Amiodarone Flashcards
What is it indicated for?
Tachyarrhythmias- atrial fibrillation, atrial flutter, supraventricular tachycardia
What is the mechanism of action?
Has many effects on myocardial cells but it reduces the ventricular rate in AF and atrial flutter, maintains or possibly restores sinus rhythm
What are the side effects?
Bradycardia
Constipation
Corneal deposit
Sleep disorders
Vomiting
Skin reactions photosensitivity or grey discolouration
Thyroid abnormalities
What are the contraindications?
Severe hypotension
Heart block
Active thyroid disease
What drugs does it interact with?
Digoxin- increased digoxin levels
Diltiazem
Verapamil
Grapefruit juice
Most drugs and food
What monitoring requirements are needed?
Thyroid function test every 6 months and for 12 months after discontinuation
Liver function test every 6 months
Serum electrolytes very 6 months
Electrocardiography every 12 months
Can it be used in pregnancy?
Possible risk of neonatal goitre; use only if no alternative.
Can patients breastfeed while on this drug?
Avoid; present in milk in significant amounts; theoretical risk of neonatal hypothyroidism from release of iodine.
What is the special warning for amiodarone?
It has a long half-life (25-100 days), thus interactions may occur for some time after drug withdrawal
What are the cautions for it?
heart failure
elderly
hypokalaemia
severe bradycardia
