Amiodarone

About these monographs

Category:

Cardiac

 

Description:

Antiarrhythmic (Singh Vaughan Williams Class III with Class I, II, and IV properties)

Indications:

First line pharmacology for ventricular fibrillation (VF) and ventricular tachycardia (VT) with or without

a pulse and a second line pharmacology for atrial dysrhythmias

Mechanism of Action:

Blocks sodium, calcium and potassium channels resulting in increased duration of cardiac action

potential, delayed cardiac muscle repolarisation, reduced rate of sinus rhythm and slowed action potential conduction through the AV node

Pharmacokinetics:

Route: IV

Onset: 5 minutes

Peak Effects: 30 minutes

Duration: 1-2 hours

Contraindications:

Second- or third- degree heart blocks, symptomatic bradycardia, sick sinus syndrome

Adverse Effects:

Hypotension, dysrhythmias, bradycardia, nausea, headache, dizziness, pulmonary toxicity, thyroid

dysfunction

Precautions and Facts:

Thyroid dysfunction, lung disease, especially with reduced diffusion capacity, electrolyte imbalances.

Caution required with iodine allergy and may be ineffective in TCA overdoses.

Presentation:

150 mg/3 mL ampoule

Dosages:

Indication: Cardiac Arrest - Adult

Route: IV/IO

Age: Adult

Initial Dose: 300 mg slow push over 2 minutes

Dose Intervals: 150 mg after 5 minutes if the dysrhythmia persists

Volume/Dilution: no dilution

Maximum Dose: 450 mg

Indication: Cardiac Arrest - Paediatric

Route: IV/IO

Age: Adult

Initial Dose: 5 mg/kg slow push over 2 minutes

Dose Intervals: every 5 minutes to max dose

Volume/Dilution: 150 mg (3 mL) diluted with 12 mL of glucose 5% to achieve a concentration of 10 mg/mL

Maximum Dose: 150 mg

Indication: Ventricular Tachycardia - Adult

Route: IV/IO

Age: Adult

Initial Dose: 300 mg infusion (ideally over 30 minutes)

Volume/Dilution: 300 mg (6 mL) diluted with 24 mL of glucose 5% to achieve a concentration of 300 mg/30 mL

Maximum Dose: 300 mg

Cite as: Maria, S., Colbeck, M., & Caffey, M. (Eds.). (2020). Amiodarone. In Paramedic & Emergency Pharmacology Guidelines (2nd ed.). Melbourne, Victoria: Pearson.

This book is for information purposes only and is designed as a general reference for paramedics, students and healthcare professionals  No responsibility will be taken for inaccuracies, omissions or errors  The authors do not accept liability to any person or organization for the information that may result in loss or damages incurred as a result of reliance upon the material in this guide While every effort has been made to ensure that the information in this text is up to date, accurate and in accordance with current clinical recommendations and practice, the dynamic nature of healthcare and pharmaceutical information requires any student or health professional to exercise independent clinical judgement when referring, using or providing information from this book

 

A body of evidence for the development of this guide has been collected by the authors to support the pharmacokinetics, indication, contraindications, adverse effects and dosage behind each medication  This body reflects information provided by Australia’s Therapeutic Goods Administration, Monthly Index of Medical Specialities, the United States’ Food and Drug Administration, and both peer-reviewed studies and clinical trials demonstrating the approved efficacy, usage and current understanding of each medication  Additionally, the Australian Resuscitation Council guidelines and each state ambulance service’s clinical practice guidelines in Australia and New Zealand were reviewed and applied in order to maximize the clinical application of this reference guide  Lastly, this guide’s information is not endorsed, nor does it reflect preferences by any particular pharmaceutical company or ambulance service as this reference was compiled only to the most current and universal information available from the above listed, publicly available resources

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