Caron M F, Kluger J, White C M
Department of Pharmacy Services, Hartford Hospital, CT, USA.
Ann Pharmacother. 2001 Oct;35(10):1248-54. doi: 10.1345/aph.10407.
To delineate amiodarone's role in the new American Heart Association guidelines for ventricular tachyarrhythmias, review the literature that supports the use of amiodarone in ventricular tachyarrhythmias, describe the pharmaceutical properties of amiodarone and elucidate their clinical implications, and discuss the dosing, preparation, and administration of amiodarone.
A search of MEDLINE (1966-October 2000) database and EMBASE Drugs and Pharmacology database (1980-October 2000) was performed. References from published articles and tertiary references were used to gather additional data.
All articles were screened, and pertinent studies were identified and evaluated.
Recent trials have demonstrated amiodarone's usefulness in the setting of ventricular tachyarrhythmias. Based on these investigations and contrary to past guidelines, amiodarone is included in the 2000 advanced cardiovascular life support guidelines as a possible agent for hemodynamically stable monomorphic ventricular tachycardia (VT), non-QT prolonged polymorphic VT, and ventricular fibrillation (VF)/pulseless VT. Although not specifically evaluated in the setting of hemodynamically stable monomorphic VT and non-QT prolonged polymorphic VT, investigations by the intravenous Amiodarone Multicenter Trial Group and other clinical trials make amiodarone an acceptable choice for these arrythmia categories. The results of the ARREST (Resuscitation of Refractory Sustained Ventricular Tachyarrhythmias) trial prove amiodarone to be the antiarrhythmic of choice for VF/pulseless VT.
Amiodarone is classified as a IIb therapeutic intervention for all three arrhythmia categories, which makes it an acceptable, safe, and useful agent with fair to good evidence to support its use. In addition, amiodarone requires careful preparation and delivery to achieve safe and effective outcomes.
阐述胺碘酮在美国心脏协会关于室性快速心律失常的新指南中的作用，回顾支持胺碘酮用于室性快速心律失常的文献，描述胺碘酮的药学特性并阐明其临床意义，以及讨论胺碘酮的给药剂量、制剂和用法。
检索MEDLINE（1966年至2000年10月）数据库和EMBASE药物与药理学数据库（1980年至2000年10月）。利用已发表文章的参考文献和三次文献收集更多数据。
筛选所有文章，识别并评估相关研究。
近期试验已证明胺碘酮在室性快速心律失常情况下的有效性。基于这些研究且与过去的指南相反，胺碘酮被纳入2000年高级心血管生命支持指南，作为血流动力学稳定的单形性室性心动过速（VT）、非QT间期延长的多形性VT以及心室颤动（VF）/无脉性VT的可能用药。尽管在血流动力学稳定的单形性VT和非QT间期延长的多形性VT情况下未进行专门评估，但静脉用胺碘酮多中心试验组的研究及其他临床试验使胺碘酮成为这些心律失常类型的可接受选择。ARREST（难治性持续性室性快速心律失常复苏）试验结果证明胺碘酮是VF/无脉性VT的抗心律失常首选药物。
胺碘酮针对所有这三种心律失常类型均被归类为IIb类治疗干预措施，这使其成为一种可接受、安全且有用的药物，有合理至充分的证据支持其使用。此外，胺碘酮需要谨慎配制和给药以实现安全有效的结果。
