prolongs refractory period in atria and ventricles thus effective for arrhythmias of various origins

• decreases SA automaticity and conduction through AV node

• Multiple dosing regimes in literature; RECOMMEND:
• Bolus Dose:
• 150-300 mg IV (maximum infusion rate 30 mg/min)
• Continuous Infusion:
• 900-1200 mg over 24 hours (37.5-50 mg per hour)
• Breakthrough arrhythmias:
• 150 mg IV (maximum infusion rate 30 mg/min)

• 900 mg/500 ml D5W or NS

• Continuous infusions should be prepared with EXCEL bags (non-PVC) to prevent adsorption of amiodarone to bag.
• Use of a 0.2 micron filter is recommended for intermittent and continuous infusions.

• Bolus doses:  in 100 ml D5W over 10 min (maximum infusion rate 30 mg/min)
• Continuous infusion:  in 500 ml D5W EXCEL bag over 24 hours

bradycardia, AV block, arrhythmias including Torsades des pointes

hepatitis, elevation of liver function tests

peripheral myopathy or tremors, headache, sleep disturbances

nausea, anorexia, constipation

• corneal microdeposits, photophobia, visual blurring, halovision
• interstitial pneumonitis
• blue-grey skin discoloration
• hypo or hyperthyroidism

• in complete heart block or type II second degree heart block unless functional pacemaker in place (can suppress a ventricular escape rhythm)

• amiodarone + digoxin = increased digoxin levels
• amiodarone + warfarin = increased warfarin effect
• amiodarone + beta blockers = increased effects of both drugs
• amiodarone + calcium channel blockers = increased effects of both drugs
• amiodarone + procainamide = increased procainamide effect

• ECG, rhythm, QT interval
• cardiac index
• breath sounds, chest xray
• liver enzymes

• May be administered as 300 mg in 30 ml D5W IV direct without a physician's order by a certified nurse in CCTC for pulseless ventricular tachycardia or ventricular fibrillation.
• May be administered by IV infusion by an approved RN in CCTC.
• Must be administered as a continuous infusion by an infusion pump.