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8 Cards in this Set
- Front
- Back
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Amiodarone Class
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-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) |
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Amiodarone Mechanism
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-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 |
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Amiodarone Mechanism (Hemodynamic)
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-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 |
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Amiodarone Indications
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-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 |
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Amiodarone Dosing
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::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 |
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Amiodarone Precautions
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-Hypotension and bradycardia most common side effects
-slow infusion or d/c if seen |
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Amiodarone Contraindications
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-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 |
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Amiodarone Special Considerations
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-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 |
