Amiodarone G3

Question 1

Amiodarone Class

Answer 1

• Antiarrhythmic agent (Class III)

Question 2

Amiodarone MOA

Answer 2

• Potassium channel blocker slows ventricular automaticity.
• Sodium channel blocker slows membrane depolarization & impulse conduction.
• Calcium channel blocker & β-blocker: negative chronotropic activity in nodal tissue; rate reduction
• Prolongs action potential and delays repolarization.
• Decreases AV (atrioventricular) node conduction and SA (sinoatrial) node function

Question 3

Amiodarone Indications

Answer 3

• VF/PVT after CPR, defibrillation, and epinephrine
• Stable, regular, narrow-complex tachycardia refractory to vagal maneuvers and adenosine
• Control of ventricular rate in: AF with RVR without preexcitation; stable wide-complex tachycardia; stable monomorphic VT; polymorphic VT with a normal QT interval

Question 4

Amiodarone Adult dose

Answer 4

• VF/PVT:
  • 300 mg IV/IO push over a minute, may repeat one time in 3 – 5 min. with 150mg IV/IO slow push (if needed)
• Wide-complex tachycardia, A-fib or flutter or SVT refractory to vagal maneuvers and adenosine:
  • 150mg in 100 mL NS IV/IO over 10min., may repeat in 10 min. (if needed)
• Infusion (if needed for reperfusion arrhythmias) after ROSC:
  • 1 – 5 mg/min. IV/IO infusion (300mg in 100mL of NS = 3 mg/mL) over 24 hrs., (max dose 2.2 G/24 hrs.)

Question 5

Amiodarone Contraindications

Answer 5

• Known hypersensitivity to amiodarone or iodine
• Cardiogenic shock
• Second or third-degree AV blocks, sick-sinus syndrome, or other SA diseases without a functioning pacemaker

Question 6

Amiodarone Adverse reactions

Answer 6

• CV: hypotension, heart failure, prolonged QT interval, bradycardia, AV block, worsening of dysrhythmias
• GI: nausea & vomiting
• Other: dizziness, IV site irritation, Steven’s-Johnson Syndrome

Question 7

Amiodarone Pediatric dose

Answer 7

• V-fib/PVT:
  • 5mg/kg IV/IO push every 3-5 min, may repeat 3 times to max 15 mg/kg over 24 hrs. (max single dose of 300mg)
• Poor perfusing ventricular or atrial rhythms with a pulse:
  • 5mg/kg IV/IO over 20-60 minutes, may repeat 3 times to 15 mg/kg over 24 hrs. (max single dose of 300mg)