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Cardio 19-9 - ben
#11
DDD
The most serious reaction that is due to amiodarone is interstitial lung disease. The incidence of pulmonary fibrosis is not dose related.

Some individuals were noted to develop pulmonary fibrosis after a week of treatment, while others did not develop it after years of continuous use.

There are no known factors that increase the incidence of amiodarone-induced pulmonary fibrosis in a particular individual. Common practice is to avoid the agent if possible in individuals with decreased lung function.

The most specific test of pulmonary toxicity due to amiodarone is a dramatically decreased DLCO noted on pulmonary function testing.

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#12
quinidine is not a rate controlling medication
maybe c
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#13
i think dddddddddd ...........amiodarone cause lungs fibrosisi...............


any way, guys patient has caplan syndrome , right ??
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#14
Amiodarone is a class 3 anti-arrhythmic agent, which has now been shown to be very effective in terminating both atrial and ventricular arrhythmias. However, administration of this drug has been known to cause lipoid accumulation in lung parenchyma and lead to fibrosis. In a patient with compromised lung function, use of amiodarone can potentiate the lung injury and its use should be with held.

Choice A: Verapamil is a calcium channel blocker, which has proven effective for the treatment of hypertension, angina and atrial fibrillation. Its use has been limited by the significant negative inotropic effect.

Choice B: Digoxin used to be the main stay of atrial fibrillation management. In the past decade, its use has declined. It is not very effective for acute episodes of atrial fibrillation and has now been replaced by newer anti-arrhythmic agents. However, digoxin is still considered the drug of choice if someone has heart failure and atrial fibrillation.

Choice C: Quinidine is a class I anti arrhythmic agent, sometimes used in the treatment of supraventricular tachycardias. Its use has also declined in the past decade because of better agents.

Choice E: Metoprolol is a beta-blocker and is extensively used for rate control in the setting of atrial fibrillation.

Educational objective:

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#15
Which one is best for this case?
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