Amiodarone, What Can’t It Do?

Amiodarone (Ami, Amio, Cordarone) is a drug commonly given during cardiac arrest.
Amio is to patients in V-fib or VF cardiac arrest. For the most part, Amio replaced Lidocaine in resuscitation. But what does it really do? Does Amiodarone stop the ventricles? Does Amio stop VF? Here’s your chance to find out!

Amiodarone

Trade names: Cordarone, Nexterone
Drug class: Class III Antiarrhythmic Agent
Pregnancy class: D (There are known human fetal risks, but the benefits to the mother out weigh the risks to the fetus)

Before we go into what Amiodarone does, there is one more side note to know. Amio comes in a few forms, Intravenous & oral. We will be talking about the IV form today. Amiodarone can be given in a bolus & drip. We’re going to be talking about both. This drug can be given via IV/IO but NEVER ETT. Oh, and everything we’re talking about (dosages and such) are all for an adult and based off the 2010 AHA Guidelines.

 Amiodarone A 10ML pre-filled Amiodarone syringe

Amiodarone Vial A 150ML/3ML Amiodarone vial

So now that we know what amio is, we can talk about what it does.

VF cardiac arrest: During a VF cardiac arrest, 300mg of Amio is given following the first dose or Epi/Vaso, via IV/IO, and 150mg after the 2nd dose of Epi/vaso. But why? Here’s what Amiodarone does:

  • Science Jargon: Amiodarone prolongs the 3rd phase of the cardiac action potential. It also has similar effects like antiarrhythmic class Ia, II & IV drugs.
  • Non-scientific words: Amiodarone acts like a beta blocker. It slows the actions of the SA & AV node.

Ventricular Tachycardia: When a patient has unstable V-tach, Amiodarone is NOT the first therapy that should be used. Patients should be cardioverted immediately. In stable patients with monomorphic VT, 300MG of amio should be used. Amio is CONTRAINDICATED in polymorphic VT.

This is only a brief look into Amiodarone. Amio is an extremely useful drug in emergency medicine. For more detailed information on Amiodarone, be sure to check out the National Library of Medicine.