Amiodarone

Question 1

What are the indications for amiodarone?

Answer 1

Cardiac arrest (in a shockable rhythm) that is refractory to 3 shocks
Sustained conscious VT (haemodynamically stable) *CCP

Question 2

What is the onset and duration of amiodarone?

Answer 2

Onset: 5mins
Duration: 30mins

Question 3

What is the mechanism of action of amiodarone?

Answer 3

Amiodarone works by prolonging the myocardial cell action potential and refractory period (slows down the heart’s electrical signals therefore helps the heart beat more steadily and prevents abnormal rhythms)

Question 4

What drug class is amiodarone?

Answer 4

Anti-arrhythmic - used to treat abnormal heart rhythms (arrhythmias) by stabilizing the electrical activity of the heart

Question 5

What are 4 common side effects of amiodarone?

Answer 5

Hypotension
Bradycardia
Nausea/vomiting
Peripheral paraesthesia (can damage nerves over time)

Question 6

What are the contraindications for amiodarone?

Answer 6

Tricyclic antidepressant (TCA) overdose

Question 7

What is the onset and duration of amiodarone?

Answer 7

Onset: 5min
Duration: 30min

Question 8

What is the initial dose of amiodarone for cardiac arrest?

Answer 8

300mg (6mL) IV
Slow push over 1-2min
Refractory to 3 shocks

Question 9

What is the maintenance dose of amiodarone after the loading dose?

Answer 9

150 mg IV
Slow push over 1-2min
Refractory to 5 shocks

Question 10

What if a patient is on oral amiodarone?

Answer 10

The cardiac arrest administration protocol continues to be authorised

Question 11

Why does amiodarone have a long half-life (14-110 days)?

Answer 11

It’s stores in fat and body tissues and then slowly released back into the blood over time

Question 12

What is the preferred method of administration for amiodarone?

Answer 12

Intravenous (IV)

Question 13

What is a significant concern regarding Amiodarone and liver function?

Answer 13

Hepatotoxicity - amiodarone is metabolised in the liver, and over time, it can build up and become toxic to liver cells

Question 14

What effect does Amiodarone have on the QT interval?

Answer 14

Amiodarone can prolong the QT interval.

Question 15

What is the presentation of amiodarone?

Answer 15

150mg/3mL

Question 16

What is the dose of amiodarone for paediatric cardiac arrest and consideration?

Answer 16

5mg/kg IV
Slow push over 1-2mins
Single dose

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