Document Detail


Relationship of steady-state serum concentrations of amiodarone and desethylamiodarone to therapeutic efficacy and adverse effects.
MedLine Citation:
PMID:  3605129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The relationship of steady-state serum levels of amiodarone and its major metabolite, desethylamiodarone, to therapeutic and toxic effects was evaluated in 111 patients treated for supraventricular and ventricular arrhythmias. All patients were treated for more than two months (mean 10 +/- 7), and repeated serum levels determined at least two months apart were within 0.5 mg/liter of each other. Effective control of arrhythmias during steady-state therapy was achieved in 91 patients (82 percent of the study populations); recurrent arrhythmias or sudden death did not correlate with levels. An adverse drug effect necessitating cessation of therapy and/or concomitant medical therapy for the adverse effect occurred in 12 patients (11 percent); an additional 33 patients (30 percent) had an adverse effect that did not require change in therapy. The mean serum concentrations of amiodarone and desethylamiodarone associated with adverse drug effects were higher (2.6 +/- 1.2 mg/liter and 2.0 +/- 0.8 mg/liter) than those in patients without adverse effects (2.1 +/- 1.0 mg/liter and 1.5 +/- 0.7 mg/liter), p less than 0.05. An amiodarone serum concentration of 2.5 mg/liter or more had a positive predictive value of 76 percent for identifying patients with an adverse effect. The level of desethyl metabolite of amiodarone correlated directly with the serum amiodarone concentration (r = 0.82). Measurement of desethylamiodarone did not increase the sensitivity or specificity of the amiodarone level alone in the identification of patients at risk for adverse drug effects.
Authors:
R Falik; B T Flores; L Shaw; G A Gibson; M E Josephson; F E Marchlinski
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  82     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  1987 Jun 
Date Detail:
Created Date:  1987-07-27     Completed Date:  1987-07-27     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1102-8     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Amiodarone / adverse effects,  analogs & derivatives*,  blood*,  therapeutic use
Arrhythmias, Cardiac / drug therapy*
Female
Humans
Male
Middle Aged
Risk
Time Factors
Grant Support
ID/Acronym/Agency:
HL-07346/HL/NHLBI NIH HHS; HL-28093/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
1951-25-3/Amiodarone; 83409-32-9/desethylamiodarone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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