Amiodarone

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Top 100 drugs.
Andrew Street
Flashcards by Andrew Street, updated more than 1 year ago
Andrew Street
Created by Andrew Street almost 8 years ago
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Indications for amiodarone. • Tachyarrythmias inc AF, atrial flutter, SVT, VT, refractory VT. Used only when other options are ineffective or inappropriate.
MOA of amiodarone. Amiodarone has many effects on myocardial cells, including blockade of sodium, calcium & potassium channels, & antagonism of α- & β-adrenergic receptors. These effects reduce spontaneous depolarisation (automaticity), slow conduction velocity, & ^resistance to depolarisation (refractoriness), including in the AV node. By interfering with AV node conduction, amiodarone reduces the ventricular rate in AF & atrial flutter. Through its other effects, it may also ^the chance of conversion to, & maintenance of, sinus rhythm. In SVT involving a self-perpetuating (‘re-entry’) circuit that includes the AV node, amiodarone may break the circuit & restore sinus rhythm. Amiodarone’s effects in suppressing spontaneous depolarisations make it an option for both treatment & prevention of VT. The same rationale underlies its use in refractory VF, although there is little evidence from clinical trials to support this.
SE's of amiodarone. • Hypotension (IV) When taken chronically: • Pneumonitis • Bradycardia • AV block • Hepatitis • Photosensitivity & grey discolouration of skin • Thyroid abnormalities
CI's, cautions, & important interactions of amiodarone. CI's: • Severe hypotension • HT block • Active thyroid disease Cautions: • None Important interactions: Amiodarone interacts with many drugs – too many to list here. Notably, it ^plasma concentrations of digoxin, diltiazem & verapamil. This may ^the risk of bradycardia, AV block & HF. The doses of these drugs should be halved if amiodarone is started.
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