Is amiodarone a dangerous drug?
The FDA has made it clear that this drug should only be prescribed for life-threatening heart rhythm abnormalities such as recurrent ventricular fibrillation. Amiodarone side effects can be life threatening. The drug can cause serious lung toxicity. It can also harm the liver and the thyroid gland.
How dangerous a drug is amiodarone?
The most notable risk is amiodarone toxicity, or lung toxicity. This can occur in a variety of forms including inflammation, fibrosis (scarring), pneumonia, and more problems. This toxicity can be life-threatening and reportedly occurs in between 10 to 17 percent of patients given the drug.
Is Pacerone the same thing as amiodarone?
Pacerone ® (Amiodarone HCl) Tablets are a member of a class of antiarrhythmic drugs with predominantly Class III (Vaughan Williams' classification) effects, available for oral administration in 100 mg and 200 mg strengths of amiodarone hydrochloride.
What is amiodarone 200 mg used for?
It is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart). Amiodarone is used to treat ventricular tachycardia or ventricular fibrillation.
Before Taking This Medicine
You should not use this medicine if you are allergic to amiodarone or iodine, or if you have: 1. a serious heart condition called "AV block" (2nd o...
How Should I Take Amiodarone?
Take amiodarone exactly as prescribed by your doctor. Follow all directions on your prescription label. Do not take this medicine in larger or smal...
What Happens If I Miss A Dose?
Take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take extra medicine to...
What Happens If I Overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of amiodarone can be fatal.Overdose symptoms may inclu...
What Should I Avoid While Taking Amiodarone?
Grapefruit and grapefruit juice may interact with amiodarone and lead to unwanted side effects. Avoid the use of grapefruit products while taking t...
Amiodarone Dosing Information
Usual Adult Dose for Arrhythmias:IV:Initial dose: 1000 mg over the first 24 hours of therapy, delivered by the following infusion regimen:-Loading...
What Other Drugs Will Affect Amiodarone?
Amiodarone takes a long time to completely clear from your body. Drug interactions are possible for up to several months after you stop using this...
What is amiodarone?
Amiodarone belongs to class III of antiarrhythmic medications, which are also known as potassium channel blockers. Amiodarone can be taken orally o...
How does amiodarone work?
Amiodarone decreases the heart’s ability to respond to unwanted electrical stimuli, which—left unaddressed—may cause an irregular heartbeat. A heal...
What is amiodarone used for?
Amiodarone can be used to treat or prevent the recurrence of certain arrhythmias, including supraventricular arrhythmias (such as atrial fibrillati...
What are the side effects of amiodarone?
The most common adverse effects of amiodarone include nausea, vomiting, weight loss, bluish-grey discoloration of the skin, hypothyroidism or hyper...
Does amiodarone affect the blood pressure?
Amiodarone can also decrease blood pressure, slow heart rate, and—at higher doses or with long-term use—even cause arrhythmias of its own. This bec...
What tests should be done before starting amiodarone?
Amiodarone can be highly toxic, so before getting started on it, individuals should be evaluated for other medical conditions. Commonly performed t...
What should be avoided when taking amiodarone?
Individuals taking amiodarone should not consume alcohol or smoke cannabis while taking amiodarone, as it may cause symptoms such as dizziness and...
How long can you take amiodarone?
Amiodarone can be taken for as long as advised by a medical practitioner, and should be continued only under their guidance, as it may require moni...
What are the most important facts to know about amiodarone?
Amiodarone is a class III antiarrhythmic medication commonly used to prevent or treat medical emergencies such as cardiac arrest and arrhythmias. H...
What is amiodarone?
Amiodarone affects the rhythm of your heartbeats. It is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles (the lower chambers of the heart that allow blood to flow out of the heart).
What other drugs will affect amiodarone?
Sometimes it is not safe to use certain medications at the same time. Some drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
How long does it take for amiodarone to clear?
Amiodarone takes a long time to completely clear from your body. Drug interactions are possible for up to several months after you stop using amiodarone. Talk to your doctor before taking any medication during this time. Keep track of how long it has been since your last dose of amiodarone.
Does amiodarone cause swelling?
Amiodarone side effects. Get emergency medical help if you have signs of an allergic reaction to amiodarone: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Amiodarone takes a long time to completely clear from your body.
Can you take Amiodarone if you have AV block?
Before taking this medicine. You should not use amiodarone if you have: a serious heart condition called "AV block" (2nd or 3rd degree), unless you have a pacemaker; a history of slow heartbeats that have caused you to faint; or. if your heart cannot pump blood properly.
Can grapefruit interact with amiodarone?
Your reactions could be impaired. Grapefruit may interact with amiodarone and lead to unwanted side effects.
Does amiodarone affect your heart?
Amiodarone can cause dangerous side effects on your heart, liver, lungs, or vision.
Is amiodarone an antiarrhythmic?
Amiodarone is a highly efficacious antiarrhythmic agent for many cardiac arrhythmias, ranging from atrial fibrillation to malignant ventricular rhythm disturbances.
Is amiodarone safe for short term use?
Amiodarone has complex pharmacological and pharmacokinetic properties. It has significant long-term adverse effects, but short-term administration of intravenous amiodarone is generally well tolerated. This article will explore issues related to the clinical use of amiodarone from an emergency medicine perspective.
What is amiodarone?
Amiodarone belongs to class III of antiarrhythmic medications, which are also known as potassium channel blockers. Amiodarone can be taken orally or through injection to prevent or treat medical emergencies such as cardiac arrest and arrhythmias. As amiodarone can decrease excitability of the cardiac cell, it is considered quite a versatile medication.
How does amiodarone work?
Amiodarone decreases the heart’s ability to respond to unwanted electrical stimuli, which—left unaddressed—may cause an irregular heartbeat.
What are the side effects of amiodarone?
The most common adverse effects of amiodarone include nausea, vomiting, weight loss, bluish-grey discoloration of the skin, hypothyroidism or hyperthyroidism, liver disease, and photosensitivity. In addition, amiodarone can often deposit in the cornea (transparent outer covering of the eye), making it appear translucent or opaque. Fortunately, this side effect is reversible once the medication is stopped and may not cause any significant vision problems.
What should be avoided when taking amiodarone?
Individuals taking amiodarone should not consume alcohol or smoke cannabis while taking amiodarone, as it may cause symptoms such as dizziness and drowsiness. Individuals should also be advised against consuming grapefruit, as this can interfere with the metabolism of amiodarone, allowing it to accumulate in the body, which in turn may increase its side effects.
How long can you take amiodarone?
Amiodarone can be taken for as long as advised by a medical practitioner, and should be continued only under their guidance, as it may require monitoring of blood values and other parameters for organ damage at least every six months. If symptoms of arrhythmia recede, dosage may be tapered to a lower dose of amiodarone, and might even be stopped under the guidance of a certified medical practitioner such as a doctor or pharmacist.
What are the most important facts to know about amiodarone?
However, it is known to interfere with other medications, and it can be highly toxic to several organs. To monitor for potential organ damage, individuals taking amiodarone should run routine tests every six months. Common side effects include nausea, vomiting, weight loss, corneal deposits, skin discoloration, photosensitivity hypothyroidism or hyperthyroidism, and liver disease. In addition, it may rarely cause optic or peripheral neuropathy, memory loss, and confusion. Individuals taking amiodarone should avoid consuming grapefruit, alcohol, and cannabis. Finally, amiodarone must be avoided in pregnancy or breastfeeding .
Does amiodarone cause shortness of breath?
Long-term usage of amiodarone can cause pulmonary toxicity or severe damage to the lungs, resulting in dry cough, shortness of breath, and chest pain. Amiodarone can also affect the heart, leading to sinus bradycardia, as well as arrhythmias such as AV block and QT prolongation. A rare, but more severe, side effect of amiodarone is optic ...
What is amiodarone used for?
Amiodarone is a potent class III anti-arrhythmic drug used in clinical practice for the prophylaxis and treatment of many cardiac rhythm disturbances, ranging from paroxismal atrial fibrillation to life threatening ventricular tachyarrhythmias . Amiodarone often causes changes in thyroid function tests mainly related to the inhibition of 5'-deiodinase activity resulting in a decrease in the generation of T3 from T4 with a consequent increase in rT3 production and a decrease in its clearance. In a group of amiodarone-treated patients there is overt thyroid dysfunction, either amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH). AIT is primarily related to excess iodine-induced thyroid hormone synthesis in an abnormal thyroid gland (type I AIT) or to amiodarone-related destructive thyroiditis (type II AIT). The pathogenesis of AIH is related to a failure to escape from the acute Wolff-Chaikoff effect due to defects in thyroid hormonogenesis, or, in patients with positive thyroid autoantibody test, to concomitant Hashimoto's thyroiditis. Both AIT and AIH may develop either in apparently normal thyroid glands or in glands with preexisting, clinically silent abnormalities. AIT is more common in iodine-deficient regions of the world, whereas AIH is usually seen in iodine-sufficient areas. In contrast to AIH, AIT is a difficult condition to diagnose and treat, and discontinuation of amiodarone is usually recommended. In this review we analyse, according to data from current literature, the alterations in thyroid laboratory tests seen in euthyroid patients under treatment with amiodarone and the epidemiology and treatment options available of amiodarone-induced thyroid dysfunctions (AIT and AIH).
What are the side effects of amiodarone?
The major side effects of amiodarone are hypotension, bradycardia and peripheral phlebitis. Major contraindications to the intravenous (i.v.) injection of amiodarone are bradycardia, senoatrial block, severe disturbs of conduction, second or third degree atrio-ventricular blocks.
Is cordarone an antiarrhythmic?
Introduction Cordarone IV is an effective antiarrhythmic agent; however, a high incidence of drug related hypotension was reported in clinical trials. The hypotension was not dose related, but related to the rate of infusion. As a result, labeling calls the standard formulation (including generics) to be administered over 10 minutes. The standard formulation contains polysorbate 80 and benzyl alcohol and each causes hypotension. A new aqueous formulation of amiodarone (AA) does not contain these solubilizing agents and therefore may cause less hypotension. This hypothesis was tested in conscious dogs. Methods Six mature beagle dogs were surgically instrumented with a telemetric device for monitoring of heart rate and blood pressure. The study was run on 5 separate days. On the first 2 days, a 10-minute IV infusion or a bolus of 5% dextrose in water (D5W) was administered (placebo). Over the following 3 days, the dogs received (in randomized order, one per day) a 10-minute infusion of 2.5 mg/kg of Cordarone® IV (C) and bolus administrations of 2.5 mg/kg and 5.0 mg/kg of AA injected over 2 to 5 seconds. The dogs were monitored for 2 hours after dosing (1-min intervals). Results Bolus administration of AA at either 2.5 mg/kg or 5.0 mg/kg produced no statistically significant changes in the mean arterial blood pressure (MABP) relative to D5W bolus (p>0.25, ANOVA). In contrast, 10-minute infusion of 2.5 mg/kg C produced statistically significant decreases in MABP relative to D5W infusion that lasted for at least 2 hours (p<0.001). The decrease in MABP became statistically significant at 3 min. post dosing (91 vs. 105 mm Hg, p<0.05) with a further drop in MABP to 62 mm Hg (p<0.001) at 10 min post dose. The MABP remained significantly lower until the end of the study (80 vs. 98 mm Hg, p<0.05). Compared to AA boluses, MABP was significantly lower following C infusion. Conclusion Aqueous amiodarone did not cause hypotension when administered as a rapid bolus. In contrast, 10 minute infusion of the standard preparation, Cordarone IV resulted in a sustained and significant hypotension. The hemodynamic profile of the aqueous formulation was significantly better than C, permitting a more rapid administration.
Is amiodarone a randomized trial?
For the European Myocardial Infarct Amiodarone Trial Investigators. Randomized trial of effect of amiodarone on mortality in patients with left-ventricular dysfunction after recent myocardial infarction: EMIAT
Can Class I drugs be used alone?
treatment. Class I drugs may be used alone
Does amiodarone cause thyroid problems?
Amiodarone is a benzofuranic-derivative iodine-rich drug widely used for the treatment of tachyarrhythmias and, to a lesser extent, of ischemic heart disease. It often causes changes in thyroid function tests (typically an increase in serum T (4) and rT (3), and a decrease in serum T (3), concentrations), mainly related to the inhibition of 5'-deiodinase activity, resulting in a decrease in the generation of T (3) from T (4) and a decrease in the clearance of rT (3). In 14-18% of amiodarone-treated patients, there is overt thyroid dysfunction, either amiodarone-induced thyrotoxicosis (AIT) or amiodarone-induced hypothyroidism (AIH). Both AIT and AIH may develop either in apparently normal thyroid glands or in glands with preexisting, clinically silent abnormalities. Preexisting Hashimoto's thyroiditis is a definite risk factor for the occurrence of AIH. The pathogenesis of iodine-induced AIH is related to a failure to escape from the acute Wolff-Chaikoff effect due to defects in thyroid hormonogenesis, and,
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A. Testa, V. Ojetti, A. Migneco, M. Serra, C. Ancona, A. De Lorenzo*, N. Gentiloni Silveri Use of amiodarone in emergency
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What is amiodarone used for?
Amiodarone also can be used to treat other supraventricular tachyarrhythmias, including atrial flutter, refractory AV (atrioventricular) nodal, and AV re-entrant tachycardia (commonly referred to as SVT). Finally, amiodarone is indicated for the treatment of ventricular arrhythmias, specifically monomorphic VT, non-Torsades polymorphic VT (secondary to myocardial ischemia and not associated with prolonged QTc), as well as for pulseless ventricular fibrillation (VF) and pulseless VT that fail to convert after CPR, defibrillation, and epinephrine administration. When studied in patients with out-of-hospital cardiac arrest, amiodarone resulted in a higher rate of return of spontaneous circulation (ROSC); however, this ROSC benefit did not result in a higher rate of survival to hospital discharge with the favorable neurological outcome. [3]
How does amiodarone work?
Like other antiarrhythmic drugs of this class, amiodarone works primarily by blocking potassium rectifier currents responsible for the repolarization of the heart during phase 3 of the cardiac action potential. This potassium channel-blocking effect results in increased action potential duration and a prolonged effective refractory period in cardiac myocytes. Myocyte excitability is decreased, preventing reentry mechanisms and ectopic foci from perpetuating tachyarrhythmias. Electrocardiographic evidence of these effects is evident as prolongation of the QRS duration and QTc interval. [4]
How long does it take to take amiodarone?
In adult patients, amiodarone can be given for VT/VF cardiac arrest via intravenous (IV)/intraosseous (IO) infusion as a 300 mg rapid bolus followed by an additional bolus of 150 mg IV/IO if VT or VF persists. If the patient achieves ROSC, a continuous infusion is started at 1 mg/min for 6 hours, followed by 0.5 mg/min. To treat all acute tachyarrhythmias in adults, amiodarone can be given IV 150 mg over 10 minutes, followed by a 1 mg/min infusion for 6 hours, followed by an infusion at 0.5 mg/min. The recommended total dose over 24 hours should not exceed 2.4 grams. Recommended oral dosing is 400 to 600 mg daily in divided doses for 2 to 4 weeks, followed by maintenance dosing of 100 to 200 mg daily. No dosage adjustment is necessary for renal impairment.
What is the most commonly used anti-arrhythmic drug?
Amiodarone is one of the most commonly used anti-arrhythmic drugs. While the United States FDA has labeled amiodarone for the treatment of life-threatening ventricular arrhythmias, the drug is commonly used off-label to treat supraventricular tachyarrhythmias such as atrial fibrillation as well as for the prevention of ventricular tachyarrhythmias (VTs) in high-risk patients. [1][2][3]
What are the effects of amiodar on the skin?
Neurologic toxicity can occur in up to 27.5% of patients, ranging from cognitive impairment to peripheral neuropathy, ataxia, and in some rare cases, quadriplegia. Dermatologic effects include blue skin discoloration ("smurf-skin") and photosensitivity. In rare instances, amiodarone may cause epididymitis and erectile dysfunction.
How long does it take for amiodarone to work?
Amiodarone has a very long half-life (t1/2 of several weeks), and it may take 6 weeks for full clinical effects with oral therapy. Also, upon discontinuation of amiodarone therapy, pharmacologic effects could continue for 1 to 3 months. [6]
How long does it take to administer a pediatric advanced life support?
For perfusing pediatric tachyarrhythmias, the patient receives a similar loading dose; however, the time of administration stretches to 20 to 60 minutes - this can be followed by a 5 mcg/kg/min infusion, which may be titrated up to a max dose of 15 mcg/kg/min for a max of no more than 20 mg/kg within 24 hours.
Indications
Amiodarone is approved for use in the secondary prevention of life-threatening ventricular arrhythmias.
Adverse Effects
Amiodarone has been associated with toxicity involving the lungs, thyroid gland, liver, eyes, skin, and nerves ( Table 2). 2, 5, 11, 19 The frequency of most adverse effects is related to the total amiodarone exposure (i.e., dosage and duration of treatment).
Drug Interactions
Amiodarone is a potent inhibitor of the hepatic and renal metabolism of several drugs ( Table 3).
Dosage and Administration
In patients receiving oral amiodarone therapy, there may be a delay of two weeks or more before antiarrhythmic effects are noted. A loading regimen (i.e., use of a relatively high dosage at the beginning of therapy) can shorten the delay.
Monitoring
Patients treated with amiodarone should be followed regularly to assess ongoing need for amiodarone, efficacy of the drug, appropriateness of dosage, adverse effects, and potential drug interactions. Consensus follow-up recommendations from the NASPE are summarized in Table 4. 4 A form to guide patient monitoring is provided in Figure 1.
Does Amiodarone Require Hospitalization?
you need to take amiodarone when your heart rate is unstable, you will need to be transported to the hospital and initially receive the first course of treatment.In this role, you are being assured that your dose of amiodarone is safe. If you are prescribed lower than the recommended dose, you may require monitoring by your doctor in the hospital.
Is Amiodarone An Emergency Drug?
In medicine, amiodarone has been one of the most commonly prescribed anti-arrhythmics medication.According to recent guidelines on cardiac arrest with shockable rhythm [refractory ventricular fibrillation (VF) orpulseless ventricular tachycardia (VT] it seems that amiodarone may provide the most benefit.
What Should You Check Before Administering Amiodarone?
A physician should be consulted before taking amiodarone if your symptoms include liver, heart, or thyroid disease.In general, you will need to take blood tests on a regular basis to check your thyroid and liver.Depending on your medical history, there may also be a breathing test required to assess the function of your pulmonary (lung) muscles.
What Should You Monitor When Patient Is Using Amiodarone?
In order to reduce the risk of a blood clot, patients on long-term amiodarone therapy are advised to frequent monitor their respiratory function throughout the period (including six-monthly chest x-rays) and heart electrical activity at e amiodarone therapy should regularly undergo the following )
Can Amiodarone Be Started Outpatient?
Amiodarone therapy is usually offered either daily within a hospital or outpatients for initial clinical control of VT and diabetic foot disease. However, in patients with existing ICDs, therapy cannot start until an outpatient is obtained.
What Does Amiodarone Do In An Emergency?
The Antiarrhythmic Agent and Asymptomatic Disrhythmide is a potent antiarrhythmic drug and used to treat ventricular arrhythmias and rhythm issues in the Irregular Heart Rate range.With the drug, high-risk patients are prevented from recurring dangerous ventricular arrhythmias and sudden deaths are slowed down to some extent.
When Do You Use Amiodarone In A Code?
Cardiovascular intervention After a third shock for ventricular fibrillation or ventricular tachycardia which is unresponsive to compressions, cardiopulmonary interventions, AEDs, or shock medication, amiodarone serves as an intermediate intervention.
