Amiodarone Flashcards
Pharmacology and presentation of Amiodarone?
(Paramedic - Cardiac Arrest only)
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.
Indicators of Amiodarone?
- 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
Contraindications of Amiodarone?
A. I. V
- Known severe allergy.
- Known severe allergy to iodine.
- VT secondary to cyclic antidepressant poisoning. (severely worsens shock)
Cautions of Amiodarone?
7x B’s 5x beats, 1x block, 1x bub
None in CA, P.S. CHAP
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.
Side Effects of Amiodarone?
- Hypotension.
- Light-headed.
- Bradydysrhythmia.
Dosing Regimes of Amiodarone?
Cardiac arrest Adults
- 300 mg for an adult on the 3rd shock. If VF or VT persists, a second dose of 150 mg may be administered on the 5th shock
Cardiac Arrest Paediatrics
- 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.
Onset and duration of Amiodarone?
Onset:
- 5-10mins IV
Duration
- 1-4hrs
