QuestionSBA
QuestionChoice
While blood dyscrasias have been reported with use of amiodarone, these are very rare and as such a full blood count would be useful as a baseline but is not routinely done
34327
c
Full blood count
QuestionChoice
Amiodarone is metabolised and excreted by the liver. Renal function would be useful as a baseline but not with respect to starting this drug
34326
b
Creatinine clearance
QuestionChoice
Amiodarone is a potassium channel blocker and as such imbalances in potassium should be corrected prior to starting this drug, rather than sodium
34328
d
Serum sodium
QuestionChoice
An elevation in cardiac enzymes may suggest some ongoing myocardial ischaemia and can be useful in the general clinical setting on a background of acute chest pain, but is of limited usefulness with respect to starting this drug
34329
e
Troponin
QuestionChoice
A potentially severe side effect of amiodarone use is pulmonary fibrosis. Existing lung damage should be ruled out prior to starting this drug
34325
a
Chest X-ray
QuestionComment
Where does it say this in the BNF?
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QuestionComment
Search "Amiodarone Hydrochloride" -> Find monitoring requirements on the drug monograph -> Under monitoring of patient parameters C&P'd:

Monitoring of patient parameters For amiodarone hydrochloride
Liver function tests required before treatment and then every 6 months.
Serum potassium concentration should be measured before treatment.
Chest x-ray required before treatment.

Hope that helps!
40853
User
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Sclerosis Myopathy
User
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Cystic Kawasaki
Concept
Chapter
#### Monitoring

The BNF advises to monitor lung function (in patients with a history of obstructive airway disease).

#### Overdoses

Overdosages with beta-blockers may cause cardiac effects such as bradycardia, hypotension, syncope, conduction abnormalities, and heart failure. Bradycardia is the most common arrhythmia, but some beta-blockers may induce ventricular tachyarrhythmias secondary to prolongation of QT interval (e.g. sotalol) or QRS duration (e.g. propranolol).
Non-cardiovascular effects include central nervous system effects (including drowsiness, confusion, convulsions, hallucinations, and in severe cases coma), respiratory depression, and bronchospasm.

Management
 - Airway protection 
 - Activated charcoal within 1 hour
 - IV Fluids
 
IV glucagon is the first-line management.
 
For symptomatic bradycardia, IV atropine may be used.

2618
2808
Amiodarone side effects
Topic
9
Internal Medicine
6876
Case Presentation: A 62 year old man is sent to the rapid access chest pain clinic by his GP following the reported results of a 24 hour ECG holter monitor. **PMH** myocardial infarction with 100% LAD occlusion, hypertension. **DH** aspirin 75mg PO OD, bisoprolol fumarate 2.5mg PO OD, ramipril 5mg PO OD. NKDA


**Investigations**

24 hour ECG holter monitor: infrequent runs of ventricular tachycardia lasting 30-40 seconds

The cardiology consultant recommends starting amiodarone hydrochloride 200mg PO TDS whilst awaiting implantation of an ICD.

Question: Select the most appropriate monitoring option required before initiating amiodarone hydrochloride.
a