Amiodarone (Cordarone)

Question 1

Amiodarone Classification

Answer 1

Antidysrhythmic

Question 2

Amiodarone Mechanism

Answer 2

Primary - Class III antiarrhythmic/K+ channel blocker -> Prolongs Phase 3 repolarization and refractory period of ventricular AP

Secondary - Class IA antiarrhythmic/Na+ channel blocker -> decreased amplitude of phase 0 depolarization of ventricular AP

Secondary - Class II antiarrhythmic/Non-competitive Beta-Blocker -> negative inotropy, chronotropy, dromotropy

Secondary - Class III antiarrhythmic/Weak Ca2+ channel blocker -> negative inotropy, chronotropy, dromotropy

Question 3

Amiodarone Pharmacokinetics

Answer 3

Onset: Immediate
Peak Effects: 30-45min
Duration: Varies
Half Life: 40-55 days

Question 4

Amiodarone Indications

Answer 4

• Cardiac Arrest (VF, Pulseless VT)

- Wide Complex Tachycardia

Question 5

Amiodarone Contratindications

Answer 5

-Bradycardia
-Hypersensitivity
2/3 degree Heart Block

Question 6

Amiodarone Side Effects/Adverse Reactions

Answer 6

Hypotension, bradycardia, dyspnea, cough, dizziness, prolonged PR, QRS, QT intervals

Question 7

Amiodarone Dose

Answer 7

Adult:
VF/Pulseless VT: 300mg IV IO, repeat dose 150mg in 3-5min
VT + pulse: 150mg IV IO over 10 min
Maintenance: 1mg/min first 6 hrs, then 0.5mg/min

Pedi:
VF/Pulseless VT: 5mg/kg IV IO; max 300mg, max total dose = 15mg/kg
VT + pulse: 5mg/kg IV IO over 20-60min; max = 300mg

Question 8

Amiodarone Precautions

Answer 8

Caution in pts with heart failure

Question 9

Amiodarone Drug Interactions

Answer 9

• Reduces renal and nonrenal clearance of digoxin
• Decreased biotransformation and clearance of warfarin -> enhanced anticoagulation
• Potentiates procainamide and quinidine