benzofurans and Eye-Diseases

Topics: Amiodarone; Benzofurans; Chemical and Drug Induced Liver Injury; Eye Diseases; Humans; Hyperthyroidism; Lung Diseases; Peripheral Nervous System Diseases; Pigmentation Disorders; Thyroid Hormones

Interest in amiodarone has increased because of its remarkable efficacy as an antiarrhythmic agent. The purpose of this report is to review what is known about the electrophysiologic actions, hemodynamic effects, pharmacokinetics, alterations of thyroid function, response to treatment of supraventricular and ventricular tachyarrhythmias and adverse effects of amiodarone. Understanding the actions of amiodarone and its metabolism will provide more intelligent use of the drug and minimize the development of side effects. The mechanism by which amiodarone suppresses cardiac arrhythmias is not known and may relate to prolongation of refractoriness in all cardiac tissues, suppression of automaticity in some fibers, minimal slowing of conduction in fast channel-dependent tissue, or to interactions with the autonomic nervous system, alterations in thyroid metabolism or other factors. Amiodarone exerts definite but fairly minor negative inotropic effects that may be offset by its vasodilator actions. Amiodarone has a reduced clearance rate, large volume of distribution, low bioavailability and a long half-life that may last 2 months in patients receiving short-term therapy. Therapeutic serum concentrations range between 1.0 and 3.5 micrograms/ml. The drug suppresses recurrences of cardiac tachyarrhythmias in a high percent of patients, in the range of 80% or more for most supraventricular tachycardias and in about 66% of patients with ventricular tachyarrhythmias, sometimes requiring addition of a second antiarrhythmic agent. Side effects, particularly when high doses are used, may limit amiodarone's usefulness and include skin, corneal, thyroid, pulmonary, neurologic, gastrointestinal and hepatic dysfunction. Aggravation of cardiac arrhythmias occurs but serious arrhythmias are caused in less than 5% of patients. Amiodarone affects the metabolism of many other drugs and care must be used to reduce doses of agents combined with amiodarone.

Topics: Administration, Oral; Amiodarone; Animals; Arrhythmias, Cardiac; Atrioventricular Node; Benzofurans; Biological Availability; Drug Interactions; Electrophysiology; Eye Diseases; Half-Life; Heart Conduction System; Humans; Injections, Intravenous; Kinetics; Lung Diseases; Metabolic Clearance Rate; Photosensitivity Disorders; Purkinje Fibers; Tachycardia; Thyroid Diseases; Wolff-Parkinson-White Syndrome

Topics: Amiodarone; Benzofurans; Brain Diseases; Cardiovascular Diseases; Eye Diseases; Humans; Skin Diseases; Thyroid Diseases

Topics: Amiodarone; Arrhythmias, Cardiac; Benzofurans; Clinical Trials as Topic; Drug Evaluation; Eye Diseases; Humans; Lung Diseases; Risk; Thyroid Diseases

Topics: Aged; Angina Pectoris; Antihypertensive Agents; Benzofurans; Clinical Trials as Topic; Cornea; Drug Eruptions; Eye Diseases; Female; Heart Rate; Humans; Male; Middle Aged; Placebos; Statistics as Topic

Kanemi Yusho is the name given to a 1968 food poisoning incident resulting from the ingestion of PCB contaminated rice bran oil that had been used as a heating medium. At the time, victims presented with mainly cutaneous manifestations and various other symptoms such as of the eyes and teeth, general fatigue, headaches, and paresthesia of the extremities. The characteristic symptoms then resolved with time. Yusho patients have been followed from immediately after the incident. Blood levels of dioxins such as PeCDF have been measured for those who wishing to since 2001.. The presence or absence of relationships between blood PeCDF level and various examination items/symptoms was investigated in 359 subjects whose blood levels of PCB-related chemical compounds such as PeCDF were measured in the Yusho related examinations between 2001 and 2003. Characteristic symptoms were also compared with the results of examinations done 15 years previously.. The average blood 2,3,4,7,8-PeCDF level in designated Yusho patients was 177.50 pg/g lipids; showing a markedly higher value than that of the normal control group (15.2 pg/g lipids). As well, the blood PeCDF level was related to PCB level, hexachlorobiphenyl level, urinary sugar, erythrocyte sedimetation rate (ESR) (2-hour), thymol and Na. There were also relationships with cutaneous findings (acneiform eruption and comedones), mucosal findings (oral pigmentation), constipation, numbness in the extremities, body weight loss, and abnormal abdominal ultrasonography. Symptoms seen in the skin and eyes in 2001 and 2003 had decreased compared with those in seen 1988. However, PCB and blood PeCDF levels remained high. Patients are continuing to present with mucosal and subjective symptoms as chronic conditions.

Topics: Benzofurans; Eye Diseases; Fatigue; Food Contamination; Headache; Humans; Japan; Oryza; Paresthesia; Plant Oils; Polychlorinated Biphenyls; Skin Diseases; Time Factors; Tooth Diseases

Topics: Adult; Aged; Aged, 80 and over; Benzofurans; Biomarkers; Dibenzofurans, Polychlorinated; Eye; Eye Diseases; Female; Food Contamination; Humans; Male; Middle Aged; Oryza; Plant Oils; Polychlorinated Biphenyls; Severity of Illness Index

More recently a few cases of pulmonary toxicity due to amiodarone administration and reversed following drug discontinuation and corticosteroid therapy have been reported. An unusual case of recurrence of amiodarone pulmonary toxicity is described. After receiving amiodarone 1.200 mg/week for 6 month a 54-year-old woman showed clear signs of pulmonary alveolitis with ray signs of diffuse pulmonary infiltrates. The pulmonary symptoms recurred after discontinuing corticosteroidis 17 months after amiodarone was stopped and were associated with a persistent amiodarone level in broncho alveolar lavage. Only after 20 months the complete resolution of pulmonary symptoms was achieved.

Topics: Amiodarone; Benzofurans; Eye Diseases; Female; Humans; Hyperthyroidism; Hypothyroidism; Middle Aged; Photosensitivity Disorders; Pulmonary Fibrosis; Radiography; Recurrence; Risk

Topics: Adult; Aged; Amiodarone; Arrhythmias, Cardiac; Benzofurans; Child; Drug Interactions; Eye Diseases; Female; Humans; Lung Diseases; Male; Peripheral Nervous System Diseases; Skin Diseases; Thyroid Diseases; Time Factors

Ocular observations in a series of 100 patients treated with amiodarone, along with the pathological changes observed in the eye tissues of two patients treated with this drug, are described in this paper. In the latter two patients intracytoplasmic membrane-bound lamellar bodies similar to myelin were observed by electron microscopy not only in the corneal epithelium and fibroblasts, the conjunctiva and the lens, but also in the corneal endothelium, the iris, the ciliary body, the choroid and the retina. It is suggested that patients taking amiodarone in high dosage for long periods have their eyes and retinal function monitored.

Topics: Amiodarone; Benzofurans; Corneal Diseases; Eye; Eye Diseases; Female; Humans; Male; Retinal Diseases

The ocular complications of long-term amiodarone therapy have been recognized for many years, but systematic data on the prognostic significance and the precise incidence of such effects have not been evaluated until recently. One hundred seventy-five patients receiving long-term amiodarone treatment have thus been followed for periods ranging from 3 months to nearly 10 years. Of 103 of these patients studied in greater depth, 98% have shown the characteristic patterns of corneal microdeposits, which progressed over several months and ultimately formed a stable appearance that changed only with an alteration of dose. The abnormalities, the nature of which is not clearly understood, disappeared within 7 months in the 16 patients whose drug was withdrawn for unrelated reasons, and no permanent ocular damage has been detected. Visual symptoms associated with the corneal deposits developed in 6% of patients: 3% had photophobia, 2% halos, and 1% blurring of vision but without impairment of visual acuity. It is concluded that ocular complications of amiodarone therapy are insignificant; they do not pose a threat to vision, and routine ophthalmologic surveillance does not appear mandatory in the majority of patients during long-term drug therapy.

Topics: Amiodarone; Benzofurans; Corneal Diseases; Eye Diseases; Humans; Vision Disorders

In 17 patients on long term therapy with amiodarone, serum drug levels measured by HPLC were related to pharmacological effects. At steady state, serum levels were directly proportional to the dose, 5 mg/kg per day leading to an average serum level of approximately 2.5 mumol/l. The non-amiodarone level of iodine averaged 4-times higher than the level of amiodarone iodine. The elimination half-life of amiodarone ranged from 21 to 78 days, and of non-amiodarone iodine from 24 to 160 days. Control of arrhythmias was satisfactory in all 12 evaluable patients, when the serum amiodarone level exceeded 1.5 mumol/l. Deterioration of vision and polyserositis occurred only at amiodarone levels above 4 mumol/l. Tentatively, a therapeutic range of 1.5 to 4 mumol/l is proposed. In contrast, thyroid dysfunction was observed at any amiodarone level. In view of the narrow therapeutic window, therapy with amiodarone may be optimized by monitoring its serum level and in addition, thyroid function should be regularly checked.

Topics: Adult; Aged; Amiodarone; Arrhythmias, Cardiac; Benzofurans; Corneal Diseases; Eye Diseases; Female; Half-Life; Humans; Iodine; Kinetics; Male; Middle Aged

Topics: Amiodarone; Benzofurans; Central Nervous System Diseases; Drug Administration Schedule; Eye Diseases; Gastrointestinal Diseases; Heart Conduction System; Humans; Liver; Peripheral Nervous System Diseases; Pulmonary Fibrosis; Skin Diseases; Thyroid Diseases

Topics: Adult; Aged; Amiodarone; Arrhythmias, Cardiac; Benzofurans; Eye Diseases; Female; Humans; Iodides; Male; Middle Aged; Retina

Topics: Adolescent; Adult; Aged; Amiodarone; Benzofurans; Cataract; Color Vision Defects; Corneal Diseases; Eye Diseases; Female; Humans; Lipidoses; Male; Middle Aged; Retinal Diseases

Topics: Age Factors; Angina Pectoris; Benzofurans; Cornea; Eye Diseases; Female; Humans; Male; Retina; Sex Factors; Time Factors

Topics: Benzoates; Benzofurans; Cornea; Coronary Disease; Drug Eruptions; Ethers; Ethylamines; Eye Diseases; Humans; Iodobenzoates; Morpholines; Photosensitivity Disorders; Pigmentation Disorders; Vasodilator Agents

Topics: Benzofurans; Cornea; Eye; Eye Diseases; Face; Humans; Iodine Isotopes; Lacrimal Apparatus; Male; Metabolic Diseases; Middle Aged; Myocardium; Neck; Pigmentation Disorders; Radionuclide Imaging

Topics: Benzofurans; Chloroquine; Cornea; Epithelium; Eye Diseases; Humans; Keratitis; Keratitis, Dendritic; Microscopy, Electron

Topics: Antihypertensive Agents; Benzofurans; Cornea; Diuretics; Drug Hypersensitivity; Electrocardiography; Eye Diseases; Heart; Heart Diseases; Humans; Iatrogenic Disease; Lupus Erythematosus, Systemic; Quinidine

Topics: Adolescent; Adult; Aged; Benzofurans; Diabetic Retinopathy; Drug Tolerance; Electroretinography; Eye Diseases; Female; Humans; Male; Middle Aged; Optic Neuritis; Retinal Degeneration; Retinal Vessels; Succinates; Visual Acuity

Topics: Animals; Benzofurans; Coronary Disease; Dogs; Drug Eruptions; Eye; Eye Diseases; Haplorhini; Humans; Male; Mice; Middle Aged; Oxazines; Rats; Skin; Vasodilator Agents

Topics: Angina Pectoris; Antihypertensive Agents; Benzofurans; Cornea; Eye Diseases; Humans

Topics: Antihypertensive Agents; Benzofurans; Coronary Disease; Eye Diseases; Humans; Pigmentation Disorders

Topics: Aged; Angina Pectoris; Antihypertensive Agents; Benzofurans; Chloroquine; Cornea; Eye Diseases; Female; Humans; Iatrogenic Disease; Male; Middle Aged

Topics: Aged; Angina Pectoris; Antihypertensive Agents; Benzofurans; Chloroquine; Cornea; Eye Diseases; Female; Humans; Male; Middle Aged

Topics: Antihypertensive Agents; Benzofurans; Cornea; Eye Diseases; Humans

Topics: Aged; Antihypertensive Agents; Benzofurans; Cornea; Eye Diseases; Female; Humans; Male; Middle Aged

Topics: Antihypertensive Agents; Benzofurans; Cornea; Coronary Disease; Eye Diseases; Humans; Ophthalmology

Topics: Antihypertensive Agents; Benzofurans; Cornea; Coronary Disease; Eye Diseases; Humans; Iodine Radioisotopes; Vision Tests

Topics: Aged; Angina Pectoris; Benzofurans; Cornea; Coronary Disease; Eye Diseases; Female; Humans; Male; Middle Aged

Topics: Adult; Angina Pectoris; Benzofurans; Coronary Disease; Eye Diseases; Humans; Metabolic Diseases; Middle Aged

Topics: Aged; Angina Pectoris; Benzofurans; Cornea; Coronary Disease; Eye Diseases; Female; Humans; Metabolic Diseases

Topics: Benzofurans; Chloroquine; Cornea; Corneal Dystrophies, Hereditary; Eye Diseases; Glycolipids; Humans; Lipid Metabolism, Inborn Errors; Metabolic Diseases

Topics: Benzofurans; Cornea; Eye Diseases; Humans