Amiodarone HCl (Cordarone®, Nexterone®)

Indications:

• Ventricular fibrillation or pulseless ventricular tachycardia that does not respond to initial defibrillation attempts
• Sustained ventricular tachycardia with a pulse

Contraindications:

Trauma patients
Co-administration with procainamide

Precautions:

• Do not shake (prevents foaming)
• Draw-up with large gauge needle (at least 18g)
• Protect from light
• Avoid contact with plastic
• Administer at IV/IO port closest to the patient
• Use with caution in renal failure patients

Side Effects:

• Bradycardia
• Hypotension

Adult Dose:

Standing order:
Ventricular fibrillation (VF); Pulseless ventricular tachycardia (pulseless VTach);

• First Dose: 300 mg
• Second Dose: 150 mg

Sustained, unstable ventricular tachycardia with a pulse (unstable VTach);

• First Dose: 300 mg
• Second Dose: 150 mg

BIOTEL AUTHORIZATION REQUIRED:

    Stable or unstable, sustained ventricular tachycardia (VT) WITH pulse

• 150 mg - over 10 minutes (Dilute 300 mg in 250 mL NS and infuse at 12.5 mL/min for 10 minutes, then discontinue infusion. BioTel may recommend alternate infusion instructions.)

Pediatric Dose:

Standing order:
Ventricular fibrillation (VF)/Pulseless ventricular tachycardia (pulseless VTach):

• First Dose: 5 mg/kg, flush with 10 mL Normal Saline
• Second Dose: 5 mg/kg, flush with 10 mL Normal Saline

 
BIOTEL AUTHORIZATION REQUIRED:

    Sustained, unstable ventricular tachycardia with a pulse (unstable VTach);

• 5 mg/kg in 100 mL NS slow infusion over 30 minutes
• Synchronized cardioversion is preferred in most cases.

Route: IV or IO

Drug Action:

• Alters movement of sodium, potassium and calcium through normal channels:
  • Increases the refractory period of all cardiac tissues
  • Slows repolarization
  • Decreases cardiac automaticity
• Blocks alpha and beta adrenergic receptors

Class: Antiarrhythmic

Onset: Within minutes

Duration: Variable