Clinical Profile And Side Effects Of Chronic Use Of Oral Amiodarone In Cardiology Out Patients Department

Abstract

Background: Amiodarone is a widely utilized antiarrhythmic drug effective in managing various cardiac arrhythmias, particularly atrial fibrillation and ventricular tachycardia. However, its chronic use is associated with a spectrum of side effects, necessitating careful monitoring in outpatient settings. 
Objectives: The objective of this study is to describe clinical profile of patients using oral amiodarone for various cardiac indications visiting cardiology outpatient departments and to know frequency of its side effects.
Study Design: A cross sectional descriptive study 
Place and Duration of the Study: Department of Cardiology, MTI Gajju Khan Medical College, Swabi, KP, Pakistan from January 2019 to December 2020.
Methodology: A total of 200 patients visiting cardiology OPD and using oral amiodarone for various indications were included in the study. Demographic and clinical data of the patient were obtained. Side effects were assessed through clinical examination, chest x-rays, pulmonary function testing, abdominal ultrasound, liver functions testing and serum TSH estimation. Data was analyzed statistically and measurement variables were described by means ± standard deviations.
Results: Thyroid dysfunction was present in 40(20%) out of 200 patients with TSH level of 4.5 ± 1.2 mIU/. Pulmonary toxicity manifested in 30 (15%) patients with a decrease in lung capacity by 8 ± 2%. Hepatotoxicity was found in 20 (10%) patients and neurological symptoms in the form of tremors in 24 (12%) patients. It affected the skin mainly in regard to photosensitivity in 36 (18%) patients. Thirty two 32 (16%) patients experienced at least one organ toxicity.
Conclusion: This study shows that chronic use of amiodarone is associated with multisystem serious adverse effects especially thyroid, pulmonary and hepatic side effects. These side effects imply that careful monitoring during routine follow-up appointments is imperative, so that patients can receive proper surveillance for toxicity and avoid serious side effects.