Amiodarone

dr.joandr.joan عضو ماسي
تم تعديل 2009/05/22 في أدوية الطوارئ Emergency drugs
5. Amiodarone:
Trade name: Cordarone, Pacerone
Class: Antiarrhythmic agent
Pregnancy: (Category D)
Action: Amiodarone is categorized as a class III antiarrhythmic agent, and prolongs phase 3 of the cardiac action potential. It has numerous other effects however, including actions that are similar to those of antiarrhythmic classes I, II, and IV.
Uses:
· Ventricular fibrillation
· Ventricular tachycardia
· Atrial fibrillation
Dose: by mouth, 200 mg 3 times daily for 1 week reduced to 200 mg twice daily for a further week; maintenance, usually 200 mg daily or the minimum required to control the arrhythmia
by intravenous infusion: initially 5 mg/kg over 20–120 minutes with ECG monitoring; subsequent infusion given if necessary according to response up to max. 1.2 g in 24 hours "900 mg over 23 hours '.
Ventricular fibrillation or pulseless ventricular tachycardia: by intravenous injection over at least 3 minutes, 300 mg
Contraindications:
· allergic reaction
· Pregnant and lactation.
· It is contraindicated in individuals with sinus nodal bradycardia, atrioventricular block, and second or third degree heart block who do not have an artificial pacemaker.
· Individuals with baseline depressed lung function should be monitored closely if amiodarone therapy is to be initiated.
· The neonates.
Side effects:
· Cardiovascular
Cardiac arrhythmias, CHF, SA node dysfunction (1% to 3%); hypotension, sinus arrest (postmarketing).
· CNS
Abnormal gait/ataxia, dizziness, fatigue, lack of coordination, malaise, paresthesias, tremor/abnormal involuntary movement (4% to 9%); decreased libido, headache, insomnia, sleep disturbances (1% to 3%); confessional states, delirium, disorientation, hallucinations, pseudotumor cerebri (postmarketing).
· Dermatologic
Photosensitivity/Solar dermatitis (4% to 9%); flushing (1% to 3%); erythema multiform, exfoliative dermatitis, pruritus, skin cancer, Stevens-Johnson syndrome, toxic epidermal necrolysis, vasculitis (postmarketing).
· EENT
Visual disturbances (4% to 9%); abnormal smell sensation (1% to 3%).
· GI
Nausea, vomiting (10% to 33%); anorexia, constipation (4% to 9%); abdominal pain, abnormal salivation, abnormal taste (1% to 3%); pancreatitis (postmarketing).
Nursing considerations:
§ During IV infusion, carefully monitor blood pressure and
§ Slow the infusion if significant hypotension occurs.
§ Bradycardia should be treated by slowing the infusion or discontinuing it if necessary. Sustained monitoring is essential because drug has an unusually long half-life.
§ Report adverse reactions promptly. Bear in mind that long
§ Elimination half-life means that drug effects will persist long
after dosage adjustments are made or drug is discontinued.
§ Be alert to signs of pulmonary toxicity: progressive dyspnea,
fatigue, cough, pleuritic pain, fever.
§ Auscultate chest periodically or when patient complains of
respiratory symptoms. Check for diminished breath sounds, rales, pleuritic friction rub; observe breathing pattern. Drug induced pulmonary function problems must be distinguished from CHF or pneumonia. Keep your medical direction physician informed.
§ Monitor heart rate and rhythm and BP until drug response
has stabilized. Report promptly symptomatic bradycardia.
§ Patients already receiving antidysrhythmic therapy when
§ Amiodarone is started must be closely observed for adverse
effects, particularly conduction disturbances and exacerbation of dysrhythmias. Dosage of previous agent should be
§ reduced by 30−50% several days after amiodarone therapy is started

التعليقات

  • Dr.AhmadDr.Ahmad مدير عام
    تم تعديل 2009/05/22
    شكرا حازم حاليا يوجد احجام عن استخدام هذا الدواء إلا في النهاية حيث اصبح خط نهائي في علاج اضطرابات النظم يسبب احتوائه على ذرة اليود