Action: Decreases myocardial excitability and conduction velocity. Reduces refractory disparity between normal and infarcted myocardium.
Possesses anticholinergic, peripheral vasoconstrictive and negative inotropic effects.
Use: Treat premature ventricular complexes, ventricular tachycardia. Conversion of atrial fibrillation, atrial flutter and paroxysmal atrial tachycardia to normal sinus rhythm and prevention of reoccurrence of these arrhythmias after conversation by other methods.
Dental Considerations: Local anesthesia with vasoconstrictor ok.Dry mouth, paresthesia, headache and blood dyscrasias.
Dental Drug Interactions: Toxicity of medication increased by Erythromycin. Increased side effects with anticholinergics, alcohol. Decreased effects with barbiturates and corticosteroids.
Amiodarone (Cordarone, Pacerone)
Action: Inhibits adrenergic stimulation, prolongs the action potential and refractory
period in myocardial tissue, decreases A-V conduction and sinus node function.
Use: Management of life threatening ventricular arrhythmias or supraventricular
arrhythmias unresponsive to conventional therapy with less toxic agents.
Dental Considerations: Local anesthesia with vasoconstrictor can cause bradycardia and
Action: Interferes with hepatic synthesis of vitamin K dependent coagulation factors (II, VII, IX and X).
Use: Prophylaxis and treatment of venous thrombosis, pulmonary embolism and thromboembolic disorders, atrial fibrillation with risk of embolism and to prophylaxis against systemic embolism after myocardial infarction.
Dental Considerations: Gingival bleeding may indicate overdose, mouth ulcers, salivary gland pain and or swelling, fever, blood dyscrasias.
Dental Considerations: Delay surgical procedures until INR is below 2.5 either by having patient lower dose of medication taken or temporarily not take medication. Dose adjustment should be with physician consultation.