Amioderone Flashcards
Amioderone is highly effective but typically limited to short term treatment because of its ____?
Side effect profile
Before initiating amiodarone, what should be done? (What tests?
Baseline ECG
CXR
ophthalmic exam
Thyroid, liver, and pulmonary function tests
Thyroid and liver function test should be monitored how often?
-An ECG should be done how often?
3-6 months
Annually
What’re some pulmonary adverse effects of amiodarone?
Pulmonary fibrosis
Chronic interstitial pneumonitis
Organizing pneumonia
ARDS (Acute respiratory Distress Syndrome)
What’re some thyroid adverse effects of amiodarone?
Hypo/hyperthyroidism
Thyrotoxicosis
Exacerbation of current thyroid condition
What’re some hepatic adverse effects of amio?
AST and ALT > 2x normal
Hepatitis and cirrhosis
Cardiac adverse effects of amio?
Proarrhythmia
Bradycardia and AV block
Hypotension
Ocular adverse effects of amio?
Corneal micro deposits
Optic neuritis
Dermal adverse effects of amio?
Photosensitivity
Blue discoloration
CNS adverse effects of amio?
Peripheral neuropathy
Ataxia
Paresthesia (abnormal pins and needles feeling)
Sleep disturbance
Impaired memory
Tremor
What leads to the most deaths associated with amiodarone therapy?
Amiodarone induced pulmonary toxicity
Treatment of amiodarone toxicity?
Quit amiodarone therapy and start corticosteroid therapy
Amiodarone causes thyroid dysfunction in ___% of patients receiving long term therapy
10
Amiodarone induced hypothyroidism:
-Pathophysiology
-Treatment
-Patho: elevated iodine content of amio causes inhibition of thyroid hormone biosynthesis
- Treatment: thyroid hormone substitution
The inhibition of thyroid hormone biosynthesis caused by elevated levels of iodine is known as what effect?
Wolff-Chaikoff effect
Amiodarone induced thyrotoxicosis:
-How many types?
-Pathophys of types?
-Treatment
-Type 1: elevated iodine causing increased thyroid hormone synthesis and release (Jod-Basedow phenomenon)
-Treatment of type 1: anti thyroid therapy; if resistant, radioiodine treatment or surgical thyroidectomy
-Type 2: drug induced damage of follicular cells leading to destructive thyroiditis causing elevated thyroid hormones
-Treatment of type 2: glucocorticoid therapy
Amiodarone consists of approximately how much iodine? (What percent)
~37%
What other drugs have interactions with amiodarone?
WAR FOR us SIMs DIGItally and CYCLicly through FLEx, PROCAmpIng, QUItting and eventual SILicon
Warfarin
Simvastatin
Digoxin
Cyclosporine
Flecainide, procainamide, quinidine
Sildenafil
Mixing warfarin and amiodarone can have what effect?
Risk of bleeding
Mixing simvastatin with amiodarone causes what effect?
Increased risk of rhabdomyolysis
Mixing amiodarone with any of the interaction drugs is wrong as amiodarone is a _____ of cytochrome P450 enzymes which causes _______ clearance of those drugs.
Inhibitor
Decreased
