Amiodarone - a drug for the treatment of diseases of the cardiovascular system.
The pharmacological action of amiodarone
The drug reduces the heart, increases blood flow in the heart vessels, reduces blood pressure and heart rate, and the effect on myocardial contractility and cardiac output, he has not.
Amiodarone reduces myocardial oxygen demand, helps to eliminate the arrhythmia increases the energy reserves of the heart muscle, increasing the level of glycogen and creatine phosphate.
Amiodarone release tablets and solution.
Amiodarone is prescribed according to the instructions for the prevention, treatment of ventricular, supraventricular arrhythmias, ventricular and atrial arrhythmias, angina pectoris, parasystole, arrhythmias, which developed because of coronary heart disease or congestive heart failure.
The preparation for the elimination of acute arrhythmias injected - 5 mg / kg in patients with chronic heart failure - 2, 5 mg / kg. Inject the drug slowly over 10-20min, spreading pre Amiodarone in 40ml 5% dextrose solution. One day you can spend reinfusion. If you assign continuous infusion of amiodarone administered 0, 6-1, 2 g / day, pre-diluted drug in 500ml - 1 liter of 5% dextrose.
Amiodarone tablets taken before meals, two or three steps - only 0, 6-0, 8 g / day. After 5-15dn dosage is reduced to 0, 3-0, 4g / day and then transferred to a daily dosage of 0, 2-0, 3a, which are received in one or two steps.
In order to prevent accumulation of the active drug substance in the organism, it is taken for 5d., And then make a two-day break. Also allowed a scheme in which taking amiodarone for three weeks and then do a seven-day break.
Angina Amiodarone instructions on starting to take a dose of 0, 2 g two or three p / day. for 8-15dn then daily dose is reduced to 0, 2g.
Amiodarone allowed in Pediatrics. The daily starting dose for children - 8-10mg / kg, the drug given for 8-15dn then transferred to a dosage of 2, 5 mg / kg.
The average therapeutic dose of amiodarone for disposable adult - 0, 2 g daily therapeutic dosage - 0, 4 g. The maximum permitted daily dosage - 1, 2g, single - no more than 1, 2r.
Side effects of amiodarone
Amiodarone can cause depression, fatigue, paresthesia, headache, tremor, ataxia, dizziness, auditory hallucinations, optic neuritis, sleep disorders, memory, sinus bradycardia, a blockade AV, uveitis, hypothyroidism, hyperthyroidism (the drug should be repealed), nausea, worsening appetite, weight and epigastric pain, bloating, diarrhea, constipation, change in taste, rash, exfoliative dermatitis, phlebitis, deterioration of potency, myopathy, alopecia, skin discoloration, vasculitis, sweating, fever.
Long-term use of amiodarone can cause tachycardia, the progression of chronic heart failure and arrhythmias, lowering the pressure, shortness of breath, coughing, alveolitis, interstitial pneumonia, pleural effusion, pulmonary fibrosis, sleep apnea, bronchospasm, chronic hepatitis, jaundice, cirrhosis, cholestasis, hemolytic anemia, aplastic.
For intravenous or intramuscular administration Amiodarone can cause increased intracranial pressure.
In case of overdose occur bradycardia, AV block, the pressure is reduced. Amiodarone treat poisoning gastric lavage, give cholestyramine. To resolve bradycardia pacemaker installed, administered beta adrenostimulyatorov to treat tachycardia occurred injected magnesium salts, carried pacing. Hemodialysis with an overdose of amiodarone is considered to be ineffective.
Amiodarone for instructions contraindicated in sinus bradycardia, SA blockade and AV 2-3 degrees in cardiogenic shock, hypersensitivity, collapse, hypotension, tiretoksikoze, interstitial lung disease, hypokalemia, hypothyroidism, while taking MAO inhibitors, lactation, pregnancy.
With care prescribe Amiodarone in patients with chronic heart failure, liver failure, asthma, elderly patients, children up to 18L.