Expected Pharmacological Action Amiodarone antiarrhythmic

MEDICATION Amiodarone
CATEGORY CLASS Class III antiarrhythmic
REVIEW MODULE CHAPTER
Expected Pharmacological Action
ats on cardiac cell membranes, prolonging
repolarization and the refractory period and
raising ventricular fibrillation threshold
Therapeutic Use
treats life threatning recurrent ventricular
fibrillation and hemodynamically unstable
ventricular tachycardia
Complications
Abnormal gait, ataxia, confusion, delirium, demyelinating polyneuropathy,
disorientation, dizziness, fatigue, fever, hallucinations, headache, insomnia, lack
of coordination, malaise, parathesia, parkisonian symptoms, peripheral
neuropathy
Contraindications/Precautions
Bradyardia that causes syncope, cardiogeni shock, hypersensitivity
to amiodarone or its components, hypokalemia,
hypomagnesemia, SA node dysfuntion, second and third degree
AV block
Interactions
Anticoagulants – serious bleeding
Azole antifungal, class I and III antiarrhythmics, fluoroquinolonres,
lithium, macrolide antibiotics, tricycli antidepressants, beta
blockers, calcium channel blockers, St Johns Wort
Medication Administration
Tablets:
loading – 800-1600mg daily in divided doses for 1-3
weeks maintenance – 600-800 mg daily in divided doses
for 1 month, then if cardiac rhythm is stable, 400mg
daily given single dose or divided into 2 doses
IV:
loading – 150 mg over 10 min followed by 360 mg over 6
hours
maintenance – 540 mg over 18 hr then after first 24 hrs
720mg over 24 hrs up to 2-3 weeks as needed
Evaluation of Medication Effectiveness
stability of cardiac rhythm
Nursing Interventions
-Check patient’s implantable cardiac device as
ordered, at the start of and during therapy dilute
-be aware that amiodarone may cause or worsen
pulmonary disorders may develop days-weeks
after therapy
-monitor vital signs and o2 levels often during and
after giving med
-monitor continious ECG for increased PR and QRS
intervals, arrythmias, and HR below 60 beats/min
Client Education
-explain pt will need frequent monitoring
and lab tests during treatment
-advise pt to report cough, dark urine,
dyspnea, fainting, fatigue, nausea,
swollen feet and hands, vomiting,
wheezing, yellow skin,
-report abnormal bleeding
-discontinue breastfeeding

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