Saturday, February 27, 2010

The Devil's Drug

Woe to the CHDer who develops an arrhythmia. (irregular heart beat) The problem is, it seems we all develop one sooner or later, and the choices we have to combat it are limited. Certainly pacemakers and ICDs are available, but those are expensive. So is an ablation; so often, we start with a drug regimen.

One of the best Antiarrhythmia drugs is Amiodarone, because it can control the irregular beats fairly well and there is less of a chance of a proarrhythmia. A proarrhythmia is a new or more frequently occurring arrhythmia that is triggered by the use of antiarrhythmia drugs. It’s diabolical – using the drugs that can calm down an irregular heartbeat can actually cause more irregular beats!

Oh, boy.

Amiodarone is pretty good about not causing proarrhythmia, but that is probably it’s one positive factor. Dr. Rich is convinced that Satan himself invented it – it’s that nasty!

For the drug to become effective, it has to saturate the body. So at first you are given a “loading dose” – a high dosage of the medication to get the patient to the proper level of the drug in their blood quickly.

Most of the time a drug is eliminated through the bloodstream, taken to the kidneys where it is filtered out, and the eliminated through the body’s natural waste disposal system. Not Amiodarone, no sir. The only way you get rid of it is by getting rid of cells. That’s a naturally occurring process, but it is slow and you can’t speed it up. Sometimes it takes a year for the Amio to completely clear your system.

And while it is in your system, it sets up shop in every organ of your body.

Possible liver damage? Yep!

Possible lung damage? Got you covered!

Thyroid damage? Amio is on top of that, too! In fact, you know that rough spot on the bottom of your left foot… well, you probably can’t blame Amiodarone for that one.

But every year you are on the drug, you’ll be visiting your eye doctor for an examination. Not the usual eye exam, mind you, but he’ll be looking for deposits in your eyes caused by the drug.

And you’ll have a lung function test every year, also. You’ll sit in a small walled in area that looks like a phone booth with a plastic tube in front of you. You’ll be asked blow as hard as possible into the tube, blow, blow, come’on empty your lungs! Then you’ll inhale as much as possible; you’ll hold your breath then blow it out – several different lung exercises. You’ll want to bring a friend with you – there’s no reason that you can’t drive home yourself, but you’ll be exhausted from the exercises. And they’ll repeat this test every year to make sure that your lungs aren’t being damaged by the Amiodarone.

If you haven’t guessed, this stuff isn’t very usuer friendly. There are newer drugs available that do not cause proarrhythmia (Yay!) and do not have the side effects of Amio (Yay again!) but isn’t as effective. (Aw, man!)

So if this drug is recommended to you by your doctor, you probably do need it. But have a long, honest discussion with your physician about the benefits and side effects of Amiodarone.

[Via http://tricuspid.wordpress.com]

No comments:

Post a Comment