Amiodarone: a multifaceted antiarrhythmic drug.
Synthesized as an antianginal compound 40 years ago, amiodarone has emerged as a uniquely effective antiarrhythmic compound in recent years. It has numerous properties, the most prominent being the ability to lengthen repolarization in the atria and ventricles associated with bradycardia without the significant potential for torsades de pointes. Amiodarone effectively controls a wide spectrum of atrial and ventricular antiarrhythmic disorders, but its limiting side effects, such as thyroid dysfunction, pulmonary fibrosis, and dermatologic changes, may limit its long-term use in some patients. What aspects of the multiplicity of the properties of amiodarone are relevant to its unusual efficacy is not known. Deiodination and other structural changes in the amiodarone molecule have has led to a the loss of thyroid and pulmonary effects in the resulting derivative, dronedarone, which is in advanced clinical development.
Singh
Bramah N
BN
Cardiology Division, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, West Los Angeles, CA 90073, USA. bsingh@ucla.edu
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000638:Amiodarone / Q000494:pharmacology / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000494:pharmacology / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000188:drug therapy*; D001281:Atrial Fibrillation / Q000188:drug therapy; D004359:Drug Therapy, Combination; D006329:Heart Conduction System / Q000187:drug effects / Q000473:pathology; D006801:Humans
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000638:Amiodarone