Amiodarone and Ocular Toxicity An arrhythmia is a problem associated with the electrical activity of the heart resulting in a heartrate that can be too fast (tachycardia) or too slow (bradycardia). Arrhythmias are generally categorized as ventricular or supraventricular.1 Ventricular arrhythmias are a condition in which extra heartbeats originate from the lower chambers of the heart and can be classified as ventricular tachycardia, ventricular fibrillation, or premature ventricular contractions. Supraventricular arrhythmias originate in the upper chambers of the heart and can be less serious than ventricular arrhythmias. Both types of arrhythmia can cause shortness of breath, chest tightness, dizziness, or syncope. The National Institute …show more content…
It is estimated that the incidence of optic neuropathy in patients treated with amiodarone is 1.76% compared to only a 0.3% incidence of optic neuropathy developing in those not treated with amiodarone.12 The exact pathophysiology of optic neuropathy caused by amiodarone is unknown, but it is postulated that damage is caused by drug induced lipidosis.9, 10 Amiodarone is a triiodated benzofuran derivative; it is a cationic amphophilic drug possessing closely spaced hydrophilic and hydrophobic groups that allow the drug to enter lysosomes and bind irreversibly to polar lipids.11 The resulting complexes accumulate in the lysosomes as lamellar inclusion bodies which phospholipases cannot catalyze, resulting in mechanical damage to optic nerve axons via blockage of axoplasmic flow.7, 11,12 This may lead to the optic edema observed in many patients that persists for months after the medication is discontinued due to the drug’s long half-life.12 Another theory is that oxidative damage is the culprit. When amiodarone is reduced, iodine is cleaved from the molecule which generated oxygen-free radicals. Amidoarone generated free radicals can cause an increase in cellular lipid peroxidation and drug-lipid …show more content…
Macaluso et al reviewed 73 cases of amiodarone induced optic neuropathy and concluded that onset is insidious, usually bilateral, and characterized by disc swelling that stabilizes after drug discontinuation.10
Although there are multiple reports of optic neuropathy caused by amiodarone, a major challenge is discerning whether the optic neuropathy has a direct causal relationship with amiodarone use or is due to other factors that increase ones risk in developing NAION. NAION is the most common cause of vision loss in individuals over
Tachycardia: Tachycardia typically refers to a heart rate that exceeds the normal range for a resting heart rate. When the heart beats rapidly, the heart pumps less efficiently and provides less blood flow to the body and the heart. The rapid heartbeat increases the workload and oxygen demand of the heart. Problems will occur with the heart as tachycardia persists over time. The heart is maintaining less oxygen, which will lead to an MI due to death of the myocardial cells. Patient will start to have angina because of this. Tachycardia is noted in many diseases and disorder like: fever endocarditis, anemia, HTN, pericarditis, abnormal heart impulses, anxiety, older age, sleep apnea, COPD, electrolyte imbalances, and many more.
At 1130 a second antiarrhythmic drug, Amiodarone 150mg, was administered via intravenous infusion. Its action is unknown however is thought to prolong the action potential duration (Siddoway, 2003). Similar to the Sotolol no effect was noted with the rate or rhythm. The patients blood pressure remained low, 96/67 and heart rate fluctuating between 100-130 beats per minute. The patient was asymptomatic with his blood pressure but remained sweaty and lethargic. He received further intravenous fluids whilst the medical officer discussed his presentation with the cardiology team.
An dysrhythmia of the heart is an irregular heartbeat rhythm. Ventricular tachycardia is an dysrhythmia in which the lower chambers of the heart, the ventricles, beat unusually fast.
causes the brain to swell and make one feel dizzy light headed and in pain. Those are
Generally adverse effects of nifurtimox or benznidazole are lower in children than in adult. There are two adverse effects of benznidazole i.e. allergic dermitis and peripheral neuropathy. Allergic dermitis occur within 8-10 days after treatment starts and there is no need to reduce dose in most patients. While sensitive neuropathy result in last part of treatment and affect mainly lower parts of limbs. The treatment should stopped in this case. Rare adverse effects includes leucopenia, weight loss, vomiting, insomnia, and nausea 26, 28.
The first disease I’m going to mention is Glaucoma, according to Web MD last updated in 2015, Glaucoma is a condition that causes damage to your eye's optic nerve and gets worse over time. It's often associated with a buildup of pressure inside the eye. Glaucoma tends to be inherited and may not show up until later in life.
Apical hypertrophic cardiomyopathy is a disease that mainly affects the apex of the heart and does not cause any obstruction. [1] These abnormalities in the heart muscle can cause a wide variety of symptoms. As the heart becomes stiff it increases the pressure in the left ventricle which can push blood back into the lungs, causing shortness of breath in exercise. Chest pain can occur as there is not enough oxygen available to the cardiac muscle due to insufficient blood supply. Palpitations and lightheadedness, along with other conditions can occur as a result of HCM. In addition to these discomforting symptoms, the patient may develop an arrhythmias that often goes unnoticed. An arrhythmia takes place as the electrical conduction of the heart is disturbed by the abnormal scattering of myocytes. The two most common arrhythmias are atrial fibrillation causing palpitations, and ventricular tachycardia that can be life threatening causing sudden death. Both conditions can be controlled with medication. [4]
Adverse drug events include adverse drug reactions (ADRs); drug-drug interactions due to uncertainty about the benefits and harms of simultaneous treatment; drug-disease interactions due to potential risk of worsening one condition by treating a co-existing one; improper drug election, sub- and supra-therapeutic dosage, noncompliance/failure to receive drug, and wrong drug (10, 13-16). Older adults are at increased risk for developing adverse drug events due to multiple concurrent diseases and physiological changes that occur as part of the ageing process, particularly, in pharmacokinetics (reduced renal elimination) and pharmacodynamics (increased sensitivity to certain medications) affecting drug disposition (10).
The heart is one of the most important organs in an organism’s body, no matter if they are aquatic, amphibian, or a mammal. This super organ works automatically, able to pump massive amounts of oxygen rich blood through the body by means of electrical impulses and the opening and closing of valves within its many layers. It is what keeps us and every other creature on this earth alive; so it is only natural for one to fear when there might be a problem with one’s heart. A cardiac arrhythmia can happen to anyone, no matter the age, race, or gender, and as such, doctors and scientist have spent years trying to better understand the heart and the way it functions so that they can try to prevent these problems and save millions of lives.
The Naranjo Adverse Drug Reaction Probability Scale was used to determine if this patients clinical signs of confusion and disorientation were caused by administration of Augmentin XR. Based on the information presented the score given was 3, which indicates that it is possible that this adverse reaction was caused by administration of Augmentin XR. The adverse affect appeared after the drug was administered and disappeared after antibiotic was discontinued. This adverse effect was confirmed by observation of the patient by hospital staff. Other information would have to be gathered including blood concentration to determine if toxic levels were present to cause the adverse
Side effects of ergotamine includes nausea, tingling sensations, cramps, chest or abdominal pain, and dizziness. Three potential, and possibly fatal, problems include toxicity, extreme blood vessel constriction, and fibrosis. Doctors may advise taking painkillers that contain opioids if the attack is very severe. Examples of opioids include morphine, codeine, meperidine, and oxycodone. Butorphanol is an opioid that is available as a nasal spray. Classic side effects of opioids include drowsiness, nausea, judgement impairment, and constipation. Drug abuse and addiction are a big complication of using opioids as a treatment option. Metoclopramide is used in combination with other drugs to treat the nausea and vomiting that may occur from medications
The signs fall into two categories: optic neuritis and transverse myelitis. Optic neuritis is inflammation of the optic nerve and can result with pain inside the eye, unclear vision, or blindness. Optic neuritis usually occurs in one eye, but can happen in both. Transverse myelitis is inflammation of the spinal cord. This inflammation can result in pain, weakness, numbness, or paralysis of the arms and legs. It could also result in loss of control of the bladder and bowel. Side effects could result in nausea, hiccups, headaches, or a stiff neck. Symptoms and signs for children who have neuromyelitis optica include confusion, seizures, or
Adverse reactions to drugs are common and almost any drug can cause an adverse reaction.
is a disease that causes optic nerve damage resulting in the gradual loss of sight. Currently, it is estimated more than 3 million
A major effect of alkalosis is hyperexcitability of the nervous system. Peripheral nerves are affected first, resulting in