Amiodarone

Question 1

Pharmacology and presentation of Amiodarone?

(Paramedic - Cardiac Arrest only)

Answer 1

150mg in 3ml
- Class III antidysrhythmic that prolongs action potential duration, reduces automaticity and prolongs the refractory period of atrial/nodal/ventricular tissues.
- Results in decreased abnormal electrical activity, electrical conduction and HR.

Question 2

Indicators of Amiodarone?

Answer 2

• Cardiac arrest in VF/VT after the first dose of adrenaline.
• Adults in conscious VT
• Adults with moderate cardiovascular compromise as a result of fast atrial fibrillation or fast atrial flutter

Question 3

Contraindications of Amiodarone?

A. I. V

Answer 3

• Known severe allergy.
• Known severe allergy to iodine.
• VT secondary to cyclic antidepressant poisoning. (severely worsens shock)

Question 4

Cautions of Amiodarone?
7x B’s 5x beats, 1x block, 1x bub

None in CA, P.S. CHAP

Answer 4

Previous 2nd/3rd heartblock with out pacemaker
Sick sinus syndrome without pacemaker

C.O low or poor perfusion
Hypotension
AFib with sepsis
Pregnancy

• None if the patient is in cardiac arrest.
• Poor perfusion or signs of low cardiac output.
• Hypotension.
• Atrial fibrillation associated with sepsis.
• Known sick sinus syndrome without an internal pacemaker in place.
• Previous 2nd or 3rd degree heart block without an internal pacemaker in place.
• Pregnancy.

Question 5

Side Effects of Amiodarone?

Answer 5

• Hypotension.
• Light-headed.
• Bradydysrhythmia.

Question 6

Dosing Regimes of Amiodarone?

Answer 6

Cardiac arrest Adults
- 300 mg for an adult. If VF or VT persists, a second dose of 150 mg may be administered after 15-20mins

Cardiac Arrest Pediatrics
- 50mg per 10kg, consult for further doses

Tachydysrhythmia Adult:
- 300 mg IV over 30 minutes, diluted in 5% Glucose @1 drop per second
- A further 150 mg IV over 30 minutes may be administered if the tachydysrhythmia persists.

Question 7

Onset and duration of Amiodarone?

Answer 7

Onset:
- 5-10mins IV

Duration
- 1-4hrs