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What is the best-known trade name for amiodarone?
Cordarone
Another trade name in the US is Pacerone.
What is the functional class of amiodarone?
Class III antidysrhythmic (potassium channel blocker)
Other class III antidysrythmics are Sotalol, Ibutilide, Dofetilide, Dronedarone and the experimental E-4031
What is the mechanism of action of amiodarone?
Amiodarone is a unique Class III antidysrhythmic that acts directly on all cardiac tissues. It prolongs the duration of the action potential and refractory period (by blocking potassium channels) without significantly affecting the resting membrane potential. It also blocks sodium channels. The IV form relaxes vascular smooth muscle, decreases peripheral vascular resistance and increases coronary blood flow. Additionally, it blocks the effects of sympathetic stimulation.
Amiodarone also resembles thyroid hormones and its binding to the nuclear thyroid receptors might contribute to some of its pharmacologic and toxic actions
What are the listed indications for amiodarone?
Life-threatening ventricular and supraventricular dysrhythmias
(VF, VT, A-Fib, A-Flutter, SVT, WPW)
Amiodarone should not be used for hemodynamically unstable ventricular tachycardia.
What are the listed contraindications for amiodarone?
- Hypersensitivity
- Cardiogenic shock
- Severe sinus bradycardia,
- AV block
Some sources also caution against use with 2nd or 3rd degree heart block in the absence of an artificial pacemaker.
What are the listed precautions for amiodarone?
Use with caution in:
- severe liver disease
- pregnancy
- nursing mothers
The injectable forms of amiodarone containing benzyl alcohol should be avoided with neonates or infants because the
What are the listed side effects for amiodarone?
- CHF
- Angioedema
- Hypotension
- AV block
- Hepatotoxicity
- Cardiogenic shock
- Fatigue
- Bradycardia
- Sinus arrest
- Permanent blindness
- N/V
- Prolonged QT interval
Long-term administration of amiodarone is associated with a blue-gray discoloration of the skin that may fade once therapy is discontinued.
What are the listed interactions for amiodarone?
- Increases digoxin levels
- Enhances pharmacological effects of:
-- Procainamide
-- Lidocaine
-- Quinidine
-- Oral anticoagulants
- Concurrent use of calcium channel blockers, beta blockers, fentanyl, or cimetidine may potentiate sinus bradycardia
Amiodarone inhibits the action of the cytochrome P450 isozyme family.
What is the dosage and route of amiodarone?
Adult:
With pulse: 150mg (in 50 - 100ml of NS) IV infusion over 10 minutes. May repeat dose once after 10 minutes

Pulseless: 300mg IVP, repeat in 3 - 5 minutes at 150mg IVP

Maintenance infusion: 1mg/min over the next 6 hours

Pedi:
5mg/kg IV/IO