2. Amiodarone

Question 1

Amiodarone

Initial dose

Answer 1

200mg TDS 7/7

200mg BD 7/7

200mg OD 7+

Question 2

Amiodarone

SE

(10)

Answer 2

1. Corneal microdeposits
   (Crystals forming in eyes, reversible on withdrawal; CI on night driving)
2. Impaired vision
   Optic neuritis can cause blindness
   STOP TX STAT

3.photoxicity, skin sensitive to light, sunburn, erythema
(Use high SPF for several months after tx)

4. Peripheral neuropathy
   Pins and needles feet + hands; tremor
5. Phneumonitis & pulmonary fibrosis
   SOB, dry cough
6. Hepatotoxic drug
   (Liver failure, jaundice, NV)
7. Thyroid disfunction ⬆️⬇️ (due to iodine)
   If ⬆️ withdraw Amiodarone and add carbimazole
   If ⬇️ keep using Amiodarone but add levothyroxine
8. HypOtension
9. Bradycardia
10. HypOkalaemia

Question 3

Amiodarone

Monitoring (6)

Answer 3

1. Thyroid function test ever 6 months
   TSH, T3, T4
2. Liver function test every 6 months
3. Chest x-ray
4. Serum k+
5. BP (+ ECG if used IV)
6. Eye test yearly

All BEFORE STARTING

Question 4

Amiodarone

Pregnancy & breast feeding

Answer 4

Not allowed!!

Question 5

Amiodarone

1/2t

Half life

Answer 5

50 days

20-100 days range

Question 6

Amiodarone

Interactions 6

Answer 6

1. Increase risk of myopathy
   Statins!!! Simvastatin 20mg MAX
2. Increased plasma concentration of coumarins
   - warfarin, phenindione, phenytoin, dabigatran, digoxin, flecainide
3. Increased risk of bradycardia, AV block, Myocardial depression when used with B.Blockers and
   (Dilitiazem, verapamil ccb)
4. Risk of severe bradycardia & heart block
   Avoid: sofobuvir, daclatasvir, ledipasvir,simeprevir
5. Grapefruit increase Amiodarone plasma concentration
6. Increased risk of ventricular arrhythmias
   Amisulpride, atomoxetine, chloroquine, citalopram, escitalopram, haloperidol, hydroxychloroquin, levofloxacin, lithium, quinine,mefloquine

Question 7

Amiodarone

MOA

Answer 7

It is used to restore normal heart rhythm and maintain a regular, steady heartbeat. Amiodarone is known as an anti-arrhythmic drug. It works by blocking certain electrical signals in the heart that can cause an irregular heartbeat.

Amiodarone is a primarily a class III antiarrhythmic. Like other antiarrhythmic drugs of this class, amiodarone works primarily by blocking potassium rectifier currents that are responsible for the repolarization of the heart during phase 3 of the cardiac action potential