Amiodorone info?

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Having been removed from nursing for almost 10 years (am now in clinical/pharmaceutical research) I need help/advice on how to understand and help my family deal with my father's health condition.

He is now 64 years old and has had diabetes Type II for 20+ years (probably longer - but he was officially diagnosed when he was 41). Since diagnosis he has had a BKA on his right leg and partial removal of his foot on his left side, he is over weight and has HTN (systolic). Last christmas he developed another infection in his left foot and was hospitalized. During this stay he developed a nosocomial infection and one of his doctors detected an arrythmia and put him on Amiodorone. He felt horrible on this med and kept telling his doctor that but his doctor insisted he remain on the drug, he just decreased the dose. (my Dad is also on Glyburide, Lasix, Norvasc, Catapress, and Cozaar) He has been on this med now for about 6 months and now has developed fluid in his lungs and is horribly SOB even during rest. He had a "normal" echocardiogram, and therefore he took himself off of the Amiodorone but is scared, depressed, confused and his Creatinine (3.9 currently) and K (5.3 currently) remain drastically out of the normal range. I read some things about Amiodorone and the side effects involving the lung, however, his symptoms also mirror that of kidney failure (third spacing fluid in the lung) and/or congestive heart failure (high systolic BP and fluid in the lung). He has four different doctors and no one can seem to regulate him or make him feel comfortable with his prognosis (or lack there of). Is he on too many meds? How can you differentiate between Amiodorone S/E's, kidney failure and/or heart failure???

Does anyone have any info they can share with me? I feel so removed from current medical/nursing info I need to reach out to those with the experience. Please help if you can!

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I can't tell you a whole bunch but I have taken care of Pt's with Amiodarone toxicity. I actually had one about 2 weeks ago and he passed away, so this is serious stuff and he needs to check it out. He also had diabetes II, and presented with symptoms of severe weakness, and very sob. O2 sats on arrival were in the 60's. He was put on Amiodarone due to a hx of Afib. We had to keep him on a Venti mask at all times and when he ate he had to be on the mask and nc 6-8 L, so that when he removed the mask he wouldn't desat so horribly. If we got him out of bed and moved to the chair, even with mask on he would desat to 70's quickly. He did not have any edema nor crackles in his lungs, just very diminished breath sounds, and skin was dusky. Hope that info helps. Your Father's kidney could be giving out. His K+ level isn't too bad, but Cr level is. What is his BUN level by the way? Also, it could be CHF, when you listen to his lungs do they sound full, how bad is his edema, does he have ascites? Have them check his BNP level, if elevated it's an idication of CHF. Amiodarone toxicity is lethal; the pt doesn't have to take too much for it to happen, such as with an overdose. This man was only on it for 6 months. It wouldn't hurt for you or your family to ask his cardiologist to check into this. And please if his cardiologist doesn't want to or just brushes it off get another opinion. Also, Diabetes is a horrible and insidious dz. My husband has it, was diagnosed when he was only 32 (runs in his family) and it's a struggle for us, so I know how hard it's been for your family. God Bless you and gl with your Dad. Keep me posted.

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THANKS for the reply. I will get back to you with his BUN. Will also demand his Cardiologist look into this a bit more seriously as my Dad looks as if he is drowning and he is so very very very depressed and scared.

Diabetes is horrible and watching his health decline like this is tortorous!

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Hi, just reading over all of your father's info. I work in ICU and we have many patient's on a variety of different anti-hypertensives as well as diuretics that are compounded with their underlying co-morbidities. In your father's case his DM and what sounds like CHF if he was on a regular dose of lasix in conjunction with those cardiac meds. A couple of questions--His bun would be important as another poster had requested so we could see what his ratio is to his creatinine. It sounds like he has issues with PVD...which amiodarone can have an effect on. When you say your father has a "normal" echo does that imply he has an ef>45% and valves appear ok. Your father's case in comlex-->Was there a big change in how he felt after intitially taking amio? Also with his recent infections antibiotics play a big role in the absorption time of amiodarone. I suggest maybe you do a search on amiodarone (cordarone) to find real specific information. I hope this was slightly helpful.

LCRN

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Hi,

Thanks! I have to f/u with my dad's BUN value.

When the doctor read his echo he stated it was normal and my dad did not inquire further on what that really meant. I ONLY WISH that I had time to go to the doctor's appt with him but I work full time and have two small children and have limited time as it is. I am so glad to have found this nursing forum, because I knew I would gather quality info from those that work in the medical field and have direct experience with patient's such as my dad.

I will do a little more research this weekend and respond on Monday with any additional details. :)

Thanks again!

TGIF!

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I'm sorry, but this thread is now closed. It is against the Terms of Service rules to seek or offer specific medical advice.

I did advise the OP to consider finding an internal medicine specialist to coordinate her father's care.

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