AMIODARONE Flashcards
Amiodarone indication
Treatment of arrhythmias
Specialist
Class
3
Amiodarone - loading dose
LOADING DOSE:
200mg TDS for 7 days →
200mg BD for 7 days →
200mg OD maintenance
Administration route
IV infusion
- rapid
- little or no myocardial depression
PO
Administration
OD
- long half life
- can extend to several weeks
- may take months of weeks to ready SS
CI
General C/I:
- Thyroid dysfunction
- sino-atrial block
Specific to IV amiodarone:
- Avoid bolus injection in Congestive Heart failure
SEs
- Corneal Microdeposits
- Brady
- Thyroid Disorders
- Photosensitivity Reaction
- Hepatotoxicity
- Pulmonary Toxicity
- Peripheral neuropathy
Amiodarone - Corneal Microdeposits
Reversible when treatment ends - if vision is impaired: STOP
Thyroid Disorders
Can cause hypo or hyperthyroidism due to iodine content
Hepatotoxicity
Stop if patient develops signs of liver disease
- dark urine
- yellow skin, jaundice
- N + V
Pulmonary Toxicity
Report in cases of new / progressive shortness of breath or coughs
Peripheral neuropathy
- new neurological symptoms
- numbness, tingling
Amiodarone - Driving and Skilled Tasks
Microdeposits may lead to blurred vision
Interactions
- Drugs that cause hypokalaemia
- Drugs that cause QT prolongation
- CYP450 Enzyme substrates (Amiodarone = inhibitor)
- Other enzyme inhibitors (grapefruit) and inducers will affect amiodarone too
- Drugs that cause bradycardia
- Beta-blockers or RL-CCBs
Monitoring
- TFTs - before, every 6m
- LFTs - before, every 6m
- Serum K+ - before
- Chest x-ray - before
- IV - ECG + liver transanimase
