ABSTRACT
Amiodarone is a coronary vasodilator and class 3 antiarrhythmic agent used to treat or prevent recurrences of supraventricular and ventricular arrhythmias. Optimal communication with physicians of these disciplines and with anaesthetists is of critical importance to prevent and detect amiodarone pulmonary toxicity (APT) in a timely fashion. The drawback of amiodarone is its extensive adverse-effect profile, which includes thyroid disorders, skin reactions, pulmonary toxicity, arrhythmias, hepatotoxicity, corneal deposits and neurologic impairment. Amiodarone pulmonary toxicity is a distinctive form of drug-induced lung injury clinically, on imaging and pathology. The cationic amphiphilic anorectic drug chlorphentermine is the prototypical phospholipidosis-inducing agent in rats. The most common pattern of APT is a subacute infiltrative lung disease with new restrictive lung dysfunction and hypoxaemia and arterial desaturation on exertion. Pulmonary function testing and the chest radiograph are recommended in the initial work-up of patients who will be treated with amiodarone.
