Mahadevappa Manjappa, Jodiya Annet, Chalasani Sri Harsha, Syed Jehath M, Ramesh Madhan, Pereira Prathibha
Department of Cardiology, JSS Medical College & Hospital, JSS Academy of Higher Education and Research, Mysore, India.
Department of Pharmacy Practice, JSS College of Pharmacy, JSS Academy of Higher Education and Research, Mysore, India.
J Pharm Pract. 2023 Jun;36(3):695-698. doi: 10.1177/08971900211054199. Epub 2021 Oct 29.
Amiodarone is an antiarrhythmic drug belonging to Vaughan-Williams Class III with additional Class IV effects, which is known to cause many adverse drug reactions (ADRs) necessitating close monitoring. In about 20% of patients, their therapy is discontinued due to adverse effects such as hepatic impairment, thyroid dysfunction, and several pulmonary complications. Although dyselectrolytemia is a common adverse reaction reported with many cardiac medications, the incidence of hyponatremia associated with amiodarone intake is not reported widely in the literature. We are reporting a case of a 73-year-old female patient, with hypertension and ischemic heart disease (IHD) receiving oral amiodarone, presenting with severe hyponatremia, requiring recurrent hospitalization. Amiodarone was found to be responsible after evaluating for the possible causes of hyponatremia. As the incidence of amiodarone-associated hyponatremia is unknown, and not many cases are reported, this case report serves to sensitize the clinician to consider amiodarone-induced hyponatremia as one of the differential diagnoses in cases of unexplained hyponatremia.
胺碘酮是一种抗心律失常药物,属于 Vaughan-Williams Ⅲ类,兼具Ⅳ类效应,已知会引发多种药物不良反应(ADR),因此需要密切监测。约 20%的患者因肝功能损害、甲状腺功能障碍及多种肺部并发症等不良反应而停药。尽管电解质紊乱是许多心脏药物常见的不良反应,但文献中关于胺碘酮所致低钠血症的发生率报道并不广泛。我们报告一例 73 岁女性患者,患有高血压和缺血性心脏病(IHD),正在接受口服胺碘酮治疗,出现严重低钠血症,需反复住院治疗。在评估低钠血症的可能病因后,发现是胺碘酮所致。由于胺碘酮相关低钠血症的发生率未知,且报道的病例不多,本病例报告旨在提醒临床医生,在不明原因低钠血症病例中,将胺碘酮诱发的低钠血症作为鉴别诊断之一。