Amiodarone-induced pulmonary toxicity--a fatal case report and literature review.

Abstract

Amiodarone is a widely used and very potent antiarrhythmic substance. Among its adverse effects, pulmonary toxicity is the most dangerous without a causal treatment option. Due to a very long half-life, accumulation can only be prevented by strict adherence to certain dosage patterns. In this review, we outline different safe and proven dosing schemes of amiodarone and compare the incidence and description of pulmonary toxicity. Reason for this is a case of fatal pulmonary toxicity due to a subacute iatrogenic overdosing of amiodarone in a 74-year-old male patient with known severe coronary artery disease, congestive heart failure and ectopic atrial tachycardia with reduced function of kidneys and liver but without preexisting lung disease. Within 30 days, the patient received 32.2 g of amiodarone instead of 15.6 g as planned. Despite early corticosteroid treatment after fast exclusion of all other differential diagnoses, the patient died another month later in our intensive care unit from respiratory failure due to bipulmonal pneumonitis.

• Authors: Felix T Range, Ekkehard Hilker, Günter Breithardt, Boris Buerke, Pia Lebiedz
• Journal: Cardiovascular drugs and therapy (Cardiovasc Drugs Ther) Vol. 27 Issue 3 Pg. 247-54 (Jun 2013) ISSN: 1573-7241 [Electronic] United States
• PMID: 23397327 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Arrhythmia Agents
• Amiodarone

Topics

• Aged
• Amiodarone (administration & dosage, adverse effects, pharmacokinetics, therapeutic use)
• Anti-Arrhythmia Agents (administration & dosage, adverse effects, pharmacokinetics, therapeutic use)
• Coronary Artery Disease (drug therapy)
• Drug Overdose
• Fatal Outcome
• Half-Life
• Humans
• Lung Diseases, Interstitial (chemically induced, complications, diagnosis, therapy)
• Male
• Respiratory Distress Syndrome (chemically induced, complications, diagnosis, therapy)