Amiodarone: Difference between revisions
No edit summary |
No edit summary |
||
| Line 1: | Line 1: | ||
== Adult Dosing == | ==General== | ||
*V-fib/pulseless V-tach | *Type: [[Antiarrhythmics]] | ||
*Dosage Forms: | |||
*Common Trade Names: | |||
==Adult Dosing== | |||
*[[V-fib]]/[[pulseless V-tach]] | |||
**Loading dose = 300mg IV bolus followed by 150mg bolus prn | **Loading dose = 300mg IV bolus followed by 150mg bolus prn | ||
*Stable V-tach or SVT | *Stable V-tach or SVT | ||
| Line 6: | Line 11: | ||
***Follow by infusion of 1mg/min x 6hr; 0.5mg/min thereafter | ***Follow by infusion of 1mg/min x 6hr; 0.5mg/min thereafter | ||
== | ==Pediatric Dosing== | ||
* | |||
* | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | |||
*Lactation: | |||
*Renal Dosing | |||
**Adult | |||
**Pediatric | |||
*Hepatic Dosing | |||
**Adult | |||
**Pediatric | |||
== Indications == | == Indications == | ||
| Line 15: | Line 28: | ||
*Used for atrial arrhythmias in pts w/ decr EF | *Used for atrial arrhythmias in pts w/ decr EF | ||
== | ==Contraindications== | ||
* | *Allergy to class/drug | ||
* | *Iodine or shellfish allergy | ||
* | *Pregnancy | ||
== Adverse | ==Adverse Reactions== | ||
*Bradycardia, hypotension | *Bradycardia, hypotension | ||
*[[Prolonged QT]] | *[[Prolonged QT]] | ||
| Line 31: | Line 42: | ||
***Drug-induced destructive thyroiditis | ***Drug-induced destructive thyroiditis | ||
****More commonly, the cytotoxic effects of amiodarone destroy thyroid cells, resulting in a release of preformed hormone. | ****More commonly, the cytotoxic effects of amiodarone destroy thyroid cells, resulting in a release of preformed hormone. | ||
==Pharmacology== | |||
*Half-life: | |||
*Metabolism: | |||
*Excretion: | |||
=== 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 | |||
==See Also== | ==See Also== | ||
*[[Critical care quick reference]] | *[[Critical care quick reference]] | ||
Revision as of 23:52, 20 February 2015
General
- Type: Antiarrhythmics
- Dosage Forms:
- Common Trade Names:
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
Pediatric Dosing
Special Populations
- Pregnancy Rating:
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Indications
- Ventricular and supraventricular arrhythmias
- 1st line for pulseless V-tach/V-fib
- Used for atrial arrhythmias in pts w/ decr EF
Contraindications
- Allergy to class/drug
- Iodine or shellfish allergy
- Pregnancy
Adverse Reactions
- 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)
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
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
See Also
Sources
- ↑ Rosen's 8th Edition