A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

Wellens, Hein J.J.; Brugada, Pedro; Abdollah, Hoshiar; Dassen, W.R.M.

doi:10.1161/01.cir.69.1.120

Cited by 129 publications

(36 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It is known that the acute and chronic electrophysiological effects of amiodarone substantially differ from each other either based on data from in vivo investigation (Wellens et al, 1984) and in vitro measurements (Kadoya et al, 1985;Varro et al, 1988) settings. This suggests that there must also be differences in the drug-evoked changes on the underlying transmembrane ionic currents between acute and chronic amiodarone applications.…”

Section: Discussionmentioning

confidence: 99%

“…This suggests that there must also be differences in the drug-evoked changes on the underlying transmembrane ionic currents between acute and chronic amiodarone applications. After acute amiodarone administration the dominant ECG change is an increase of PQ interval (Wellens et al, 1984). QTc lengthening was usually observed only after chronic amiodarone treatment (Debbas et al, 1984;Wellens et al, 1984;Kodama et al, 1992).…”

Section: Discussionmentioning

confidence: 99%

“…Amiodarone also blocks a-and 3-adrenoceptors in a noncompetitive manner (Polster & Broekhuysen, 1976). It must be emphasized that the cardiac eletrophysiological effects of amiodarone differ markedly after acute and chronic administration (Wellens et al, 1984;Kadoya et al, 1985;Varro et al, 1988). This latter fact suggests that the ionic mechanisms which underlie its marked effects on cardiac electrical activity can be understood only if both acute and chronic effects are analyzed in detail.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Comparison of the chronic and acute effects of amiodarone on the calcium and potassium currents in rabbit isolated cardiac myocytes

Varró

Virág

Papp

1996

British J Pharmacology

View full text Add to dashboard Cite

1 The acute and chronic effects of amiodarone were studied on the transmembrane ionic currents in rabbit single ventricular myocytes at 35°C by applying the whole-cell configuration of the patch-clamp technique. 2 Acute exposure to 1 and 5 gM amiodarone significantly reduced the amplitude (-53.9 + 3.9%, n = 5 and -64.0+2.0%, n=3, P<0.01), but chronic amiodarone treatment (i.p. 50 mg kg-' day-' for 3-4 weeks) changed neither the amplitude nor the kinetics of the inward calcium current.3 Both acute superfusion with amiodarone (1 and 5 gM) and chronic amiodarone treatment significantly decreased the amplitude of the delayed rectifier outward potassium current (IK). 4 Acute application of amiodarone (1 and 5 gM) did not alter but chronic amiodarone treatment moderately depressed the transient outward current (Ito).5 Neither the acute (1 and 5 gM) nor the chronic amiodarone treatment changed the magnitude of the inward rectifier potassium current (Ikl).6 It is concluded that acute amiodarone application and chronic amiodarone treatment alter transmembrane ionic currents of ventricular myocytes differently. This may explain, at least in part, the marked differences in the cardiac electrophysiological effects observed after acute and chronic amiodarone treatment in patients.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison of the chronic and acute effects of amiodarone on the calcium and potassium currents in rabbit isolated cardiac myocytes

Varró

Virág

Papp

1996

British J Pharmacology

View full text Add to dashboard Cite

show abstract

“…This uncertainty is increased because of differences in electrophysiological effects of oral and intravenous amiodarone (Wellens et al, 1984). Therefore a suggested therapeutic range of 1.0-2.5 mg 1-l (Latini et al, 1984) must be regarded as provisional.…”

Section: Discussionmentioning

confidence: 99%

Plasma amiodarone concentrations during intravenous infusion.

Watt¹,

Hutchings²,

Stephens³

et al. 1986

Brit J Clinical Pharma

View full text Add to dashboard Cite

Amiodarone is a useful antiarrhythmic agent whose pharmacokinetics are incompletely characterised. In order to optimise efficacy of an antiarrhythmic drug, information regarding plasma concentrations achieved during use of the drug is necessary. We report plasma amiodarone and desethylamiodarone concentrations in eight patients following intravenous infusion at a rate of 175 mg h-1 for the first 2 h, followed by infusion at a rate of 50 mg h-1 for a further 46 h a regimen very similar to that recommended by the manufacturers. In at least three of eight patients plasma concentrations were below the suggested therapeutic range of 1.0-2.5 mg 1L1 from 3 to 16 h after the infusion was started. Our data suggests that larger doses of intravenous amiodarone than those previously recommended may be necessary to obtain optimal benefit from the drug.

show abstract

“…It is important to note that amiodarone has distinctly different effects when administered chronically as opposed to acute intravenous administration [18,50,51]. For this study, only acute effects are applicable.…”

Section: Amiodaronementioning

confidence: 99%

The effect of amiodarone pretreatment on survival of mice with cocaine toxicity

et al. 2005

View full text Add to dashboard Cite

Introduction: Cocaine is a common drug of abuse and use has been associated with ventricular dysrhythmias. Published guidelines suggest that amiodarone is the first line antidysrhythmic for ventricular tachycardia and fibrillation. However, the effects amiodarone in the setting of cocaine toxicity are unknown and unstudied. The purpose of this study was to evaluate the safety and efficacy of amiodarone pretreatment in a murine model of acute cocaine toxicity.Methods: This was a randomized, blinded, placebo controlled investigation using male CF-1 mice weighing 29-37 g. First, the safety of an intraperitoneal dose of amiodarone (40 mg/kg) was confirmed in 5 mice. Second, based on preliminary investigations, an approximate intraperitoneal LD 50 dose of cocaine (110 mg/kg) was identified and used as the cocaine dose in this study. Animals were then randomized to 2 groups. The control group received 0.5 mL of intraperitoneal 0.9% saline 30 minutes before cocaine. The study group received 40 mg/kg of intraperitoneal amiodarone (40 mg/kg) 30 minutes before cocaine. A blinded observer monitored mice for 2 hours after cocaine administration.Results: No mice in the amiodarone-only group developed any signs of toxicity or died. In the saline ϩ cocaine group 31/32 (96.9%; 95% CI 83.8 to 99.9) mice seized with a median time to seizure of 2.5 minutes, and 23/32 (71.9%; 95% CI 52.3 to 86.3) died with a median time to death of 5.5 minutes. In the amiodarone ϩ cocaine group 31/33 (93.9%; 95% CI 79.0 to 99.3) mice seized with a median time to seizure of 2.0 minutes, and 24/33 (72.7%; 95% CI 54.5 to 86.7) died with a median time to death of 6.0 minutes. All animals that died did so within 9 minutes. The difference in the proportion of animals dying in the amiodarone ϩ cocaine group compared to the saline ϩ cocaine group was 0.008 (Ϫ21 to 22%).Conclusions: In this study, pretreatment with amiodarone in cocaine poisoned mice resulted in no change in seizure incidence or mortality. However, definite conclusions about the reason for these findings cannot be drawn from this model.

show abstract

A comparison of the electrophysiologic effects of intravenous and oral amiodarone in the same patient.

Cited by 129 publications

References 20 publications

Comparison of the chronic and acute effects of amiodarone on the calcium and potassium currents in rabbit isolated cardiac myocytes

Comparison of the chronic and acute effects of amiodarone on the calcium and potassium currents in rabbit isolated cardiac myocytes

Plasma amiodarone concentrations during intravenous infusion.

The effect of amiodarone pretreatment on survival of mice with cocaine toxicity

Contact Info

Product

Resources

About