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Amiodarone

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Structure

  • Amiodarone is a class III antiarrhythmic agent with a complex structure containing two iodine atoms attached to a benzofuran ring fused to a diethylamino side chain.

  • Chemical Formula: C₂₉H₄₈I₂N₂O₂

    Chemical Formula of Amiodarone
Structure of Amiodarone
Structure of Amiodarone

Mode of Action

  • Class III Antiarrhythmic: Prolongs repolarization by blocking potassium channels, thereby extending the action potential and refractory period.

  • Multifaceted Mechanism: Exhibits class I (sodium channel blockade), class II (beta-blockade), and class IV (calcium channel blockade) properties.

  • Alpha-Adrenergic Blockade: Exhibits some alpha-adrenergic antagonistic effects, contributing to vasodilation.

  • Thyroid Modulation: Contains iodine, affecting thyroid hormone synthesis and metabolism.

Uses

  • Ventricular Arrhythmias: Treats ventricular tachycardia and ventricular fibrillation, especially in life-threatening arrhythmias.

  • Atrial Fibrillation and Flutter: Maintains sinus rhythm in patients with atrial fibrillation.

  • Post-Myocardial Infarction: Prevents ventricular arrhythmias after myocardial infarction.

  • Supraventricular Arrhythmias: Manages certain supraventricular tachycardias.

  • Tachycardia-Induced Cardiomyopathy: Helps in reversing cardiomyopathy caused by persistent tachycardia.

Side Effects of Amiodarone

  • Thyroid Dysfunction: Hypothyroidism or hyperthyroidism due to iodine content.

  • Pulmonary Toxicity: Can cause interstitial pneumonitis and fibrosis.

  • Hepatotoxicity: Elevated liver enzymes and potential liver damage.

  • Ocular Effects: Corneal microdeposits and optic neuropathy.

  • Skin Reactions: Photosensitivity and blue-gray skin discoloration.

  • Neurological Effects: Tremors, ataxia, and peripheral neuropathy.


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