抗心律失常新药决奈达隆的不良反应与相互作用

决奈达隆是一种化学结构与胺碘酮相似的新的抗心律失常药物。2011年美国版和2010年欧洲版心房颤动指南均推荐决奈达隆用于心房颤动的治疗。决奈达隆的疗效虽然不如胺碘酮,但不良反应及耐受性明显好于胺碘酮,无甲状腺毒性、肺毒性和眼毒性,致心律失常的可能性也很低。决奈达隆的不良反应主要是消化系统反应(腹泻、恶心和呕吐等)、循环系统反应(致尖端扭转型室速、心动过缓、心血管不良事件死亡率升高等)、升高血清肌酐水平及头晕、头痛等神经系统不良反应。决奈达隆与其他药物的不良相互作用主要涉及经CYP450 3A4和CYP450 2D9代谢(诱导剂和抑制剂)的药物。决奈达隆的不良反应及药物相互作用值得心血管内科临床医生重视。

Adverse reactions and interactions of the antiarrhythmic drug dronedarone

Dronedarone is a new antiarrhythmic drug that chemical structure is similar with amiodarone.In the guidelines of atrial fibrillation of USA in 2011 and European in 2010,dronedarone has been recommended for the treatment of atrial fibrillation.The efficacy of dronedarone is not as good as amiodarone,but its adverse effects and tolerability are significantly better.Dronedarone has no thyroid toxicity,pulmonary toxicity and ocular toxicity,and its proarrhythmic possibility is very low.The adverse reactions of dronedarone mainly include digestive system reactions(diarrhea,nausea and vomiting),circulatory response torsade de points(TdP),bradycardia,higher cardiovascular adverse events and mortality],elevated serum creatinine level and dizziness,headache and other nervous system adverse reactions.The adverse interactions of dronedarone with other drugs mainly involve the CYP450 3A4 and CYP450 2D9 metabolism of drugs(inducers and inhibitors).Cardiovascular physicians should pay high attention to the adverse reactions of dronedarone and its adverse drug interactions.