Amiodarone monitoring should include which of the following?

• A. Baseline lung function testing only
• B. Baseline thyroid function testing only
• C. Baseline lung function, thyroid function, and eye examination
• D. No monitoring required

Answer: (C)

Amiodarone carries risks of toxicity to several organs, so a comprehensive baseline assessment helps detect preexisting problems and provides a reference for future monitoring. The lungs are a key concern because amiodarone can cause serious pulmonary toxicity, including interstitial pneumonitis or fibrosis, which can be life-threatening. Having a baseline lung function test (such as spirometry and possibly DLCO) allows you to compare future results if symptoms develop or if there’s any suspicion of lung involvement.

Thyroid dysfunction is another well-known adverse effect of amiodarone. The drug contains a large amount of iodine and can induce both hypothyroidism and hyperthyroidism, so checking baseline thyroid function (typical tests are TSH and free T4) helps identify any preexisting abnormalities and guides ongoing monitoring.

Eye effects are also associated with amiodarone; corneal microdeposits are common and can be seen even in asymptomatic patients, and in rare cases optic neuropathy can occur. An initial eye examination establishes a reference and supports vigilance for any emerging ocular symptoms during therapy.

So, evaluating lung function, thyroid function, and eyes at baseline best prepares you to monitor for the major potential toxicities of amiodarone. Options that include only one system or none at all would miss other significant risks.