CORDAREX

introduction

According to Vaughan-Williams, Cordarex® belongs to the group of class III antiarrythmic agents (Potassium channel blockers) and is used for cardiac arrhythmias. The electrical heart action arises in the sinus node (is located in the auricles) by opening and closing certain channels for the ions sodium, potassium and calcium in the heart cells (heart) at certain times. First the sodium channels open and the cell depolarizes. A calcium influx follows (Plateau phase). Then an outward potassium current ensures a regression of the electrical excitation (Repolarization). After complete regression, the cell can now be re-excited. During the regression of excitation, the cells are not excitable or more difficult to excite for a while (absolute and relative refractory phase). The active ingredient amiodarone contained in Cordarex® mainly blocks potassium channels in heart cells.

Mode of action

Of the point of action of the Cordarex® are the cells in the Auricleswhich are responsible for the formation and transmission of electrical activity. The regression of excitation is delayed by inhibiting the outward flow of potassium. A new excitation can now only set in later (extended refractory period). In addition to the potassium channels, sodium and calcium channels are also blocked. This means that it also takes longer before a new arousal can develop (slower depolarization). The result is a slowed one Heart rate. In addition, the transmission of electrical activity (to AV node) reduced.

application

Cordarex® is a very effective one drug. It is applied when others Antiarrhythmics (Meditative cardiac arrhythmias) can no longer work or be given. It is used for severe arrhythmias that cause the Chambers of the heart affect (ventricular arrhythmias) and circling excitations. The use of therapy-resistant products is becoming increasingly important Atrial flutter or atrial fibrillation. The drug can also be used with restrictions Heart failure (Heart failure) can be used.

Pharmacokinetics

Cordarex is usually given as a tablet. In some cases, infusion may also be indicated. Since it is relatively poorly soluble in water, it binds in the blood on Egg whitesthrough which it is transported. Amiodarone accumulates in the cells. Therefore the degradation rate is very long (Elimination half-life up to 100 days). Despite the high effectiveness of the active ingredient amiodarone, the drug should only be used if other therapy options fail because of the relatively frequent and severe side effects, especially in the case of prolonged therapy.

Side effects

Amiodarone (Cordarex) can with Fats (Phospholipids) interact and form complexes. These are then stored e.g. in the Cornea (Cornea) of Eye decrease and decrease eyesight. Other deposits are often found in the lung (Pulmonary fibrosis) or the liver (Lboar fibrosis). Also heart valves can be affected. The skin can react with increased sensitivity to light. Before starting and during therapy, the function of the thyroid must be examined in detail. In the Cordarex® or the active ingredient Amiodarone iodine atoms contained in it can lead to disorders of the thyroid function. Both under- and over-functions are observed. It should also be noted that all antiarrhythmics themselves turn Cardiac arrhythmias can trigger (pro-arrhythmic).

Drug interactions

Drug interactions can occur with simultaneous administration of Beta blockers, Acetylsalicylic acid (ASS 100, Aspirin®), Statins, Phenytoin and Phenprocoumon. The effect of these drugs can be enhanced by Cordarex®, because the substance has certain activities Enzymes (CYP2C8 / 9, 2D6) elevated. The dose of Cordarex® must then be reduced.

Amiodarone itself is made in the liver by an enzyme called CYP2A4 metabolized. Certain medications like Simvastatin or Azole antifungal drugs inhibit the enzyme, the effect of amiodarone is weakened.