No abstract available.
Amiodarone/*adverse effects ; Anti-Arrhythmia Agents/*adverse effects ; Female ; Humans ; Male

Amiodarone ; adverse effects ; Female ; Humans ; Middle Aged ; Muscular Diseases ; chemically induced

Aged ; Amiodarone ; adverse effects ; Chemical and Drug Induced Liver Injury ; etiology ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Male

Amiodarone ; adverse effects ; Anti-Arrhythmia Agents ; adverse effects ; Arrhythmias, Cardiac ; drug therapy ; Corneal Diseases ; chemically induced ; Humans ; Male ; Middle Aged

The lungs are frequently the site of adverse drug reactions because of their higher oxygen concentration, the distinctive properties of the pulmonary circulation, and the close proximity of the alveolar epithelium to the blood. Amiodarone, an iodinated benzofuran derivative, is an effective antiarrhythmic drug commonly used for refractory tachyarrhythmia. However, it has a wide range of adverse effects, the most serious of which is lung disease. Most patients present with the insidious onset of dyspnea and a nonproductive cough, and generally recover after withdrawing the drug. We recently experienced four fatal cases of amiodarone pulmonary toxicity. Therefore, we discuss these unusual drug-induced pulmonary toxicity cases with a review of the relevant literature.
Amiodarone ; Cough ; Drug-Related Side Effects and Adverse Reactions ; Dyspnea ; Epithelium ; Humans ; Lung ; Lung Diseases ; Oxygen ; Pulmonary Circulation ; Tachycardia

OBJECTIVETo report the clinical features and the prognosis, the methods of diagnosis and treatment, and the early detection of the pulmonary toxicity induced by amiodarone.

METHODThe clinical course, the findings of X-ray and CT and the results of treatment were summarized and analyzed in six patients with amiodarone-induced pulmonary toxicity.

RESULTSFive males, one female, aged 62 - 69 (66.0 +/- 2.4) years. Amiodarone was used because of paroxysmal atrial fibrillation in five patients and ventricular arrhythmia in one. The loading dose was 7 g and the maintaining dose was 0.2 g/d or less. Pulmonary toxicity was recognized at the times in 0.5 - 4.0 (2.1 +/- 1.3) years after amiodarone therapy. Dyspnea occurred, crack rales were audible in both lower parts of the lungs, and the chest X-ray showed grid-like changes in case one. No symptom was found in the others. Their diagnosis was made according to the pulmonary intestinal changes by high-resolution computerized tomography when the lung marking was increased or deranged by chest X-ray during the regular follow-up. Pulmonary function examination showed that the restrictive ventilation and the CO diffusing capacity decreased in case one, while the CO diffusing capacity was normal in the others. The decreased obstructive ventilation capacity was found in case six. Amiodarone was discontinued in all the cases after the diagnosis of induced pulmonary toxicity. One patient was treated with corticosteroid, three with azithromycin, and the another two patients were not treated with drug. During 0.1 - 5.0 year period of follow-up the symptoms were markedly attenuated in case one, and no new symptoms and radiography findings were found in the others.

CONCLUSIONSPulmonary toxicity is a serious adverse effect of amiodarone. The typical feature is pulmonary intestinal fibrosis and thick pulmonary intestine in the early stage. Corticosteroid treatment seems effective. It would be helpful for early diagnosis to take chest X-ray examination regularly and CT examination in suspicions cases during the therapy. The prognosis may be good in the early diagnosed cases.

Aged ; Amiodarone ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Pulmonary Fibrosis ; chemically induced ; diagnostic imaging ; Radiography

No abstract available.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Hepatitis, Alcoholic/diagnosis/etiology ; Hepatitis, Chronic, Drug-Induced/*diagnosis/etiology/pathology ; Humans ; Male

Amiodarone chlorhydrate is a diiodated benzofuran derivative, and it is used to treat cardiac rhythm abnormalities. Hepatotoxicity is a relatively uncommon side effect of amiodarone, and symptomatic hepatic dysfunction occurs in fewer than 1% of the patients taking amiodarone. Cirrhosis is a rare complication that's been confirmed in 12 cases. Peripheral neuropathy occurs in 10% of patients taking aminodarone. We report here on an unusual case of amiodarone-induced hepatotoxicity and peripheral neurotoxicity. A 75 year old man with normal liver function was given amiodarone for treating his atrial fibrillation and heart failure. He developed nausea, vomiting, muscle weakness and wasting after 17.8 months therapy with amiodarone (400 mg orally once per day). Liver biopsy showed the presence of foam cells in the hepatic sinusoids and Mallory bodies in the periportal hepatocytes on light microscopy. Sural nerve biopsy showed demyelination, and nerve conduction studies showed mixed sensorimotor polyneuropathy. These observations show the necessity of monitoring the hepatic function and conducting neurologic examination of the patients treated with amiodarone.
Aged ; Amiodarone/*adverse effects ; Anti-Arrhythmia Agents/*adverse effects ; Hepatitis, Toxic/*etiology ; Humans ; Liver Cirrhosis/chemically induced ; Male ; Polyneuropathies/*chemically induced

OBJECTIVETo observe the efficacy and safety of oral cordarone dir reversing persistent atrial fibrillation (AF). METHODS; Eighty-two symptomatic chronic AF out-patients without history of acute diseases or severe hepatic/thyroid dysfunction were given oral cordarone at the loading dose of 200 mg thrice a day for 1-4 weeks followed by a twice-daily administration for another 1-4 weeks, with the maintenance dose of 200 or 100 mg once a day. The incidence of stroke and cardiac events and the mortality rate were compared between 43 patients with restored rhythm on cordarone and 39 patients on digoxin and/or betaloc for ventricular rhythm control.

RESULTSAmong the 82 patients, sinus rhythm restoration was achieved in 43, with a successful rate of 52%. In 18 patients, the ejection fraction increased from (32+/-8)% to (46+/-10)%, left atrium diameter decreased from (4.6+/-1.1) cm to (4.1+/-0.8) cm. Except for slight T4 increase, QT prolongation and bradycardia in 3 cases, severe side effects were not observed in this study. Only one patient with restored sinus rhythm required rehospitalization after half a year for worsened heart failure, but in patients with controlled ventricular rhythm, 1 developed stroke, 1 experienced heart attack and 1 died of heart failure with bleeding.

CONCLUSIONFor patients with symptomatic reversible persistent AF, active treatment with cordarone can be convenient, effective and safe for sinus rhythm restoration.

Adult ; Aged ; Amiodarone ; adverse effects ; therapeutic use ; Anti-Arrhythmia Agents ; adverse effects ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Female ; Humans ; Male ; Middle Aged

OBJECTIVETo evaluate the efficacy and safety of amiodarone and metoprolol in the treatment of ventricular premature beats.

METHODSControlled randomized clinical trials from 1999 through 2009 were retrieved in China HowNet, VIP Web, Pubmed home. Using Rev Man4.2 software provided by Cochrane Collaboration, Meta-analysis was conducted of 30 articles meeting the inclusion criteria involving a total of 1188 patients.

RESULTSMerged analysis of amiodarone and metoprolol in the treatment of premature ventricular merge showed a comprehensive test results of Z=1.25, P=0.21, OR=1.18, 95%CI: 0.91-1.54; funnel plot analysis suggested the possible presence of publication bias. The comprehensive test of the incidence of adverse reactions in relation to the two drugs resulted in an OR of 1.96 (95%CI: 1.39-2.77), and funnel plot analysis also indicated publication bias.

CONCLUSIONSThe total response rate of amiodarone does not seem to be superior to metoprolol in the treatment of premature ventricular contractions, and amiodarone is associated with higher incidence of adverse reactions.

Amiodarone ; adverse effects ; therapeutic use ; Drug Therapy, Combination ; Humans ; Metoprolol ; adverse effects ; therapeutic use ; Treatment Outcome ; Ventricular Premature Complexes ; drug therapy