Amiodarone: Difference between revisions
Kurtucla05 (talk | contribs) (updated amiodarone drug info from epocrates) |
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==General== | ==General== | ||
*Type: [[Antiarrhythmics]] | *Type: [[Antiarrhythmics]] | ||
*Dosage Forms: | *Dosage Forms: 200mg | ||
*Common Trade Names: | *Common Trade Names: Cordarone | ||
==Adult Dosing== | ==Adult Dosing== | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D | ||
*[[Lactation Risk Categories]]: | *[[Lactation Risk Categories]]: Unsafe | ||
*Renal Dosing | *Renal Dosing- no adjustment | ||
**Adult | **Adult | ||
**Pediatric | **Pediatric | ||
*Hepatic Dosing | *Hepatic Dosing- caution and consider dose decrease | ||
**Adult | **Adult | ||
**Pediatric | **Pediatric | ||
| Line 45: | Line 45: | ||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Half-life: 58 days | ||
*Metabolism: | *Metabolism: Liver extensively | ||
*Excretion: | *Excretion: Bile primarily | ||
=== Mechanism of Action === | === Mechanism of Action === | ||
Revision as of 16:39, 31 July 2015
General
- Type: Antiarrhythmics
- Dosage Forms: 200mg
- Common Trade Names: Cordarone
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: D
- Lactation Risk Categories: Unsafe
- Renal Dosing- no adjustment
- Adult
- Pediatric
- Hepatic Dosing- caution and consider dose decrease
- 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 with older solvent-based formulation. Uncommon with newer aqueous formulation.
- 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: 58 days
- Metabolism: Liver extensively
- Excretion: Bile primarily
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