Terapevticheskii arkhivTerapevticheskii arkhivТерапевтический архив0040-36602309-5342LLC Obyedinennaya Redaktsiya30881Editorial articleПередовая статьяAmiodaron: decades of administrationАмиодарон десятилетия спустяGolitsynSergey PavlovichГолицынСергей Павлович

д-р мед. наук, проф., рук. отд. клинической электрофизиологии и рентгенохирургических методов лечения нарушений ритма сердца РКНПК, тел.: 8-495-414-65-46; ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития РФ

GolitsynS P

Russian Cardiological Research Center, Moscow

ФГУ Российский кардиологический научно-производственный комплекс Минздравсоцразвития РФRussian Cardiological Research Center, Moscow15082011838NO8 (2011)ТОМ 83, №8 (2011)253310042020Copyright ©; 2011, Consilium MedicumCopyright ©; 2011, ООО "Консилиум Медикум"2011Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://ter-arkhiv.ru/0040-3660/article/view/30881

The review of long-term international clinical experience with amiodaron covers pharmacological properties of the drug, mechanisms of development of its pharmacodynamic effects basing on its action on ionic channels, receptors, impact on thyroid function. Unique pharmacokinetics of amiodaron, high antiarrhythmic efficacy of the drug in supraventricular and ventricular arrhythmia, positive experience in primary and secondary prevention of sudden death are characterized. Amiodaron is effective in patients with atrial fibrillation including those with organic heart disease and chronic cardiac failure. It is safe in relation to different cardiac side effects which are minimal but has some non-cardiac side effects which require control during long-term treatment.

Представлены обзорные данные, характеризующие многолетний международный опыт применения амиодарона в клинической практике. Рассматриваются фармакологические свойства препарата, механизмы формирования его фармакодинамических эффектов на основе его влияния на ионные каналы, рецепторы, влияние на функцию щитовидной железы. Дается подробная характеристика уникальной фармакокинетики амиодарона, предъявляющей особые требования и к режиму дозирования, и к анализу клинико-инструментальных проявлений его действия, изменяющихся во времени в условиях длительного применения. Приводятся данные, характеризующие непревзойденную антиаритмическую эффективность препарата при лечении как наджелудочковых, так и желудочковых нарушений ритма сердца. Подводятся итоги многолетнего положительного опыта использования амиодарона как средства не только вторичной, но и первичной профилактики внезапной смерти. Приведены данные, характеризующие высокую эффективность применения амиодарона у больных с фибрилляцией предсердий, в том числе при органическом заболевании сердца и хронической сердечной недостаточности. Дается объективная оценка безопасности амиодарона как препарата с минимальными проявлениями кардиального побочного действия, с одной стороны, обладающего при этом различными несердечными побочными эффектами, с другой стороны, что требует специального наблюдения и контроля за пациентами, длительно принимающими этот препарат.

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