Amiodarone: Difference between revisions
| Line 25: | Line 25: | ||
*Bradycardia, hypotension | *Bradycardia, hypotension | ||
*[[Prolonged QT]] | *[[Prolonged QT]] | ||
*Thyrotoxicosis<ref>Rosen's 8th Edition</ref> | *[[Thyrotoxicosis]]<ref>Rosen's 8th Edition</ref> | ||
**Between 5-20% of patients treated with amiodarone have thyrotoxicosis (higher in areas of iodine deficiency) | **Between 5-20% of patients treated with amiodarone have thyrotoxicosis (higher in areas of iodine deficiency) | ||
***Iodine-induced hyperthyroidism | ***Iodine-induced hyperthyroidism | ||
Revision as of 23:24, 20 February 2015
Adult Dosing
- V-fib/pulseless V-tach
- Loading dose = 300mg IV bolus followed by 150mg bolus prn
- Stable V-tach or SVT
- Loading dose = 150mg IV in 100mL D5W over 10min
- Follow by infusion of 1mg/min x 6hr; 0.5mg/min thereafter
- Loading dose = 150mg IV in 100mL D5W over 10min
Contraindications
- Iodine or shellfish allergy
- Pregnancy
Indications
- Ventricular and supraventricular arrhythmias
- 1st line for pulseless V-tach/V-fib
- Used for atrial arrhythmias in pts w/ decr EF
Mechanism of Action
- Class III - Inhibits potassium channels
- Impairs SA and AV node conduction
- Decreases automaticity
- Prolongs refractory period in accessory pathways
- Also has class I & II properties
Adverse Drug Rxns
- Bradycardia, hypotension
- Prolonged QT
- Thyrotoxicosis[1]
- Between 5-20% of patients treated with amiodarone have thyrotoxicosis (higher in areas of iodine deficiency)
- Iodine-induced hyperthyroidism
- It is thought that the iodine load may unmask hyperthyroidism in patients with multinodular goiter and subclinical Graves’ disease
- Drug-induced destructive thyroiditis
- More commonly, the cytotoxic effects of amiodarone destroy thyroid cells, resulting in a release of preformed hormone.
- Iodine-induced hyperthyroidism
- Between 5-20% of patients treated with amiodarone have thyrotoxicosis (higher in areas of iodine deficiency)
See Also
- ↑ Rosen's 8th Edition