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אסיף מאגר המחקר החקלאי
פותח על ידי קלירמאש פתרונות בע"מ -
Complex Drug-Drug-Disease Interactions between Amiodarone, Warfarin, and the Thyroid Gland
Year:
2004
Source of publication :
Medicine
Authors :
עזרא, דוד
;
.
Volume :
83
Co-Authors:
Kurnik, D., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel
Loebstein, R., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel
Farfel, Z., Department of Internal Medicine E, Chaim Sheba Medical Center, Tel Hashomer, Israel
Ezra, D., Department of Internal Medicine A, Chaim Sheba Medical Center, Tel Hashomer, Israel
Halkin, H., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel, Div. of Clin. Pharmacol./Toxicol., Chaim Sheba Medical Center, Tel Hashomer, Israel
Olchovsky, D., Department of Internal Medicine A, Chaim Sheba Medical Center, Tel Hashomer, Israel, Department of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
Facilitators :
From page:
107
To page:
113
(
Total pages:
7
)
Abstract:
Many patients with cardiac arrhythmias require concomitant therapy with warfarin and amiodarone. Beyond the predictable pharmacokinetic drug-drug interaction requiring a significant warfarin dose reduction, the iodine-rich amiodarone affects the thyroid gland, causing overt hypothyroidism or thyrotoxicosis in 14%-18% of cases. In turn, thyroid disorders may affect warfarin sensitivity, with hypothyroidism and thyrotoxicosis resulting in increased or decreased warfarin requirements, respectively. We describe 3 patients on concomitant amiodarone and warfarin who developed amiodarone-induced thyrotoxicosis heralded by a significant decrease in warfarin requirements. We review the literature on the mechanisms of the complex drug-drug and drug-disease interactions within the thyroid gland, warfarin, and amiodarone triad. Given that significant thyroid disorders may be only mildly symptomatic and thus may escape clinical detection, we suggest that thyroid function should be tested in any patient with otherwise unexplained changes in warfarin dose requirements, particularly if concomitantly treated with amiodarone.
Note:
Related Files :
adult
Anti-Arrhythmia Agents
Anticoagulants
Female
Hypothyroidism
iodine
Male
Risk Factors
עוד תגיות
תוכן קשור
More details
DOI :
10.1097/01.md.0000123095.65294.34
Article number:
Affiliations:
Database:
סקופוס
Publication Type:
מאמר
;
.
Language:
אנגלית
Editors' remarks:
ID:
24667
Last updated date:
02/03/2022 17:27
Creation date:
17/04/2018 00:09
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Scientific Publication
Complex Drug-Drug-Disease Interactions between Amiodarone, Warfarin, and the Thyroid Gland
83
Kurnik, D., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel
Loebstein, R., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel
Farfel, Z., Department of Internal Medicine E, Chaim Sheba Medical Center, Tel Hashomer, Israel
Ezra, D., Department of Internal Medicine A, Chaim Sheba Medical Center, Tel Hashomer, Israel
Halkin, H., Div. Clin. Pharmacol./Anticoagul. C., Chaim Sheba Medical Center, Tel Hashomer, Israel, Div. of Clin. Pharmacol./Toxicol., Chaim Sheba Medical Center, Tel Hashomer, Israel
Olchovsky, D., Department of Internal Medicine A, Chaim Sheba Medical Center, Tel Hashomer, Israel, Department of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
Complex Drug-Drug-Disease Interactions between Amiodarone, Warfarin, and the Thyroid Gland
Many patients with cardiac arrhythmias require concomitant therapy with warfarin and amiodarone. Beyond the predictable pharmacokinetic drug-drug interaction requiring a significant warfarin dose reduction, the iodine-rich amiodarone affects the thyroid gland, causing overt hypothyroidism or thyrotoxicosis in 14%-18% of cases. In turn, thyroid disorders may affect warfarin sensitivity, with hypothyroidism and thyrotoxicosis resulting in increased or decreased warfarin requirements, respectively. We describe 3 patients on concomitant amiodarone and warfarin who developed amiodarone-induced thyrotoxicosis heralded by a significant decrease in warfarin requirements. We review the literature on the mechanisms of the complex drug-drug and drug-disease interactions within the thyroid gland, warfarin, and amiodarone triad. Given that significant thyroid disorders may be only mildly symptomatic and thus may escape clinical detection, we suggest that thyroid function should be tested in any patient with otherwise unexplained changes in warfarin dose requirements, particularly if concomitantly treated with amiodarone.
Scientific Publication
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