Amiodarone Therapy for Cardiac Arrhythmias: Is It Associated with the Development of Cancers?

Mali, Padmavathi; Salzman, Michele M; Vidaillet, Humberto; Rezkalla, Shereif H.

doi:10.4236/wjcd.2014.43017

Cited by 4 publications

(4 citation statements)

References 36 publications

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“…Alveolar macrophages isolated from AM-treated rats released large amounts of TNF-α [18]. Pulmonary toxicity by AM is an immuno-mediated process involving an imbalance in T-helper cells and over-production of cytokines which are reported to significantly increase serum TNF-α [14].In addition, the oxidative capacity of ROS leads to generation of oxidation products and cellular damage within the lungs. Malondialdehyde (MDA) is an index of membrane LPO which damages pulmonary endothelium [17].…”

Section: Discussionmentioning

confidence: 99%

“…These changes can be attributed to AMinduced pulmonary toxicity. Several mechanisms are involved in the accumulation of iodine-rich AM in pneumocytes [14]. The mechanisms involve direct toxic effect that disrupts cellular membranes through the activation of protein kinase C, release of toxic reactive oxygen species (ROS), decreases in GSH, mitochondrial dysfunction, necrosis and ultimately apoptosis [15].…”

Section: Discussionmentioning

confidence: 99%

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Therapeutic effects of Laser and L-carnitine against amiodarone-induced pulmonary toxicity in adult male rats

El-Nahrawy¹,

Zaher²,

Ali³

2017

Trop. J. Pharm Res

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Purpose: To compare the effects of laser and/or L-carnitine (LC) on amiodarone (AM)-induced lung toxicity in adult male rats. Methods: Lung toxicity was induced in 50 healthy male albino rats (150-180 g) by AM for 8 weeks. The rats were divided into 4 groups (7 per group): AM recovery, LC, laser, and laser + LC. After a 4-week exposure to laser and/or LC, key antioxidant enzymes, nitric oxide (NO), angiotensin II, cyclooxygenase-II (COX-II) and lipoxygenase (LOX) as well as oxidative stress and inflammation parameters were determined. Results: Administration of LC and/or laser exposure led to significant increases in reduced glutathione (GSH), superoxide dismutase (SOD), catalase (CAT) and angiotensin II; and significant decreases in nitric oxide (NO) level and glutathione-S-transferase (GST) activity in the AM

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Therapeutic effects of Laser and L-carnitine against amiodarone-induced pulmonary toxicity in adult male rats

El-Nahrawy¹,

Zaher²,

Ali³

2017

Trop. J. Pharm Res

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“…Cheng et al [9] described a case of APT rapidly progressive organizing pneumonitis mimicking lung cancer. Mali et al [10] focuses on the ever increasing evidence in the literature that suggests amiodarone therapy, especially with longterm use, may increase the potential risk of cancer development [10].…”

Section: Discussionmentioning

confidence: 99%

Amiodarone-Induced Pulmonary Toxicity Mimicking Metastatic Lung Disease: Case Report

Milenković¹

2014

J Pharmacovigil

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Amiodarone is an antiarrhythmic drug that is commonly used for the treatment of ventricular and supraventricular arrhythmias. It is an iodine-containing compound, and has a tendency to accumulate in certain organs, including in the lungs. We describe a case of amiodarone induced pulmonary toxicity with concurrent lung cancer which demonstrated good treatment response. A sixty nine-year old male smoker presented to our emergency department with a four-month history of progressive dyspnea, cough and 5 kilogram weight loss. Chest x-ray at admission showed enlarged heart shadow and prominent hilum bilaterally; CT revealed ground glass opacities in right lung and enlarged mediastinal lymph nodes. His past medical history was significant for dilated myocardiopathy and atrial fibrillation (for which he had been taking amiodarone for 5 years). Radiological findings, decrease in total lung capacity (TLC=84%), decrease in lung diffusing capacity (DLCOc=73%), and corneal epithelial opacities suggested amiodarone-induced pulmonary toxicity (APT) and/or advanced malignant disease. Amiodarone was eliminated from his medication profile due to suspicion of drug toxicity. The patient's clinical condition promptly improved, and chest x-ray performed after 7 days showed corresponding improvement. Subsequent bronchoscopy included a transbronchial biopsy which revealed lung adenocarcinoma. The patient's presumed APT was treated with methylprednisolone 40mg IV daily during the first two weeks, and subsequently with prednisone 20 mg/day orally for two months. One month after steroid therapy (and prior to chemotherapy) both lungs demonstrated radiographic improvement. Treatment response to chemotherapy was successful, with good performance status (ECOG1) after 10 months. This case with comorbid APT and lung cancer illustrates the importance of diligence in developing differential diagnoses for pulmonary infiltrates. Chest physicians should take care to remember that amiodarone induced pulmonary toxicity (APT) can sometimes mimic disseminated lung malignancy. Figure 1: ECG At admission Left bundle branch block and monomorphic ventricular premature beats.

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“…3 Previous studies have suggested a potential association between amiodarone and cancer, particularly cancers of the thyroid, liver, lungs, and skin. 4,5,6,7,8 A metaanalysis of randomized controlled trials (RCTs) evaluating amiodarone for the prevention of sudden cardiac death demonstrated an increased risk of cancer-related death with amiodarone versus control. 9 However, this meta-analysis included only a subset of RCTs and was limited to trials with short follow-up.…”

Section: J O U R N a L P R E -P R O O F Introductionmentioning

confidence: 99%

Chronic Amiodarone Use and the Risk of Cancer: A Systematic Review and Meta-analysis

et al. 2021

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Amiodarone Therapy for Cardiac Arrhythmias: Is It Associated with the Development of Cancers?

Cited by 4 publications

References 36 publications

Therapeutic effects of Laser and L-carnitine against amiodarone-induced pulmonary toxicity in adult male rats

Therapeutic effects of Laser and L-carnitine against amiodarone-induced pulmonary toxicity in adult male rats

Amiodarone-Induced Pulmonary Toxicity Mimicking Metastatic Lung Disease: Case Report

Chronic Amiodarone Use and the Risk of Cancer: A Systematic Review and Meta-analysis

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