Amiodorone

Question 1

Amiodorone (Cordarone, Pacerone)

Class

Answer 1

• Antiarrhythmic

Question 2

Amiodorone (Cordarone, Pacerone)

MOA

Answer 2

• Blocks sodium & myocardial potassium channels

Question 3

Amiodorone (Cordarone, Pacerone)

Indications

Answer 3

• VF/pulseless VT
• Unstable VT refractory to other therapy
• Persistant SVT refractory to other therapy

Question 4

Amiodorone (Cordarone, Pacerone)

Contraindications

Answer 4

• Hypersensitivity
• Cardiogenic shock
• Sinus bradycardia
• 2^nd or 3^rd deg AV block (unless functional pacemaker available)

Question 5

Amiodorone (Cordarone, Pacerone)

Adverse reactions

Answer 5

• Bradycardia
• Hypotension
• Prolongation of:
  
  • PRI
  • QRS
  • QTi

Question 6

Amiodorone (Cordarone, Pacerone)

Drug Interactions

Answer 6

• Digoxin may cause digitalis toxicity
• Antiarrhythmics may cause increased serum levels
• Beta-blockers and calcium channel blockers may potentiate bradycardia, sinus arrest, & AV heart blocks

Question 7

Amiodorone (Cordarone, Pacerone)

Adult Dosage

Answer 7

Adult:

• VF/pulseless VT unresponsive to CPR, defib & pressors
  
  • 300 mg IV push, flush, 150 mg follow up dose
• Recurrent life-threatening vent arrhythmias
  
  • Rapid infusion 150 mg IV over 10 min (15 mg/min)
    
    • May repeat rapid infusion q 10 min as needed
  • Slow infusion 360 mg IV over 6 hrs (1 mg/min)
  • Maintenance infusion 540 mg IV over 18 hrs (0.5mg/min)
  • Max total dose is 2.2g/24hrs

Question 8

Amiodorone (Cordarone, Pacerone)

Ped Dosage

Answer 8

Ped:

• Pulseless arrest (ie, VF/pulseless VT)
  
  • 5 mg/kg IV bolus
    
    • ​Can repeat 5mg/kg bolus to daily max of 15 mg/kg per 24 hrs
    • Max single dose is 300 mg
• Perfusing SVT & VT
  
  • Loading dose of ​5 mg/kg IV drip over 20-60 min
    
    • Max single dose is 300 mg
    • Can repeat to daily max of 15 mg/kg

Question 9

Amiodorone (Cordarone, Pacerone)

Duration

Answer 9

• Onset: Immediate
• Peak: 10-15 min
• Duration: 30-45 min

Question 10

Amiodorone (Cordarone, Pacerone)

Special Considerations

Answer 10

• Preg Cat: D
• Monitor for hypotension
• May worsen arrhythmias or precipitate new ones