Amiodarone pulmonary toxicity - Revision history

Rossdonaldson1 at 20:12, 24 April 2024

2024-04-24T20:12:19Z

← Older revision		Revision as of 20:12, 24 April 2024
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	===Pathophysiology===		===Pathophysiology===
	~~[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]]~~
	~~[[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]~~
	*Amiodarone and metabolites damage lungs:<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref>		*Amiodarone and metabolites damage lungs:<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref>
	**Directly by cytotoxic effect, production of toxic O2 radicals<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>		**Directly by cytotoxic effect, production of toxic O2 radicals<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>
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	==Evaluation==		==Evaluation==
			[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]]
			[[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]
	*Often clinical diagnosis based on history of amiodarone use, presence of ground glass opacities on CT, and exclusion of alternate diagnoses (such as pneumonia)		*Often clinical diagnosis based on history of amiodarone use, presence of ground glass opacities on CT, and exclusion of alternate diagnoses (such as pneumonia)
	*CT chest:		*CT chest:

Rossdonaldson1: /* Clinical Features */

2024-04-24T20:12:03Z

Clinical Features

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	*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>		*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>

	~~===Amiodarone Adverse effects===~~
	{{Amiodarone adverse effects}}		{{Amiodarone adverse effects}}

Rossdonaldson1 at 20:09, 24 April 2024

2024-04-24T20:09:07Z

← Older revision		Revision as of 20:09, 24 April 2024
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	*Low grade [[fever]]		*Low grade [[fever]]
	*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>		*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>

			===Amiodarone Adverse effects===
			{{Amiodarone adverse effects}}

	==Differential Diagnosis==		==Differential Diagnosis==
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	*[[Pulmonary fibrosis]]		*[[Pulmonary fibrosis]]
	*[[Interstitial lung disease]]		*[[Interstitial lung disease]]
	~~===Amiodarone Adverse effects===~~
	~~{{Amiodarone adverse effects}}~~

	==Evaluation==		==Evaluation==

Rossdonaldson1 at 20:07, 24 April 2024

2024-04-24T20:07:49Z

← Older revision		Revision as of 20:07, 24 April 2024
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	===Pathophysiology===		===Pathophysiology===
	[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]][[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]		[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]]
	*Amiodarone and metabolites damage lungs<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref>:		[[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]
			*Amiodarone and metabolites damage lungs:<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref>
	**Directly by cytotoxic effect, production of toxic O2 radicals<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>		**Directly by cytotoxic effect, production of toxic O2 radicals<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>
	**Indirectly via immunological reaction		**Indirectly via immunological reaction

Rossdonaldson1: /* Background */

2024-04-24T20:06:42Z

Background

← Older revision		Revision as of 20:06, 24 April 2024
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	==Background==		==Background==
			[[File:Lung and diaphragm.jpg\|thumb\|Lobes of the lung with related anatomy.]]
	*[[Amiodarone]] is an antiarrhythmic agent commonly used to treat [[SVT\|supraventricular]] and ventricular [[arrhythmias]]		*[[Amiodarone]] is an antiarrhythmic agent commonly used to treat [[SVT\|supraventricular]] and ventricular [[arrhythmias]]
	*Iodine-containing compound with large volume of distribution		*Iodine-containing compound with large volume of distribution

ClaireLewis at 16:53, 19 September 2019

2019-09-19T16:53:53Z

← Older revision		Revision as of 16:53, 19 September 2019
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	==Background==		==Background==
	[[Amiodarone]] is an antiarrhythmic agent commonly used to treat supraventricular and ventricular arrhythmias~~. This drug is an iodine~~- containing compound with a large volume of distribution ~~that tends~~ to accumulate in several organs, including ~~the~~ lungs~~. Although the~~ incidence ~~of this complication~~ has decreased with ~~the~~ use of lower doses ~~of amiodarone, it can occur with any dose.~~<ref>Wolkove N, Baltzan M. Amiodarone pulmonary toxicity. Can Respir J. 2009;16(2):43-48.</ref> ~~Since amiodarone has a long~~ half life ~~it is possible~~ of effects to persist ~~well~~ after discontinuation.		*[[Amiodarone]] is an antiarrhythmic agent commonly used to treat [[SVT\|supraventricular]] and ventricular [[arrhythmias]]
			*Iodine-containing compound with large volume of distribution
			*Tends to accumulate in several organs, including lungs
			*Can occur with any dose, though incidence has decreased with use of lower doses<ref>Wolkove N, Baltzan M. Amiodarone pulmonary toxicity. Can Respir J. 2009;16(2):43-48.</ref>
			*Long half life of amiodarone--> effects can persist long after discontinuation

	===Pathophysiology===		===Pathophysiology===
	[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]][[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]		[[File:Xray Amiodarone Lung toxicity.png\|thumbnail]][[File:CT Amiodarone Lung Toxicity.png\|thumbnail]]
	Amiodarone and ~~its~~ metabolites ~~can produce lung~~ damage ~~dir- ectly by a cytotoxic effect and indirectly by an immunological reaction.~~<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref> ~~Amiodarone may induce the~~ production of toxic O2 radicals~~, which can directly damage cells.~~<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>		*Amiodarone and metabolites damage lungs<ref>Martin WJ, Rosenow EC. Amiodarone pulmonary toxicity: Recognition and pathogenesis (Part 2). Chest 1988;93:1242-8.</ref>:
			**Directly by cytotoxic effect, production of toxic O2 radicals<ref>Jessurum GA, Crijns HJG. Amiodarone pulmonary toxicity. BMJ 1997;314:619-20.</ref>
			**Indirectly via immunological reaction

	==Clinical Features==		==Clinical Features==
	*Dyspnea, particularly with exertion		*[[Dyspnea]], particularly with exertion
	*Cough		*[[Cough]]
	*Low grade fever		*Low grade [[fever]]
	*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>		*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>

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	==Evaluation==		==Evaluation==
	~~The~~ diagnosis ~~is often clinical and due~~ presence of ground glass opacities of CT ~~in the setting of amiodarone use~~ and ~~after~~ exclusion of ~~an infectious etiology~~ such as pneumonia.		*Often clinical diagnosis based on history of amiodarone use, presence of ground glass opacities on CT, and exclusion of alternate diagnoses (such as pneumonia)
			*CT chest:
	~~===Lung~~ CT ~~Findings===~~		**Ground glass opacities with interstitial or alveolar inflitrations and lung nodules
	*Ground glass opacities with interstitial or alveolar inflitrations and lung nodules		**Pleural thickening and pleural effusions
	*Pleural thickening and pleural effusions

	==Management==		==Management==
	* ~~cessation of~~ amiodarone		*Discontinue amiodarone
	* ~~steroids~~		*[[Steroids]]

	==Disposition==		==Disposition==

Jmenyart81: /* Management */

2018-01-09T01:49:50Z

Management

← Older revision		Revision as of 01:49, 9 January 2018
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	==Management==		==Management==
			* cessation of amiodarone
			* steroids

	==Disposition==		==Disposition==

Jmenyart81: /* Clinical Features */

2018-01-09T01:06:57Z

Clinical Features

← Older revision		Revision as of 01:06, 9 January 2018
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	*Cough		*Cough
	*Low grade fever		*Low grade fever
	*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>~~Insert footnote text here~~</ref>		*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Dusman, RE, Stanton MS, Miles WM, Klein LS, Clinical features of amiodarone induced pulmonary toxicity. Circulation. 1990;82:51-59.</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Jmenyart81: /* Clinical Features */

2018-01-09T01:00:10Z

Clinical Features

← Older revision		Revision as of 01:00, 9 January 2018
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	==Clinical Features==		==Clinical Features==
			*Dyspnea, particularly with exertion
			*Cough
			*Low grade fever
			*Less common features include: nausea, generalized fatigue, weight loss, pleuritic chest pain <ref>Insert footnote text here</ref>

	==Differential Diagnosis==		==Differential Diagnosis==

Rossdonaldson1: /* Amiodarone Adverse effects */

2016-08-31T03:26:41Z

Amiodarone Adverse effects

← Older revision		Revision as of 03:26, 31 August 2016
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	*[[Pulmonary fibrosis]]		*[[Pulmonary fibrosis]]
	*[[Interstitial lung disease]]		*[[Interstitial lung disease]]
	==Amiodarone Adverse effects==		===Amiodarone Adverse effects===
	{{Amiodarone adverse effects}}		{{Amiodarone adverse effects}}