Amiodarone

Question 1

Indications for amiodarone use?

Answer 1

• VF/pVT unresponsive to shock delivery, CPR, and Epi
• Recurrent, hemodynamically unstable VT as a 2nd line treatment after cardioversion (Mandatory OLMC)

Question 2

Adult dose for amiodarone for VF/pVT?

Answer 2

VF/pVT - 300 mg IV/IO. Repeat at 150mg if required q5min prn to total max of 450mg. Can be given undiluted if followed by a 10mL flush. Recommended to dilute in 20mL syringe.

Question 3

Contraindications to amiodarone use?

Answer 3

• None when used in cardiac arrest
• Hypersensitivity to drug or iodine
• Cardiogenic shock, sinus bradycardia, or AV (2nd or 3rd degree) unless a pacemaker is present
• Cardiovascular collapse, severe atrial hypotension
• Patients predisposed to intracranial hypertension
• Acute hepatitis
• Thyroid dysfunction
• Interstitial pulmonary disease

Question 4

Pediatric dose for amiodarone in VF/pVT?

Answer 4

5mg/kg IV/IO to a single max dose of 300mg

q5min PRN to a total max of 15mg/kg or 450mg (whichever is less)

Can be administered undiluted if followed by a 10mL flush

Question 5

Adult dose for amiodarone in ventricular tachycardia (with a pulse)?

Answer 5

150mg IV/IO diluted in 150mL D5W bag and infuse over 10min with a 10gtt and an in-line filter at 2 drops/sec (900mL/hr). Do not repeat dose.

Prepare by wasting 100mL D5W from a 250mL bag, and then adding the 150mg (3mL) of amiodarone

Question 6

Pediatric dose of amiodarone for ventricular tachycardia (with a pulse).

Answer 6

5mg/kg IV/IO to a single max dose of 300mg, dilute in 150mL D5W, and infuse with a 60gtt, inline filter, and drip rate flow controller (or IV pump) over 60min (2.5gtt/sec).

Prepare by wasting 100mL from a 250mL D5W bag and adding required dose, OR, add 150mL to a buretrol set and add required dose