Cardio high risk

Question 1

What drug class is amiodarone?

Answer 1

antiarrthymic drug

Question 2

What is the half life of amiodarone?

Answer 2

around 50 days

Question 3

How is amiodarone initiated?

Answer 3

using loading doses to reach therapeutic levels quickly :
200mg TID for 1 week à 200mg BID for 1 week
à maintenances dose of 200mg daily

Question 4

What key parameters must be monitored when taking amiodarone? and at what frequency

Answer 4

Thyroid function (T4,TSH,t3)- before treatment and then every 6 months
liver function- before and every 6 months
serum potassium before treatment
chest x-ray- before treatment
ECG (or IV use)

Question 5

What conditions is amiodarone used in ?

Answer 5

ventricular arrhtymias, AF

Question 6

What advice is given to patients taking amiodarone?

Answer 6

- Shield skin from light during &
several months after treatment
- Use wide spectrum sunscreen
- Seek medical help if they
develop: shortness of breath, light
headedness, palpitation, fainting,
unusual tiredness or chest pain
- any visual disturbances should be reported and amiodarone should be discontinued

Question 7

What are the side effects of amiodarone?

Answer 7

Pulmonary toxicity - Suspect
pneumonitis if progressive shortness
of breath or cough develop
Hepatotoxicity (Discontinue if signs 
of liver disease develop)
Nausea
Corneal microdeposits (reversed on withdrawal)
Thyroid function; Amiodarone contains iodine and can cause disorders of thyroid function; both hypo/ hyperthyroidism can occur. Hypothyroidism can be treated with replacement therapy without withdrawing amiodarone if it is essential; careful supervision is required.

Question 8

important drug interactions with amiodarone

Answer 8

hep c treatments
antiarrthymics
statins (increased risk of myopathy)
increase plasma conc beta blockers
Increase plasma concentration of Warfarin Digoxin Ciclosporin Phenytoin
drugs that prolong QT interval (SSRIs,TCAs, macrolides , fluoroquinalones , antiemetics,opiods, antipsychotics