Università Politecnica delle Marche, Azienda Ospedaliero Universitaria Ospedali Riuniti , Clinica di Cardiologia, Via Conca 71, Località Torrette, 60126 (AN), Italy.
Expert Opin Pharmacother. 2012 Mar;13(4):573-84. doi: 10.1517/14656566.2012.656589. Epub 2012 Jan 28.
Intravenous (IV) amiodarone is the most used and effective drug to manage life-threatening ventricular arrhythmias. However, its administration is associated with important adverse effects, the most frequent of which is hypotension. Nexterone® is a novel IV amiodarone formulation, proved to be devoid of hypotensive effects in clinical studies and may represent an improved and safer instrument in this setting.
The Medline Database was searched for articles on the efficacy and safety of IV amiodarone in ventricular arrhythmias and cardiac arrest. This article summarizes the key findings of the most relevant studies conducted so far, with a special attention to the limitations of the currently available IV amiodarone and the potential advantages of the recently approved Nexterone. The role given to IV amiodarone in the guidelines on Advanced Cardiovascular Life Support is also reported and discussed.
Available studies demonstrated a convincing efficacy of IV amiodarone in ventricular arrhythmias and cardiac arrest. The new formulation seems to resolve concerns about tolerability. However, despite proven antiarrhythmic efficacy of the drug, no improved survival was showed in different settings. The search for an antiarrhythmic drug able to impact on hard endpoint as survival to hospital discharge is therefore far from being concluded.
静脉注射胺碘酮是治疗危及生命的室性心律失常最常用和最有效的药物。然而，其应用与重要的不良反应相关，最常见的是低血压。Nexterone®是一种新型的静脉注射胺碘酮制剂，在临床研究中被证明没有低血压作用，在这种情况下可能代表一种改进和更安全的工具。
检索了 Medline 数据库中关于静脉注射胺碘酮治疗室性心律失常和心脏骤停的疗效和安全性的文章。本文总结了迄今为止进行的最相关研究的关键发现，特别关注了目前可用的静脉注射胺碘酮的局限性和最近批准的 Nexterone 的潜在优势。还报告并讨论了 IV 胺碘酮在高级心血管生命支持指南中的作用。
现有研究表明，静脉注射胺碘酮对室性心律失常和心脏骤停具有令人信服的疗效。新制剂似乎解决了关于耐受性的担忧。然而，尽管该药物已被证明具有抗心律失常作用，但在不同情况下并未显示出生存率的提高。因此，寻找一种能够对生存至出院这一硬终点产生影响的抗心律失常药物的研究远未结束。
