Amiodarone

Question 1

In what sol’n should it mix in

Answer 1

• D5W rec [ ] = 1-6 mg/mL

Question 2

Dose in PO

Answer 2

• LD: 800-1600 mg/d (BID/TID) for 2-3 weeks

- MD: 200-600 mg/d (BID/TID)

Question 3

Dose in IV

Answer 3

• 150 mg over 10 min then IV infuse 1mg/min (360mg) x 6H. Then 0.5mg/min (540mg) x 18H

Question 4

ADEs

Answer 4

• Photosensitivity
• Pulm fibrosis => CXR Q6M
• Corneal micro-deposit => opthal exam
• Thyroid dysfxn: hypo/hyper
• Smurfing: gray-blue discoloration of skin
• Inc QT: Torsades de pointes
• LFT
• CNS
• Hypotension
• Bradycardia & 2nd/3rd degree AV block

Question 5

DDI

Answer 5

• Increase Digoxin level: by 70%
• Inc INR w/ warfarin by 100% => dec dose of 33-50% is rec
• CYP 1A2, 2C9, 2D6, 3A4 inhibitors
• Inc:
• Theophylline, carvedilol, methadone
• Amprenavir
• Carbamazepine
• Sildenafil

Question 6

Monitoring

Answer 6

Baseline test:

• TSH
• LFT
• Eyes
• CXR

Question 7

Half life

Answer 7

• T1/2 = 30-60 days

- DDI may persistent after d/c due to long t1/2

Question 8

Others:

• Storage:
• Light protection:
• Container:
• Filter:

Answer 8

• Store at room temperature
• Protect from light
• Ok to use in polyvinyl chloride (PVC) container for up to 2 hours. Infusion > 2H, must dilute in a glass (Stable in glass for 24H)
• 0.2 or 0.22 micron in-line filter