Amiodarone and sildenafil

 Q: Amiodarone ____________ the efficacy of sildenafil? (select one) 

A) increases 

B) decreases

Answer: A

Sildenafil has been increasingly used in ICU for pulmonary hypertension. Simultaneously these patients are prone to arrhythmia particularly atrial fibrillation, requiring amiodarone for rapid ventricular rate (RVR) control. 

Amiodarone interacts with many drugs commonly used in ICU and as a rule of thumb increases the efficacy, and subsequently the potential of their side effects. Some of these drugs include digoxin, warfarin, simvastatin, sildenafil, cyclosporine, and many hepatically metabolized drugs such as antidepressants.

#pharmacology

#cardiology

#pulmonary

References:

1. Colunga Biancatelli RM, Congedo V, Calvosa L, Ciacciarelli M, Polidoro A, Iuliano L. Adverse reactions of Amiodarone. J Geriatr Cardiol. 2019;16(7):552-566. doi:10.11909/j.issn.1671-5411.2019.07.004

2. Florek JB, Girzadas D. Amiodarone. 2020 Aug 23. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan–. PMID: 29489285.

3. McDonald MG, Au NT, Rettie AE. P450-Based Drug-Drug Interactions of Amiodarone and its Metabolites: Diversity of Inhibitory Mechanisms. Drug Metab Dispos. 2015 Nov;43(11):1661-9. doi: 10.1124/dmd.115.065623. Epub 2015 Aug 21. PMID: 26296708; PMCID: PMC4613947.