Endocrine Abstracts

Introduction: Amiodarone is a commonly prescribed antiarrythmic drug. It can cause potentially serious adverse effects involving the thyroid gland, lungs, liver and eyes. It is recommended that patients on amiodarone have regular monitoring tests.

Methods: We conducted an audit of patients who were prescribed amiodarone by various physicians in our hospital between January 2007 and March 2008. The data was obtained from the patients case notes. We looked at tests done at baseline and regular intervals thereafter up to two years, including thyroid, liver, renal and pulmonary function tests and chest X-rays.

Results: The case notes of 79 patients (52 males and 27 females) were reviewed. The mean age was 70±11 years. The commonest indication for amiodarone was atrial fibrillation (77%). 55, 39, 32, 27 and 26 patients continued therapy at 3, 6, 12, 18 and 24 months respectively. Thyroid function tests were performed in 78% of patients at baseline, 31% at 3 months, 64% at 6 months, 53% at 12 months, 55% at 18 months and 35% at 24 months. Liver function tests were performed in 82% of patients at baseline, 59% at 6 months, 50% at 12 months, 48% at 18 months and 31% at 24 months. Urea and electrolytes were checked in 95% of patients at baseline. Chest radiography was performed in 48% of patients at baseline, 9% at 12 months and 4% at 24 months. Pulmonary function tests were performed in 9% of patients at baseline.

Conclusion: This audit shows that a significant number of patients on amiodarone do not get the recommended regular monitoring for potential adverse effects of amiodarone. This highlights the need to increase awareness among physicians so that abnormalities can be detected at an early stage.