van der Zeyden H, Zandstra D, van Hengstum M
Andreas Hospital, Amsterdam, The Netherlands.
Intensive Care Med. 1992;18(7):422-3. doi: 10.1007/BF01694345.
A case of amiodarone pulmonary toxicity (APT) is described following a low dosage of amiodarone (200 mg/day) with serious respiratory insufficiency in a patient after right pneumonectomy. The patient was successfully treated by discontinuation of amiodarone, mechanical ventilation and prednisolone (40 mg/day). A literature study indicates that APT is a dose related toxicity. In our opinion a higher pulmonary drug concentration of amiodarone could exist from a change in pharmacokinetics because of a low fat storage in a thin patient and compensatory growth of the remaining lung which occurs after pneumonectomy. Given these findings we suggest that if amiodarone is indicated in such patients both loading and maintenance doses should be adapted.
本文描述了一例右肺切除术后患者在服用低剂量胺碘酮（200mg/天）后出现胺碘酮肺毒性（APT）并伴有严重呼吸功能不全的病例。通过停用胺碘酮、机械通气和使用泼尼松龙（40mg/天），该患者得到了成功治疗。一项文献研究表明，APT是一种与剂量相关的毒性。我们认为，由于瘦患者脂肪储存量低以及肺切除术后剩余肺组织的代偿性生长，药代动力学发生改变，可能导致胺碘酮在肺部的药物浓度升高。基于这些发现，我们建议，如果在此类患者中需要使用胺碘酮，负荷剂量和维持剂量均应进行调整。
