Drug Summary

Amiodarone (Cordarone®)

Pharmacologic properties:

Amiodarone is considered a class III antiarrhythmic. It possesses electrophysiologic characteristics of sodium, potassium and calcium channel blockade, as well as alpha and beta adrenergic blocking activity. These properties prolong action potentials and repolarization, stabilizing myocardial membranes.

Indications:

  • Ventricular fibrillation/pulseless ventricular tachycardia
  • Ventricular tachycardia without overt signs of shock (SBP > 90)
  • Wide complex tachycardia of unknown etiology
  • Pediatric ventricular fibrillation/pulseless ventricular tachycardia

Contraindications:

  • Cardiogenic shock
  • Marked sinus bradycardia
  • Second or third degree AV block
  • Known hypersensitivity

Precautions:

  • Solution is extremely viscous, Do Not Shake
  • Administer the medication slowly
  • Use large bore filtered needles, or needless filter straws

Side effects/ adverse reactions:

  • Hypotension
  • Bradycardia
  • Adverse effects can be treated by the following:
    • Slow the rate of drug infusion
    • IVF bolus, pressors, chronotropic agents, or temporary pacing

Dosage and administration:

  • Adult cardiac arrest
    • 300 mg, IV/IO bolus
      • If administered undiluted, immediately follow with 10-20 ml bolus of NS
    • For persistent VF/VT repeat 150 mg, IV/IO bolus (maximum total dose 450 mg)
  • Adult noncardiac arrest
    • 150 mg (mixed in 100 ml of D5W), IV over 10 minutes
    • Repeat 150 mg IV (over 10 min) every 10-15 min as needed (maximum total dose 450 mg)
  • Pediatric cardiac arrest
    • 5 mg/kg, IV/IO bolus (maximum individual dose 300 mg)
    • For persistent VF/VT repeat 5 mg/kg, IV/IO bolus (maximum total dose 15 mg/kg)