Amiodarone

Question 1

Trade Name

Answer 1

Cordarone, Pacerone

Question 2

Class

Answer 2

Class III antidysrhythmic

Question 3

Actions

Answer 3

1. Prolongs duration of the action potential.
2. Prolongs effective refractory period.
3. Non-competitively inhibits alpha & beta receptors and possesses vagolytic & calcium channel blocking properties.
4. Negative dromotrope, chronotrope, & vasodilator.

Question 4

Indications

Answer 4

1. Pulseless ventricular tachycardia (VT) and ventricular fibrillation (VF).
2. Ventricular tachycardia (VT) with a pulse.

Question 5

Contraindications

Answer 5

1. Pulmonary Congestion
2. Cardiogenic Shock
3. Amiodorone Sensitivity
4. Bradycardia
5. Procainamide use
6. TCA Overdose

Question 6

Precaution

Answer 6

1. Hypotension
2. Heart failure
3. Long QT syndrome

Question 7

Dosage

PULSELESS VT/VF

Answer 7

1. Pulseless VT/VF:
   •IV/IO : 300 mg IV/IO initial dose, consider repeat dose
   of 150 mg 3-5 minutes after initial dose.
2. Wide Complex Tachycardia (with a pulse):
   •LOADING DOSE - IV/IO:150 mg IV infusion over 10
   minutes. oMay repeat once as needed. (max dose
   loading dose of 300 mg).

Question 8

Dosage

POST ROSC

Answer 8

To be initiated if V-fib/V-Tach resolves after administration of Amiodarone
•Loading dose: A loading dose of 150 mg over 10
minutes may also be considered if max 300 mg bolus
has not been administered.
•Maintenance Infusion: 1 mg/minute titrated for effect.

Question 9

Dosage

WIDE COMPLEX TACHYCARDIA (with pulse)

Answer 9

LOADING DOSE - IV/IO:150 mg IV infusion over 10 minutes.
oMay repeat once as needed. (max dose loading dose
of 300 mg).oConvert to maintenance infusion once
complete.
•MAINTENANCE INFUSION: IV/IO: 1 mg/min
oTo Mix: 450
mg/250 cc, infuse via infusion pump.

Question 10

Pedi Dose

PULSELESS VT/VF

Answer 10

5 mg/kg IV/IO. May repeat doses up to 15 mg/kg (max dose of 300 mg).

Question 11

Pedi Dose

WIDE COMPLEX TACHYCARDIA (w/ pulse)

Answer 11

• 5 mg/kg IV/IO over 30 min. May repeat dose up twice (up to 15 mg/kg )
• Max total loading dose of 300 mg.

Question 12

Side Effects

Answer 12

1. Hypotension 2. Headache 3. Dizziness 4. Bradycardia 5. AV nodal conduction abnormalities 6. QT prolongation 7. Flushing 8. Salivation

Question 13

Interactions

Answer 13

1. Potentiates bradycardia and hypotension with calcium
   channel blockers and beta blockers.
2. Increases risk of AV nodal blockade with calcium
   channel blockers.
3. May increase anticoagulation effects of Warfarin.•May
   increase serum levels of Phenytion, Procainamide,
   Quinidine, and Theophylines.
4. Should not be used with other medications which
   prolong the QT interval.
5. Should not run through the same IV line in which
   Sodium Bicarb or Furosemide have been used.

Question 14

Precations

Answer 14

1. Rapid infusion may lead to hypotension.
2. Terminal elimination is extremely long (half-life lasts up
   to 40 days).

Question 15

Special Info

Answer 15

1. Evidence for one particular antiarrhythmic over another
   is inconclusive.
2. A maintenance infusion is not typically needed