Acute Amiodarone Pulmonary Toxicity

Feduska, Eric; Thoma, Brandi; Torjman, Marc C.; Goldhammer, Jordan E.

doi:10.1053/j.jvca.2020.10.060

Cited by 25 publications

(18 citation statements)

References 91 publications

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“…The active metabolite of AMD (deethylamiodarone) formed after absorption enters the transintestinal hepatic circulation and can extend the elimination half-life to approximately 60 days. As a result, active metabolites tend to accumulate in vivo , which can cause damage to non-therapeutic target organs such as the lungs, liver, and thyroid, causing serious adverse effects such as chronic interstitial pneumonia or pulmonary fibrosis ( 53 , 56 , 57 ). Amira et al encapsulated AMD into PLGA nanoparticles prepared from polylactic acid-hydroxyacetic acid, which have good bioavailability.…”

Section: Practical Application Of Af Treatment Methods Based On Nano ...mentioning

confidence: 99%

“…Traditional systemic drug delivery methods are insufficient in terms of stability, solubility, and bioavailability, and have various adverse side effects. Amiodarone (AMD) is commonly used as a class III antiarrhythmic drug for the conversion of AF ( 53 – 55 ), but due to its accumulation in untreated tissues, especially the lung, spleen, and liver, it can cause serious adverse reactions, and can also lead to hypothyroidism or a risk of hyperactivity ( 56 – 58 ).These problems can be well-addressed by using nanotechnology-based methods.…”

Section: Nano Drug Delivery Systemmentioning

confidence: 99%

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Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Wang

Tong

et al. 2022

Front. Cardiovasc. Med.

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Atrial fibrillation (AF) is one of the most common sustained tachyarrhythmias worldwide, and its prevalence is positively correlated with aging. AF not only significantly reduces the quality of life of patients but also causes a series of complications, such as thromboembolism, stroke, and heart failure, increases the average number of hospitalizations of patients, and places a huge economic burden on patients and society. Traditional drug therapy and ablation have unsatisfactory success rates, high recurrence rates, and the risk of serious complications. Surgical treatment is highly traumatic. The nano drug delivery system has unique physical and chemical properties, and in the application of AF treatment, whether it is used to assist in enhancing the ablation effect or for targeted therapy, it provides a safer, more effective and more economical treatment strategy.

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Section: Practical Application Of Af Treatment Methods Based On Nano ...mentioning

confidence: 99%

Section: Nano Drug Delivery Systemmentioning

confidence: 99%

Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Wang

Tong

et al. 2022

Front. Cardiovasc. Med.

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“…It is rarer and more aggressive with typical presentation as acute respiratory distress syndrome and has associated high mortality. 2 Understanding of the incidence, underlying risk factors and pathogenesis is poorly understood. Current management suggests cessation of amiodarone and supportive care.…”

Section: Images In…mentioning

confidence: 99%

“…Current management suggests cessation of amiodarone and supportive care. 2 Contributors JC and SH were both involved in the clinical care for the patient. JC drafted the manuscript with SH supervision and revision input.…”

Section: Images In…mentioning

confidence: 99%

Acute amiodarone interstitial toxicity presenting as unilateral pneumonitis

Chen

Hinton

2021

BMJ Case Rep

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“…2,3 Prolonged oral dose load may be required to achieve AMIO efficacy, which may predispose to serious side effects, including pulmonary toxicity. 4 AMIO is an iodine-containing compound. It is lipophilic, has a large distribution volume, has a long half-life, and tends to accumulate in several organs, 5 including the lungs.…”

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confidence: 99%

Nicorandil mitigates amiodarone‐induced pulmonary toxicity and fibrosis in association with the inhibition of lung TGF‐β1/PI3K/Akt1‐p/mTOR axis in rats

Harb

Ashour

ARashed

et al. 2022

Clin Exp Pharma Physio

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The long‐term side effect of the antiarrhythmic drug, amiodarone (AMIO), such as lung toxicity, remains a critical clinical issue. The previous knowledge denotes diverse antioxidant, anti‐inflammatory, and antifibrotic properties of the anti‐anginal drug, nicorandil (NI). Therefore, we aimed to investigate the possible protective effect of NI on pulmonary tissue remodelling following AMIO‐induced lung toxicity. The included rats were assigned into four equal groups (n = 8): (1) control, (2) control group that received NI 10 mg kg−1 day−1, (3) model group that received AMIO in a dose of 60 mg kg−1 day−1, and (4) treated group (AMIO‐NI) that were treated with AMIO plus NI as shown above. Drug administration continued for 10 weeks. AMIO resulted in deteriorated (p < 0.001) pulmonary functions accompanied by respiratory acidosis. AMIO showed an obvious histological injury score with intense collagen deposition, disturbed nitric oxide synthase enzymes (NOS/iNOS), and increased alpha smooth muscle actin expression. Furthermore, AMIO upregulated the transforming growth factor (TGF‐β1)/phosphoinositide‐3 kinase (PI3K)‐Akt1‐p/mammalian target of rapamycin (mTOR) axis, which determined the possible mechanism of AMIO on pulmonary remodelling. NI treatment significantly (p < 0.001) prevented the AMIO‐induced lung toxicity, as well as inhibited the TGF‐β1/PI3K/Akt1‐p/mTOR axis in the lung tissue of rats. The results were confirmed by an in‐vitro study. Conclusion The current results revealed that NI was effective in preserving the lung structure and functions. Amelioration of the oxidative stress and modulation of TGF‐β1/PI3K/Akt1‐p/mTOR have been achieved. This study suggests NI administration as a preventive therapy from the serious pulmonary fibrosis side effect of AMIO.

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Acute Amiodarone Pulmonary Toxicity

Cited by 25 publications

References 91 publications

Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Nano drugs delivery system: A novel promise for the treatment of atrial fibrillation

Acute amiodarone interstitial toxicity presenting as unilateral pneumonitis

Nicorandil mitigates amiodarone‐induced pulmonary toxicity and fibrosis in association with the inhibition of lung TGF‐β1/PI3K/Akt1‐p/mTOR axis in rats

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