amiodarone.txt

Cordarone

Antidysrhythmic

• Prolongation of Action Potential
• Non-competitive alpha and beta sympathetic blocking effects
• Calcium channel blocking effects

• Suppression of Ventricular Fibrillation (VF)
• Suppression of Ventricular Tachycardia (VT)
• Management of Ventricular Ectopy

• Second or Third Degree heart block
• Medication-induced Ventricular dysrhythmias
• Hypotension
• Bradycardia
• Torsades de Pointes
• Profound Sinus Bradycardia

• Hypotension
• Bradycardia
• Pulseless Electrical Activity (PEA)
• Congestive Heart Failure
• Nausea
• Fever
• Abnormal Liver Function Tests
• Thrombocytopenia (disorder of too few platelets)

Incompatible with: Sodium Bicarbonate (will precipitate)

150 mg in 3 ml ampules or vials

• VF/ Pulseless VT:
• Initial Dose-300mg slow IVP over 1-2 minutes in 10 cc NS
• Repeat dose-150 mg slow IVP over 1-2 minutes in 10 cc NS
• Ventricular Ectopy (PVC’s):
• Initial Dose-150 mg slow IVP over 10 minutes
• Repeat Dose-150 mg slow IVP over 10 minutes (to a total dose of 300mg)
• IV Infusion mix 150 mg in 100 ml NS yield 1.5mg/ml run at 0.5-15mg per minute. (For malignant ventricular arrhythmias) per ordering physician

The use of Amiodarone is relatively new in pediatric cardiology and there is currently no prehospital protocol in Massachusetts or Rhode Island

• Onset: Within 5-15 minutes
• Peak Effect: Variable
• Duration: Variable

• Pregnancy safety: Category C
• Maintain at room temperature and protect from light in storage (light protection not required during administration).
• Hypotension usually responsive to slowing infusion rate, IV Normal Saline
• Administer cautiously in patients with Heart Failure or poor systolic function
• May be especially effective in high-risk patients with recent acute MI
• There are questions of compatibility with delivery systems containing PVC
• MA-Statewide Protocol does not address the issue, RI Prehospital Care Protocols state Amiodarone must be mixed with D5W
• MA-Statewide Protocol does not address the issue, RI Prehospital Care Protocols state Amiodarone should be administered using a "PVC-free" bag and tubing if available and run as an isolated IV (not piggybacked into NS or LR solutions)