Amiodarone

Question 1

What is the mechanism of Amiodarone?

Answer 1

●It is an antidysrhythmic with broad spectrum activity.
●Has class 3 activity, prolongs the action potential duration, reduces automaticity and prolongs the refractory period of atrial, nodal, and ventricular tissues.
●The electrophysiological effects result in a reduction in abnormal electrical activity, conduction, and HR, and stabilises the SA and AV nodes.

Question 2

What are the indications for Amiodarone?

Answer 2

●Cardiac Arrest with VT or VF after the first dose of adrenaline.
●Adults with sustained VT not in cardiac arrest.
●Atrial Fibrillation or Atrial Flutter with moderate cardiovascular compromise.

Question 3

What are the contraindications of Amiodarone?

Answer 3

●Known severe allergy.
●Known severe allergy to iodine.
●VT secondary to tricyclic poisoning. (Worsens shock doesn’t fix the rhythm).

Question 4

What are the cautions for Amiodarone? (7)

Answer 4

●None in a cardiac arrest.
●Poor perfusion/low cardiac output.
●Hypotension.
●AF secondary with sepsis.
●Known sick sinus syndrome without a pacemaker.
●Previous second or third heart block without a pacemaker.
●Pregnancy.

Question 5

What is the adult dose of Amiodarone in a cardiac arrest?

Answer 5

●300mg after the first dose of adrenaline. (Do not dilute).
●Next dose is 150mg after DSD or 15 minutes if VT/VF persists.

Question 6

What are the adverse effects of Amiodarone?

Answer 6

●Hypotension.
●Lightheadness.
●Bradydysrhythmia.

Question 7

What is the onset time for Amiodarone?

Answer 7

●5-10mins.

Question 8

What is the duration of effect time for Amiodarone?

Answer 8

●1-4 hours.

Question 9

What is the preparation of Amiodarone in a cardiac arrest for an adult?

Answer 9

Ampoule containing 150mg/3ml
Draw up x2 for first dose into a 10ml syringe (do not dilute.) Administer IV. Flush with 10ml of saline.