Amiodarone Flashcards
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Questions and Answers

What is amiodarone?

An antiarrhythmic drug used to treat heart rhythm problems.

Which of the following are common brands of amiodarone?

  • Nexterone
  • Cordarone
  • Pacerone
  • All of the above (correct)

    • What is the pregnancy category of amiodarone?

    D

    What is the primary purpose of amiodarone?

    <p>To manage heart rhythm problems.</p> Signup and view all the answers

    What types of administration are used for amiodarone?

    <p>PO (oral) and IV (intravenous)</p> Signup and view all the answers

    Which of the following are indications for the use of amiodarone?

    <p>All of the above</p> Signup and view all the answers

    Amiodarone belongs to the __________ class of antiarrhythmic drugs.

    <p>Class III</p> Signup and view all the answers

    What are the main actions of amiodarone?

    <p>Prolongs action potential, inhibits adrenergic stimulation.</p> Signup and view all the answers

    Match the following conditions with their association with amiodarone:

    <p>Nonvalvular Atrial Fibrillation = Associated Condition Tachycardia, Supraventricular = Associated Condition Recurrent Ventricular Fibrillation = Associated Condition Recurrent Hemodynamically Unstable Ventricular Tachycardia = Associated Condition</p> Signup and view all the answers

    What is the half-life of amiodarone?

    <p>13 to 107 days</p> Signup and view all the answers

    Amiodarone is contraindicated in patients with severe sinus node dysfunction.

    <p>True</p> Signup and view all the answers

    What should be monitored when administering amiodarone?

    <p>Heart rate and rhythm.</p> Signup and view all the answers

    Which drug interaction is a concern when using amiodarone?

    <p>All of the above</p> Signup and view all the answers

    For adults, the initial oral dosage of amiodarone ranges from __________ mg per day.

    <p>800 to 1600</p> Signup and view all the answers

    Hypersensitivity to amiodarone or __________ is a contraindication.

    <p>iodine</p> Signup and view all the answers

    What is the reported efficacy rate of amiodarone in pediatric patients for treating SVT?

    <p>84% to 93%</p> Signup and view all the answers

    Amiodarone is often used as the first line treatment for pediatric arrhythmias.

    <p>False</p> Signup and view all the answers

    What is the dosage of amiodarone for adults during the first 7 to 14 days?

    <p>600 to 800 mg PO once daily</p> Signup and view all the answers

    Amiodarone can suppress ventricular __________ and improve left ventricular ejection fraction (LVEF) in heart failure patients.

    <p>arrhythmias</p> Signup and view all the answers

    What should be monitored in patients with hepatic impairment when using amiodarone?

    <p>Drug efficacy and safety, including hepatic function</p> Signup and view all the answers

    Which of the following conditions is a contraindication for amiodarone?

    <p>Hypotension</p> Signup and view all the answers

    What is one common adverse reaction of amiodarone?

    <p>Bradycardia</p> Signup and view all the answers

    Amiodarone does not have any effect on mortality in heart failure patients.

    <p>True</p> Signup and view all the answers

    What is a key nursing implication when administering amiodarone?

    <p>Monitor ECG continuously</p> Signup and view all the answers

    What instructions should be given to patients regarding grapefruit juice while taking amiodarone?

    <p>Avoid drinking grapefruit juice</p> Signup and view all the answers

    The dosage of amiodarone is __________ mg PO for children during the first 10 days.

    <p>10 mg/kg/day</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Hepatic Impairment = Monitor drug efficacy and hepatic function Renal Impairment = No dosage adjustment needed Geriatric = Slower clearance in patients over 65 Contraindications = Conditions where amiodarone should not be used</p> Signup and view all the answers

    What is a potential side effect related to vision when taking amiodarone?

    <p>Optic neuropathy</p> Signup and view all the answers

    Amiodarone is safe for use in pregnant women without any precautions.

    <p>False</p> Signup and view all the answers

    What should be done if a patient misses two doses of amiodarone?

    <p>Consult healthcare professional</p> Signup and view all the answers

    Study Notes

    Amiodarone Overview

    • Amiodarone is an antiarrhythmic medication used to treat life-threatening ventricular arrhythmias.
    • Common brand names include Cordarone, Pacerone, and Nexterone.
    • Available in both oral (PO) and intravenous (IV) forms.

    Pregnancy and Classification

    • Classified under Pregnancy Category D, indicating potential risks to the fetus.
    • Belongs to Vaughan-Williams Class III antiarrhythmics.

    Therapeutic Use

    • Primarily indicated for life-threatening ventricular arrhythmias unresponsive to other treatments.
    • Also used for management of supraventricular tachyarrhythmias.
    • Included in Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) guidelines for managing specific cardiac emergencies.

    Pharmacodynamics and Mechanism of Action

    • Prolongs action potential duration and refractory period in myocardial cells.
    • Slows heart rate by inhibiting adrenergic stimulation and decreasing peripheral vascular resistance.
    • Also mimics actions of other antiarrhythmic classes (Ia, II, and IV).

    Dosage Information

    • Oral Dosage for Adults: Initial 800-1600 mg/day for 1-3 weeks, then maintenance at 400 mg/day.
    • Intravenous Dosage for Adults: Initial 150 mg IV over 10 minutes, followed by a continuous infusion.
    • Conversion from IV to oral dosing is based on the duration of IV therapy.

    Associated Conditions

    • Effective for conditions like nonvalvular atrial fibrillation, tachycardia, recurrent ventricular fibrillation, and unstable ventricular tachycardia.

    Contraindications and Precautions

    • Contraindicated in patients with cardiogenic shock, severe sinus node dysfunction, and significant AV block.
    • Caution required in patients with history of heart failure, thyroid disorders, and severe pulmonary or liver disease.

    Interactions

    • Caution with other drugs that prolong QT interval (e.g., fluoroquinolones, macrolides).
    • Significant drug-drug interactions with digoxin, warfarin, and statins, requiring dose adjustments.
    • Avoid grapefruit juice, as it may increase amiodarone levels.

    Clinical Studies and Efficacy

    • Clinical trials (CAMIAT and EMIAT) showed that amiodarone did not increase overall mortality in post-myocardial infarction patients.
    • Studies suggest its efficacy in maintaining sinus rhythm compared to other agents in atrial fibrillation cases.

    Pediatric Use

    • Important for treating pediatric patients with life-threatening arrhythmias, with dosage based on body surface area.
    • Long-term use should be approached cautiously due to potential adverse effects.

    Summary of Key Dosing Guidelines

    • For ventricular arrhythmias, adults may require initial high doses with gradual reduction to maintenance.
    • Administration can be tailored for children based on age and body surface area, with careful monitoring for responses and side effects.### Dosage Guidelines
    • PALS guidelines recommend 5 mg/kg bolus for pulseless VF/VT in children and infants.
    • For perfusion tachycardia, a loading dose of 5 mg/kg is given over 20-60 minutes, with a maximum of 15 mg/kg/day.
    • In adults, oral dosing for supraventricular tachycardia starts at 600-800 mg/day for one week, reducing to 400 mg/day for three weeks, then maintenance of 200-400 mg/day.
    • Children’s oral dosing is 10 mg/kg/day for 10 days, followed by 5 mg/kg/day for several weeks, and can be reduced to 2.5 mg/kg/day for maintenance.

    Dosing Considerations

    • Hepatic impairment necessitates cautious dosage reduction and monitoring due to hepatic metabolism of amiodarone and its metabolite.
    • No dosage adjustments are required for renal impairment or during intermittent hemodialysis.

    Administration Details

    • Amiodarone administration should be done under close monitoring, especially for patients with life-threatening arrhythmias to prevent medication errors.
    • Administer only through appropriate IV setups to avoid drug instability.

    Contraindications and Precautions

    • Contraindicated in patients with cardiogenic shock, heart failure, and electrolyte imbalances.
    • Regular monitoring for visual disturbances and thyroid dysfunction is essential due to potential side effects.
    • Special attention is needed for electrolyte balance, especially for patients on diuretics or with severe diarrhea.

    Adverse Reactions

    • Common side effects include bradycardia, AV block, cardiac arrest, and various arrhythmias.
    • Serious reactions may involve pulmonary complications, liver failure, or Stevens-Johnson syndrome.

    Nursing Implications

    • Essential to continuously monitor ECG, heart rate, and signs of pulmonary toxicity.
    • Be vigilant for bradycardia or worsening arrhythmias during therapy and assess for neurotoxicity and signs of thyroid dysfunction.
    • Monitor liver and thyroid function regularly throughout the treatment course.

    Patient Education

    • Instruction on adherence to prescribed dosage, monitoring pulse daily, and avoiding grapefruit juice is crucial.
    • Advise patients about potential delayed side effects requiring ongoing communication with healthcare providers.
    • Emphasize the need for regular follow-up exams, including chest x-rays and pulmonary function tests.

    Evaluation

    • Desired outcomes include the cessation of life-threatening ventricular arrhythmias, requiring up to four months for adverse effects to resolve post-treatment.

    Drug Purpose

    • Amiodarone is prescribed for treating serious irregular heartbeats, specifically to restore normal heart rhythm and maintain a steady heartbeat as an anti-arrhythmic medication.

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    Description

    Test your knowledge of amiodarone with these flashcards. This quiz covers its definition, purpose, and various brands. Perfect for students or professionals in the medical field.

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