Ben-Chetrit E, Ackerman Z, Eliakim M
Am J Med Sci. 1985 Mar;289(3):114-6. doi: 10.1097/00000441-198503000-00005.
The problem of a possible interaction between amiodarone and digoxin is still unsettled. We have recently treated two patients with digoxin intoxication who had received amiodarone for eight and 36 months respectively. Both developed extreme bradycardia requiring temporary pacemakers. The presence of hypothyroidism was confirmed in both cases by laboratory data. Judging by present knowledge concerning the interaction between amiodarone, thyroid function, and digoxin, it is suggested that digoxin intoxication was not the result of its direct interaction with amiodarone. The possibility that amiodarone-induced hypothyroidism precipitated digoxin intoxication seems to be more plausible. Prevention of digitalis toxicity in amiodarone-treated patients would therefore require monitoring of thyroid function every three to six months. Frequent monitoring of digitalis blood levels is also indicated in patients with amiodarone associated hypothyroidism. Early detection of hypothyroidism and digitalis intoxication is necessary in view of the severity of the course of the disease.
胺碘酮与地高辛之间可能存在相互作用的问题仍未解决。我们最近治疗了两名地高辛中毒患者，他们分别接受胺碘酮治疗8个月和36个月。两人均出现极度心动过缓，需要临时起搏器。两例患者的甲状腺功能减退均经实验室数据证实。根据目前有关胺碘酮、甲状腺功能和地高辛之间相互作用的知识判断，提示地高辛中毒并非其与胺碘酮直接相互作用的结果。胺碘酮诱发的甲状腺功能减退导致地高辛中毒的可能性似乎更合理。因此，对于接受胺碘酮治疗的患者，预防洋地黄毒性需要每三到六个月监测一次甲状腺功能。对于胺碘酮相关性甲状腺功能减退的患者，也需要频繁监测地高辛血药浓度。鉴于该疾病病程的严重性，早期发现甲状腺功能减退和洋地黄中毒很有必要。
