Amiodarone Flashcards
1
Q
Amiodarone Name
A
Amiodarone
2
Q
Amiodarone Class
A
Antiarrhythmic Agent
3
Q
Amiodarone Mechanism of Action
A
- Multiple effects on sodium, potassium and calcium channels.
- Prolongs action potential, refractory period.
- Ventricular automaticity (potassium channel blockade).
- Slows membrane depolarization and impulse conduction (sodium channel blockade).
- Negative chronotropic activity in nodal tissue, rate reduction, and antisympathetic activity (calcium channel and β-blockade).
- Dilates coronary arteries due to calcium channel and alpha-adrenergic blocking action
4
Q
Amiodarone Indications
A
- Treatment of: defibrillation-refractory VF/pulseless VT, polymorphic VT, and wide complex tachycardia of uncertain origin.
- Control hemodynamically stable ventricular tachycardia when cardioversion unsuccessful.
- Adjunct to cardioversion of SVT and PSVT. Rate control in atrial fibrillation or flutter.
5
Q
Amiodarone Contraindications
A
- Bradycardia
- Second or third degree heart block unless a functioning pacemaker is present
- Cardiogenic shock
- Hypotension
- Pulmonary congestion
6
Q
Amiodarone Adverse Reactions
A
- Cardiovascular: bradycardia, hypotension, asystole/cardiac arrest, atrio-ventricular block
- Torsades de Pointes (prolongs QTc interval), congestive heart failure
- GI & Hepatic: nausea, vomiting, abnormal liver function tests
- Skin: slate-blue pigmentation
- Other: fever, headache, dizziness, flushing, abnormal salivation, photophobia
7
Q
Amiodarone Incompatibilities/Drug Interactions
A
- Beta blockers, calcium channel blockers, and other antiarrhythmics are additive and can be proarrhythmic when given in combination with Amiodarone due to similar mechanisms of action.
- Amiodarone precipitates at certain concentrations when mixed at a Y-site with sodium bicarbonate, furosemide, and heparin.
8
Q
Amiodarone Adult Dosage
A
- VF/Pulseless VT: 300 mg IV push over 30 – 60 seconds, may repeat in 3-5 minutes with 150 mg IV push
- Wide-Complex Tachycardias, Atrial Flutter, Atrial Fibrillation, SVT with cardioversion: 150 mg IV over 10 minutes (mix in 50 mL bag of D5W) may repeat every 10 minutes
- Maintenance Infusion Post Resuscitation/Conversion: After successful defibrillation, follow with up to 1mg/min IV infusion for 6 hours, then up to 0.5 mg/min IV infusion for up to 18 hours, maximum daily dose is 2.2 grams. Mix 450 mg in 250 mL of D5W (special polyolefin bag), concentration 1.8 mg/mL, and run at 33.3 mL/hr for 1 mg/min or 16.7 mL/hr for 0.5 mg/min
- For Other Maintenance infusion: Rates range from 0.5 mg/min to 1mg/min. Maximum daily dose is 2.2 grams
9
Q
Amiodarone Pediatric Dosage
A
- VF/Pulseless VT: 5 mg/kg IV push (max 300 mg single dose), may repeat every 5 minutes two times to a total maximum of 15 mg/kg/day
- Probable VT with pulse: 5 mg/kg IV administered over 20 minutes may repeat two more times to a total of 15 mg/kg/day
10
Q
Amiodarone Routes of Administration
A
IV/IO bolus, IV/IO infusion
11
Q
Amiodarone Onset
A
Variable
12
Q
Amiodarone Peak Effects
A
Variable
13
Q
Amiodarone Duration
A
Half-life may exceed 40 days
14
Q
Amiodarone AZ Drug Box Minimum
A
Optional 300 mg
