Acute Liver and Renal Failure: A Rare Adverse Effect Exclusive to Intravenous form of Amiodarone.

Robin Paudel,Jyoti Matta,Prerna Dogra,Saurav Acharya,Saurav Suman

doi:10.1155/2016/5232804

Robin Paudel, Jyoti Matta + Show 3 more

Open Access

https://doi.org/10.1155/2016/5232804

Copy DOI

Abstract

Amiodarone is an antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias making it irreplaceable in certain group of patients. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone which resolved after stopping the medication. The mechanism of acute liver and renal toxicity is not clearly known but is believed to be secondary to amiodarone induced (relative) hypotension, idiosyncratic reaction to the drug, and toxicity of the vector that carries the medication, polysorbate-80. In this case review, we discuss the hyperacute drug toxicity caused by IV amiodarone being a distinctly different entity compared to the adverse effects shown by oral amiodarone and support the suggestion that oral amiodarone can be safely administered even in patients who manifest acute hepatitis with the IV form.

Highlights

Amiodarone is a class III antiarrhythmic drug highly effective against a wide spectrum of ventricular tachyarrhythmias
We discuss the hyperacute drug toxicity caused by IV amiodarone being a distinctly different entitycompared to the adverse effects shown by oral amiodarone and support the suggestion that oral amiodarone can be safely administered even in patients who manifest acute hepatitis with the IV form
Amiodarone is an iodinated-benzofuran class III antiarrhythmic drug which is highly effective against a wide spectrum of ventricular tachyarrhythmias

Summary

Introduction

Amiodarone is a class III antiarrhythmic drug highly effective against a wide spectrum of ventricular tachyarrhythmias. We report an unusual case of acute liver and renal failure within 24 hours of initiation of intravenous (IV) amiodarone. Despite wide popularity and efficacy of amiodarone in the treatment of various kinds of cardiac arrhythmias, little is understood about the mechanisms by which IV amiodarone can lead to acute liver and renal failure. Most of the physicians end up withholding this medication altogether. In this case review, we discuss the hyperacute drug toxicity caused by IV amiodarone being a distinctly different entitycompared to the adverse effects shown by oral amiodarone and support the suggestion that oral amiodarone can be safely administered even in patients who manifest acute hepatitis with the IV form

Case Summary

Discussion

Findings

Duration for which amiodarone was given