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Amiodarone belongs to class III of antiarrhythmic drugs (class of repolarization inhibitors) and has a unique mechanism of antiarrhythmic action, because in addition to the properties of class III antiarrhythmic agents (potassium channel blockade) it has the effects of class I antiarrhythmic agents (sodium channel blockade), class IV antiarrhythmics (calcium channel blockade) and non-competitive beta-adrenoblocking action.

In addition to antiarrhythmic action, amiodarone has antianginal, coronary dilating, alpha- and beta-adrenoblocking effects.

Antiarrhythmic properties:

- increase in the duration of the 3rd phase of the action potential of cardiomyocytes, mainly due to blocking the ionic current in potassium channels (the effect of antiarrhythmic agents of class III according to the Vaughan-Williams classification);

- reduction of sinus node automatism, leading to a decrease in heart rate;

- non-competitive blockade of alpha- and beta-adrenergic receptors;

- slowing of sinoatrial, atrial and atrioventricular conduction, more pronounced in tachycardia;

- no changes in ventricular conduction;

- increased refractory periods and decreased excitability of atrial and ventricular myocardium, as well as increased refractory period of the atrioventricular node;

- slowing of conduction and increasing the refractory period in additional atrial-ventricular conduction bundles.

Other effects:

- Absence of negative inotropic action when taken orally;

- decrease in myocardial oxygen consumption due to a moderate decrease in peripheral resistance and heart rate;

- increase in coronary blood flow due to a direct effect on the smooth muscle of coronary arteries;

- maintenance of cardiac output by decreasing aortic pressure and reducing peripheral resistance;

- influence on thyroid hormone metabolism: inhibition of T3 to T4 conversion (blockade of thyroxine-5-deiodinase) and blocking the capture of these hormones by cardiocytes and hepatocytes, resulting in weakening the stimulating effect of thyroid hormones on myocardium;

Therapeutic effects are observed on average one week after the start of taking the drug (from a few days to two weeks). After its discontinuation, amiodarone is determined in blood plasma for 9 months. It should be taken into account the possibility of preservation of pharmacodynamic effect of amiodarone for 10-30 days after its withdrawal.

Manufacturer[HTML

LLC Pharmasyntez-Tyumen

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