Question:
A patient has pulmonary fibrosis. Which antiarrhythmic drug should NOT be given to this patient?
A patient has pulmonary fibrosis. Which antiarrhythmic drug should NOT be given to this patient?
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One of these drugs is famous for causing the very lung disease in question.
Updated On: Jun 23, 2026
- Amiodarone
- Flecainide
- IV ibutilide
- Lidocaine
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The Correct Option is A
Solution and Explanation
Step 1: Identify the toxic drug. Amiodarone is well known for pulmonary toxicity. It can cause an interstitial pneumonitis that progresses to pulmonary fibrosis.
Step 2: Mechanism. Amiodarone and its metabolites injure the lung directly through a cytotoxic effect and indirectly through an immune reaction (cytotoxic T cells found in bronchoalveolar lavage fluid). It also generates toxic oxygen radicals that damage alveolar cells.
Step 3: Why avoid it here. In a patient who already has pulmonary fibrosis, adding amiodarone risks worsening the lung disease, so it is contraindicated.
Step 4: The others. Flecainide, ibutilide, and lidocaine do not carry this pulmonary fibrosis risk and are acceptable from a lung standpoint. Ref: Goodman and Gilman, 13e.
Step 2: Mechanism. Amiodarone and its metabolites injure the lung directly through a cytotoxic effect and indirectly through an immune reaction (cytotoxic T cells found in bronchoalveolar lavage fluid). It also generates toxic oxygen radicals that damage alveolar cells.
Step 3: Why avoid it here. In a patient who already has pulmonary fibrosis, adding amiodarone risks worsening the lung disease, so it is contraindicated.
Step 4: The others. Flecainide, ibutilide, and lidocaine do not carry this pulmonary fibrosis risk and are acceptable from a lung standpoint. Ref: Goodman and Gilman, 13e.
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