• Tuberculosis and Respiratory Diseases
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• v.53 no.6
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• pp.656-661
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• 2002

Amidarone is one of the most commonly prescribed anti-arrythmic agents for almost all arrythmias, whether atrial or ventricular in origin. There are several side effects associated with amiodarone therapy. These include corneal deposits, abnormal liver function tests, hyper and hypothyroidism, bluish discolorations of the skin, bone marrow suppression, coagulopathies, peripheral neuropathies, and pulmonary toxicity. Amiodarone-induced pulmonary toxicity(APT), which was first described in 1980, is potentially serious side effects that are believed to develop in 5% of patients. Doctors often assume that APT occurs only when high amiodarone doses are used for a long time, but in practice a low maintenance dose of amiodarone may also be toxic. In this report, a case of amiodarone-induced pulmonary toxicity after a long course of a low dose therapy for refractory supraventricular arrythmia is described.

• Tuberculosis and Respiratory Diseases
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• v.59 no.4
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• pp.413-417
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• 2005

Amiodarone is widely used to control fatal arrhythmia. However, amiodarone therapy is associated with a relatively high incidence of pulmonary toxicity, up to 5 to 10%. Typical symptoms are nonspecific and often manifest as nonproductive cough, dyspnea and interstitial infiltrates in patients with acute pneumonitis or chronic fibrosis. However, hemoptysis is a very rare symptom of amiodarone pulmonary toxicity. We report a case of amiodarone pulmonary toxicity, who presented with hemoptysis and was successfully treated with the cessation of amiodarone, with review of the relevant literature.

• The Korean Journal of Food & Health Convergence
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• v.5 no.4
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• pp.13-17
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• 2019

Amiodarone hydrochloride is an antiarrhythmic agent which has low aqueous solubility and presents bioavailability problem. These properties are a challenge for the pharmaceutical industry. Inclusion of lipophilic compound in the hydrophobic core of micelles, i.e. self-assembled structures based on surfactants in aqueous solution, is one way of increasing the solubility. Intravenous formulation of amiodarone hydrochloride with polysorbate 80 as a detergent and benzyl alcohol as a co-solvent is used in medical practice. This paper aimed to study the effect of polysorbate 80 and benzyl alcohol on the water solubility of amiodarone hydrochloride. Formation of mixed micelles consisting of nonionic surfactant polysorbate 80 and cationic amiodarone with chloride counterion was investigated by fluorescence spectroscopy. Benzyl alcohol was found to decrease the stability of the mixed micelles and lead to crystallization of amiodarone hydrochloride. The greatest amounts of crystals formed at 4℃ for 30 days in the model drug solutions with polysorbate 80 concentrations of 100.1 mg/mL and 97.9 mg/mL. A change of the polysorbate 80 concentration and avoidance the use of benzyl alcohol are recommended to improve the stability of the parenteral dosage form. These results can open new perspectives in the optimization of amiodarone intravenous formulations.

• Tuberculosis and Respiratory Diseases
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• v.41 no.1
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• pp.51-57
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• 1994

Amiodarone is a potent antiarrythmic agent used in the treatment of refractory tachyarrythmias and premature ventricular contractions. Amiodarone may be responsible for the frequent and various side effects including corneal deposits, abnormal liver function test, hyperthyriodism or hypothyroidism, bluish discoloration of the skin, neuropathies, and the others. However, pulmonary toxicity is most serious adverse reaction limiting the clinical efficacy. Rescently, we experienced a case of pulmonary toxicity induced by low dose 10-month amiodarone treatment for atrial fibrilation with rapid ventricular response. Lung biopsy reveals interstitial inflammation, fibrosis, hyperplasia of pneumocytes, and foamy macrophages. Respiratory symptoms and abnormal chest X-ray findings were nearly complete cleared after using steroid and withdrawal of amiodarone. We report a case of amiodarone-induced pulmonary toxicity with literature review.

• Journal of Yeungnam Medical Science
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• v.11 no.1
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• pp.186-192
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• 1994

Amiodarone has a potent suppressive effect on supraventricular and ventricular dysrhythmias, so has widely used as a class III antiarrhythmic agent. However, significant side effects were noted in over 50% of patients treated. Pulmonary toxicity represents the most serious adverse raeaction limiting the clinical efficacy of this new antidysrhythmic drug. A 66-year-old male had received amiodarone 200mg/day for 7 months to control high grade ventricular premature contraction and was admitted due to dyspnea on exertion for 1 week. At the time of admission end-inspiratory crepitant rale was heard on auscultation. The roentgenogram of his chest revealed reticular and granular radioopaque densities on both lower lung fields and high resonance CT revealed interstitial fibrosis and pneumonic consolidations on the periphery of the both middle and lower lobes. Trans-bronchoscopic lung biopsy revealed nonspecific intersitial fibrosis. The laboratory findings were non-specific. We present a case of amiodarone-induced interstitial pulmonary disease clinically improved by cortico-steroid therapy.

• Journal of Chest Surgery
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• v.35 no.8
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• pp.594-598
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• 2002

Amiodarone is an iodinated benzofuran derivative that has been proved effective in the control of supraventricular and ventricular arrhythmias refractory to other antiarrhythmic drugs. In patients treated with amiodarone, subsequent surgical intervention is a common clinical scenario, but unfortunately we do not have definite data about complications due to amiodarone after cardiac surgery. Some reports have shown that amiodarone treatment can be associated with a state of $\alpha$-adrenergic and $\beta$-adrenergic receptor blockade, which requires more pacing and epinephrine infusion for perioperative hemodynamic support. And some reports have also identified a severe form of ARDS in patients on amiodarone therapy which was associated with siginificant morbidity and mortality. We exprienced a patient who expired after mitral valve replacement due to amiodarone-induced ARDS; therefore, we report this case with a brief literature.

• Journal of Yeungnam Medical Science
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• v.28 no.1
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• pp.90-93
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• 2011

Although amiodarone is generally regarded as safe with a low incidence of associated arrhythmias, torsade de pointes (TdP) has been observed usually in the presence of predisposing factors. We report a case of amiodarone-induced TdP after long-term administration of alow dose of oral amiodarone in the absence of predisposing factors.

• Journal of Chest Surgery
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• v.49 no.3
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• pp.177-184
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• 2016

Background: Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Several therapeutic and preventive strategies have been introduced for postoperative AF, but the treatment and prophylaxis of AF remain controversial. We aimed to compare the efficacy of intravenous amiodarone and oral propafenone in the treatment of AF after coronary artery bypass grafting (CABG). Methods: This was a randomized controlled trial performed in two hospitals in Shiraz, Iran from 2009 to 2012. We included all patients who underwent elective CABG and developed AF postoperatively. The patients were randomly assigned to receive propafenone or amiodarone. The duration of AF, the success rate of the treatment, the need for cardioversion, the frequency of repeated AF, and the need for repeating the treatment were compared. Results: The duration of the first (p=0.361), second (p=0.832), and third (p=0.298) episodes of AF, the need for cardioversion (p=0.998), and the need to repeat the first and second doses of drugs (p=0.557, 0.699) were comparable between the study groups. Repeated AF was observed in 17 patients (30.9%) in the propafenone group and 23 patients (34.3%) in the amiodarone group (p=0.704). Conclusion: Oral propafenone and intravenous amiodarone are equally effective in the treatment and conversion of recent-onset AF after CABG.

• The Journal of Internal Korean Medicine
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• v.24 no.2
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• pp.387-394
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• 2003

Amiodarone is an effective antiarrhythmic agent because of its vasodilator actions. Nowadays it is mostly used to treat patients with severe cardiomyopathy or coronary artery disease complicated by disturbances in the supraventricular or ventricular rhythm. But, some doctors are reluctant to prescribe it because of its many side effects. These include impairment of liver and thyroid fuction and, rarely, damage to the lungs. Most of all, its most serious side effect is amiodarone-induced pulmonary toxicity, which can occur in up to 10% of patients, with mortality rates as high as 50%. We recently experienced one case of the patient with the Amiodarone-induced pulmonary toxicity. The clinical manifestations of the patient was cough, painful breathing, fever, presence of rales, decreased breath sounds, and sputum. We report the change of the patient's symptoms through both western medical treatment and oriental medical treatment.

• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.155-160
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• 2020

Torsades de pointes refers to polymorphic ventricular tachycardia (PMVT), which is caused by the suppression of potassium channels owing to genetic and electrolytic abnormalities, resulting in the extension of the QT interval. Symptoms range from spontaneous circulation recovery to fainting and sudden death. Defibrillation, magnesium correction, and the use of lidocaine as an antiarrhythmic agent are recommended as treatments for persistent torsades de pointes. Currently, only amiodarone is available in the ambulance; however, torsades de pointes does not respond efficiently to amiodarone because it suppresses potassium channels and increases the refractory period of the myocardium. Lidocaine, in contrast, reduces the relative refractory period of the myocardium caused by suppressing sodium channels; thus, it inhibits the occurrence of and treats arrhythmia. In cases where PMVT did not respond to defibrillation, the administration of lidocaine showed no difference in survival and discharge rates compared to amiodarone. Thus, ambulances must be equipped with provisions to administer lidocaine.