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Cordarone (Amiodarone)
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Cordarone

Cordarone is used to treat a variety of different types of fast, abnormal heart rhythms (these are known as tachyarrhythmias). It is used for severe rhythm disorders when other treatments are not effective or cannot be used.

Other names for this medication:
Amidrone, Amiobal, Amiocar, Amiodacore, Amiodar, Amiodarex, Amiodaron, Amiodarona, Amiodaronum, Amiodura, Amiogamma, Amiohexal, Amiokordin, Amiorit, Amiotach, Amirone, Ancaron, Ancoron, Angoron, Angoten, Aratac, Arycor, Asulblan, Atlansil, Braxan, Cardilor, Cardiodarone, Cardiron, Cor mio, Coradona, Corbionax, Cordalin, Cordan, Cordarex, Cornaron, Coronal, Coronax, Coronovo, Daritmin, Daronal, Diarona, Escodaron, Eudarona, Eurythmic, Hexarone, Kendaron, Keritmon, Miocor, Miodar, Miodrone, Mioritmin, Miotenk, Nexterone, Nodis, Novarona, Opacorden, Pacerone, Pacet, Procor, Rhythmiodarone, Rithmik, Ritmocardyl, Rivodaron, Rivodarone, Sedacoron, Tiaryt, Trangorex

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Also known as: Amiodarone.

Description

Cordarone is an antiarrhythmic. It works by stabilizing the heart rhythm in conditions in which the heart is beating too fast or in an irregular rhythm.

Generic name of Cordarone is Amiodarone.

Cordarone is also known as Amiodarone, Pacerone.

Brand name of Cordarone is Cordarone.

Dosage

Cordarone is best taken with food. However, it is more important to take it consistently with regard to meals. If you take it with food, try to always take it with food to improve absorption of this medicine. If you prefer to take it on an empty stomach, then always try to take it on an empty stomach.

If you want to achieve most effective results do not stop taking Cordarone suddenly.

Overdose

If you overdose Cordarone and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 20 and 25 degrees C (68 and 77 degrees F) away from moisture, light and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Cordarone are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Cordarone if you are allergic to Cordarone components.

Do not take Cordarone if you're pregnant or you plan to have a baby, or you are a nursing mother.

Do not take Cordarone if you have complete, second degree, third degree, or severe sinoatrial heart block, an abnormally slow heartbeat, or shock due to serious heart problems, or if you have had fainting due to slow heartbeat (except if you have a pacemaker).

Do not take Cordarone if you are taking cisapride, dofetilide, an H1 antagonist (eg, astemizole, loratadine, terfenadine), an HIV protease inhibitor (eg, ritonavir), a phosphodiesterase type 5 inhibitors (eg, vardenafil), or a streptogramin (eg, dalfopristin, quinupristin).

Lab tests, including electrocardiogram (ECG), chest x-rays, lung tests, liver tests, thyroid tests, and eye exams, may be performed to monitor your progress.

Be careful with Cordarone if you have allergies to medicines, foods, or other substances.

Use Cordarone with great care in case you want to undergo an operation (dental or any other).

Avoid alcohol.

Avoid machine driving.

Try to protect your skin from the sunlight.

Do not stop taking Cordarone suddenly.

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A 55-year-old obese man had taken amiodarone (200 mg/d) for 3 years and stopped 2 years earlier. He underwent total thyroidectomy for papillary cancer with extrathyroidal extension and a metastatic central lymph node, requiring RI treatment. But iodine overload, with no other documented iodinated drug intake, was found (urinary iodine excretion = 472 microg/24 h; normal < 150 microg/24 h), and persisted 3 months later. Plasma exchanges (PE) were prescribed.

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Study was undertaken to assess whether proarrhythmic response to antiarrhythmic drug is a risk factor for cardiac death in patients (pts) with ischaemic heart disease (IHD). In 782 pts with IHD and frequent and/or complex ventricular ectopic beats (VEB) 1041 drug tests guided by 24 hour Holter monitoring were conducted. The following drugs were assessed: propranolol, disopyramide, mexiletine, amiodarone. Pro-arrhythmia was defined according to Velebit: 1/greater than or equal to 4-fold increase in VEBs, 2/greater than or equal to 10-fold increase in repetitive forms of 3/new occurrence of ventricular tachycardia or ventricular fibrillation (VT/VF). Proarrhythmic effect was observed in 8.4% of pts and in 7.9% of drug tests. The frequency with individual drugs ranged from 5.7% to 9%. No drug was completely free of this type of reaction. Antiarrhythmic drugs inducing arrhythmogenic response were eliminated. Pts were followed-up for a mean of 22 months (range 1-49). Chronic antiarrhythmic treatment was conducted. Pts were discharged taking the agent deemed most effective for suppression of arrhythmia. Follow-up visits were made every 6-12 months. All cases of death were verified. In long-term observation cardiac death and sudden death occurred in 53 and 32 pts. With actuarial analysis (Kaplan-Meler method, log rank test) there was significant difference in cardiac death (p less than 0.05) of pro-arrhythmia (+) compared with ++pro-arrhythmia (-) pts at yr (11% v 4%, 7% v 3%) and 3 yr (24% x 11%, 16% v 7%). The relative importance of baseline clinical variables in predicting survival was assessed with a stepwise Cox regression.(ABSTRACT TRUNCATED AT 250 WORDS)

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A 55-year-old male presented with history of nausea, vomiting, palpitation paresthesis and profuse sweating in emergency department 2h after ingestion of "Bachnaag" (Aconite) root. Examination revealed shock with irregular pulses. Initial ECG showed frequent multifocal ventricular ectopics (VE), which later turned to short runs of ventricular tachycardia (VT). Immediate gastric lavage was done and activated charcoal given. Patient was treated with fluid resuscitation without any improvement in blood pressure. Patient was started on nor-adrenaline infusion with gradual recovery from hypotension over a period of 6h, but support was continued for 48h. Amiodarone was started to control ventricular excitability, which persisted over 72h with gradual decrease in frequency of VT and VE. Patient was discharged with normal sinus rhythm on oral amiodarone on 5th day of hospitalization. On follow-up after 2 weeks patient was totally asymptomatic and amiodarone was stopped.

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Five patients with the bradycardia-tachycardia syndrome have been treated successfully with the antiarrhythmic agent amiodarone. Three patients were treated for over nine months and one of these patients had corneal micro deposits. One patient had to be taken off the drug because of side effects. Amiodarone should be tried in patients suffering from the bradycardia-tachycardia syndrome before resorting to cardiac pacing.

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An antiarrhythmic drug, amiodarone, contains 37% iodine by weight and is structurally similar to the thyroid hormones. The drug inhibits hepatic 5'-deiodinase, resulting in increases in serum thyroxin and "reverse" triiodothyronine, whereas the concentration of triiodothyronine in serum is decreased. There is a significant incidence of either hypothyroidism or hyperthyroidism in patients who are being treated with the drug. This is largely the effect of iodine released from the drug during chronic therapy, but in susceptible individuals amiodarone may unmask autoimmune thyroid disease. Some effects of the drug suggest that it may interfere with the action of thyroid hormones at the cellular level, inducing a state of localized hypothyroidism.

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Amiodarone hydrochloride is an iodine-rich drug effective in the control of various tachyarrhythmias. It is known to cause refractory to thyrotoxicosis, which usually does not respond to regular antithyroid drugs. Lithium bicarbonate is a medication used to treat psychiatric disorders; it also influences thyroid production and release of hormones. We tried it in combination with propylthiouracil (PTU) for the treatment of amiodarone-induced thyrotoxicosis.

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In ARISTOTLE, 2,051 (11.4%) patients received amiodarone at randomization. Patients on warfarin and amiodarone had time in the therapeutic range that was lower than patients not on amiodarone (56.5% vs. 63.0%; p < 0.0001). More amiodarone-treated patients had a stroke or a systemic embolism (1.58%/year vs. 1.19%/year; adjusted hazard ratio [HR]: 1.47, 95% confidence interval [CI]: 1.03 to 2.10; p = 0.0322). Overall mortality and major bleeding rates were elevated, but were not significantly different in amiodarone-treated patients and patients not on amiodarone. When comparing apixaban with warfarin, patients who received amiodarone had a stroke or a systemic embolism rate of 1.24%/year versus 1.85%/year (HR: 0.68, 95% CI: 0.40 to 1.15), death of 4.15%/year versus 5.65%/year (HR: 0.74, 95% CI: 0.55 to 0.98), and major bleeding of 1.86%/year versus 3.06%/year (HR: 0.61, 95% CI: 0.39 to 0.96). In patients who did not receive amiodarone, the stroke or systemic embolism rate was 1.29%/year versus 1.57%/year (HR: 0.82, 95% CI: 0.68 to 1.00), death was 3.43%/year versus 3.68%/year (HR: 0.93, 95% CI: 0.83 to 1.05), and major bleeding was 2.18%/year versus 3.03%/year (HR: 0.72, 95% CI: 0.62 to 0.84). The interaction p values for amiodarone use by apixaban treatment effects were not significant.

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Amiodarone, a potent antiarrhythmic drug, decreases plasma and tissue triiodothyronine (T3) and increases plasma cholesterol levels, resembling changes seen during hypothyroidism. The increase of serum cholesterol during amiodarone medication is associated with a decreased expression of the hepatic low-density lipoprotein (LDL) receptor mRNA. To further elucidate the mechanism of amiodarone-induced hypercholesterolemia, we investigated whether the decreased mRNA levels are the result of decreased transcription or increased degradation or both, and whether protein expression is decreased accordingly. Relative to pair-fed controls, amiodarone treatment increased plasma cholesterol by 69% and decreased expression of the mRNA encoding for the hepatic LDL receptor by 45%. To study this decrease in mRNA, we performed a run-on assay, from which it appears that amiodarone acts by decreasing LDL receptor mRNA expression 2.5-fold at the transcriptional level. The decay rate of liver LDL receptor mRNA, measured at different time points after injecting actinomycin D, was not different between amiodarone-treated and control animals (116+/-32 minutes and 84+/-10 minutes, P=.44). Hepatocytes in primary culture isolated from amiodarone-treated and control animals were used to determine specific binding of [125I]-LDL to hepatic LDL receptors. Amiodarone decreased specific LDL binding and Scatchard analysis demonstrated that amiodarone treatment reduced the number of LDL receptors by 69%, without affecting the dissociation constant (Kd). In conclusion, amiodarone-induced hypercholesterolemia can be explained by decreased transcription of the LDL receptor gene, resulting in lower mRNA and protein levels.

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To review the published literature evaluating the effectiveness of statin therapy for preventing postoperative atrial fibrillation (POAF) after coronary artery bypass graft (CABG) surgery.

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To evaluate the clinical and electrophysiological determinants of arrhythmia recurrence in patients undergoing internal atrial cardioversion for chronic atrial fibrillation (AF).

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Liver biopsies with a main histological diagnosis of steatosis were selected from 3,422 liver biopsies carried out in our department between January 1995 and December 1998. Patients with known risk factors for steatosis, such as excessive alcohol consumption, hepatitis C infection, treatment with amiodarone, perhexiline maleate, tamoxifen, antiviral drugs (didanosine, zidovudine) methotrexate, sodium valproate or total parenteral nutrition, Wilson's disease and organ transplant were subsequently excluded. Of the 43 liver biopsies finally included in the study, 23 showed simple steatosis and 20 steatohepatitis. Eighty-one per cent of the patients were male (mean age of 44 years) and the majority were asymptomatic. The most frequent indication for liver biopsy was hypertransaminasemia. No differences were observed between the two groups in terms of frequency and severity of classical risk factors for steatosis (diabetes mellitus, dyslipemia and obesity). Thirty-five percent of patients with steatohepatitis and 26% of those with simple steatosis had none of these risk factors. Patients with steatohepatitis were older than those with simple steatosis. They presented more severe symptomatology, the degree of steatosis was more intense and laboratory investigations showed greater alterations. These results suggest that simple steatosis and nonalcoholic steatohepatitis are two different phases of the same disease. The difficulty in clinical differentiation justifies carrying out liver biopsy, especially in patients with more severe symptomatology whose laboratory results show greater alterations, since these patients present more marked histological lesions, are at risk of developing liver cirrhosis and require therapy.

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cordarone generic 2016-06-30

The authors describe an 11-year-old girl who presented with congestive heart failure due to arrhythmogenic dilated cardiomyopathy. She had curly, woolly hair since birth and palmoplantar keratoderma. Molecular genetic analysis of the desmoplakin gene revealed that she was homozygous for the c.3901C>T (p.Gln1301X) change in exon 23 of the desmoplakin (DSP) gene, confirming the diagnosis of Carvajal disease. As per the Arrhythmogenic Right Ventricular Dysplasia/ Cardiomyopathy Genetic Variants Database, this is a novel mutation. She was managed with Buy Vermox diuretics, enalapril, carvedilol and amiodarone, is presently stable, and on regular follow-up. Carvajal disease is a rare cardiocutaneous disorder and few cases have been reported in the literature. The authors review the published cases of the Naxos-Carvajal phenotype from India. Pediatricians need to be aware of this clinical entity whenever arrhythmogenic dilated cardiomyopathy is associated with woolly hair and/or palmoplantar keratoderma.

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The study comprised 229 patients from an iodine-replete area (115 women, 114 men, Crestor Generic Launch mean age 63.8 ± 9.2 years), chronically treated with AMD. The cases were clinically investigated prior to, and during treatment, by thyroid 2D and color Doppler flow sonography, thyroid function tests (TSH, FT3, FT4), and antithyroid antibodies.

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The cellular profile of BAL in Am pneumonitis is highly variable, and no cellular pattern of BAL seems to be predictive of a detrimental outcome or of irreversible fibrosis. Aside from excluding other illnesses, and due to its extreme variability, the contribution of BAL differential Aciphex Sprinkle Cost in the initial workup of patients suspected of having Am pneumonitis is limited.

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It is generally known that there are many endocrine disrupting compounds (EDCs) in the effluents from wastewater treatment plants (WWTPs). Most research has focused on the occurrence of estrogenic or androgenic activities, while ignoring that there are environmental chemicals disrupting thyroid system, which is essential for growth and development in both humans and animals. In the present work, a two-hybrid yeast assay was conducted to evaluate the removal efficiencies of agonistic or antagonistic thyroid receptor (TR) mediated effects in different treatment processes of three WWTPs located in Beijing. We found no TR agonistic, but TR antagonistic activities in all processes from the WWTPs. The TR antagonistic activities in organic extracts of water samples were then calibrated regarding to a known TR-inhibitor, amiodarone hydrochloride (AH). The observed concentration of TR disrupting substances ranged from 2.35 x 10(-8) to 6.19 Levitra Cost Walmart x 10(-7) mol/L AH in Gaobeidian WWTP, 3.76 x 10(-8) to 8.75 x 10(-8) mol/L AH in Lugouqiao WWTP, and 4.80 x 10(-9) to 2.55 x 10(-8) mol/L AH in Beixiaohe WWTP. Of the three WWTPs, the removal rates were 92.7%, 42.2%, and 23.1% respectively. Industrial sewage may contain more TR disrupting substances compared with domestic sewage. The recipient waters were found to contain considerable concentrations of TR disrupting substances that may cause adverse effects on the exposed organisms.

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Atrial fibrillation (AF) is the most common dysrhythmia following open heart surgery with or without cardiopulmonary bypass. In previous studies, the AF incidence varied between 25.0% and 60.0% of all patients. The conventional treatment of postoperative AF periods consists of antiarrhythmic medication, most frequently calcium channel antagonists, beta-adrenergic blockers, or amiodarone. If the pharmacological treatment is ineffective or leads to further impairment of hemodynamics Lasix Buy Online , external electrical cardioversion under general anesthesia and simultaneous transesophageal echocardiography is performed. Systemic heparinization is recommended to prevent neurological events related to AF. In 1995, a new method for internal electrical cardioversion using epicardial wire electrodes with low shock energies was developed in a canine model. Since June 1997, this device for internal cardioversion that consisted of two multifilament stainless steel wires has been available clinically (TADpole followed by Syncrus heart wires, Guidant Corporation C and VS, Cupertino, California, USA). The safety and efficacy of this innovative strategy for treatment of postoperative AF has been investigated in two pilot studies. These studies demonstrated a success rate of internal cardioversion up to 92.9% with optimized pre-shock treatment that leads to a significant shortening of AF periods, with the expectation of reduction in hospital length of stay.

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Overall, 75% of patients relapsed into AF during the 3-year study period. AF recurrence was significantly lower in the 1st CRP tertile group (P = 0.039). The Kaplan-Meier survival analysis showed that the rate of AF recurrence was significantly lower in the lowest CRP tertile (log rank; P < 0.001). In a multivariable Cox regression model adjusted for other potential covariates, only CRP (upper two tertiles) was an independent predictor of AF recurrence (heart rate: 6.3, 95% confidence Flomax Generic Picture interval: 3.1-12.7, P < 0.001).

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The Cochrane Collaboration's database Plavix Generic Equivalent of controlled clinical trials and MEDLINE.

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Amiodarone is effective in reducing the total mortality rate by 13% to Cozaar Medication Generic 19%, and the implantable defibrillator reduces the mortality rate by a further 24%.

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To evaluate treatment Zetia Generic Launch of junctional ectopic tachycardia after cardiac surgery.

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In 18 patients receiving amiodarone, the functional class and heart rate decreased significantly (p < 0.05 Singulair Generic Names ) from 2.7 +/- 0.4 to 1.2 +/- 0.4 and 103 +/- 15 to 69 +/- 8.5 bpm respectively. The ejection fraction and the exercise tolerance increased significantly (p < 0.05) from 29.2 +/- 5.5% to 41.5% and from 379.8 +/- 271 sec to 897.8 +/- 350.8 sec, respectively. The incidence of atrial and ventricular arrhythmias decreased significantly and no side effects were observed.

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We present the results of the first detailed study of the antiproliferative and ultrastructural effects of amiodarone on Trypanosoma cruzi, the causative agent of Chagas' disease. Moreover, we report the effects of this compound on the recovery of F-actin fibrils, connexin43, and contractility in T. cruzi-infected cardiac myocytes. Amiodarone is the most prescribed class III antiarrhythmic agent and is frequently used for the symptomatic treatment of Chagas' disease patients with cardiac compromise. In addition, recent studies identified its antifungal and antiprotozoal activities, which take place through Ca(2+) homeostasis disruption and ergosterol biosynthesis blockade. We tested different concentrations of amiodarone (2.5 to 10 μM) on infected primary cultures of heart muscle cells and observed a dose- and time-dependent effect on growth of the clinically relevant intracellular amastigote form of T. cruzi. Ultrastructural analyses revealed that amiodarone had a profound effect on intracellular amastigotes, including mitochondrial swelling and disorganization of reservosomes and the kinetoplast and a blockade of amastigote-trypomastigote differentiation. Amiodarone showed no toxic effects on host cells, which recovered their F-actin fibrillar organization, connexin43 distribution, and spontaneous contractility concomitant with the drug-induced eradication of the intracellular parasites. Amiodarone is, therefore, a promising compound for the development of new drugs against T. cruzi.

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An Omni Orthocor 234A special device pacemaker was implanted in nine patients for treatment of drug-resistant supraventricular tachycardia (three patients) or ventricular tachycardia (six patients). This device is activated using a special external unit, which delivers from six to 15 stimuli at preselected coupling intervals ranging from 195 to 500 ms. Serial noninvasive electrophysiology studies were performed either in the hospital or on an outpatient basis using the triggered mode, which can respond to programmed chest wall stimulation. Three patients with reciprocating supraventricular tachycardia were treated effectively by this device during an average follow-up of 2.2 years. Of the six patients with stable ventricular tachycardia amenable to pacemaker termination, only four remained successful during an average follow-up of 1.9 years. Such devices may find important use in serial noninvasive electrophysiologic testing during long-term clinical follow-up. The present form of this device is inadequate for widespread application, but may be useful for highly selected individuals.