Does amiodarone cause skin discoloration?
Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. … Amiodarone photosensitivity Arch Dermatol. 1984 Dec;120(12):1591-4. Authors J F Walter, H Bradner, G P Curtis PMID: 6508331
What are the symptoms of amiodarone photosensitivity?
We report observations on a case of amiodarone photosensitivity and corneal deposits developing in a patient shortly after amiodarone therapy was begun. Symptoms included burning and stinging of the skin, with redness and swelling that developed immediately after sun exposure.
What is the prevalence of adverse effects of amiodarone?
The prevalence of adverse effects from amiodarone therapy is as high as 15% within the first year of use and 50% for long-term use. The risk/benefit ratio often leads to the discontinuation of amiodarone in the first year of treatment for patients with atrial fibrillation.
What is the mechanism of action of amiodarone?
Mechanism of Action Amiodarone is primarily a class III antiarrhythmic. Like other antiarrhythmic drugs of this class, amiodarone works primarily by blocking potassium rectifier currents responsible for the repolarization of the heart during phase 3 of the cardiac action potential.
How does amiodarone affect skin?
Amiodarone can cause a red rash which resembles a bad sunburn, and this rash can be triggered with prolonged sun exposure. After several years of exposure, amiodarone can cause a bluish discoloration of the skin. Many drugs interact with amiodarone.
Does amiodarone cause Photodermatitis?
Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin.
What are the most common side effects of amiodarone?
More commonCough.dizziness, lightheadedness, or fainting.fever (slight)numbness or tingling in the fingers or toes.painful breathing.sensitivity of the skin to sunlight.trembling or shaking of the hands.trouble with walking.More items...•
What are the five drugs that are attributed to photosensitivity?
Drugs that have been implicated in causing photosensitive eruptions are reviewed. Tetracycline, doxycycline, nalidixic acid, voriconazole, amiodarone, hydrochlorothiazide, naproxen, piroxicam, chlorpromazine and thioridazine are among the most commonly implicated medications.
Which drug is most likely to cause a photosensitivity reaction?
Primary Classes of Medications Responsible for Photosensitizing ReactionsAntihistamines.Coal Tar and Derivatives.Contraceptives, Oral and Estrogens.Non-Steroidal Anti-Inflammatory Drugs.Phenothiazines.Psoralens.Sulfonamides.Sulfonylureas.More items...•
How do you counteract photosensitivity?
Topical corticosteroids and cool compresses may alleviate drug-induced photosensitivity. The use of systemic corticosteroids should be reserved for the most severe cases. If sunscreens are not the cause of the photosensitivity, they should be used liberally.
What should be avoided while taking amiodarone?
Amiodarone may be taken with or without food but should be taken at the same way each time. You should avoid consuming grapefruits and grapefruit juice while taking amiodarone. Do not increase or decrease the amount of grapefruit products in your diet without first talking to your doctor.
What drugs should not be taken with amiodarone?
Amiodarone can slow down the removal of other medications from your body, which may affect how they work. Examples of affected drugs include clopidogrel, macitentan, phenytoin, certain "statin" drugs (atorvastatin, lovastatin), trazodone, warfarin, among others.
When should amiodarone be stopped?
Hepatic toxicity occurs commonly in patients receiving long-term amiodarone. Liver enzymes should be checked every six months. If concentrations reach three times the upper limit of normal, amiodarone should be discontinued, unless the patient has a life-threatening arrhythmia.
What medications should you stay out of the sun?
There are certain types of medicines that can cause sensitivity to the sun. Some of these include: Antibiotics (ciprofloxacin, doxycycline, levofloxacin, ofloxacin, tetracycline, trimethoprim) Antifungals (flucytosine, griseofulvin, voricanozole)
Is drug induced photosensitivity reversible?
Adverse photosensitivity responses to drugs occur predominantly as a phototoxic reaction which is more immediate than photoallergy, and can be reversed by withdrawal or substitution of the drug.
What is severe drug photosensitivity?
Drug-induced photosensitivity is an adverse skin reaction induced by sun exposure in some patients taking particular medicines1. As the skin absorbs ultraviolet (UV) radiation this can cause a chemical change to a medicine that is present in the skin resulting in a phototoxic or photoallergic reaction2.
What dermatological issue is linked to amiodarone use?
The amiodarone molecule contains a large amount of inorganic iodine, which may exacerbate certain skin diseases, such as dermatitis herpetiformis and psoriasis.
Does amiodarone cause skin discoloration?
Blue-gray discoloration is seen in 2% to 24 % of patients and appears to be related to a daily amiodarone dose of more than 200 mg. Skin deposits are observed 7 to 60 months after the start of therapy.
Why does amiodarone cause discoloration?
Finally, the presence of amiodarone deposits in the skin, with or without lipofuscin, is able to induce the blue-gray hyperpigmentation. This pigmentation could be explained by the Tyndall effect, in which dermal pigment, whether melanin, iron, or other pigment, is perceived as blue, gray, or blue-gray.
Is amiodarone an irritant?
Background Intravenous amiodarone is irritable to the venous system and should be administered through a central venous catheter whenever possible.
Does amiodarone cause photosensitivity?from pubmed.ncbi.nlm.nih.gov
Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. In addition, corneal microdeposits of yellow-brown granules may occur. We report observations on a case of amiodarone photosensitivity and corneal deposits developing in a patient shortly after amiodarone therapy was begun. Symptoms included burning and stinging of the skin, with redness and swelling that developed immediately after sun exposure. Phototesting showed that the photoactivating wavelengths were primarily in the long-wave UV-A spectrum between 350 and 380 nm. Prior application of a 10% dioxybenzone sunscreen greatly reduced the phototest reaction. Four weeks after the patient stopped taking amiodarone, the UV-A sensitivity was still present but diminished, and by ten weeks it had disappeared. During this time, the corneal deposits were reduced in number. All ten patients we have treated so far with amiodarone for cardiac arrhythmias have shown a similar photosensitivity, indicating that this is probably a phototoxic reaction.
Is amiodarone a cardiac antiarrhythmic?from pubmed.ncbi.nlm.nih.gov
Amiodarone hydrochloride is currently being investigated in the United States as a cardiac antiarrhythmic agent. Previous reports from Europe indicate that amiodarone occasionally causes a cutaneous photosensitivity reaction that may be associated with a peculiar blue-gray discoloration of the skin. …
Is amiodarone a vasodilator?from pubmed.ncbi.nlm.nih.gov
Amiodarone, a benzofuran derivative, has been used therapeut ically as an antiarrhythmic and coronary vasodilator in Europe since 1964. One of its commoner side effects is cutaneous photosensitivity; more rarely, after ingestion of the drug for around 12 months, a slate-grey or violaceous discoloration of sun-exposed sites may gradually develop.
What percentage of people have hypotension?
Very common (10% or more): Hypotension (up to 20.2%)
What are the symptoms of a scrotum?
nervousness. pain and swelling in the scrotum. sensitivity of the eyes to light. sensitivity to heat. slow heartbeat. sweating. swelling of the feet or lower legs. trouble with sleeping. unusual tiredness.
What does it mean when you have trouble walking?
trouble with walking. unusual and uncontrolled movements of the body. weakness of the arms or legs. Less common. Blue-gray coloring of the skin on the face, neck, and arms. blurred vision or blue-green halos seen around objects. coldness. dry eyes. dry, puffy skin.
Does amiodarone cause pulmonary toxicity?
Amiodarone can cause pulmonary toxicity (hypersensitivity pneumonitis or interstitial/alveolar pneumonitis) that has resulted in clinically manifest disease at rates as high as 17% in some series of patients. Pulmonary toxicity has been fatal about 10% of the time.
What are the symptoms of a swollen hand?
More common. Cough. dizziness, lightheadedness, or fainting. fever (slight) numbness or tingling in the fingers or toes. painful breathing. sensitivity of the skin to sunlight. trembling or shaking of the hands. trouble with walking.
What does it mean when you have a hive?
joint or muscle pain. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals. loss in sexual ability, desire, drive, or performance. loss of consciousness. loss of heat from the body. lower back or side pain. mood or mental change.
Can amiodarone cause hepatoxicity?
Repeat history, physical exam, and chest X-ray every 3 to 6 months. Amiodarone can cause hepatoxicity, which can be fatal.
How much amiodarone should I take a day?from medicalrepublic.com.au
Doctors will often prescribe a loading dose of up to 600mg of amiodarone a day in younger patients with ventricular arrhythmias, and then taper the dose over time. “But with older patients, if you do need to use amiodarone, be cautious. Start low. I really wouldn’t give more than a 100mg a day,” Dr Allahwala said.
How long does amiodarone last?from medicalrepublic.com.au
Amiodarone is fat soluble with a long half-life of around three months. As older people have a greater fat-to-muscle ratio than younger people, the drug is more likely to build up in their system and cause problems.
What is the name of the drug that slows the heart?from mayoclinic.org
Amiodarone belongs to the group of medicines known as antiarrhythmics. It works directly on the heart tissue and will slow the nerve impulses in the heart. This helps keep your heart rhythm normal.
What percentage of people have hypotension?from drugs.com
Very common (10% or more): Hypotension (up to 20.2%)
What does it mean when your hands are burning?from mayoclinic.org
These could be symptoms of a condition called peripheral neuropathy.
What does it mean when you have a hive?from drugs.com
joint or muscle pain. large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals. loss in sexual ability, desire, drive, or performance. loss of consciousness. loss of heat from the body. lower back or side pain. mood or mental change.
What is the term for inflammation of the skin due to an allergy?from webmd.com
inflammation of the skin due to an allergy. inflammation of the skin with blisters. erythema multiforme, a type of allergic skin reaction. a skin disorder with blistering and peeling skin called toxic epidermal necrolysis.
What is the best treatment for TDP?
Treatment of acute toxicity may include vasopressor support as well as magnesium for TdP. Temporary pacing may be necessary for bradycardia, and TdP treatment may warrant over-drive pacing. Activated charcoal is the recommended therapy for acute oral ingestions. No specific antidote for amiodarone toxicity is available, and amiodarone is not dialyzable.
How long does it take to take amiodarone?
In adult patients, amiodarone can be given for VT/VF cardiac arrest via intravenous (IV)/intraosseous (IO) infusion as a 300 mg rapid bolus followed by an additional bolus of 150 mg IV/IO if VT or VF persists. If the patient achieves ROSC, a continuous infusion is started at 1 mg/min for 6 hours, followed by 0.5 mg/min. To treat all acute tachyarrhythmias in adults, amiodarone can be given IV 150 mg over 10 minutes, followed by a 1 mg/min infusion for 6 hours, followed by an infusion at 0.5 mg/min. The recommended total dose over 24 hours should not exceed 2.4 grams. Recommended oral dosing is 400 to 600 mg daily in divided doses for 2 to 4 weeks, followed by maintenance dosing of 100 to 200 mg daily. No dosage adjustment is necessary for renal impairment.
What is amiodarone used for?
Amiodarone also can be used to treat other supraventricular tachyarrhythmias, including atrial flutter, refractory AV (atrioventricular) nodal, and AV re-entrant tachycardia (commonly referred to as SVT). Finally, amiodarone is indicated for the treatment of ventricular arrhythmias, specifically monomorphic VT, non-Torsades polymorphic VT (secondary to myocardial ischemia and not associated with prolonged QTc), as well as for pulseless ventricular fibrillation (VF) and pulseless VT that fail to convert after CPR, defibrillation, and epinephrine administration. When studied in patients with out-of-hospital cardiac arrest, amiodarone resulted in a higher rate of return of spontaneous circulation (ROSC); however, this ROSC benefit did not result in a higher rate of survival to hospital discharge with the favorable neurological outcome. [3]
What is the most commonly used anti-arrhythmic drug?
Amiodarone is one of the most commonly used anti-arrhythmic drugs. While the United States FDA has labeled amiodarone for the treatment of life-threatening ventricular arrhythmias, the drug is commonly used off-label to treat supraventricular tachyarrhythmias such as atrial fibrillation as well as for the prevention of ventricular tachyarrhythmias (VTs) in high-risk patients. [1][2][3]
How does amiodarone work?
Like other antiarrhythmic drugs of this class, amiodarone works primarily by blocking potassium rectifier currents responsible for the repolarization of the heart during phase 3 of the cardiac action potential. This potassium channel-blocking effect results in increased action potential duration and a prolonged effective refractory period in cardiac myocytes. Myocyte excitability is decreased, preventing reentry mechanisms and ectopic foci from perpetuating tachyarrhythmias. Electrocardiographic evidence of these effects is evident as prolongation of the QRS duration and QTc interval. [4]
What are the effects of amiodar on the skin?
Neurologic toxicity can occur in up to 27.5% of patients, ranging from cognitive impairment to peripheral neuropathy, ataxia, and in some rare cases, quadriplegia. Dermatologic effects include blue skin discoloration ("smurf-skin") and photosensitivity. In rare instances, amiodarone may cause epididymitis and erectile dysfunction.
How long does it take for amiodarone to work?
Amiodarone has a very long half-life (t1/2 of several weeks), and it may take 6 weeks for full clinical effects with oral therapy. Also, upon discontinuation of amiodarone therapy, pharmacologic effects could continue for 1 to 3 months. [6]
What is the most common type of sun allergy?
Polymorphic light eruption is the most common type of sun allergy. The condition can have a genetic component or be caused by medications, particularly drugs that are used topically. Negative reactions occur from exposure to UV radiation, which alters the structure of the chemicals in particular medications.
What are the two types of photosensitivity?
There are two types of photosensitivity: photo-toxicity and photo-allergy. Photo-toxicity is a chemically-induced irritation of the skin following sun exposure that doesn’t involve the immune system. The reaction it induces resembles an exaggerated sunburn, which is caused by a chemical absorbing into the skin topically, ...
What wavelength of light is most prone to photosensitivity?
Certain people are more prone to photosensitivity than others. Wavelengths that fall within the 320-400 nm range (UVA radiation) are more apt to initiate drug-induced photosensitivity reactions. To a lesser degree, UVB radiation, in the 290-320 nm range, can also cause skin reactions. Sunlight in this range is responsible for sunburn, and non-melanoma skin cancer, including basal cell carcinoma.
How long does it take for photosensitivity to manifest?
Reactions can be triggered by brief moments in the sun, and commonly present within 24 hours of exposure, but may take several days of continuous sun exposure to manifest.
What is photosensitivity in the sun?
What Is Photosensitivity? Photosensitivity, also called sun allergy, is the result of an immune system reaction that occurs in the skin following sun exposure. Although, the exact mechanism is undetermined regarding these reactions, it’s supposed that the immune system recognizes certain components of the skin as foreign or non-self.
Can photo toxicity be caused by exposure to sunlight?
This causes an allergic reaction within the skin that produces the symptoms, which unlike photo-toxicity, can spread to areas that haven’t been exposed to sunlight. Mild cases of photo-allergy often resolve without treatment, with more severe cases being treated with steroid pills or creams.
Does UVA cause skin cancer?
UVA radiation penetrates deeply into the dermis of the skin, causing photo-aging, cellular DNA damage, and immune-suppression.