Kimia Organik Obat

Amiodaron

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Program Studi Magister Farmasi

Universitas Sumatera Utara
Medan
2016

Struktur
Kekule

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3-D

Nama Sistematik (IUPAC)

(2-{4-[(2-butyl-1-benzofuran-3yl)carbonyl]-2,6diiodophenoxy}ethyl)diethylamine

Nama Dagang
Cordarone, Nexterone

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Data Farmakokinetik
Bioavailabilitas; 20 55%
Metabolisme; Liver
Waktu paruh biologis; 58 d (range 15
142 d)
Ekskresi; Primarily liver and bile

Data Kimia
Rumus; C25H29I2NO3
Massa molar; 645.31 g/mol
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Kegunaan Medis
Amiodarone has been used both in
the treatment of acute lifethreatening arrhythmias as well as
the chronic suppression of
arrhythmias.
Digunakan untuk mengobati aritmia
supravetrikular dan aritmia
ventrikular.
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Mekanisme Aksi
Amiodarone is categorized as a class
IIIantiarrhythmic agent (Class III
Prolong repolarization), and prolongs
phase 3 of thecardiac action potential,
the repolarization phase where there is
normally decreased calcium permeability
and increased potassium permeability.
It has numerous other effects however,
including actions that are similar to those
of antiarrhythmic classes I, II and IV.
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Classification of antiarrhythmics
(based on mechanisms of action)

Class III K+ channel blockers

Cause delay in repolarization and prolonged

refractory period
Includes

Amiodarone: prolongs action

potential by delaying K+ efflux but
many other effects characteristic of
other classes
Ibutilide: slows inward movement of Na+ in addition to
delaying K + influx.
Bretylium: first developed to treat hypertension but
found to also suppress ventricular fibrillation associated
with myocardial infarction
Dofetilide: prolongs action potential by delaying K +
efflux with no other effects

Dosis
Oral
200 mg 3 kali sehari selama 1 minggu
200 mg 2 kali sehari selama 1 minggu
berikutnya
Dosis penunjang
200 mg sehari atau dosis minimal yang
diperlukan untuk mengendalikan aritmia
Infus intravena via kateter vena sentral
5 mg/kgBB selama 20 120 menit dengan
pantauan EKG; maksimal 1,2 g dalam 24 jam.
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Metabolisme
Amiodarone is extensively metabolized in the
liver by cytochrome P450 3A4, and can affect
the metabolism of numerous otherdrugs. It
interacts with digoxin, warfarin, phenytoin.
The major metabolite of amiodarone is
desethylamiodarone (DEA), which also has
antiarrhythmic properties.
The metabolism of amiodarone is inhibited by
grapefruit juice, leading to
elevatedserumlevels of amiodarone.
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Ekskresi
Excretion is primarily hepatic and biliary with
almost no elimination via the renal route and it
is not dialyzable.
Elimination half-life average of 58 days
(ranging from 25 100 days [Remington: The
Science and Practice of Pharmacy 21st edition])
for amiodarone and 36 days for the active
metabolite, desethylamiodarone (DEA).
There is 10 50% transfer of amiodarone and
DEA in the placenta as well as presence in
breast milk.
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Interaksi
Amiodarone inhibits the action of the cytochrome
P450 isozyme family. This the clearance of
many drugs, including the following:
Digoxin
Procainamide
Quinidine
Sildenafil
Simvastatin
Theophylline
Warfarin
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Terima Kasih

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