Comparative Effects of Rapid Bolus Administration of Aqueous Amiodarone Versus 10-Minute Cordarone I.V. Infusion on Mean Arterial Blood Pressure in Conscious Dogs

Somberg, John C.; Cvetanovic, I.; Ranade, Vasant; Molnár, J.

doi:10.1007/s10557-005-5058-8

Cited by 15 publications

(7 citation statements)

References 30 publications

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“…The results from the present study confirm the previously reported hypotensive liability of the conventional formulation of intravenous amiodarone 7,9,11–16 and extend the observation of hypotension to the maintenance infusion period. Moreover, these data indicate that administration of the maintenance dose alone, without having administered the loading dose, can produce significant hypotension.…”

Section: Discussionsupporting

confidence: 91%

“…Presumably, this response is due to the cosolvents (i.e. polysorbate 80 and benzyl alcohol) used to formulate intravenous amiodarone 7,15 . In contrast with the conventional formulation of intravenous amiodarone, a formulation of amiodarone devoid of the cosolvents (i.e.…”

Section: Discussionmentioning

confidence: 61%

“…We and others have reported previously an increase in HR with administration of the loading dose of the conventional formulation of intravenous amiodarone, which was attributed to a baroreceptor reflex 15,16 . Administration of the loading dose of intravenous amiodarone formulations devoid of polysorbate 80 and benzyl alcohol do not cause hypotension or increases in HR 15,16 . One potential difference between the reflex tachycardia reported by these laboratories and those of others is the dose of amiodarone.…”

Section: Discussionmentioning

confidence: 71%

“…Previous animal and human studies have fully characterized the haemodynamic effects associated with the loading dose of intravenous amiodarone 7,9,11–16 . We recently reported that administration of the loading dose of intravenous amiodarone produced a profound and sustained cardiac depressant effect 16 .…”

Section: Introductionmentioning

confidence: 99%

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The hypotensive effect of intravenous amiodarone is sustained throughout the maintenance infusion period

Cushing¹,

Cooper²,

Gralinski

et al. 2010

Clin Exp Pharma Physio

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1. Hypotension frequently occurs with use of intravenous amiodarone and is managed by slowing the rate of administration. This response has been attributed to the cosolvents in the formulation and is believed to be solely related to the initial loading dose. The present study was performed to determine whether intravenous amiodarone-induced hypotension persists beyond the loading dose and into the maintenance infusion period and also whether hypotension occurs with maintenance level dosing alone. 2. Anaesthetized beagle dogs (n = 7/group) were instrumented to assess haemodynamics. Animals were treated with the human-equivalent dosing regimen (loading dose followed by maintenance infusion) of intravenous amiodarone or control (5% dextrose in water). 3. No haemodynamic changes were observed in the control group during the 6 h study. In contrast, administration of the standard intravenous amiodarone regimen produced rapid and significant decreases in mean aortic pressure, cardiac output and maximum rate of change of left ventricular pressure that persisted throughout the 6 h maintenance infusion period. Administration of amiodarone as the maintenance infusion dose alone produced haemodynamic changes that were similar in magnitude to those observed with administration of the full dosing regimen, but were delayed in onset by approximately 60 min. 4. Dosing with a cosolvent-free formulation of amiodarone (PM101) caused no haemodynamic effects during the 6 h dosing period, indicating that the cardiodepressant effects of intravenous amiodarone were due to its cosolvents. 5. These data suggest that consideration should be given to intravenous amiodarone as a potential cause for sustained hypotension during prolonged infusion.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 71%

Section: Introductionmentioning

confidence: 99%

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The hypotensive effect of intravenous amiodarone is sustained throughout the maintenance infusion period

Cushing¹,

Cooper²,

Gralinski

et al. 2010

Clin Exp Pharma Physio

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“…Aqueous preparations of amiodarone (Amio-Aqueous d ) prevent hypotension in dogs and humans, and may be better suited for IV use. 9,10 Amiodarone and other class-III antiarrhythmics are associated with prolongation of the QT-interval and potential for proarrhythmia, specifically torsades de pointes. This complication is unlikely when amiodarone is used as a short-term IV infusion, 11 and we did not detect any significant QT-prolongation in the cases reported here.…”

mentioning

confidence: 99%

Acute Conversion of Atrial Fibrillation in Two Dogs by Intravenous Amiodarone Administration

Oyama

Prosek

2006

Veterinary Internal Medicne

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A 30-kg, 10-year-old, castrated male Siberian Husky (dog 1) was presented to the Emergency Service of the Veterinary Teaching Hospital of the University of Illinois with a 14-day history of cardiac arrhythmias after splenectomy for a benign splenic mass. On presentation, the dog was bright, alert, and responsive. Heart rate was 200 beats per minute (bpm) and cardiac murmurs were not ausculted. Femoral pulses were weak, and pulse deficits were noted, resulting in a rate of approximately 60 bpm. The abdominal incision from the recent splenectomy appeared to be healing normally. A small subcutaneous mass in the left inguinal area was noted. The dog had been diagnosed previously with a seizure disorder and was receiving phenobarbital (81 mg PO q12h). In response to the cardiac arrhythmia, atenolol (25 mg PO q8h) administration had been started 24 hours before presentation at the hospital.Hematologic (CBC) and serum biochemical analyses, blood pressure measurement, mass aspiration, and electrocardiography were performed. The CBC was unremarkable, except for mild thrombocytopenia of 170 3 10 3 cells/mL (reference interval [RI], 200-900 3 10 3 cells/mL). Serum biochemical analysis revealed mild decrease in c-globulin concentration (2.3 g/dL; RI, 2.7-4.4 g/dL); increased total alkaline phosphatase (ALP: 4,416 U/L; RI, 12-110 U/L), alanine transaminase (ALT: 289 U/L; RI, 17-87 U/L), and c-glutamyltransferase (24 U/L; RI, 1-11 U/L) activities; and increased total bilirubin concentration (0.6 mg/dL; RI, 0.08-0.50 mg/dL). Systolic, diastolic, and mean blood pressures measured by oscillometric technique were 124, 110, and 116 mm Hg, respectively. Results of an examination of a fine needle aspirate of the inguinal mass were consistent with benign lipoma. A 6-lead ECG identified atrial fibrillation, with a ventricular rate of 130 bpm. The dog was admitted to the intensive care unit for overnight evaluation, and was placed on telemetric ECG monitoring.Over the next 8 hours, heart rate varied from 162 to 211 bpm. The next morning, the dog was referred to the Cardiology Service for evaluation of atrial fibrillation. A 10-lead ECG was obtained, and confirmed atrial fibrillation, with a ventricular rate of 145 bpm. The QRS amplitudes and durations were within normal limits. Cardiac ultrasonography was performed and normal cardiac size and systolic function were identified. A small echogenic mass was visualized on the dorsal portion of the left atrium, from which a finger-like appendage projected into the left atrial chamber. On the basis of the presence of atrial fibrillation and the location and echocardiographic appearance of the mass, atrial thrombus was considered the most likely diagnosis. Heparin therapy (1,000 U SC q8h) was initiated. In an attempt to restore sinus rhythm, procainamide (230 mg, slow bolus) was administered IV. An effect on the ECG was not observed. The dog was returned to the intensive care unit (ICU), and 24 hours later, cardioversion with amiodarone was attempted.A solution of 5 mg of amiodarone/mL was mad...

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Evaluation of the Effects of PM101, a Cyclodextrin-Based Formulation of Intravenous Amiodarone, on Blood Pressure in Healthy Humans

Cushing¹,

Adams²,

Cooper³

et al. 2009

The American Journal of Cardiology

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Comparative Effects of Rapid Bolus Administration of Aqueous Amiodarone Versus 10-Minute Cordarone I.V. Infusion on Mean Arterial Blood Pressure in Conscious Dogs

Abstract: Amio-Aqueous had significantly better hemodynamic profile permitting rapid intravenous administration. This is a significant advantage over the standard formulation, because Cordarone cannot be administered by rapid bolus due to excipient-related hypotension.

Cited by 15 publications

References 30 publications

The hypotensive effect of intravenous amiodarone is sustained throughout the maintenance infusion period

The hypotensive effect of intravenous amiodarone is sustained throughout the maintenance infusion period

Acute Conversion of Atrial Fibrillation in Two Dogs by Intravenous Amiodarone Administration

Evaluation of the Effects of PM101, a Cyclodextrin-Based Formulation of Intravenous Amiodarone, on Blood Pressure in Healthy Humans

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