Department of Medicine, North Shore University Hospital, 350 Community Drive, Manhasset, NY 11030, USA.
Nat Rev Endocrinol. 2010 Jan;6(1):34-41. doi: 10.1038/nrendo.2009.225.
Amiodarone is a benzofuran derivative approved for the treatment of cardiac arrhythmias. Traditionally classified as a class III antiarrhythmic agent, amiodarone possesses electrophysiologic properties of all four Vaughan-Williams classes. This drug, however, has high iodine content, and this feature plus the intrinsic effects on the body make amiodarone especially toxic to the thyroid gland. Treatment can result in a range of effects from mild derangements in thyroid function to overt hypothyroidism or thyrotoxicosis. The diagnosis and treatment of amiodarone-induced hypothyroidism is usually straightforward, whereas that of amiodarone-induced thyrotoxicosis and the ability to distinguish between the type 1 and type 2 forms of the disease are much more challenging. Dronedarone was approved in 2009 for the treatment of patients with atrial fibrillation. As amiodarone, dronedarone is a benzofuran derivative with similar electrophysiologic properties. In contrast to amiodarone, however, dronedarone is structurally devoid of iodine and has a notably shorter half-life. In studies reported before FDA approval, dronedarone proved to be associated with significantly fewer adverse effects than amiodarone, making it a more attractive choice for patients with atrial fibrillation or flutter, who are at risk of developing amiodarone-induced thyroid dysfunction.
胺碘酮是一种苯并呋喃衍生物，被批准用于治疗心律失常。传统上被归类为 III 类抗心律失常药物，胺碘酮具有 Vaughan-Williams 所有四类的电生理特性。然而，这种药物含有高碘含量，再加上对身体的内在影响，使胺碘酮对甲状腺特别有毒。治疗可能会导致从甲状腺功能轻度紊乱到明显的甲状腺功能减退或甲状腺功能亢进的一系列影响。胺碘酮引起的甲状腺功能减退症的诊断和治疗通常很直接，而胺碘酮引起的甲状腺功能亢进症以及区分 1 型和 2 型疾病的能力则更加具有挑战性。多非利特于 2009 年被批准用于治疗心房颤动患者。与胺碘酮一样，多非利特也是一种苯并呋喃衍生物，具有相似的电生理特性。然而，与胺碘酮不同的是，多非利特在结构上不含碘，半衰期明显较短。在 FDA 批准前报告的研究中，多非利特被证明与胺碘酮相比，不良反应明显减少，因此对于有发生胺碘酮引起的甲状腺功能障碍风险的心房颤动或心房扑动患者来说，多非利特是一个更有吸引力的选择。
