Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027497 (nausea)
 23,468 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Oral dronedarone is a non-iodinated benzofurane derivative structurally related to amiodarone. Although it is considered a class III antiarrhythmic agent like amiodarone, it demonstrates multi-class electrophysiological activity. Data from the ATHENA study demonstrated that patients receiving oral dronedarone 400 mg twice daily for 12-30 months had a significantly lower risk of experiencing first hospitalization due to a cardiovascular event or death from any cause than those receiving placebo. Dronedarone exhibited rate- and rhythm-controlling properties in patients with atrial fibrilation (AF) or atrial flutter, significantly reducing the risk of a first recurrence of AF versus placebo following 12 months' therapy in the ADONIS and EURIDIS studies. In the ERATO study, dronedarone was also significantly more effective than placebo in terms of ventricular rate control. Furthermore, the beneficial effects of oral dronedarone on ventricular rate control were maintained during exercise and sustained with continued therapy. Oral dronedarone was generally well tolerated in the treatment of adult patients with AF and/or atrial flutter in clinical studies. The incidence of diarrhoea, nausea, bradycardia, rash and QT-interval prolongation was significantly higher with oral dronedarone than placebo in the large ATHENA study; however, serious cardiac-related adverse events were observed in <1% of oral dronedarone recipients.
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PMID:Dronedarone. 1967 15

In the armamentarium for rhythm control, amiodarone has been a mainstay of therapy for the management of atrial fibrillation (AF). Although amiodarone has shown to be effective in maintaining sinus rhythm, it has many extracardiac adverse effects. Dronedarone, a benzofuran amiodarone derivative, is structurally modified to reduce toxicities often associated with chronic amiodarone therapy. With the addition of a methylsulfonyl group, dronedarone is less lipophilic, has lower tissue accumulation, and a much shorter serum half-life of 24 hours compared with amiodarone. Dronedarone is also designed without the iodine moieties that are responsible for thyroid dysfunctions associated with amiodarone. Similar to amiodarone, dronedarone exhibits electrophysiologic characteristics of all 4 Vaughan Williams classifications. Phase III clinical trials have shown dronedarone to be effective at reducing ventricular rate, reducing recurrence of AF, and reducing cardiovascular morbidity and mortality in patients with AF or atrial flutter (AFL). However, dronedarone was associated with increased mortality in one study that included patients with severe heart failure (HL) and left ventricular dysfunction. Overall, dronedarone appears to be well tolerated. The most common side effects are gastrointestinal in nature and include nausea, vomiting, and diarrhea. Because of its more favorable adverse effect profile, dronedarone is likely to be a useful addition to the therapeutic management of AF. However, further comparative studies with amiodarone are needed to define dronedarone's place in therapy more clearly.
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PMID:Dronedarone: a new antiarrhythmic agent for the treatment of atrial fibrillation. 1969 Apr 74

Dronedarone is an antiarrhythmic agent recently approved by the United States Food and Drug Administration for the reduction of cardiovascular-related hospitalizations in patients with paroxysmal or persistent atrial fibrillation or atrial flutter. The drug is a derivative of amiodarone and has been modified to reduce the organ toxicities frequently encountered with amiodarone. Dronedarone exerts its antiarrhythmic effects through multichannel blockade of the sodium, potassium, and calcium channels and also possesses antiadrenergic activity, thereby exhibiting pharmacologic effects of all four Vaughan Williams classes of antiarrhythmics. The efficacy of dronedarone for the maintenance of sinus rhythm, ventricular rate control, and reduction in cardiovascular-related hospitalizations has been demonstrated in several randomized, placebo-controlled trials. Although a high rate of gastrointestinal events (e.g., nausea, vomiting, and diarrhea) has been associated with dronedarone, more serious adverse events such as thyroid, liver, or pulmonary toxicities have not been observed. Because of a possible increase in mortality, dronedarone should be avoided in patients with New York Heart Association class IV or II-III heart failure with a recent decompensation. Given the efficacy and safety data currently available, dronedarone represents a reasonable alternative for maintenance of sinus rhythm in appropriately selected patients.
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PMID:Dronedarone: a new antiarrhythmic agent. 2079 46