||antiarrhythmic: Class III
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)
- 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
|| Acute effects:
bradycardia, AV block, arrhythmias including Torsades des pointes
hepatitis, elevation of liver function tests
peripheral myopathy or tremors, headache, sleep disturbances
nausea, anorexia, constipation
Long term effects:
- 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.