High dose oral amiodarone loading: Electrophysiologic effects and clinical tolerance
| Autor: | Thomas Peter, Carol vaughn, Daniel S. Oseran, Mark R. Myers, Peter C. Nalos, Eli Gang, William J. Mandel, Carol Zaher, Jay S. Simonson, Steven James Loring vans |
|---|---|
| Rok vydání: | 1992 |
| Předmět: |
Time Factors
medicine.medical_treatment Administration Oral Amiodarone Ventricular tachycardia Loading dose Maintenance therapy Recurrence Oral administration Tachycardia Heart rate Humans Medicine cardiovascular diseases Chemotherapy Dose-Response Relationship Drug business.industry Drug Tolerance Middle Aged medicine.disease Electrophysiology Regimen Anesthesia cardiovascular system Drug Evaluation Cardiology and Cardiovascular Medicine business Follow-Up Studies medicine.drug |
| Zdroj: | Journal of the American College of Cardiology. 19:169-173 |
| ISSN: | 0735-1097 |
| DOI: | 10.1016/0735-1097(92)90069-y |
| Popis: | Although amiodarone is an effective drug for the treatment of life-threatening ventricular arrhythmias, no standard oral loading dose protocol has been defined, and patients often undergo prolonged hospitalization for amiodarone loading. High dose (>1,800 mg/day) oral loading has usually been reserved for unstable patients with incessant ventricular tachyarrhythmias. The current study was designed to 1) examine the clinical and electrophyslologic effects of a high dose oral antiodarone loading regimen in more stable patients; and 2) ascertain its safety and tolerance, possibly allowing shortened amiodarone loading periods and potentially decreased length of hospital stay. The study group included 16 patients with a history of recurrent ventricular arrhythmias and decreased left ventricular function, who were refractory to prior antiarrhythmic drag therapy. The oral loading protocol was 50 mg/kg per day of amiodarone for 3 days, then 30 mg/kg per day for 2 days, followed by maintenance therapy of 300 to 400 mg twice daily. Electrophysiologic testing was performed at baseline, on days 1 and 5 and during week 6. Amiodarone and desethylamiodarone levels were measured and symptoms monitored. Clinically, the high dose loading protocol was well tolerated in 15 of the 16 patients. Arrhythmias were rendered noninducible by day 1 in three patients and remained noninducible throughout the study period in two of the three. The remaining patients continued to have inducible ventricular tachycardia. Ventricular tachycardia cycle length and right ventricular effective refractory period both progressively increased significantly over baseline, starting on day 1. The 15 patients who remained in the study had no significant side effects during the loading period. Eleven patients have teen followed up for >2 years without any clinical recurrence of their presenting arrhythmia. High dose oral amiodarone loading is clinically well tolerated in patients with life-threatening ventricular arrhythmias who have depressed ventricular function. This regimen may allow decreased loading periods, thereby permitting shorter hospital stays in this patient population. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|