Amiodarone: Pharmacology, Clinical Actions, and Relationships Between Them

Authors

  • STANLEY NATTEL M.D.,

    Corresponding author
    1. Department of Medicine, Montreal Heart Institute and University of Montreal, Departments of Pharmacology and Medicine, McGill University, Montreal, Canada
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  • MARIO TALAJIC M.D.,

    1. Department of Medicine, Montreal Heart Institute and University of Montreal, Departments of Pharmacology and Medicine, McGill University, Montreal, Canada
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  • BERNARD FERMINI Ph.D.,

    1. Department of Medicine, Montreal Heart Institute and University of Montreal, Departments of Pharmacology and Medicine, McGill University, Montreal, Canada
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  • DENIS ROY M.D.

    1. Department of Medicine, Montreal Heart Institute and University of Montreal, Departments of Pharmacology and Medicine, McGill University, Montreal, Canada
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  • Supported by the Medical Research Council of Canada, the Quebec Heart Foundation, and the Fonds de Recherche de l'Institut de Cardiologie de Montreal. Dr. Nattel is an FRSQ Research Scholar. Dr. Talajic is a Canadian Heart Foundation Research Scholar, and Dr. Fermini is a Knoll-FRSQ Chercheur Boursier.

Stanley Nattel, M.D., Montreal Heart Institute, 5000 Belanger Street East, Montreal, Quebec, Canada HIT 1C8. Fax:514–376–1355.

Abstract

Amiodarone Therapy. Amiodarone is a unique compound, with actions of all four antiarrhythmic drug classes. It has been used effectively to treat a broad range of ventricular and supraventricular arrhythmias. As a result of amiodarone's enormous volume of distribution and slow disposition kinetics, gradual accumulation occurs during maintenance dosing, and the drug's clinical action can be produced more rapidly with the use of an early loading period. Similarly, plasma concentrations and effects of amiodarone decrease slowly after drug discontinuation. There is a clinical impression that amiodarone is superior over other agents for a wide variety of arrhythmias, but this remains unproven. Because of uncertainty regarding amiodarone's efficacy compared to alternative therapies, and amiodarone's important potential for causing cardiac, pulmonary, hepatic, central nervous system, ocular, thyroid, and cutaneous adverse effects, amiodarone's precise role in antiarrhythmic therapy remains to be established. (J Cardiovasc Electrophysiol, Vol. 3, pp. 266–280, June 1992)

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