AMIODARONE HCL (Cordarone®)

Question 1

Drug Classification

Answer 1

Antidysrhythmic

Question 2

Mechanism of Action

Answer 2

• Primary* Class III Antiarrhythmic/K+channel blocker →Prolongs phase 3 repolarization and refractory period of non-pacemaker action potential
• Secondary* Class IA Antiarrhythmic/Na+channel blocker →Decreases amplitude of phase 0 depolarization of non-pacemaker action potential
• Secondary* Class II Antiarrhythmic/Non-competitive β blocker →Negative chronotropy, inotropy, dromotropy
• Secondary* Class IV Antiarrhythmic/Weak Ca2+channel blocker →Negative chronotropy, inotropy, dromotropy

Question 3

Pharmacokinetics

Answer 3

Onset of Action = Immediate
Peak Effects = 30-45min
Duration of Effect = Varies
Half-Life = 40-55 days

Question 4

Indications

Answer 4

Cardiac Arrest (VF, Pulseless VT)
Stable Wide Complex Tachycardia

Question 5

Contraindications

Answer 5

Hypersensitivity

Question 6

Side effects

Answer 6

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

Question 7

Dose

Answer 7

VF/Pulseless VT (ADULT): 300mg IV, IO, repeat dose 150mg IV, IO in 3-5min PRN

VF/Pulseless VT (PEDI): 5mg/kg IV, IO; max dose 300mg, max total dose 15mg/kg

VT +Pulse (ADULT): 150mg IV, IO over 10 min, may repeat once in 10 min
VT +Pulse (PEDI): 5mg/kg IV, IO over 20-60 min; max dose 300mg
VT +Pulse – Maintenance (ADULT): 1mg/min first six hours, then 0.5mg/min for 18 hours

Question 8

Precautions

Answer 8

Caution in patients with heart failure

Question 9

Drug Indications

Answer 9

Reduces renal and non-renal clearance of digoxin
Decreased biotransformation and clearance of warfarin enhanced anticoagulation
Potentiates procainamide and quinidine