PubMed · 11176750
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B Goichot, F Grunenberger, J L Schlienger. 2001-01-22. Amiodarone-induced hyperthyroidism.. https://doi.org/10.1001/archinte.161.2.295
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PURPOSE OF REVIEW: Atrial fibrillation after cardiac surgery is associated with adverse outcomes and increased costs. Accordingly, therapy should be provided to prevent postoperative atrial fibrillation. The evaluation of therapies to do so is an area of active investigation with significant recent advances. The purpose of this review is to summarize these recent advances in the context of our previous knowledge base regarding the prevention of postoperative atrial fibrillation. RECENT FINDINGS: Recent evaluations of therapy to prevent postoperative atrial fibrillation have raised the prominence of prophylactic amiodarone, redefined the efficacy of prophylactic standard beta-blockers in contemporary cardiac surgical populations, provided further evidence for the use of prophylactic sotalol, magnesium, and atrial pacing, and identified new approaches, including the use of combination therapy, for the prevention of postoperative atrial fibrillation. SUMMARY: According to newly released ACC/AHA/ESC guidelines, use of standard beta-blockers or amiodarone to prevent postoperative atrial fibrillation have a level of evidence of A. Use of prophylactic sotalol has a level of evidence of B, while the use of prophylactic intravenous magnesium or atrial pacing has a lower level of evidence. The use of novel and combination therapies continues to be an area of active investigation.
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A simple, accurate and selective LC-MS/MS method was developed and validated for simultaneous quantification of ten antiarrhythic drugs (diltiazem, amiodarone, mexiletine, propranolol, sotalol, verapamil, bisoprolol, metoprolol, atenolol, carvedilol) and a metabolite (norverapamil) in human plasma. Plasma samples were simply pretreated with acetonitrile for deproteinization. Chromatographic separation was performed on a Capcell C(18) column (50mmx2.0mm, 5microm) using a gradient mixture of acetonitrile and water (both containing 0.02% formic acid) as a mobile phase at flow rate of 0.3ml/min. The analytes were protonated in the positive electrospray ionization (ESI) interface and detected in multiple reaction monitoring (MRM) mode. Calibration curves were linear over wide ranges from sub- to over-therapeutic concentration in plasma for all analytes. Intra- and inter-batch precision of analysis was <12.0%, accuracy ranged from 90% to 110%, average recovery from 85.0% to 99.7%. The validated method was successfully applied to therapeutic drug monitoring (TDM) of antiarrhythic drugs in routine clinical practice.