Editing Pharmacology – RN Practice Questions (section)

==Question 14==
A client has been taking amiodarone for six months for atrial fibrillation. Which new finding requires the most immediate provider notification?
# Blue-gray discoloration of the skin on the face
# A nonproductive cough with progressive exertional dyspnea and new bibasilar crackles
# A thyroid stimulating hormone level of 6.2 microunits per milliliter
# Corneal microdeposits noted on a routine eye examination

'''Answer:''' 2 (B) A nonproductive cough with progressive exertional dyspnea and new bibasilar crackles.

''Rationale:'' Amiodarone pulmonary toxicity, which can progress to irreversible fibrosis, is the most dangerous adverse effect of the drug and requires prompt evaluation and usually discontinuation. Option 1 is a cosmetic photosensitivity-related change that should be reported but is not urgent. Option 3 reflects amiodarone-induced hypothyroidism, which is common, expected on monitoring, and treatable with levothyroxine. Option 4 is very common, generally asymptomatic, and monitored rather than treated emergently.