Name a significant adverse effect of amiodarone that requires monitoring.

• A. Hyperglycemia.
• B. Hyponatremia.
• C. Hypokalemia.
• D. Pulmonary fibrosis.

Answer: (D)

Pulmonary toxicity is the key adverse effect of amiodarone that requires careful monitoring. Amiodarone can lead to pneumonitis and, with longer use or higher cumulative doses, progress to pulmonary fibrosis. This toxicity can be serious or even fatal, so early detection is essential. Baseline and periodic lung assessment—such as chest imaging and pulmonary function testing (spirometry with DLCO)—helps catch early changes. If new symptoms like cough or shortness of breath appear, or radiographs show abnormalities, reassess the therapy and consider stopping or adjusting the dose. While amiodarone can affect other organs (thyroid, liver, eyes, skin), the potential for severe lung injury makes pulmonary monitoring particularly important.