Amiodarone

Question 1

Indications (3) for amiodarone use?

Answer 1

❑ VF/pVT unresponsive to shock delivery, CPR, and a vasopressor
❑ Recurrent, hemodynamic unstable VT (second line treatment after cardioversion X 3)
❑ With expert consultation amiodarone may be used for tx of some atrial (SVT) and ventricular arrhythmias

Question 2

Adult dose for amiodarone?

Answer 2

VF/pVT - 300 mg IVP (recommend dilution in 20 to 30 mL D5W or NS); 2nd dose if needed 150 mg IVP in 3-5 minutes

Recurrent Life-threatening Arrhythmias -
Rapid Infusion: 150 mg/10 minutes q 10 minutes (until suppression of arrhythmia or max cumulative dose is reached). Mix 150mg in 100ml bag of NS or D5W (Concentration: 1.5 mg/ml)

Slow Infusion (Immediately post suppression of arrhythmia): 1 mg/min over 6 hours (360 mg)
Maintenance Infusion: 0.5 mg/min over 18 hours (540 mg)
 *Note: Max cumulative dose of 2.2 gms/24 hrs

Question 3

Contraindications (4 points) to amiodarone use?

Answer 3

❑ SA node dysfunction. AV block, pre-existing 2nd or 3rd degree block (without artificial pacemaker)
❑ Bradycardia resulting in syncope
❑ Sensitivity to amiodarone or iodine (contains iodine)
❑ Cardiogenic shock if you haven’t tried cardioversion X 3 first

Question 4

Pediatric dose for amiodarone?

Answer 4

Pediatric: use 5 mg/kg doses x 3 over 20 to 60 minutes up to a max of 300 mg IV/IO diluted in 5 mL NS