Amiodarone

Provider Level

RN/Paramedic

Class

Class III antiarrhythmic

Mechanism of Action

Prolongs the cardiac action potential and refractory period by blocking potassium channels. Also possesses secondary sodium, calcium, and sympathetic (beta) blocking properties.

Indications

Pulseless Ventricular Fibrillation (VF), Pulseless Ventricular Tachycardia (pVT), and stable wide-complex tachycardias.

Contraindications

Cardiogenic shock, marked sinus bradycardia, second or third degree AV block (unless a functional pacemaker is present), and known hypersensitivity to the drug or iodine.

Routes

IV, IO

Onset / Duration

Onset: Minutes for IV/IO administration. Duration: Variable, with an exceptionally long terminal half-life.

Adverse Effects

Hypotension, bradycardia, prolonged QT interval, atrioventricular block, proarrhythmia, phlebitis, and long-term pulmonary or hepatic toxicity.

Precautions & Interactions

Rapid infusion can cause profound hypotension and bradycardia. Use with extreme caution in patients receiving other QT-prolonging medications.

Special Considerations

Authorized for RN/Paramedic use. Draws up slowly to avoid foaming. Do not mix with sodium bicarbonate or other incompatible medications in the same line. May require an in-line filter per local protocols.