How 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).

How is amiodarone pulmonary toxicity diagnosed?

Amiodarone-induced pulmonary toxicity is a diagnosis of exclusion. Pulmonary evaluation with chest X-ray and pulmonary function testing, including diffusion capacity for carbon monoxide is recommended when amiodarone is started.

How long does it take for amiodarone to cause pulmonary toxicity?

Amiodarone-induced pulmonary toxicity can present acutely (hours to days after surgery or angiography) or chronically (months to years after starting amiodarone treatment). Acute toxicity (eg, acute respiratory distress syndrome) is rare but is associated with high mortality (up to 50%).

What is the most concerning toxicity of amiodarone?

Amiodarone-induced pulmonary toxicity (APT) is one of the most serious side effects of use. Incidence is approximately 5% when doses of 400 mg or more are used daily.

What are signs 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.

What are the symptoms of pulmonary toxicity?

What are the symptoms of lung toxicity?

  • Breathlessness during exercise.
  • Fatigue.
  • Dry cough.
  • Shortness of breath.
  • Discomfort or worsening symptoms when lying on your back.

Is amiodarone pulmonary 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.

What are the symptoms of amiodarone toxicity?

Can amiodarone cause pulmonary edema?

Amiodarone-induced pulmonary toxicity (APT) is one of the most serious side effects of amiodarone therapy. Often the clinical manifestation of APT resembles pulmonary infection, pulmonary edema, pulmonary thromboembolism or heart failure and makes the diagnosis of APT difficult.

What is signs of pulmonary toxicity?