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Amiodarone Long Half-Life — FRCA Primary MCQ

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HardPharmacology - CardiovascularAmiodarone Long Half-LifeFRCA Primary

A patient taking amiodarone for eight months develops progressive dry cough, exertional hypoxaemia and new bilateral interstitial shadowing. Infection and pulmonary oedema are unlikely. Which action is most appropriate?

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Correct answer: E — Stop amiodarone and assess urgently for pulmonary toxicity

The best answer is “Stop amiodarone and assess urgently for pulmonary toxicity”. Amiodarone can cause serious interstitial pneumonitis or fibrosis and the presentation warrants prompt withdrawal and respiratory assessment after competing diagnoses are considered. Toxicity is not confined to intravenous loading, and the long half-life means exposure and injury may persist after cessation. Thyroid dysfunction is another recognised toxicity but does not explain the specific pulmonary pattern.

Reference: Amiodarone hydrochloride 200 mg tablets, UK SmPC: https://www.medicines.org.uk/emc/product/101141/smpc; Royal College of Anaesthetists, Primary FRCA syllabus v2.2: https://www.rcoa.ac.uk/sites/default/files/documents/2026-01/Primary-FRCA-Syllabus.pdf