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8 Cards in this Set

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Amiodarone Class
-Class III Antiarrthythmic
-it possesses electrophysiologic characteristics of all four classes of antiarrhythmics
-Blocks Na channels (Class III) as well as Ca channels (Class IV)
Amiodarone Mechanism
-slows conduction in His-Purkinjie system and in accessory pathway of WPW syndrome
-Inhibits alpha and beta receptors, and possesses both vagolytic and calcium channel blockering properties
-Lengthens the action potential duration and increases the refractory period in cardiac tissues, including SA node, AV node, atrial cells purkinjie fibers and ventricular myocardium
Amiodarone Mechanism (Hemodynamic)
-Coronary and peripheral vasodilator
-mild decrease in myocardial contractility however, cardiac output may actually in increase d/t decreased afterload
-Supressess SA node function
-Prolongs PR, QRS and QT interval
-Slows conduction @ AV junction
Amiodarone Indications
-Pulseless VT/VF(after CPR, Defib, and vassopressor)
-Polymorphic VT
-Wide-complex tachycardia u/k orgin
-Stable VT when cardioverison unsucessful
-adjunct to electrical cardioverison of SVT/PSVT, atrial tach
-pharmalogical conversion of AFib
-rate control of Afib or Flutter when other therapies ineffective
Amiodarone Dosing
::Cardiac Arrest-Pulseless v tach
-Initial bolus 300mg IV/IO
-spontaneous circ, consider IV infusion 1mg/min first 6 hours
::Other Indications-150mg over 10 minutes, may repeat every 10minutes as needed.
-after conversion 1mg/1min for 6 hours
Amiodarone Precautions
-Hypotension and bradycardia most common side effects
-slow infusion or d/c if seen
Amiodarone Contraindications
-known hypersensitivity
-severe sinus node dysfunction causing marked sinus bradycardia
-second and third degree block
-syncope d/t brady(except in conjuction with a pacer)
-caution with uncorrected electrolyte abnormalities, particularly hypokalemia and/or hypomagnesemia since they make this proarrthythmic
Amiodarone Special Considerations
-Additive effect with other meds that prolong QT (eg:Class Ia antiarrhythmics, phenothiazines, tricyclic antidepressants, thiazide diuretics, sotalol)
-in therapeutic doses, has only mild negative effect on myocardial contractility. This is reason appears in multiple algorithms involving patients experienceing dysrhythmias, but who have signs of heart failure