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Amiodarone

Amiodarone Hydrochloride
(Cordarone®)

CLASS

Antiarrhythmic agent

DOSAGE

    Adult:

    Atrial Fib 150 mg IV/IO in 50 ml D5W/NS over 10 minutes.
    May repeat 10 minutes after last drip was completed. (3 times)

    VT with pulse (stable) and SVT: 150 mg IV/IO in 50 ml D5W/NS over 10 minutes.
    May repeat every 10 minutes PRN.

    VT with pulse unstable: 1st dose 150mg IVP/IOP under 2 minutes - 2nd dose 150mg IV/IO in 50ml D5W/NS over 10 min.

    VF and pulseless VT: 300 mg IV/IO push.

    Pediatric:

    VT with a pulse and SVT: 5 mg/kg in 50 ml D5W / IV/IO over 20 minutes.

    VF and pulseless VT: 5 mg/kg IV/IO push.

How to mix
150mg of medication in 50ml IV bag of D5W/NS. Use a 10gtts/ml (macro) set give 50 gtts/min to achieve 150mg over 10 min.

ACTIONS

    Amiodarone blocks sodium channels at rapid pacing frequencies and exerts a non-competitive antisympathetic action. One of its main effects, with prolonged administration, is to lengthen the cardiac action potential. In addition, it produces a negative chronotropic effect in nodal tissues. Amiodarone also blocks potassium channels, which contributes to slowing of conduction and prolongation of refractoriness. Its vasodilatory action can decrease cardiac workload and consequently myocardial consumption.

INDICATIONS

    Indicated for initiation of treatment and prophylaxis of frequently recurring ventricular fibrillation, atrial fibrillation and hemodynamically unstable ventricular tachycardia in patient refractory to other therapy. Amiodarone may also be used to treat supraventricular tachycardia.

CONTRAINDICATIONS

    Contraindicated in patients with known hypersensitivity to Amiodarone, or in patients with cardiogenic shock, marked sinus bradycardia, and second or third degree AV block. Contraindicated in patients with iodine hypersensitivity.

WARNINGS

    May worsen existing or precipitate new dysrhythmia's, including torsades d pointes,and VF. Use with beta-blocking agents could increase risk of hypotension and bradycardia. Amiodarone inhibits atrioventricular conduction and decreases myocardial contractility, increasing the risk of AV block with verapamil or diltiazem or of hypotension with any calcium channel blocker. Use with caution with pregnancy and with nursing mothers.

SIDE EFFECTS

    Adverse reactions include fever, bradycardia, CHF, cardiac arrest, hypotension, ventricular tachycardia, nausea, and abnormal liver function.

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