Amiodarone

What is Amiodarone?

Amiodarone is an antiarrhythmic agent used in ACLS to treat VF or pulseless VT that does not respond to treatment with defibrillation, CPR, or vasopressors (epinephrine). It is recommended to only use Amiodarone for life-threatening arrythmias because of its association with toxicity and complex possible drug interactions.

Amiodarone has been shown to increase short-term survival in hospital compared to placebo or lidocaine. However, there is no evidence showing increased survival after hospital discharge.

Amiodarone Indications

• Pulseless VT
• Ventricular Fibrillation (V-Fib)
• Hypertrophic Cardiomyopathy
• Recurrent Hemodynamically
• Unstable Ventricular Tachycardia
• Supraventricular Tachyarrhythmias

Amiodarone Dosage

• For VT / V-Fib: 300 mg IV/IO. May administer additional 150 mg following initial dose if VF/pVT persists after 3-5 minutes.
• For Tachy / VT: 150 mg IV/IO over 10 minutes. Continuous infusion of 1 mg/min via IV for 6 hours, 0.5 mg/min via IV for subsequent 18 hours

Amiodarone Precautions/Side Notes

• Atrial fibrillation, supraventricular arrhythmias and hypertrophic cardiomyopathy are typically treated with oral form of amiodarone.
• Rapid infusion may cause hypotension.
• If cumulative dosing exceeds 2.2 grams in 24 hours, significant hypotension may occur. Avoid administration with any drug that may prolong QT interval.
• Amiodarone is very unstable and foams easily which leads to innaccurate dosage (avoid foaming).