prescribing dronedarone and that serial QTc interval monitoring may be appropriate. In addition, clinicians should have a low threshold to perform Holter monitoring if symptoms develop during dronedarone therapy.

  3. 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

  4. 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

  5. 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

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

    Science.gov (United States)

    Haugan, Ketil; Lam, Henrik Rye; Knudsen, Carsten Boye; Petersen, Jørgen Søberg

    2004-07-01

    Non-pharmacological in vivo models of atrial fibrillation (AF) have been developed in large animals only. We aimed to develop and characterize a new small animal non-pharmacological in vivo model of AF. AF was induced by transesophageal atrial burst pacing during 35 seconds periods of asphyxia in 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 AAP10 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 verapamil. Relative to existing models of AF in larger animals, this model offers rapid, predictive, and inexpensive testing of antiarrhythmic/profibrillatory effects of new drugs.

  7. 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.

  8. 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.

  9. 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.)

  10. 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.

  11. 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.

  12. 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 ...

  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. 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.

  15. 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.

  16. 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

  17. 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

  18. 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

  19. 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

  20. 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

  1. 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

  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. 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.

  5. Determination of the sputtering yield of cholesterol using Arn(+) and C60(+(+)) cluster ions.

    Science.gov (United States)

    Rakowska, P D; Seah, M P; Vorng, J-L; Havelund, R; Gilmore, I S

    2016-08-01

    The sputtering yield of cholesterol films on silicon wafers is measured using Arn(+) and C60(+(+)) ions in popular energy (E) and cluster size (n) ranges. It is shown that the C60(+(+)) ions form a surface layer that stabilizes the film so that a well-behaved profile is obtained. On the other hand, the Arn(+) gas clusters leave the material very clean but, at room temperature, the layer readily restructures into molecular bilayers, so that, although a useful measure may be made of the sputtering yield, the profiles become much more complex. This restructuring does not occur at room temperature normally but results from the actions of the beams in the sputtering process for profiling in secondary ion mass spectrometry. Better profiles may be made by reducing the sample temperature to -100 °C. This is likely to be necessary for many lower molecular weight materials (below 1000 Da) to avoid the movement of molecules. Measurements for cholesterol films on 37 nm of amiodarone on silicon are even better behaved and show the same sputtering yields at room temperature as those films directly on silicon at -100 °C. The yields for both C60(+(+)) and Arn(+) fit the Universal Equation to a standard deviation of 11%.

  6. Estimation of iodine intake from various urinary iodine measurements in population studies

    DEFF Research Database (Denmark)

    Vejbjerg, P.; Knudsen, N.; Perrild, H.;

    2009-01-01

    Background: Iodine intake is often measured by a surrogate measure, namely urine iodine excretion as almost all ingested iodine is excreted in the urine. However, the methods for urine collection and the reporting of the results vary. These methods, and their advantages and disadvantages, are con......Background: Iodine intake is often measured by a surrogate measure, namely urine iodine excretion as almost all ingested iodine is excreted in the urine. However, the methods for urine collection and the reporting of the results vary. These methods, and their advantages and disadvantages...... or concentration and reported without modification or as a function of creatinine in the same sample. The 24-hour urine for iodine measurement is often considered as the “reference standard” for giving a precise estimate of the individual iodine excretion and thereby iodine intake. As 24-hour collections...... iodine intake, makes the iodine measurement in spot urine samples unreliable for evaluating individuals for iodine deficiency, though they can be used to screen for exposure to large amounts of iodine from sources such as amiodarone and certain radiographic contrast agents. In populations of at least 500...

  7. 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).

  8. 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 ...

  9. 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.

  10. 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.

  11. The virtual heart as a platform for screening drug cardiotoxicity.

    Science.gov (United States)

    Yuan, Yongfeng; Bai, Xiangyun; Luo, Cunjin; Wang, Kuanquan; Zhang, Henggui

    2015-12-01

    To predict the safety of a drug at an early stage in its development is a major challenge as there is a lack of in vitro heart models that correlate data from preclinical toxicity screening assays with clinical results. A biophysically detailed computer model of the heart, the virtual heart, provides a powerful tool for simulating drug-ion channel interactions and cardiac functions during normal and disease conditions and, therefore, provides a powerful platform for drug cardiotoxicity screening. In this article, we first review recent progress in the development of theory on drug-ion channel interactions and mathematical modelling. Then we propose a family of biomarkers that can quantitatively characterize the actions of a drug on the electrical activity of the heart at multi-physical scales including cellular and tissue levels. We also conducted some simulations to demonstrate the application of the virtual heart to assess the pro-arrhythmic effects of cisapride and amiodarone. Using the model we investigated the mechanisms responsible for the differences between the two drugs on pro-arrhythmogenesis, even though both prolong the QT interval of ECGs. Several challenges for further development of a virtual heart as a platform for screening drug cardiotoxicity are discussed.

  12. 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

  13. 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.

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 心脏直视手术同期双极射频消融迷宫术治疗心房颤动%Intraoperative radiofrequency ablation to treat atrial fibrillation during concomitant cardiac surgery

    Institute of Scientific and Technical Information of China (English)

    石开虎; 曹炜; 龚文辉; 张飞; 吴君旭; 徐盛松; 宣海洋; 赵旭东

    2011-01-01

    Objective:To observe the effect of bipolar ablation system for intraoperative treatment of atrial fibrillation (AF). Methods:From December 2008 to February 2010, the bipolar radiofrequency ablation CardioblateTM washing machine was used to treat 21 patients with organic heart disease ( 19 cases with rheumatic valve disease, 2 patients with congenital heart disease) and AF who underwent combined intraoperative RFA. The ablation lesion pattern was modified Cox mini-maze, including 17 case of persistent/permanent AF and 4 paroxysmal AF cases. Results: All operations were successfully completed, with a mean RF ablation time of (15.4 ± 6. 8) min, of which 16 cases had restoration ofsinus rhythm after operation, 5 had paroxysmal AF 1 to 4 days after operation, and were converted to sinus rhythm after intravenous injection of amiodarone hydrochloride, with oral amiodarone maintained.No complete atrioventricular block occurred. Neither cardiac perforation nor operative mortality was observed. Average time of stay was (10.2 ± 2.5) days. During a mean follow-up time of (11.2 ± 1.4)months, 85.71% (18/21) had sinus rhythm, while 14.29% (3/21) had the AF rhythm. Conclusion:In patients with organic heart disease concomitant with AF, during open heart surgery the bipolar radiofrequency ablation for AF under the same washing line CardioblateTM is a simple, safe and effective method.%目的:探讨心内直视下同期双极射频消融治疗器质性心脏病合并心房颤动的经验及疗效.方法:2008年12月至2010年2月间采用Cardioblate冲洗式双极射频消融机为21例器质性心脏病(19例为风湿性瓣膜病、2例为先天性心脏病)合并心房颤动患者施行消融术,其中持续性/永久性房颤17例,阵发性房颤4例,消融经线为改良Cox Mini-maze手术.结果:21例手术均顺利完成,平均消融时间为(15.4±6.8)min,术后当天有16例恢复为窦性心律;5例分别于术后1~4 d发生阵发性房颤,经静脉注射盐酸胺

  1. 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

  2. 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

  3. Cardiac conductive disease with atrial fibrillation in a Chinese pedigree and evaluation of the treatments%家族性心脏传导疾病并房颤一家系报道及其治疗

    Institute of Scientific and Technical Information of China (English)

    刘福强; 李岩; 谢勇; 赵冬华; 萧钟波; 周桂芳; 彭健

    2012-01-01

    Objective To investigate the clinical characteristics of a Chinese pedigree with cardiac conductive disease complicated by atrial fibrillation and the therapeutic effect of the treatments. Methods All the family members including the proband were screened with routine examination, electrocardiography, echocardiograpy, Holter recording, chest X-ray, blood biochemistry tests and autoanribody test. The proband received dual chamber pacemaker implantation combined with oral amiodarone treatment for 3 months. The patient was monitored for thyreoid function and chest X-ray during the treatments, and was followed up for another 3 months. Results Clinical evidence of organic heart disease was found in none of the family members. The proband showed recurrent dizziness and chest distress, which exacerbated after exercise, and ECG showed atrial fibrillation and severe A-V block. The proband's uncle was found to have atrial fibrillation and III degree A-V block after a syncope episode at the age of 30, and received a pacemaker treatment. Her grandpa died from a heart attack without detailed clinical documentations. No other family members showed abnormal ECG or a history of any heart events. The proband's condition was improved by treatments, after which ECG and Holter recording showed pace rhythm without atrial fibrillation. Conclusion Cardiac conductive disease with atrial fibrillation can present in one family, and can be managed effectively and safely with implantation of dual chamber pacemaker combined with oral amiodarone.%目的 探讨一个家族性心脏传导疾病并房颤家系的临床特征及其有效的治疗方案.方法 对先证患者所在家系的家族成员进行常规临床体检和心电图、超声心动图、动态心电图、X线胸片、生化、自身抗体等检查.同时对先证者行双腔起搏器安置术联合口服胺碘酮治疗3个月,期间监测患者甲功及肺部情况,治疗完成后随访3个月,并对

  4. Pre-hospital care of acute myocardial infarction with malignant arrhythmia:an analysis of 200 cases%200例急性心肌梗死合并恶性心律失常的院前急救分析

    Institute of Scientific and Technical Information of China (English)

    张静

    2015-01-01

    目的:分析探讨急性心肌梗死合并恶性心律失常的院前急救措施。方法选取我院2011年-2014年出现心肌梗死合并恶性心律失常的患者200例,200例患者均进行院前抢救的措施。为200例患者进行了院前吸氧、静脉通路、硝酸甘油、镇定止痛的处理,没有出现血压下降的患者,给予静推胺碘酮300mg,如果无效在15分钟后再静推一次,剂量减半。出现室颤给予除颤。结果在进行院前抢救的200例患者中,有80例使用胺碘酮复苏成功,其余120例患者都接受了电除颤的处理,其中40例患者在2分钟内实施了除颤,全部一次性复苏成功,其余的80例患者没有在最佳的时间进行除颤治疗,71例复苏成功,9例死亡。结论为急性心肌梗死合并恶性心律失常的患者进行院前急救,可以最大限度的维持患者的生命,为患者争取治疗时间,对患者病情康复有重要的意义。%Objective To investigate the pre-hospital care of acute myocardial infarction (AMI) with malignant arrhythmia (MA). Methods A total of 200 AMI patients with MA who were admitted to our hospital from 2011 to 2014 were given pre-hospital care, including oxygen inhalation, venous access, nitroglycerin, and pain relief. Patients demonstrating no drop of blood pressure were given intravenous injection of 300 mg amiodarone, and patients with unsatisfactory outcome would repeat the injection in half dose 15 min later. Defibrillation would be carried out in case of ventricular fibrillation. Results Among the 200 patients who received pre-hospital care, 80 cases had successful resuscitation with amiodarone, and the other 120 cases all received electric defibrillation. Out of the 120 cases, 40 cases underwent defibrillation within two minutes and had one-time success of resuscitation; the other 80 cases did not receive defibrillation at the optimal time, and consequently 71 cases had successful resuscitation and

  5. 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

  6. Reliability of the thyroid stimulating hormone receptor antibodies level determination in diagnosing and prognosing of immunogenic hyperthyroidism

    Directory of Open Access Journals (Sweden)

    Aleksić Aleksandar Z.

    2009-01-01

    Full Text Available Background/Aim. Graves disease (GD is defined as hyperthyroidism with diffuse goiter caused by immunogenic disturbances. Antibodies to the thyroid stimulating hormone (TSH receptors of thyroid gland (TRAb have crucial pathogenetic importance in the development and maintenance of autoimmune hyperthyroidism. The aim of this study was to identify sensitivity, specificity, positive an negative predictive value of TRAb level in sera of patients with GD as well as to estimate significance of TRAb level for remission and GD relapses occurrence. Methods. We studied prospectively and partly retrospectively 149 patients, 109 female and 40 male patients, 5-78 years old, in the period 1982-2007. There were 96 patients with GD. The control group consisted of 53 patients, 21 with hyperthyroidism of second etiology and 32 patients on amiodarone therapy, with or without thyroid dysfunction TRAb was measured by radioreceptor assay (TRAK Assay and DYNO Test TRAK Human Brahms Diagnostica GMBH. Results. According to the results the sensitivity (Sn of TRAb test was 80%, specificity (Sp 100%, positive predictive value (PP 100% and negative predictive value (NP 83%. Also, the Sn of hTRAb test was 94%, Sp 100%, PP 100% and NP 94%. Our results show that an increased level of TRAb/hTRAb at the beginning of the disease and the level at the end of medical therapy is associated with an increased number of GD relapses and a shorter remission duration. Conclusion. Detection and measurement of TRAb in serum is a very sensitive method for diagnosing GD and very highly specific in vitro method for differential diagnosis of various forms of hyperthyroidism. Clinical significance of differentiating various forms of hyperthyroidism, using this in vitro assay, lays in adequate therapeutic choice for these entities.

  7. Pharmacoelectrophysiology of viral-free induced pluripotent stem cell-derived human cardiomyocytes.

    Science.gov (United States)

    Mehta, Ashish; Chung, YingYing; Sequiera, Glen Lester; Wong, Philip; Liew, Reginald; Shim, Winston

    2013-02-01

    Development of pharmaceutical agents for cardiac indication demands elaborate safety screening in which assessing repolarization of cardiac cells remains a critical path in risk evaluations. An efficient platform for evaluating cardiac repolarization in vitro significantly facilitates drug developmental programs. In a proof of principle study, we examined the effect of antiarrhythmogenic drugs (Vaughan Williams class I-IV) and noncardiac active drugs (terfenadine and cisapride) on the repolarization profile of viral-free human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). Extracellular field potential (FP) recording using microelectrode arrays demonstrated significant delayed repolarization as prolonged corrected FP durations (cFPDs) by class I (quinidine and flecainide), class III (sotalol and amiodarone), and class IV (verapamil), whereas class II drugs (propranolol and nadolol) had no effects. Consistent with their sodium channel-blocking ability, class I drugs also significantly reduced FPmin and conduction velocity. Although lidocaine (class IB) had no effects on cFPDs, verapamil shortened cFPD and FPmin by 25 and 50%, respectively. Furthermore, verapamil reduced beating frequencies drastically. Importantly, the examined drugs exhibited dose-response curve on prolongation of cFPDs at an effective range that correlated significantly with therapeutic plasma concentrations achieved clinically. Consistent with clinical outcomes, drug-induced arrhythmia of tachycardia and bigeminy-like waveforms by quinidine, flecainide, and sotalol was demonstrated at supraphysiological concentrations. Furthermore, off-target effects of terfenadine and cisapride on cFPD and Na( + ) channel blockage were similarly revealed. These results suggest that hiPSC-CMs may be useful for safety evaluation of cardioactive and noncardiac acting drugs for personalized medicine.

  8. 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.

  9. Development of a liquid chromatography-mass spectrometry (LC/MS) assay method for the quantification of PSC 833 (Valspodar) in rat plasma.

    Science.gov (United States)

    Binkhathlan, Ziyad; Somayaji, Vishwa; Brocks, Dion R; Lavasanifar, Afsaneh

    2008-06-15

    A liquid chromatography-mass spectrometry (LC/MS) assay method was developed for the quantification of PSC 833 in rat plasma, using amiodarone as internal standard (IS). Separation was achieved using a C(8) 3.5 microm (2.1 mm x 50 mm) column heated to 60 degrees C with a mobile phase consisting of acetonitrile-ammonium hydroxide 0.2% (90:10 v/v) pumped at a rate of 0.2 mL/min. Detection was accomplished by mass spectrometer using selected ion monitoring (SIM) in positive mode. An excellent linear relationship was present between peak height ratios and rat plasma concentrations of PSC 833 ranging from 10 to 5000 ng/mL (R(2)>0.99). Intra-day and inter-day coefficients of variation (CV%) were less than 15%, and mean error was less than 10% for the concentrations above the limit of quantification. The validated limit of quantification of the assay was 10 ng/mL based on 0.1 mL rat plasma. The method limit of detection, based on an average signal-to-noise (S/N) ratio of 3, was found to be 2.5 ng/mL. The assay was capable of measuring the plasma concentrations of PSC 833 in rats injected with a single dose of 5 mg/kg of the drug. PSC 833 and IS eluted within 4 min, free of interfering peaks. The method was found to be fast, sensitive, and specific for the quantification of PSC 833 in rat plasma.

  10. Ocular and systemic adverse effects of ophthalmic and non ophthalmic medications.

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    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

  11. [Heart rate and outcome in patients with acute and chronic heart failure].

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    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

  12. Ablation of atrial fibrillation with the Epicor system: a prospective observational trial to evaluate safety and efficacy and predictors of success

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    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

  13. 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.

  14. 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

  15. Adverse drug events associated with vitamin K antagonists: factors of therapeutic imbalance

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    El-Helou N

    2013-03-01

    Full Text Available Nancy El-Helou, Amal Al-Hajje, Rola Ajrouche, Sanaa Awada, Samar Rachidi, Salam Zein, Pascale SalamehClinical and Epidemiological Research Laboratory, Faculty of Pharmacy, Lebanese University, Beirut, LebanonBackground: Adverse drug events (ADE occur frequently during treatment with vitamin K antagonists (AVK and contribute to increase hemorrhagic risks.Methods: A retrospective study was conducted over a period of 2 years. Patients treated with AVK and admitted to the emergency room of a tertiary care hospital in Beirut were included. The aim of the study was to identify ADE characterized by a high international normalized ratio (INR and to determine the predictive factors responsible for these events. Statistical analysis was performed with the SPSS statistical package.Results: We included 148 patients. Sixty-seven patients (47.3% with an INR above the therapeutic range were identified as cases. The control group consisted of 81 patients (54.7% with an INR within the therapeutic range. Hemorrhagic complications were observed in 53.7% of cases versus 6.2% of controls (P < 0.0001. No significant difference was noticed between cases and controls regarding the indication and the dose of AVK. Patients aged over 75 years were more likely to present an INR above the therapeutic range (58.2%, P = 0.049. Recent infection was present in 40.3% of cases versus 6.2% of controls (P < 0.0001 and hypoalbuminemia in 37.3% of cases versus 6.1% of controls (P < 0.0001. Treatment with antibiotics, amiodarone, and anti-inflammatory drugs were also factors of imbalance (P < 0.0001.Conclusion: Many factors may be associated with ADE related to AVK. Monitoring of INR and its stabilization in the therapeutic range are important for preventing these events.Keywords: adverse drug events, vitamin K antagonists, bleeding risks, therapeutic imbalance

  16. Increase in thyroid stimulating hormone levels in patients with gout treated with inhibitors of xanthine oxidoreductase.

    Science.gov (United States)

    Perez-Ruiz, Fernando; Chinchilla, Sandra Pamela; Atxotegi, Joana; Urionagüena, Irati; Herrero-Beites, Ana Maria; Aniel-Quiroga, Maria Angeles

    2015-11-01

    Increase in thyroid stimulating hormone (TSH) levels over the upper normal limit has been reported in a small percentage of patients treated with febuxostat in clinical trials, but a mechanistic explanation is not yet available. In an observational parallel longitudinal cohort study, we evaluated changes in TSH levels in patients with gout at baseline and during urate-lowering treatment with febuxostat. Patients to be started on allopurinol who had a measurement of TSH in the 6-month period prior to baseline evaluation were used for comparison. TSH levels and change in TSH levels at 12-month follow-up were compared between groups. Patients with abnormal TSH levels or previous thyroid disease or on amiodarone were not included for analysis. Eighty-eight patients treated with febuxostat and 87 with allopurinol were available for comparisons. Patients to be treated with febuxostat had higher urate levels and TSH levels, more severe gout, and poorer renal function, but were similar regarding other characteristics. A similar rise in TSH levels was observed in both groups (0.4 and 0.5 µUI/mL for febuxostat and allopurinol, respectively); at 12-mo, 7/88 (7.9 %) of patients on febuxostat and 4/87 (3.4 %) of patients on allopurinol showed TSH levels over 0.5 µUI/mL. Doses prescribed (corrected for estimated glomerular filtration rate in the case if patients on allopurinol) and baseline TSH levels were determinants of TSH levels at 12-month follow-up. No impact on free T4 (fT4) levels was observed. Febuxostat, but also allopurinol, increased TSH levels in a dose-dependent way, thus suggesting rather a class effect than a drug effect, but with no apparent impact on either clinical or fT4 levels.

  17. 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

  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. 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.

  20. Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

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    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.

  1. 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

  2. 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

  3. 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

  4. 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

  5. P-glycoprotein expression and pharmacological modulation in larval stages of Echinococcus granulosus.

    Science.gov (United States)

    Nicolao, María Celeste; Denegri, Guillermo M; Cárcamo, Juan Guillermo; Cumino, Andrea C

    2014-02-01

    P-glycoprotein (Pgp) is an ATP-dependent transporter involved in the efflux of a wide variety of lipophilic substrates, such as toxins and xenobiotics, out of cells. Pgp expression level is associated with the ineffective therapeutic treatment of cancer cells and microbial pathogens which gives it high clinical importance. Research on these transporters in helminths is limited. This work describes for the first time the Echinococcus granulosus Pgp (Eg-Pgp) expression, in a model cestode parasite and an important human pathogen. Based on calcein efflux assays in the presence of common Pgp modulators, we demonstrated the occurrence of active Eg-Pgp in protoscoleces and metacestodes. Eg-Pgp, which showed a molecular mass of ~130 kDa in western blots, is localized in the suckers and the tegument of control protoscoleces as well as in the subtegument or all parenchymatous cells of protoscoleces treated with Pgp-interfering agents. We also identified five genes encoding Pgp which are constitutively expressed in protoscoleces and metacestodes. We showed that the Eg-pgp1 and Eg-pgp2 transcripts were up-regulated in response to in vitro drug treatment with amiodarone and loperamide, in agreement with the increased polypeptide levels. Finally, in vitro treatment of protoscoleces and metacestodes with trifluoperazine and loperamide was lethal to the parasites. This indicates that both drugs as well as cyclosporine A negatively modulate the E. granulosus Pgp efflux activity, favoring the retention of these drugs in the larval tissue. These events could be associated with the reduction in protoscolex and metacestode viability.

  6. 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。

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. 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.

  12. Paroxysmal supraventricular tachycardia: physiopathology and management

    Directory of Open Access Journals (Sweden)

    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

  13. Detection of metabolic activation leading to drug-induced phospholipidosis in rat hepatocyte spheroids.

    Science.gov (United States)

    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

  14. 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

  15. 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

  16. 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.

  17. 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.

  18. 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。

  19. In vitro thyroid disrupting effects of organic extracts from WWTPs in Beijing

    Institute of Scientific and Technical Information of China (E