High Risk Drugs

Question 1

What is amiodarone used for?

Answer 1

The treatment of arrhythmias.

Question 2

Does amiodarone require a loading dose?

Answer 2

Yes.

Question 3

What is the dosing of amiodarone?

Answer 3

200mg TDS for 7 days, then 200mg BD for 7 days, then 200mg daily. (3 for 7, 2 for 7, then 1).

Question 4

What are the side effects of amiodarone?

Answer 4

Nausea, vomiting, taste disturbance, pulmonary toxicity, reversible corneal micro-deposits, phototoxicity, slate grey discolouration, tremor, sleep disorder, thyroid changes, jaundice.

Question 5

What monitoring is required for amiodarone?

Answer 5

LFTs, TFTs before and every 6 months, serum potassium before treatment, ECG monitoring.

Question 6

Describe the half-life of amiodarone?

Answer 6

Very long half-life, interactions may persist for a while (weeks or months) after treatment.

Question 7

What can occur when amiodarone and warfarin are used together?

Answer 7

Amiodarone inhibits warfarin metabolism. Enhanced anticoagulant affect. Increased bleeding risk.

Question 8

What can occur when amiodarone and beta-blockers are used together?

Answer 8

Increased risk of bradycardia, AV block, and myocardial depression.

Question 9

What can occur when amiodarone and lithium are used together?

Answer 9

Increased risk of ventricular arrhythmias.

Question 10

What can occur when amiodarone and digoxin are used together?

Answer 10

Increased digoxin concentration.

Question 11

What is digoxin used for?

Answer 11

AF, tachycardias and heart failure.

Question 12

How does digoxin work?

Answer 12

A positive inotrope. Increases the force of myocardial contraction and reduced AV node conductivity.