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Amiodarone induced thyrotoxicosis (AIT) is a form of hyperthyroidism due to treatment with antiarrhythmic drug, amiodarone. Amiodarone induced thyroid dysfunction more commonly results in hypothyroidism , estimated to occur in 6-32% of patients, whereas hyperthyroidism from amiodarone use is estimated at 1-12%. [ 1 ]
The administration of beta-1-selective beta blockers (e.g. metoprolol) is recommended to reduce the effect of circulating thyroid hormone on end organs. [4] [21] [6] Propranolol at high doses is a common first-line treatment, as it reduces peripheral conversion of T4 to T3, which is the more active form of thyroid hormone.
Amiodarone is also safe to use in individuals with cardiomyopathy and atrial fibrillation, to maintain normal sinus rhythm. Amiodarone prolongation of the action potential is uniform over a wide range of heart rates, so this drug does not have reverse use-dependent action. Amiodarone was the first agent described in this class. [4]
The progress in β-blocker development led to the introduction of drugs with variety of properties. β-blockers were developed having a relative selectivity for cardiac β1-receptors (for example metoprolol and atenolol), partial adrenergic agonist activity , concomitant α-adrenergic blocking activity (for example labetalol and carvedilol) and ...
Amiodarone has been used both in the treatment of acute life-threatening arrhythmias as well as the long-term suppression of arrhythmias. [13] Amiodarone is commonly used to treat different types of abnormal heart rhythms, such as atrial arrhythmias (supraventricular arrhythmias) and ventricular arrhythmias.
Metoprolol, sold under the brand name Lopressor among others, is a medication used to treat angina and a number of conditions involving an abnormally fast heart rate. [4] It is also used to prevent further heart problems after myocardial infarction and to prevent headaches in those with migraines . [ 4 ]
Compounds that prolong the action potential: matching the modern classification, with the key drug example being amiodarone, and a surgical example being thyroidectomy. This was not a defining characteristic in an earlier review by Charlier et al. (1968), [ 17 ] but was supported by experimental data presented by Vaughan Williams (1970).
Budiodarone (ATI-2042) is an antiarrhythmic agent and chemical analog of amiodarone that is currently being studied in clinical trials.Amiodarone is considered the most effective antiarrhythmic drug available, [1] [2] [3] but its adverse side effects, including hepatic, pulmonary and thyroid toxicity as well as multiple drug interactions, [4] are discouraging its use.
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