Dr. Saltiel received his Pharm.D. from the University of California, San Francisco, in 1980, following undergraduate work at UCLA. At UCSF, he was the recipient of the Outstanding Service Award and the Bowl of Hygeia Award. He completed a residency in clinical pharmacy practice at the University of Illinois, in Chicago.
Jay W. Marks, MD, is a board-certified internist and gastroenterologist. Dr. graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.
DRUG CLASS AND MECHANISM: Amiodarone is used to correct abnormal rhythms of
the heart. (It is an antiarrhythmic medication.) Amiodarone was discovered in
1961 and approved by the FDA in December of 1985. Although amiodarone has many
side effects, some of which are severe and potentially fatal, it has been
successful in treating many arrhythmias where other antiarrhythmic drugs have
failed. Amiodarone is considered a "broad spectrum" antiarrhythmic medication,
that is, it has multiple and complex effects on the electrical activity of the
heart which is responsible for the heart's rhythm. Among its most important
electrical effects are:
a delay in the rate at which the heart's electrical system "recharges"
after the heart contracts (repolarization);
a prolongation in the electrical phase during which the heart's muscle
cells are electrically stimulated (action potential);
a slowing of the speed of electrical conduction (how fast each individual
impulse is conducted through the heart's electrical system);
a reduction in the rapidity of firing of the normal generator of
electrical impulses in the heart (the heart's pacemaker);
a slowing of conduction through various specialized electrical pathways
(called accessory pathways) which can be responsible for arrhythmias.
In addition to being an antiarrhythmic medication, amiodarone also causes
blood vessels to dilate (enlarge). This effect can result in a
drop in blood pressure. Because of this effect, it also may be of benefit in patients with
congestive heart failure.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets (pink), round in shape: 200 mg.
STORAGE: Tablets should be kept at room temperature, less than 30°C (86°F).
DOSING: Amiodarone usually is given in several daily doses to minimize
stomach upset which is seen more frequently with higher doses. For this same
reason, it is also recommended that amiodarone be taken with meals.
DRUG INTERACTIONS: Amiodarone may interact with
beta-blockers such as
atenolol (Tenormin), propranolol (Inderal), metoprolol (Lopressor), or certain
calcium channel blockers, such as verapamil (Calan, Isoptin, Verelan, Covera-HS)
or diltiazem (Cardizem, Dilacor, Tiazac), resulting in an excessively slow heart
rate or a block in the conduction of the electrical impulse through the heart.
Amiodarone increases the blood levels of digoxin (Lanoxin) when the two drugs
are given together. It is recommended that the dose of digoxin be cut by 50%
when amiodarone therapy is started.
Flecainide (Tambocor) blood concentrations increase by more than 50% with
amiodarone. Procainamide (Procan-SR, Pronestyl) and quinidine (Quinidex,
Quinaglute) concentrations increase by 30%-50% during the first week of
amiodarone therapy. Additive electrical effects occurs with these combinations,
and worsening arrhythmias may occur as a result. Some experts recommend that the
doses of these other drugs be reduced when amiodarone is started.
Premature ventricular contractions (PVCs) are premature heartbeats originating from the ventricles of the heart. PVCs are premature because they occur before the regular heartbeat. There are many causes of premature ventricular contractions to include: heart attack, high blood pressure, congestive heart failure, mitral valve prolapse, hypokalemia, hypoxia, medications, excess caffeine, drug abuse, and myocarditis.
The liver, located in the right upper portion of the abdominal cavity just
beneath the right side of the rib cage, has many vital functions. Briefly, some
of these functions are:
Detoxification of blood
Production of important clotting factor and other important proteins
Metabolizing (processing) medications and nutrients
Processing of waste products of hemoglobin
Storing of vitamins, fat, cholesterol, and bile
Production of glucose
What are common liver blood tests?
Liver blood tests are some of the most commonly performed blood tests. These tests can assess liver functions or liver injury. An initial step in detecting liver damage is a simple blood test to determine the presence of certain liver enzymes (proteins) in the blood. Under normal circumstances, these enzymes reside within the cells of the liv...