Fever amiodarone

Amiodarone is the preferred antiarrhythmic during cardiac arrest according to the 2005 guidelines. Hypotension occurs frequently but can generally be reversed by decreasing the infusion rate. Other acute effects include fever, elevated liver function tests, confusion, nausea, and thrombocytopenia. 

Methimazole (Tapazole) [Antithyroid Agent] Uses Hyperthy-roidism, thyrotoxicosis, pr for thyroid surgery or radiation Action Blocks T3 T4 formation Dose Adults. Initial 15-60 mg/d PO tid Maint 5-15 mg PO daily Peds. Initial 0.4-0.7 mg/kg/24 h PO tid Maint V h- U h of initial dose PO daily w/ food Caution [D, +/-] Contra Breast-feeding Disp Tabs SE GI upset, dizziness, blood dyscrasias Interactions t Effects OF digitalis glycosides, metoprolol, propranolol X effects OF anticoagulants, theophylline X effects W/ amiodarone EMS None OD May cause N/V, HA, abd pain, fever, and pale skin symptomatic and supportive... 

A 77-year-old man who had taken amiodarone 400 mg/day for 11 months developed crackles at the lung bases and scattered respiratory wheeze (76). His leukocyte count was raised at 13.5 x 109/1 and he had progressive reduction in carbon monoxide diffusing capacity, serially measured. A chest X-ray showed bilateral opacities in the upper zones, peripheral in distribution, and a CT scan showed dense bilateral lung parenchjmal opacities. The symptoms of dyspnea on exertion, cough with minimal sputum, pleuritic chest pain, and low-grade fever abated after withdrawal, and the upper lobe densities resolved. 

A 71-year-old woman, who had been taking amiodarone 200 mg bd for 2 years, developed malaise, intermittent fever, arthralgia, and weight loss (210). She had a malar rash and hypoventilation at both lung bases. Her erythrocyte sedimentation rate was markedly raised (90 mm/hour), there was a mild normochromic... 

A 59-year-old man, who had taken amiodarone 200 mg/day for 2 years, developed fever, pleuritic chest pain, dyspnea at rest, a non-productive cough, malaise, and joint pains (211). He had a verrucous endocarditis and a pleuropericardial effusion. He had raised titers of antinuclear antibodies (1 320) with anti-Ro specificity. Serum complement was normal and there were no circulating immune complexes, no cryoglobulins, and no anti-dsDNA, anti-La, anti-Ul ribonucleoprotein, anti-Sm, anti-Scl, 70, anti-Jo 1, antihistone, antiphosphohpid, anticentromere, anticardioli-pin, or anticytoplasmic antibodies. Within 7 days of withdrawal of amiodarone the signs and symptoms started to resolve, and he recovered fuUy with the addition of prednisolone. 

Amiodarone HCl (Cordarone) (Comeal microdeposits are noted in almost all patients treated for >6 months [can lead to blurry vision], hypotension, rutusea, fever, bradycardia, constipation, headache, decreased appetite, nausea, vomiting, numbness offingers/toes, photosensitivity, muscular incoordination ... 

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