UNCONTROLLED WHEN PRINTED
 Introduction
  • Amiodarone is a Class III antidysrhythmic agent that prolongs the action potential duration and hence the refractory period of atrial, nodal and ventricular tissue, thereby giving a very broad spectrum of activity.
  • Immediate onset, peak <10min, duration 30-60mins

Pharmacology Review

 Indications
  • Cardiac Arrest with persistent/shock resistant Ventricular Fibrillation/pulseless Ventricular Tachycardia, post 3rd shock (ANZCOR 2016).
Critical Care
  • Tachyarrhythmias including:
    • Supraventricular tachycardia (SVT)
    • Nodal and Ventricular tachycardia
    • Atrial flutter and fibrillation
    • Ventricular fibrillation
    • Wolff-Parkinson-White (WPW) syndrome
 Contraindications
  • No contraindications in cardiac arrest 
  • Not compatible with Saline (if infusion dose is advocated by a specifically authorised person)
Critical Care
  • Hypersensitivity to Amiodarone or Iodine
  • Bradycardia or AV block
  • Sick sinus syndrome
  • Severe conduction disorders
  • Hypotension
  • Severe respiratory failure
  • Circulatory collapse
  • Cardiomyopathy
 Precautions / Notes
  • Heart failure
  • Thyroid dysfunction
  • Amiodarone is only indicated for shock resistant or recurrent VF / pulseless VT

MUST NOT be diluted into NaCl (e.g. if infusion doses are advised via ASMA / CSP)

 Preparation
Preparation
 Management
 Weight-based Calculations
 
Clear
 kg 
Mode: 
Weight: 
IV Amiodarone for Cardiac Arrest
Presentation: /mL
Calculated dose:  in
Subsequent dose:  in
IV Amiodarone for Tachydysrhythmias
Presentation: /mL
Calculated dose:  in

Cardiac Arrest

Adult:

  • 300 mg in 6 mL IV/IO as soon as practicable after 3rd shock
  • Repeat dose of 150 mg in 3 mL may be administered after 5th shock

Paediatric / Infant:

  • 5 mg/kg IV/IO (to maximum 300mg) as soon as practicable after 3rd shock
  • Repeat 5 mg/kg IV/IO (to maximum 150mg) after 5th shock
Critical Care
Tachyarrhythmias
  • Dilute 300 mg in 100 - 250 mL of Glucose 5% and infuse over 20 minutes
 Special Considerations
  • Bradycardia
  • Hypotension
  • Polymorphic tachycardias
  • Nausea
  • Tremor
  • Dizziness
  • Paraesthesia
  • Headaches
  • Phlebitis
Presentation
150 mg in a 3 mL ampoule
Amiodarone
Settings
Current mode:
Extended Care:
Colour assist:

References
References

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

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