Amiodarone

Question 1

Amiodarone indication

Answer 1

AF, flutter, SVT, VT only used if other options ineffective/inappropriate, bolus injection in cardiac arrest for VF or pulseless VT after third shock

Question 2

Amiodarone MOA

Answer 2

Blocks sodium, calcium, potassium channels and antagonises alpha and beta adrenergic receptors thus reducing spontaneous depolarization, slowing conduction velocity, interferes with AV node to reduce ventricular rate in AF/Flutter, attempts to restore sinus rhythm

Question 3

Amiodarone side effects

Answer 3

hypotension, pneumonitis, bradycardia, AV block, hepatitis, photosensitivity, grey discolouration, thyroid abnormalities (hypo/hyper), very long half life so side effect may persist
constipation; corneal deposits; movement disorders; sleep disorders; taste altered; vomiting, QT

Question 4

Amiodarone c.i

Answer 4

severe hypotension, heart block, active thyroid disease

Question 5

Notable amiodarone interactions

Answer 5

Digoxin, diltiazem, verapamil, ciclosporin, SSRI, beta blockers,

Question 6

Amiodarone regimen

Answer 6

200 mg 3 times a day for 1 week, then reduced to 200 mg twice daily for a further week, followed by maintenance dose, usually 200 mg daily or the minimum dose required to control arrhythmia