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39 Cards in this Set

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  • Back
Amiodarone is a Class III?
antiarrhythmic
Two brands of amiodarone are?
Cordarone
Pacerone
amiodarone in indicated in what kind of arrhthmias?
life-threatening and unresponsive to less toxic agents
The PO form of management of amiodarone is used for the management of what kind of tachyarrythmias?
supraventricular
The IV form of amiodarone is used for the management of?
ventricular fibrillation/pulseless
ventricular tachycardia
after CPR and defib have
failed
also for other life-threaten-
ing tachyarrhythmias
Amiodarone's method of action prolongs?
action potential and refractory period
Amiodarone's method of action
inhibits?
blocks both alpha and beta adrenergic receptors of SNS
Amiodarone's MOA slows?
sinus rate
Amiodarone's MOA increases?
PR and QT intervals
Amiodarone's MOA decreases?
<peripheral vascular resistance
(vasodilation)>
The THERAPEUTIC EFFECTS of amiodarone is?
suppression of arrhythmias
Amiodarone is contraindicated with severe?
sinus node dysrhythmia
Amiodarone is contraindicated in what kind of blocks?
2nd and 3rd-degree AV blocks
Amiodarone is contraindicated in bradycardia because?
it has caused syncope unless a pacemaker is in place
Amiodarone interactions...increase blood levels and may lead to toxicity from which drug?
digoxin (decreased dose of digoxin by 50%)
Amiodarone interactions...increase blood levels and may lead to toxicity from?
other class I antiarrhythmics
ex: quinidine
procainamide
mexiletine
lidocaine
flecainide
Amiodarone interactions...
increase blood levels of?
cyclosporine
dextromethorphan
methotrexate
phenytoin
theophylline
Amiodarone

Phenytoin does what to amiodarone levels?
decreases
Amiodarone does what to the activity of warfarin?
increases
Amiodarone increases the risk of?
bradyarrhythmias
sinus arrest
AV heart block with beta
blockers or CCBs
Cholestyramine may do what to amiodarone blood levels?
decrease
Cimetidine nd ritonavir does what to amiodarone blood levels?
increases
What should be monitored continuously with amiodarone?
ECG
report bradycardia
What is the most serious adverse effect which can be fatal in about 10% of amiodarone patients?
hint: toxicity
PULMONARY TOXICITY
ex: rales/crackles
decreased breath sounds
pleuritic friction rub
fatigue
dyspnea
cough
pleuritic pain
fever
these symptoms can damage alveoli causing possible pulmonary fibrosis
With IV amiodarone, assess patient for signs and symptoms of?
ARDS...report dyspnea, tachypnea, or rales/crackles promptly
With IV amiodarone, monitor blood pressure frequently. What condition usually occurs during first several hours?
hypotension...if it occurs, slow rate of infusion
What vision problems may occur with IV amiodarone?
photophobia
halos around lights
decreased acuity
possible permanent loss of
vision

(at home: patient may experience photosensitivity...use protective clothing and sunblock)
Signs of hypothyroidism may occur with IV amiodarone. What are the symptoms?
lethargy
weight gain
edema of hands, feet, and
periorbital region
cool, pale skin
Signs of hyperthyroidism may occur with IV amiodarone. What are the symptoms?
tachycardia
weight loss
nervousness
sensitivity to heat
insomnia
warm, flushed, moist skin
With IV amiodarone, monitor which functions?
liver function
thyroid function
What other lab tests should be evaluated with amiodarone?
AST
ALT
alkaline phosphatase
Teaching. If a dose of amiodarone is missed?
don't take it at all
Teaching. Photosensitivity while taking amiodarone may occur. Tell patient?
wear sunscreen
wear protective clothing
reaction may occur if patient
wears thin clothing or
sits near window
Teaching. Prolonged use of amiodarone may cause what to happen to face, neck, arms?
bluish discoloration...reversible and will disappear over several months
Teaching. What condition may appear in males taking amiodarone?
epididymitis which is pain and swelling in scrotum
What does amiodarone have in it's chemical structure that can cause hyper or hypothyroidism?
iodine
What does amiodarone do to the eyes with prolonged use that causes visual disturbances?
causes corneal microdeposits which results in visual halos, photophobia, and dry eyes in everyone taking it more than 6 months
Ammiodarone can treat dysrhthmias, and can also?
provoke dysrhythmias

avoid use with CHF
Amiodarone is very lipophilic or fat loving...which means?
it accumulates slowly in body tissues and can reach high levels in FAT, muscle, liver, spleen, lungs