アミオダロン

使用用途

• For atrial fibrillation or ventricular arrhythmias primarily in ambulatory patients
• For ventricular arrhythmias secondary to occult cardiomyopathy in Doberman pinschers
• For ventricular tachycardia when other first line drugs (Class I antiarrhythmics ± beta-blockers) are ineffective
• For SVTs or Vtach
• Ventricular and supraventricular arrhythmias, atrial fibrillation, ventricular pre-excitation syndromes
• For conversion of atrial fibrillation or ventricular tachycardia

投与方法

考えられる副作用

• Vomiting
• Anorexia
• Hepatopathy (elevated liver enzymes, bilirubinemia)
• Bradycardia
• Neutropenia
• Thrombocytopenia
• Positive Coombs' test
• Corneal deposits
• Injection site pain (IV)
• Facial pruritus and hyperemia (IV)
• Hind limb weakness (horses)
• Diarrhea (horses)

注意事項と禁忌

• Hypersensitivity to amiodarone or iodine
• Severe sinus-node dysfunction
• Severe sinus bradycardia
• 2nd or 3rd degree AV block
• Bradycardial syncope
• > **High Toxicity Potential:** Clinical experience in veterinary patients is limited. Use only when other less toxic and more commonly used drugs are ineffective. * **Hepatic Effects:** Hepatopathy can occur before clinical signs are noted; routine serial evaluation of liver enzymes and bilirubin is strongly recommended. * **Thyroid Function:** May alter thyroid hormone levels (increases T4 and reverse T3, decreases T3) due to high iodine content. * **Pregnancy:** FDA Category D. Embryotoxic in laboratory animals; congenital thyroid abnormalities detected in offspring. Use only if benefits outweigh risks.

薬物相互作用

• Warfarin (Anticoagulants): Significantly increases serum levels and/or pharmacologic/toxic effects of the anticoagulant.
• Digoxin: Significantly increases serum levels and/or toxic effects of digoxin.
• Cyclosporine: Increases cyclosporine levels; may increase creatinine.
• Lidocaine: Significantly increases serum levels and/or toxic effects of lidocaine.
• Methotrexate: Significantly increases serum levels and/or toxic effects with prolonged amiodarone administration.
• Phenytoin: Significantly increases serum levels and/or toxic effects of phenytoin.
• Procainamide: Significantly increases serum levels and/or toxic effects of procainamide.
• Quinidine: Significantly increases serum levels and/or toxic effects of quinidine.
• Azole Antifungals (ketoconazole, itraconazole): Additive effects on QTc interval; possible serious arrhythmias.
• Cisapride: Additive effects on QTc interval; possible serious arrhythmias.
• Disopyramide: Additive effects on QTc interval; possible serious arrhythmias.
• Dolasetron: Additive effects on QTc interval; possible serious arrhythmias.
• Fluoroquinolones (e.g., moxifloxacin): Additive effects on QTc interval; possible serious arrhythmias.
• Macrolide Antibiotics (e.g., erythromycin): Additive effects on QTc interval; possible serious arrhythmias.
• Ondansetron: Additive effects on QTc interval; possible serious arrhythmias.
• General Anesthetics: Increased risks for hypotension or arrhythmias.
• Beta-Adrenergic Blockers: Possible potentiation of bradycardia, AV block, or sinus arrest.
• Calcium-Channel Blockers (diltiazem, verapamil): Possible potentiation of bradycardia, AV block, or sinus arrest.
• Cimetidine: Increased amiodarone levels.
• Fentanyl: Possible hypotension, bradycardia.
• Rifampin: Decreased amiodarone levels.
• Anticoagulants: May significantly increase serum levels and/or pharmacological effects
• Beta-blockers: May significantly increase serum levels and/or pharmacological effects
• Calcium-channel blockers: May significantly increase serum levels and/or pharmacological effects
• Ciclosporin: May significantly increase serum levels and/or pharmacological effects
• Theophylline: May significantly increase serum levels and/or pharmacological effects

よくある質問