Non-life-threatening atrial fibrillation greater than 48 hour duration.
headache, dizziness, hypotension, bradycardia, dysrhythmias.
Potentially Lethal Side Effects:
hepatotoxicity, sinus arrest, CHF, SA Nodal dysfunction, corneal microdeposits, pulmonary fibrosis
Ventricular Tachycardia refractory to Sync DC Cardioversion, with evidence of ejection impairment:
Dose 1: IV: 150mg/10 min, followed by synchronized cardioversion
Pulseless Arrest, Ventricular Fibrillation, Pulseless Ventricular Tachycardia:
Dose 1: IV: 300mg in20-30ml D5W
Dose 2 for recurrent: 150 mg, 3-5 min. after dose 1.
Max: 2.2g/24 hr
Atrial Fibrillation
If >48 hrs have passed since onset, per ACLS, "use agents with potential to convert rhythy with extreme caution in patients not receiving adequate anti-coagulation because of possible embolic complications."
Maintenence Infusion:15mg/min for 10 minutes, then 1mg/min for 6hrs, then 0.5 mg/min for 18 hours.**
Ventricular Tachycardia with good perfusion:
IV/IO Infused: 5mg/kg/20 min to 5mg/kg/60 min
Ventricular Tachycardia with poor perfusion:
IV/IO Infused: 5mg/kg/20 min to 5mg/kg/60 min
Ventricular Fibrillation/Pulseless V Tach:
IV/IO Bolus: 5mg/kg with 30 seconds circulation, followed by shock if no return of perfusing rhythm.
- Not routinely administered with Procainamide, secondary to pro-rhythmic potentiation.
- This drug should be drawn up slowly due to tendency to bubble/foam.
- Therapeutic range for Amiodarone is 1-2.5 mcg/ml (U of MN, College of Pharmacy)
First 10 min: 15 gtt/ml set: 300mg in 50cc set to 38 gtt/min.
Six Hours of: 60 gtt/ml set: 450mg in 1000cc set to 27 gtt/min.
18 hours of : 60 gtt/ml set: 600mg in 1000cc set to 35 gtt/min.