Amiodarone and Digoxin

Question 1

When is Amiodarone contra-indicated and why

Answer 1

• Heart block
• Bradycardia

(as it already slows down heart rate)

Question 2

Amiodarone side effects

Answer 2

• corneal microdeposites (impaired vision)
• Thyroid disorders
• Photosensitivity
• grey stools
• hepatotoxicity
• pulmonary toxicity

Question 3

What to do with simvastatin daily dose if taking with Amiodarone

Answer 3

Max daily dose at 20mg

Question 4

Amiodarone and Pregnancy effects

Answer 4

Neonatal goitre risk
(only use if no alternative)

(goitre= swelling of neck when thyroid glands swell)

Question 5

Amiodarone and Breastfeeding

Answer 5

AVOID (presence in milk)

Question 6

How long after treatment do Amiodarone interactions still occur

Answer 6

after several months of stopping

Question 7

Amiodarone interaction

Answer 7

• Drugs that cause hypokalaemia
• drugs that cause QT prolongation
• grapefruit juice
• bradycardia causing drugs (BB, RL-CCBS)

Question 8

What to do with Digoxin dose if it is used with Amiodarone, Dronedarone and Quinine

Answer 8

half Digoxin dose

Question 9

What monitoring requirements does Amiodarone require

Answer 9

• Thyroid function (before, every 6 months)
• Liver Funciton
  (before, every 6 months)
• Potassium Levels (before)
• Chest x-ray
• eye examination

Question 10

If patients need to start:
- Daclastavir
- Sofosbuvir
- ect…
and they have recently stopped amiodarone, what needs to happen and why

Answer 10

FULL monitoring as there is a risk of heart block

Question 11

What is the loading dose for Amiodarone

Answer 11

200mg TDS: 7 days
200mg BD: 7 days
200mg DO: maintenance