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2011-04-03 22:35:51
paramedic medications drugs prehospital amiodarone cordarone

Prehospital Medication Flashcards for Paramedic School - Massachusetts and Rhode Island
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  1. Amiodarone

    Trade Name
  2. Amiodarone

  3. Amiodarone

    Mechanism of Action
    • Prolongation of Action Potential
    • Non-competitive alpha and beta sympathetic blocking effects
    • Calcium channel blocking effects
  4. Amiodarone

    • Suppression of Ventricular Fibrillation (VF)
    • Suppression of Ventricular Tachycardia (VT)
    • Management of Ventricular Ectopy
  5. Amiodarone

    • Second or Third Degree heart block
    • Medication-induced Ventricular dysrhythmias
    • Hypotension
    • Bradycardia
    • Torsades de Pointes
    • Profound Sinus Bradycardia
  6. Amiodarone

    Adverse Reactions
    • Hypotension
    • Bradycardia
    • Pulseless Electrical Activity (PEA)
    • Congestive Heart Failure
    • Nausea
    • Fever
    • Abnormal Liver Function Tests
    • Thrombocytopenia (disorder of too few platelets)
  7. Amiodarone

    Drug Interactions
    Incompatible with: Sodium Bicarbonate (will precipitate)
  8. Amiodarone

    How Supplied
    150 mg in 3 ml ampules or vials
  9. Amiodarone

    Dosage and Administration
    • VF/ Pulseless VT:
    • Initial Dose-300mg slow IVP over 1-2 minutes in 10 cc NS
    • Repeat dose-150 mg slow IVP over 1-2 minutes in 10 cc NS
    • Ventricular Ectopy (PVC’s):
    • Initial Dose-150 mg slow IVP over 10 minutes
    • Repeat Dose-150 mg slow IVP over 10 minutes (to a total dose of 300mg)
    • IV Infusion mix 150 mg in 100 ml NS yield 1.5mg/ml run at 0.5-15mg per minute. (For malignant ventricular arrhythmias) per ordering physician
  10. Amiodarone

    Dosage and Administration
    The use of Amiodarone is relatively new in pediatric cardiology and there is currently no prehospital protocol in Massachusetts or Rhode Island
  11. Amiodarone

    Duration of Action
    • Onset: Within 5-15 minutes
    • Peak Effect: Variable
    • Duration: Variable
  12. Amiodarone

    Special Considerations
    • Pregnancy safety: Category C
    • Maintain at room temperature and protect from light in storage (light protection not required during administration).
    • Hypotension usually responsive to slowing infusion rate, IV Normal Saline
    • Administer cautiously in patients with Heart Failure or poor systolic function
    • May be especially effective in high-risk patients with recent acute MI
    • There are questions of compatibility with delivery systems containing PVC
    • MA-Statewide Protocol does not address the issue, RI Prehospital Care Protocols state Amiodarone must be mixed with D5W
    • MA-Statewide Protocol does not address the issue, RI Prehospital Care Protocols state Amiodarone should be administered using a "PVC-free" bag and tubing if available and run as an isolated IV (not piggybacked into NS or LR solutions)