Generic Name:

Amiodarone

Trade Name:

Cordarone

Action:

Considered Class III Antiarrhythmic, but possessed characteristics of all classes

Indications:

Hemodynamically unstable ventricular tachycardia

Initiation of amiodarone treatment in recurrent ventricular fibrillation

Supraventricular tachycardia, atrial fibrillation

Refractory Atrial fibrillation

Arrest; Pulseless VT/VF

WPW & PSVT

Administration Guidelines

Usual Dose and Route

Arest; Pulseless VT /VF:
300mg IVP; consider repeating 150mg IVP in 3-5 minutes

LOADING DOSE Rapid: 150mg in 100ml D5W over 10 minutes (15mg/min)

followed by :

Slow: 360mg over the next 6 hours @ a rate of 1mg/min

MAINTENANCE INFUSION: 540 mg over the remaining 18 hours at a rate of 0.5mg/min as titrated to patient response

SUPPLEMENTAL DOSES: 150mg over 10 minutes for episodes of VF or symptomatic VT

Unstable VT/VF doses up to 100mg/hr may be required with aggresive monitoring.

Standard Concentration:

Peripheral:

Load 150mg/D5W 100ml bag stable for 2 hours

Maintenance 900mg/D 5 W 500ml Glass bottle stable for 24 hours

Central: Please consult pharmacist

Load 150mg/D5W 100ml bag stable for 2 hours

Maintenance 900mg/D 5 W 150ml Glass bottle stable for 24 hours

EW Standard

Peripheral:

Load 150mg/D5W 100ml bag stable for 2 hours

Maintenance 900mg/D 5 W 500ml Glass bottle stable for 24 hours

Central: Please consult pharmacist

Load 150mg/D5W 100ml bag stable for 2 hours

Maintenance 900mg/D 5 W 150ml Glass bottle stable for 24 hours

Special Considerations

Blood pressure, heart rate and QTc parameters should be clearly specified in the orders. Infusion should be discontinued at the first sign of these side effects and call H.O.

Contraindicated in patients sinus bradycardia, 1st, 2nd, 3rd heart block, or cardiogenic shock

Oral and intravenous may be administered together to decrease loading period.

Periodic laboratory indices such as LFT's, TFT's, PFT's, RFT's, and serum electrolytes are recommended

May potentiate the action of oral anticoagulants, digoxin, anti-arrhythmics, and cyclosporin

Precautions and Side Effects:

Immediate Phlebitis

Hypotension, usually rate related

PR and QT interval prolongation, bradycardia, AV Block

GI Disturbances, constipation

Delayed Thyroid suppression

Corneal microdeposits

Interstitial pneumonititis, pulmonary fibrosis

Solvent of injection contains castor oil, use with caution in patients who have exhibited adverse reactions to castor oil

Skin color changes