cardio:arrhythmias:dronedarone
Differences
This shows you the differences between two versions of the page.
| cardio:arrhythmias:dronedarone [2026/02/15 03:12] – created andrew2393cns | cardio:arrhythmias:dronedarone [2026/02/15 03:15] (current) – andrew2393cns | ||
|---|---|---|---|
| Line 5: | Line 5: | ||
| ^ Dronedarone | {{ : | ^ Dronedarone | {{ : | ||
| | Brand Name | Multaq® | | | Brand Name | Multaq® | | ||
| - | | Drug Class | [[cardio:antiarrhythmics: | + | | Drug Class | [[cardio:arrhythmias: |
| - | | Vaughan-Williams Class | Class III (Multichannel | + | | Vaughan-Williams Class | Class III (Multichannel |
| | Primary Indication | Atrial Fibrillation / Atrial Flutter | | | Primary Indication | Atrial Fibrillation / Atrial Flutter | | ||
| | QT Prolongation | Yes | | | QT Prolongation | Yes | | ||
| Line 18: | Line 18: | ||
| ===== Overview ===== | ===== Overview ===== | ||
| - | Dronedarone is a multichannel antiarrhythmic agent structurally related to amiodarone but lacking | + | Dronedarone is a multichannel antiarrhythmic agent structurally related to [[cardio: |
| It is used for rhythm control in paroxysmal or persistent atrial fibrillation (AF) and atrial flutter (AFL). | It is used for rhythm control in paroxysmal or persistent atrial fibrillation (AF) and atrial flutter (AFL). | ||
| - | Compared to amiodarone, dronedarone has fewer thyroid and pulmonary toxicities but is less effective and carries a black box warning in patients with heart failure. | + | Compared to amiodarone, dronedarone has fewer thyroid and pulmonary toxicities but is less effective and carries a boxed warning in patients with heart failure. |
| <WRAP clear></ | <WRAP clear></ | ||
| Line 32: | Line 32: | ||
| Dronedarone blocks multiple cardiac ion channels: | Dronedarone blocks multiple cardiac ion channels: | ||
| - | * Potassium channels | + | * Potassium channels |
| - | * Sodium channels | + | * Sodium channels |
| - | * Calcium channels | + | * Calcium channels |
| - | * Noncompetitive | + | * Noncompetitive |
| - | Net effect: | + | Net effects: |
| - | * Prolonged | + | * Prolonged |
| - | * Slowed AV nodal conduction | + | * Slowed AV nodal conduction |
| - | * Reduced | + | * Reduced AF recurrence |
| - | Multichannel blockade resembles | + | Mechanistically similar to amiodarone but with shorter half-life |
| ---- | ---- | ||
| Line 53: | Line 53: | ||
| Goal: | Goal: | ||
| - | * Reduce hospitalization | + | * Reduce hospitalization |
| Not indicated for: | Not indicated for: | ||
| Line 64: | Line 64: | ||
| ===== Black Box Warning ===== | ===== Black Box Warning ===== | ||
| - | Dronedarone increases | + | Dronedarone increases risk of death in: |
| - | * Patients with symptomatic | + | * Symptomatic |
| * Recently decompensated heart failure | * Recently decompensated heart failure | ||
| * Permanent atrial fibrillation | * Permanent atrial fibrillation | ||
| Line 110: | Line 110: | ||
| Absorption: | Absorption: | ||
| - | * Oral; improved | + | * Oral; increased |
| Metabolism: | Metabolism: | ||
| Line 119: | Line 119: | ||
| Elimination: | Elimination: | ||
| - | * Fecal (primary) | + | * Primarily fecal |
| - | Shorter half-life than amiodarone. | + | Shorter half-life |
| </ | </ | ||
| Line 140: | Line 140: | ||
| * Heart failure exacerbation | * Heart failure exacerbation | ||
| - | Less pulmonary and thyroid | + | Lower risk of: |
| + | * Thyroid | ||
| + | * Pulmonary fibrosis | ||
| + | |||
| + | Compared | ||
| </ | </ | ||
| Line 156: | Line 160: | ||
| QT-prolonging agents: | QT-prolonging agents: | ||
| * Fluoroquinolones | * Fluoroquinolones | ||
| - | * Other antiarrhythmics | + | * Other Class III antiarrhythmics |
| - | + | ||
| - | Warfarin: | + | |
| - | * May increase INR | + | |
| Digoxin: | Digoxin: | ||
| * Increases digoxin levels | * Increases digoxin levels | ||
| + | |||
| + | Warfarin: | ||
| + | * May increase INR | ||
| </ | </ | ||
| Line 176: | Line 180: | ||
| * Electrolytes | * Electrolytes | ||
| - | Avoid use if patient | + | Discontinue |
| </ | </ | ||
| Line 185: | Line 189: | ||
| ===== Clinical Pearls ===== | ===== Clinical Pearls ===== | ||
| - | * Structurally | + | * Structurally |
| - | * Fewer thyroid and pulmonary toxicities | + | * Less effective than amiodarone. |
| + | * Fewer thyroid and pulmonary toxicities. | ||
| * Contraindicated in symptomatic heart failure. | * Contraindicated in symptomatic heart failure. | ||
| - | * Not effective | + | * Not used for ventricular arrhythmias. |
| - | * Shorter half-life than amiodarone. | + | |
| </ | </ | ||
| Line 197: | Line 201: | ||
| ===== Comparison Within Class ===== | ===== Comparison Within Class ===== | ||
| - | Compared to [[cardio:antiarrhythmics: | + | Compared to [[cardio:arrhythmias: |
| * Less effective | * Less effective | ||
| - | * Less organ toxicity | + | * Fewer organ toxicities |
| - | * No iodine | + | |
| * Shorter half-life | * Shorter half-life | ||
| - | Compared to [[cardio:antiarrhythmics: | + | Compared to [[cardio:beta_blockers: |
| - | * Multichannel | + | * Multichannel |
| - | * No renal dosing | + | * No renal dosing |
| - | Compared to [[cardio:antiarrhythmics: | + | Compared to [[cardio:arrhythmias: |
| - | * Less torsades risk | + | |
| * No inpatient loading required | * No inpatient loading required | ||
| + | * Lower torsades risk | ||
| ---- | ---- | ||
| Line 215: | Line 218: | ||
| ===== Related ===== | ===== Related ===== | ||
| - | * [[cardio: | ||
| - | * [[cardio: | ||
| - | * [[cardio: | ||
| * [[cardio: | * [[cardio: | ||
| + | * [[cardio: | ||
| + | * [[cardio: | ||
| + | * [[cardio: | ||
cardio/arrhythmias/dronedarone.txt · Last modified: by andrew2393cns