UNCONTROLLED WHEN PRINTED
Introduction
  • 150mg in a 3ml ampoule
  • Amiodarone has effects within the first four classes of the Vaughan-Williams classification. However it is primarily classified as a Class III antidysrhythmic agent that prolongs the action potential duration and hence the refractory period of atrial, nodal and ventricular tissue. It has characteristics of all Vaughan-Williams classes of antidysrhythmics
  • 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 Paramedic only
  • Tachydysrhythmias including:
    • SVT
    • Nodal and Ventricular tachycardia
    • Atrial flutter and fibrillation
    • WPW syndrome
Contraindications
  • No contraindications in cardiac arrest 
  • Not compatible with Saline (if infusion dose is advocated by a specifically authorised person)
Critical Care Paramedic only
  • Hypersensitivity to Amiodarone or iodine
  • Bradycardia or AV block
  • Sick sinus syndrome
  • Severe conduction disorders
  • Hypotension
  • Severe respiratory failure
  • Circulatory collapse
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)

Management
Cardiac Arrest

Adult:

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

Paediatric / Infant:

  • 5mg/kg IV/IO (to maximum 300mg) as soon as practicable after 3rd shock
  • Repeat 5mg/kg IV/IO (to maximum 150mg) after 5th shock
Critical Care Paramedic only
Tachydysrhythmias
  • 300mg infusion over 20 minutes using Dextrose 5% as a diluent
Special Considerations
  • Bradycardia
  • Hypotension
  • Polymorphic tachycardias
  • Nausea
  • Tremor
  • Dizziness
  • Paraesthesia
  • Headaches

References
References
Presentation
150mg in 3mL vial
Amiodarone
Colour assist:

Document Control


Directorate
Clinical Services

Responsible Manager
Head of Clinical Services

Date of Issue

Date of Expiry

St John WA © Copyright 2020. All Rights Reserved

Privacy Policy | Copyright Statement & Disclaimer