Zusammenfassung
□ Amiodaron ist ein sehr wirksames Antiarrhythmikum zur Unterdrückung ventrikulärer und supraventrikulärer Tachyarrhythmien. Die wichtigste unerwünschte Wirkung ist die pulmonale Toxizität. Die den pulmonalen Veränderungen zugrundeliegenden molekularen Mechanismen sind nicht eindeutig geklärt. Die Lungenveränderungen können sich in verschiedenen Formen präsentieren, beispielsweise als interstitielle Pneumonitis, Fibrose oder organisierende Pneumonie. Die Inzidenz ist bei niedriger Erhaltungsdosis (≤ 300 mg/d) geringer. Es existieren keine eindeutigen Prädiktoren der pulmonalen Toxizität. Die Diagnose der amiodaroninduzierten Lungenveränderungen ist in der Regel eine Absschlußdiagnose. Die wichtigste Therapiemaßnahme besteht im Absetzen des Antiarrhythmikums. Bei schweren Verlaufsformen oder falls das Antiarrhythmikum unverzichtbar ist, wird eine Therapie mit Glukokortikoiden durchgeführt.
Summary
□ Amiodarone is highly effective in suppressing ventricular and supraventricular tachyarrhythmias. The most serious adverse reaction is pulmonary toxicity. The mechanisms involved in amiodarone-induced pulmonary injury are incompletely understood. Several forms of pulmonary disease occur including interstitial pneumonitis, fibrosis or organizing pneumonia. The incidence is generally lower with lower maintenance doses (≤ 300 mg/d). There are no adequate predictors of pulmonary toxicity due to amiodarone. The diagnosis of amiodarone-induced pulmonary toxicity is one of exclusion. Treatment consists primarily of stopping amiodarone application. Corticosteroid therapy can be life-saving for severe cases and for patients in whom withdrawl of amiodarone is not possible.
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Heisel, A., Berg, M., Stopp, M. et al. Amiodaroninduzierte Lungenveränderungen. Med Klin 92 (Suppl 5), 33–36 (1997). https://doi.org/10.1007/BF03041977
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DOI: https://doi.org/10.1007/BF03041977