Amiodarone G3 Flashcards
1
Q
Amiodarone Class
A
- Antiarrhythmic agent (Class III)
2
Q
Amiodarone MOA
A
- Potassium channel blocker slows ventricular automaticity.
- Sodium channel blocker slows membrane depolarization & impulse conduction.
- Calcium channel blocker & β-blocker: negative chronotropic activity in nodal tissue; rate reduction
- Prolongs action potential and delays repolarization.
- Decreases AV (atrioventricular) node conduction and SA (sinoatrial) node function
3
Q
Amiodarone Indications
A
- VF/PVT after CPR, defibrillation, and epinephrine
- Stable, regular, narrow-complex tachycardia refractory to vagal maneuvers and adenosine
- Control of ventricular rate in: AF with RVR without preexcitation; stable wide-complex tachycardia; stable monomorphic VT; polymorphic VT with a normal QT interval
4
Q
Amiodarone Adult dose
A
- VF/PVT:
• 300 mg IV/IO push over a minute, may repeat one time in 3 – 5 min. with 150mg IV/IO slow push (if needed) - Wide-complex tachycardia, A-fib or flutter or SVT refractory to vagal maneuvers and adenosine:
• 150mg in 100 mL NS IV/IO over 10min., may repeat in 10 min. (if needed) - Infusion (if needed for reperfusion arrhythmias) after ROSC:
• 1 – 5 mg/min. IV/IO infusion (300mg in 100mL of NS = 3 mg/mL) over 24 hrs., (max dose 2.2 G/24 hrs.)
5
Q
Amiodarone Contraindications
A
- Known hypersensitivity to amiodarone or iodine
- Cardiogenic shock
- Second or third-degree AV blocks, sick-sinus syndrome, or other SA diseases without a functioning pacemaker
6
Q
Amiodarone Adverse reactions
A
- CV: hypotension, heart failure, prolonged QT interval, bradycardia, AV block, worsening of dysrhythmias
- GI: nausea & vomiting
- Other: dizziness, IV site irritation, Steven’s-Johnson Syndrome
7
Q
Amiodarone Pediatric dose
A
- V-fib/PVT:
• 5mg/kg IV/IO push every 3-5 min, may repeat 3 times to max 15 mg/kg over 24 hrs. (max single dose of 300mg) - Poor perfusing ventricular or atrial rhythms with a pulse:
• 5mg/kg IV/IO over 20-60 minutes, may repeat 3 times to 15 mg/kg over 24 hrs. (max single dose of 300mg)