6481579
Description
Flashcards by Andrew Street, updated more than 1 year ago
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Created by Andrew Street
about 8 years ago
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| Question | Answer |
| 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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