Please use this identifier to cite or link to this item:
http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57030Full metadata record
| ???org.dspace.app.webui.jsptag.ItemTag.dcfield??? | Value | Language |
|---|---|---|
| dc.contributor.advisor | 何藴芳(Yunn-Fang Ho) | |
| dc.contributor.author | Hsin-Ying Chou | en |
| dc.contributor.author | 周欣穎 | zh_TW |
| dc.date.accessioned | 2021-06-16T06:33:17Z | - |
| dc.date.available | 2019-10-15 | |
| dc.date.copyright | 2014-10-15 | |
| dc.date.issued | 2014 | |
| dc.date.submitted | 2014-08-04 | |
| dc.identifier.citation | 1. Mason JW. Amiodarone. N Engl J Med 1987;316:455-66. 2. Waxman HL, Groh WC, Marchlinski FE, Buxton AE, Sadowski LM, Horowitz LN, Josephson ME, Kastor JA. Amiodarone for control of sustained ventricular tachyarrhythmia: clinical and electrophysiologic effects in 51 patients. Am J Cardiol 1982;50:1066-74. 3. Fogoros RN, Anderson KP, Winkle RA, Swerdlow CD, Mason JW. Amiodarone: clinical efficacy and toxicity in 96 patients with recurrent, drug-refractory arrhythmias. Circulation 1983;68:88-94. 4. Haffajee CI, Love JC, Canada AT, Lesko LJ, Asdourian G, Alpert JS. Clinical pharmacokinetics and efficacy of amiodarone for refractory tachyarrhythmias. Circulation 1983;67:1347-55. 5. Morady F, Sauve MJ, Malone P, Shen EN, Schwartz AB, Bhandari A, Keung E, Sung RJ, Scheinman MM. Long-term efficacy and toxicity of high-dose amiodarone therapy for ventricular tachycardia or ventricular fibrillation. Am J Cardiol 1983;52:975-9. 6. Rotmensch HH, Belhassen B, Swanson BN, Shoshani D, Spielman SR, Greenspon AJ, Greenspan AM, Vlasses PH, Horowitz LN. Steady-state serum amiodarone concentrations: relationships with antiarrhythmic efficacy and toxicity. Ann Intern Med 1984;101:462-9. 7. Raeder EA, Podrid PJ, Lown B. Side effects and complications of amiodarone therapy. Am Heart J 1985;109:975-83. 8. Anastasiou-Nana MI, Anderson JL, Nanas JN, Lutz JR, Smith RA, Anderson KP, Crapo RO, Call NB. High incidence of clinical and subclinical toxicity associated with amiodarone treatment of refractory tachyarrhythmias. Can J Cardiol 1986;2:138-45. 9. Smith WM, Lubbe WF, Whitlock RM, Mercer J, Rutherford JD, Roche AH. Long-term tolerance of amiodarone treatment for cardiac arrhythmias. Am J Cardiol 1986;57:1288- 93. 10. Raebel MA, Carroll NM, Simon SR, Andrade SE, Feldstein AC, Lafata JE, Nelson WW, Chan KA, Gunter MJ, Tolsma D, Platt R. Liver and thyroid monitoring in ambulatory patients prescribed amiodarone in 10 HMOs. J Manag Care Pharm 2006;12:656-64. 11. Bickford CL, Spencer AP. Adherence to the NASPE guideline for amiodarone monitoring at a medical university. J Manag Care Pharm 2006;12:254-9. 12. Suk KT, Kim DJ. Drug-induced liver injury: present and future. Clin Mol Hepatol 2012;18:249-57. 13. Bjornsson E. Review article: drug-induced liver injury in clinical practice. Aliment Pharmacol Ther 2010;32:3-13. 14. Ratz Bravo AE, Drewe J, Schlienger RG, Krahenbuhl S, Pargger H, Ummenhofer W. Hepatotoxicity during rapid intravenous loading with amiodarone: Description of three cases and review of the literature. Crit Care Med 2005;33:128-34; discussion 245-6. 15. Huang X, Yang Y, Zhu J, Gao X, Wang G, Tan H, Liang Y, Li J. Clinical Applications and Acute Hepatotoxicity of Intravenous Amiodarone. J Int Med Res 2009;37:1928-36. 16. Navarro VJ, Senior JR. Drug-related hepatotoxicity. N Engl J Med 2006;354:731-9. 17. Lee WM. Acute liver failure in the United States. Semin Liver Dis 2003;23:217-26. 18. Lee WM, Senior JR. Recognizing drug-induced liver injury: current problems, possible solutions. Toxicol Pathol 2005;33:155-64. 19. Reuben A. Hy's law. Hepatology 2004;39:574-8. 20. Tajiri K, Shimizu Y. Practical guidelines for diagnosis and early management of drug- induced liver injury. World J Gastroenterol 2008;14:6774-85. 21. Larrey D. Drug-induced liver diseases. J Hepatol 2000;32:77-88. 22. Chalasani N, Bjornsson E. Risk factors for idiosyncratic drug-induced liver injury. Gastroenterology 2010;138:2246-59. 23. Andrade RJ, Lucena MI, Fernandez MC, Pelaez G, Pachkoria K, Garcia-Ruiz E, Garcia- Munoz B, Gonzalez-Grande R, Pizarro A, Duran JA, Jimenez M, Rodrigo L, Romero- Gomez M, Navarro JM, Planas R, Costa J, Borras A, Soler A, Salmeron J, Martin- Vivaldi R. Drug-induced liver injury: an analysis of 461 incidences submitted to the Spanish registry over a 10-year period. Gastroenterology 2005;129:512-21. 24. Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver Philadelphia Lippincott Williams Wilkins 1999. 25. Miljkovic MM, Dobric S, Dragojevic-Simic V. Accuracy and reproducibility of two scales in causality assessment of unexpected hepatotoxicity. J Clin Pharm Ther 2012;37:196-203. 26. Danan G, Benichou C. Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. J Clin Epidemiol 1993;46:1323-30. 27. Benichou C, Danan G, Flahault A. Causality assessment of adverse reactions to drugs--II. An original model for validation of drug causality assessment methods: case reports with positive rechallenge. J Clin Epidemiol 1993;46:1331-6. 28. Singh BN. Amiodarone: historical development and pharmacologic profile. Am Heart J 1983;106:788-97. 29. Cordarone product label 2011. 2014, at http://www.accessdata.fda.gov/scripts/cder/drugsatfda/index.cfm?fuseaction=Search.Lab el_ApprovalHistory.) 30. Goldschlager N, Epstein AE, Naccarelli GV, Olshansky B, Singh B, Collard HR, Murphy E. A practical guide for clinicians who treat patients with amiodarone: 2007. Heart Rhythm 2007;4:1250-9. 31.Vorperian VR, Havighurst TC, Miller S, January CT. Adverse effects of low dose amiodarone: a meta-analysis. J Am Coll Cardiol 1997;30:791-8. 32. Hilleman D, Miller MA, Parker R, Doering P, Pieper JA. Optimal management of amiodarone therapy: efficacy and side effects. Pharmacotherapy 1998;18:138S-45S. 33. Stravitz RT, Sanyal AJ. Drug-induced steatohepatitis. Clin Liver Dis 2003;7:435-51. 34. Flaharty KK, Chase SL, Yaghsezian HM, Rubin R. Hepatotoxicity associated with amiodarone therapy. Pharmacotherapy 1989;9:39-44. 35. Bach N, Schultz BL, Cohen LB, Squire A, Gordon R, Thung SN, Schaffner F. Amiodarone hepatotoxicity: progression from steatosis to cirrhosis. Mt Sinai J Med 1989;56:293-6. 36. Lewis JH, Mullick F, Ishak KG, Ranard RC, Ragsdale B, Perse RM, Rusnock EJ, Wolke A, Benjamin SB, Seeff LB, et al. Histopathologic analysis of suspected amiodarone hepatotoxicity. Hum Pathol 1990;21:59-67. 37. Lewis JH, Ranard RC, Caruso A, Jackson LK, Mullick F, Ishak KG, Seeff LB, Zimmerman HJ. Amiodarone Hepatotoxicity - Prevalence and Clinicopathologic Correlations among 104 Patients. Hepatology 1989;9:679-85. 38. Lahbabi M, Aqodad N, Ibrahimi A, Lahlou M, Aqodad H. Acute hepatitis secondary to parenteral amiodarone does not preclude subsequent oral therapy. World J Hepatol 2012;4:196-8. 39. Chan AL, Hsieh HJ, Hsieh YA, Lin SJ. Fatal amiodarone-induced hepatotoxicity: a case report and literature review. Int J Clin Pharmacol Ther 2008;46:96-101. 40. Rhodes A, Eastwood JB, Smith SA. Early acute hepatitis with parenteral amiodarone: a toxic effect of the vehicle? Gut 1993;34:565-6. 41. Gluck N, Fried M, Porat R. Acute amiodarone liver toxicity likely due to ischemic hepatitis. Isr Med Assoc J 2011;13:748-52. 42. B M. Adverse reactions during treatment with amodarone hydrochloride 43. Adams PC, Bennett MK, Holt DW. Hepatic effects of amiodarone. Br J Clin Pract Suppl 1986;44:81-95. 44. Tisdale JE, Follin SL, Ordelova A, Webb CR. Risk-Factors for the Development of Specific Noncardiovascular Adverse-Effects Associated with Amiodarone. J Clin Pharmacol 1995;35:351-6. 45. Felser A, Blum K, Lindinger PW, Bouitbir J, Krahenbuhl S. Mechanisms of hepatocellular toxicity associated with dronedarone--a comparison to amiodarone. Toxicol Sci 2013;131:480-90. 46. Russmann S, Kullak-Ublick GA, Grattagliano I. Current concepts of mechanisms in drug-induced hepatotoxicity. Curr Med Chem 2009;16:3041-53. 47. Kaufmann P, Torok M, Hanni A, Roberts P, Gasser R, Krahenbuhl S. Mechanisms of benzarone and benzbromarone-induced hepatic toxicity. Hepatology 2005;41:925-35. 48. Gough WB, Zeiler RH, Barreca P, El-Sherif N. Hypotensive action of commercial intravenous amiodarone and polysorbate 80 in dogs. J Cardiovasc Pharmacol 1982;4:375-80. 49. Platou ES, Refsum H. Acute electrophysiologic and blood pressure effects of amiodarone and its solvent in the dog. Acta Pharmacol Toxicol (Copenh) 1986;58:163-8. 50. Munoz A, Karila P, Gallay P, Zettelmeier F, Messner P, Mery M, Grolleau R. A randomized hemodynamic comparison of intravenous amiodarone with and without Tween 80. Eur Heart J 1988;9:142-8. 51. van Zuylen L, Verweij J, Sparreboom A. Role of formulation vehicles in taxane pharmacology. Invest New Drugs 2001;19:125-41. 52. James PR, Hardman SM. Acute hepatitis complicating parenteral amiodarone does not preclude subsequent oral therapy. Heart 1997;77:583-4. 53. Harris L, McKenna WJ, Rowland E, Krikler DM. Side effects and possible contraindications of amiodarone use. Am Heart J 1983;106:916-23. 54. Desai AD, Chun S, Sung RJ. The role of intravenous amiodarone in the management of cardiac arrhythmias. Ann Intern Med 1997;127:294-303. 55. Podrid PJ. Amiodarone: reevaluation of an old drug. Ann Intern Med 1995;122:689-700. 56. Scheinman MM, Levine JH, Cannom DS, Friehling T, Kopelman HA, Chilson DA, Platia EV, Wilber DJ, Kowey PR. Dose-ranging study of intravenous amiodarone in patients with life-threatening ventricular tachyarrhythmias. The Intravenous Amiodarone Multicenter Investigators Group. Circulation 1995;92:3264-72. 57. Pollak PT. How toxic is amiodarone to the liver? J Gastrointestin Liver Dis 2010;19:11- 3. 58. Nasser M, Larsen TR, Waanbah B, Sidiqi I, McCullough PA. Hyperacute drug-induced hepatitis with intravenous amiodarone: case report and review of the literature. Drug Healthc Patient Saf 2013;5:191-8. 59. Poucell S, Ireton J, Valencia-Mayoral P, Downar E, Larratt L, Patterson J, Blendis L, Phillips MJ. Amiodarone-associated phospholipidosis and fibrosis of the liver. Light, immunohistochemical, and electron microscopic studies. Gastroenterology 1984;86:926- 36. 60. Guidance for industry drug-induced liver injury: premarketing clinical evaluation. 2009 61. Boh LE. Clinical clerkship manual Vancouver, Washington Applied Therapeutics, Inc. ; 1993. 62. Devarbhavi H, Dierkhising R, Kremers WK, Sandeep MS, Karanth D, Adarsh CK. Single-center experience with drug-induced liver injury from India: causes, outcome, prognosis, and predictors of mortality. Am J Gastroenterol 2010;105:2396-404. 63. Bjornsson E, Jerlstad P, Bergqvist A, Olsson R. Fulminant drug-induced hepatic failure leading to death or liver transplantation in Sweden. Scand J Gastroenterol 2005;40:1095- 101. 64. Tatro DS. Drugs Interaction Facts 2013: The Authority on Drug Interactions: Lippincott Williams Wilkins; 2013. 65. N.J.D. N. A note on a general definition of the coefficient of determination Biometrika 1991;78:691-2. 66. VGAM: Vector generalized linear and additive models. R package, version 0.9-2 2013. 2014, 67. Yee TW, Wild CJ. Vector generalized additive models Journal of the Royal Statistical Society Series B (Methodological) 1996;58:481-93. 68. Kum LC, Chan WW, Hui HH, Wong GW, Ho SS, Sanderson JE, Yu CM, Fung JW. Prevalence of amiodarone-related hepatotoxicity in 720 Chinese patients with or without baseline liver dysfunction. Clin Cardiol 2006;29:295-9. 69. Mansourian AR. A review of literatures on the adverse effects of thyroid abnormalities and liver disorders: an overview on liver dysfunction and hypothyroidism. Pak J Biol Sci 2013;16:1641-52. 70. Lemeshow S, Klar J, Teres D, Avrunin JS, Gehlbach SH, Rapoport J, Rue M. Mortality probability models for patients in the intensive care unit for 48 or 72 hours: a prospective, multicenter study. Crit Care Med 1994;22:1351-8. 71. Hussain N, Bhattacharyya A, Prueksaritanond S. Amiodarone-induced cirrhosis of liver: what predicts mortality? ISRN Cardiol 2013;2013:617943. 72. Klotz U. Antiarrhythmics: elimination and dosage considerations in hepatic impairment. Clin Pharmacokinet 2007;46:985-96. 73. Verbraecken J, Van de Heyning P, De Backer W, Van Gaal L. Body surface area in normal-weight, overweight, and obese adults. A comparison study. Metabolism 2006;55:515-24. 74. Paniagua Clusells J, Arcusa Gavalda R, Goma Masip F, Pons Masanes S, Soler Masana JM. Acute hepatitis caused by intravenous amiodarone. Rev Esp Cardiol 1996;49:384-5. 75. Lopez-Gomez D, Nicolas J, Frigola JM, Manito N, Esplugas E. The use of oral amiodarone as a chronic treatment in a patient with prior fulminant hepatitis due to intravenous amiodarone. Rev Esp Cardiol 1999;52:201-3. 76. Cataldi A, Gonella D, Robutti N, Siri M, Buonocore S, Odetti P. Hepatotoxicity after intravenous amiodarone. Aging Clin Exp Res 2008;20:593-6. 77. Phillips BG, Bauman JL. Prescribing trends and pharmacoeconomic considerations in the treatment of arrhythmias. Focus on atrial fibrillation and flutter. Pharmacoeconomics 1995;7:521-33. 78. Chang CC, Petrelli M, Tomashefski JF, McCullough AJ. Severe intrahepatic cholestasis caused by amiodarone toxicity after withdrawal of the drug - A case report and review of the literature. Arch Pathol Lab Med 1999;123:251-6. 79. Morse RM, Valenzuela GA, Greenwald TP, Eulie PJ, Wesley RC, McCallum RW. Amiodarone-induced liver toxicity. Ann Intern Med 1988;109:838-40. 80. Lim PK, Trewby PN, Storey GC, Hole DW. Neuropathy and fatal hepatitis in a patient receiving amiodarone. Br Med J (Clin Res Ed) 1984;288:1638-9. 81. Rinder HM, Love JC, Wexler R. Amiodarone hepatotoxicity. N Engl J Med 1986;314:318-9. 82. Classification and causes of jaundice or asymptomatic hyperbilirubinemia Wolter Kluwer (Accessed March 12, 2014, at http://www.uptodate.com/contents/classification- and-causes-of-jaundice-or-asymptomatic- hyperbilirubinemia?source=search_result search=jaundice selectedTitle=2~150.) 83. Mattar W, Juliar B, Gradus-Pizlo I, Kwo PY. Amiodarone hepatotoxicity in the context of the metabolic syndrome and right-sided heart failure. J Gastrointestin Liver Dis 2009;18:419-23. 84. Chen YS, Lin JW, Yu HY, Ko WJ, Jerng JS, Chang WT, Chen WJ, Huang SC, Chi NH, Wang CH, Chen LC, Tsai PR, Wang SS, Hwang JJ, Lin FY. Cardiopulmonary resuscitation with assisted extracorporeal life-support versus conventional cardiopulmonary resuscitation in adults with in-hospital cardiac arrest: an observational study and propensity analysis. Lancet 2008;372:554-61. 85. Sakr Y, Lobo SM, Moreno RP, Gerlach H, Ranieri VM, Michalopoulos A, Vincent JL. Patterns and early evolution of organ failure in the intensive care unit and their relation to outcome. Crit Care 2012;16:R222. 86. Hilleman DE, Spinler SA. Conversion of recent-onset atrial fibrillation with intravenous amiodarone: a meta-analysis of randomized controlled trials. Pharmacotherapy 2002;22:66-74. 87. Roy D, Talajic M, Dorian P, Connolly S, Eisenberg MJ, Green M, Kus T, Lambert J, Dubuc M, Gagne P, Nattel S, Thibault B. Amiodarone to prevent recurrence of atrial fibrillation. Canadian Trial of Atrial Fibrillation Investigators. N Engl J Med 2000;342:913-20. 88. Tuseth V, Jaatun HJ, Dickstein K. Amiodarone infusion in the treatment of acute atrial fibrillation or flutter: high versus low dose treatment. Heart 2005;91:964-5. 89. Wilson JS, Podrid PJ. Side effects from amiodarone. Am Heart J 1991;121:158-71. 90. Heger JJ, Prystowsky EN, Zipes DP. Relationships between amiodarone dosage, drug concentrations, and adverse side effects. Am Heart J 1983;106:931-5. 91. Stelfox HT, Ahmed SB, Fiskio J, Bates DW. Monitoring amiodarone's toxicities: recommendations, evidence, and clinical practice. Clin Pharmacol Ther 2004;75:110-22. 92. Sanoski CA, Schoen MD, Gonzalez RC, Avitall B, Bauman JL. Rationale, development, and clinical outcomes of a multidisciplinary amiodarone clinic. Pharmacotherapy 1998;18:146S-51S. | |
| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57030 | - |
| dc.description.abstract | Amiodarone為一抗心律不整藥品，其效用及應用廣而常見於臨床使用。然而amiodarone易引起許多副作用，經臨床文獻回顧發現肝毒性並非罕見，其中不乏死亡案例，但臨床使用上此副作用卻常被輕忽，而迄今有關amiodarone引致肝毒性相關危險因子報導極有限。本研究旨在探討國內醫學中心amiodarone處方及相關肝傷害之因子以及臨床上遵照North American Society for Pacing and Electrophysiology (NASPE)治療指引監測相關潛在副作用之比率。 本研究係世代研究，採病歷回顧方式取得相關資料。研究對象為2011年2月至2013年1月新使用amiodarone口服或靜脈注射之加護病房住院患者，包含成人以及小兒。病人若有肝功能異常之相關體質，諸如已存在之肝臟疾病、 病毒性肝炎以及懷孕等皆被排除。本研究定義肝傷害為alanine aminotransferase (ALT)值大於或等於正常值上限3倍以上; total bilirubin (T-bil)值大於正常值上限2倍以上; alkaline phosphatase (ALP)值大於正常值上限1.5倍以上（僅限於成人）。以獨立樣本t檢定、Wilcoxon等級和檢定、卡方檢定以及對數等級檢定分析病例組與對照組之間連續變項分布狀況及類別變項之差異性，並使用存活分析探討時間相依之相關因子。本研究共納入275名病人，其中61名在使用amiodarone後，發生肝功能檢測值異常。在遵照NASPE指引監測各類相關副作用方面，無論是使用藥品前各類應監測之基礎值或是使用藥品期間之相關監測比率皆偏低。研究顯示amiodarone相關肝傷害之因子包含基礎肝功能檢測異常 (HR, 5.31; 95% CI, 3.11-9.06; p < 0.001)、靜脈注射劑量佔肝毒性當日總計量百分比 (HR, 1.01; 95% CI, 1.00-1.02; p = 0.02)、總累積劑量除以體表面積大於3800 mg/m2 (HR 8.11; 95% CI, 1.84-35.84, p = 0.006)、 肝毒性當日之日處方劑量和 (HR 1.00; 95% CI, 1.00-1.00; p = 0.01)、因陣發性上心室心搏過速使用amiodarone (HR, 6.21; 95% CI, 1.39-27.88; p = 0.02)、使用葉克膜 (HR, 3.46; 95% CI, 1.84-6.53; p < 0.001)、住院期間發生過低血壓 (HR, 3.02; 95% CI, 1.64-5.54; p = 0.0004)以及本身有先天性心臟疾病 (HR, 8.95; 95% CI, 3.42-23.40; p < 0.001)、動脈瘤 (HR, 3.93; 95% CI, 1.13-13.70; p = 0.03)或甲狀腺低下 (HR, 8.10; 95% CI, 1.06-62.02; p = 0.04)。多數肝傷害發生於基礎ALT、T-bil或ALP功能表現異常者。本研究找出預測amiodarone相關肝傷害因子之實證，其中總累積劑量除以體表面積為3800 mg/m2之數值或可做為臨床是否持續處方之臨界參考值，可增益amiodarone於臨床上使用之有效性及安全性。 | zh_TW |
| dc.description.abstract | Amiodarone-induced hepatotoxicity is not uncommon and fatal cases have been reported. However, hepatic adverse effects of amiodarone are often neglected in clinical practice. The effectiveness and applicability of amiodarone make it a widely used antiarrhythmic agent. Nonetheless, research to delineate predisposing factors of amiodarone-related liver injury for promoting safe use of amiodarone is still limited. The aims of the study are: (1) to identify risk factors associated with amiodarone-related liver injury, and (2) to examine guideline adherence rate of potential adverse-effect monitoring set by the North American Society for Pacing and Electrophysiology (NASPE) at a 2500-bed medical center in Taiwan. This cohort study was conducted on new users of oral or intravenous (IV) amiodarone, initiated at pediatric or adult intensive care units during February 2011 and January 2013, through medical chart review. Patients with pre-existing liver diseases, viral hepatitis, or pregnancy were excluded. Liver injury was defined as alanine aminotransferase (ALT) higher than or equal to 3 times of upper limit of normal (ULN); total bilirubin (T-bil) exceeding 2 times of ULN; or, alkaline phosphatase (ALP) higher than 1.5 times of ULN (adults only). Two-sample t test, Wilcoxon rank-sum test, chi-square test, and log-rank test were used to examine the differences in the distributions of continuous variables, categorical variables, and time-to-event outcomes between the case and control groups. Cox’s proportional hazards model was applied to estimate the effects of associated factors or predictors on continuous, binary, and time-dependent outcomes. A total of 275 patients were recruited and 61 patients (22.2%) developed liver injury. Adherence to NASPE monitoring guideline was poor, both at baseline and during follow-up periods. Identified predictors for amiodarone-related hepatic injury included baseline liver function test abnormalities (HR, 5.31; 95% CI, 3.11-9.06; p < 0.001), percentage of IV versus total daily amiodarone dosage on the event day (HR, 1.01; 95% CI, 1.00-1.02; p = 0.02), amiodarone cumulative dosage divided by body surface area higher than 3800 mg/m2 (HR, 8.11, 95% CI, 1.84-35.84; p =0.006), amiodarone daily dosage on the event day (HR, 1.00; 95% CI, 1.00-1.00; p = 0.01), with diagnosis of paroxysmal supraventricular tachycardia (HR, 6.21; 95% CI, 1.39-27.88; p = 0.02), under extracorporeal membrane oxygenation (HR, 3.46; 95% CI, 1.84-6.53; p < 0.001), with hypotensive events during hospital stay (HR, 3.02; 95% CI, 1.64-5.54; p = 0.0004), and with comorbid conditions such as congenital heart disease (HR, 8.95; 95% CI, 3.42-23.40; p < 0.001), aneurysm (HR, 3.93; 95% CI, 1.13-13.70; p = 0.03), and hypothyroidism (HR, 8.10; 95% CI, 1.06-62.02; p = 0.04). Liver toxicity with amiodarone may occur at 3800 mg/m2 body surface area. These predictors for amiodarone-related liver injury and threshold of dose-limiting toxicity recognized by the study may help safe and effective use of amiodarone in the future. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T06:33:17Z (GMT). No. of bitstreams: 1 ntu-103-R00451002-1.pdf: 1941502 bytes, checksum: e1f223ce853a818cc4b8132ecb3c242b (MD5) Previous issue date: 2014 | en |
| dc.description.tableofcontents | Chapter 1 Introduction p.1 Chapter 2 Literature Review p.2 2.1 Drug-induced Liver Injury p.2 2.2 Causality Assessment of Drug-induced Liver Injury p.4 2.3 Amiodarone p.5 2.3.1 Pharmacokinetics p.6 2.3.2 Indications and Administration Dosages p.6 2.3.3 Drug Interactions p.7 2.3.4 Adverse Effects p.8 2.4 Guideline for Amiodarone Use and Monitoring p.9 2.5 Amiodarone-induced Liver Injury: Epidemiology and Patients at Risks Factors p.10 2.6 Amiodarone-induced Liver Injury: Pathophysiology and Histology p.12 Chapter 3 Study Objectives p.15 Chapter 4 Methods p.16 4.1 Study Design p.16 4.2 Patient Population p.17 4.2.1 Characteristics of Intensive Care Units p.19 4.3 Data Collection p.20 4.4 Definition of Terms p.20 4.5 Clinical Outcomes p.22 4.6 Study Protocol p.23 4.7 Statistical Analysis p.24 Chapter 5 Results p.27 5.1 Baseline Characteristics of Study Population p.27 5.2 Comorbidities p.30 5.3 Diagnoses and Amiodarone Prescription p.32 5.4 Compliance with Amiodarone Monitoring Guideline p.33 5.5 Clinical Outcomes of Cases with Amiodarone-Related Injury p.38 5.6 Time to Event of the Case Cohort p.39 5.7 Multivariate Analysis p.40 Chapter 6 Discussions p.42 6.1 Factors for Amiodarone-Associated Related Liver Injury p.42 6.2 Exploration of Amiodarone Dose-Limiting Toxicity p.44 6.3 Types of Hepatotoxicity p.45 6.4 Clinical Outcomes p.45 6.5 Possible Indications for Amiodarone Prescriptions p.46 6.6 Monitoring of Amiodarone Adverse Reactions p.46 6.7 Study Limitations p.47 6.8 Future Perspectives p.48 Chapter 7 Conclusions p.49 References p.50 Appendix I. Case Report Form p.55 II. RUCAM Causality Assessment p.61 III. Naranjo Adverse Drug Reaction Probability Scale p.62 | |
| dc.language.iso | en | |
| dc.subject | 重症加護病房 | zh_TW |
| dc.subject | Amiodarone | zh_TW |
| dc.subject | 肝傷害 | zh_TW |
| dc.subject | 臺灣 | zh_TW |
| dc.subject | intensive care units | en |
| dc.subject | liver injury | en |
| dc.subject | Taiwan | en |
| dc.subject | Amiodarone | en |
| dc.title | 某醫學中心重症病人Amiodarone相關肝傷害之研究 | zh_TW |
| dc.title | A Study on Amiodarone-Related Liver Injury in Intensive Care Units at a Medical Center | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 102-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 李秉穎(Ping-Ing Lee) | |
| dc.contributor.oralexamcommittee | 呂立(Lu Lee) | |
| dc.subject.keyword | Amiodarone,重症加護病房,肝傷害,臺灣, | zh_TW |
| dc.subject.keyword | Amiodarone,intensive care units,liver injury,Taiwan, | en |
| dc.relation.page | 62 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2014-08-05 | |
| dc.contributor.author-college | 醫學院 | zh_TW |
| dc.contributor.author-dept | 臨床藥學研究所 | zh_TW |
| Appears in Collections: | 臨床藥學研究所 | |
Files in This Item:
| File | Size | Format | |
|---|---|---|---|
| ntu-103-1.pdf Restricted Access | 1.9 MB | Adobe PDF |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.