Why does amiodarone cause pulmonary toxicity?

Why does amiodarone cause pulmonary toxicity?

Amiodarone may induce the production of toxic O2 radicals, which can directly damage cells (9). It also appears to promote the accumulation of phospholipids in tissues (9). Typically, the lungs of patients with APT show a diffuse interstitial pneumonitis on microscopic inspection (Figure 1).

What drugs cause DILD?

Nitrofurantoin, amphotericin B, sulfonamides, and sulfasalazine are known to cause DILD. For example, nitrofurantoin is associated with acute or chronic pulmonary injury. The acute manifestation of this process is the most common and is thought to be due to a hypersensitivity reaction from the drug.

Which drugs cause pulmonary toxicity?

Bleomycin, gold salts, cyclophosphamide, and methotrexate are the most common drugs that cause this form of lung injury (,2,,4,,11). Amiodarone, nitrofurantoin, penicillamine, and sulfasalazine are less common causes of drug-induced BOOP (,11). Affected patients present with progressive dyspnea, dry cough, and fever.

What drugs are commonly associated with development of a medication induced interstitial lung disease?

Table 1: Examples of medicines and their pattern of induced lung injury1,4

Can amiodarone cause interstitial lung disease?

Interstitial pneumonitis is the most common presentation of amiodarone-induced pulmonary disease. Interstitial pneumonitis usually presents after two or more months of therapy, especially in patients in whom the dose of amiodarone exceeds 400 mg per day [3].

What medications can cause organizing pneumonia?

Organizing pneumonia due to acebutolol, sotalol, and statins have been associated with interstitial lung diseases such as nonspecific interstitial pneumonia and organizing pneumonia.

What are the symptoms of amiodarone toxicity?

The clinical presentation of amiodarone pulmonary toxicity is very nonspecific. Common symptoms are shortness of breath, dry cough, fever, respiratory distress, and fatigue; sometimes it can mimic acute respiratory distress syndrome.

What causes pulmonary toxicity?

Pulmonary toxicity may be caused by chemotherapy, radiation therapy to the lungs, environmental or occupational toxins, medications or genetics.

Can drug induced interstitial lung disease be reversed?

Other treatments depend on your specific symptoms. For example, you may need oxygen until the drug-induced lung disease improves. Anti-inflammatory medicines called corticosteroids are most often used to quickly reverse the lung inflammation.

Is amiodarone lung toxicity reversible?

One well known serious side effect of amiodarone is pulmonary toxicity which can be acute, sub-acute, or chronic and can be irreversible and fatal.

What are some of the major amiodarone adverse effects on lungs?

Several forms of pulmonary disease occur among patients treated with amiodarone, including interstitial pneumonitis, eosinophilic pneumonia, organizing pneumonia, acute respiratory distress syndrome (ARDS), diffuse alveolar hemorrhage (DAH), pulmonary nodules and solitary masses, and also (rarely) pleural effusion.

Is amiodarone pulmonary toxicity reversible?

Is amiodarone induced pulmonary fibrosis reversible?

For most patients with the less severe forms of lung toxicity (IP, typical pneumonia, or a pulmonary mass), the lungs often eventually improve if the drug is stopped. 2 Amiodarone should also be stopped for people who develop ARDS, but the damage might not be reversible in these cases.

How is pulmonary toxicity treated?

While there is no specific treatment to reverse lung damage, your doctor may prescribe medications or therapies to help manage the symptoms of lung toxicity. Corticosteroids: Steroids work by decreasing inflammation and relieve the cough and some pain associated with lung toxicity.

Is lung damage from amiodarone permanent?

Can amiodarone lung toxicity be cured?

How is lung toxicity treated?

What is amiodarone pulmonary toxicity?

Abstract Amiodarone is an antiarrhythmic agent commonly used to treat supraventricular and ventricular arrhythmias. This drug is an iodine-containing compound that tends to accumulate in several organs, including the lungs. It has been associated with a variety of adverse events. Of these events, the most serious is amiodarone pulmonary toxicity.

Does amiodarone cause high attenuation on HRCT?

High attenuation may be noted incidentally during HRCT on views of the liver and spleen, related to the accumulation of amiodarone and its metabolites in tissue macrophages. This latter finding, although suggestive of amiodarone exposure, is not necessarily associated with APT.

Is there a temporal relationship between amiodarone and pulmonary fibrosis?

While the temporal relationship to amiodarone administration suggests a causal relationship, it is conceivable that some cases represent coincident idiopathic pulmonary fibrosis. An unusual manifestation of APT is alveolar hemorrhage with associated hemoptysis (26).

What is the best treatment for amiodarone toxicity?

There is no specific therapy that has been shown to be effective. The mainstay of treatment is stopping amiodarone. Unfortunately, it takes many months to rid the body of amiodarone after the last dose.