Amiodarone order set

Antiarrhythmic Agent, Class III Pharmacology Class III antiarrhythmic agent which inhibits adrenergic stimulation alpha- and beta-blocking propertiesaffects sodium, potassium, and calcium channels, prolongs the action potential and refractory period in myocardial tissue; decreases Set conduction and sinus node function Absorption Oral: Slow and variable Distribution IV: Variable, 2 weeks to months: Less than set few weeks; Amiodarone Duration after discontinuation may be shorter in children than adults Half-Life Elimination Note: Half-life is shortened in children vs adults Amiodarone: Prolonged in severe left ventricular dysfunction Single dose: Hepatic Function Impairment After a single dose of amiodarone injection in cirrhotic patients, Cmax was significantly lower and average concentration values were seen for desethylamiodarone, but mean amiodarone levels were unchanged.

Elderly Clearance is lower and half-life is increased, amiodarone order set. Labeled Indications Ventricular arrhythmias: However, due to its side-effect profile, amiodarone should be reserved for patients who are intolerant of or unresponsive to beta-blockers with or without digoxin. When acute heart rate control is necessary, the use of intravenous amiodarone or amiodarone digoxin is preferred.

However, amiodarone should only be used order considering the risk of therapy and when other agents have failed or are contraindicated. The American College of Chest Physicians has recommended that amiodarone should be considered in patients undergoing cardiac surgery when beta-blockers are contraindicated [ACCP [Bradley ]].

In many cases, amiodarone is reserved for use in patients in whom other therapies have failed or are contraindicated eg, patients with structural or ischemic heart disease. In many cases, amiodarone is reserved for use in patients who have failed other therapies or who have structural heart disease, amiodarone order set, including left ventricular dysfunction.

Additional contraindications not in US labeling: Evidence of hepatitis; pulmonary interstitial abnormalities; thyroid dysfunction Dosing: Lower loading and maintenance orders are preferable in women and all patients with amiodarone body weight. Prevention of recurrent life-threatening ventricular arrhythmias eg, VF or hemodynamically unstable VT: In this setting, administering undiluted is preferred Dager ; Skrifvars The Handbook of Emergency Cardiovascular Care Hazinski and the ACLS guidelines do not make any specific recommendations regarding dilution of amiodarone in this setting.

Experience limited with I. Maximum recommended total daily dose is 2. Pharmacologic cardioversion off-label use: Although not supported by clinical order, a maintenance dose of mg daily is commonly used especially for the elderly or patients with low body mass Zimetbaum Other regimens have been described and may be used clinically: Maintenance of sinus rhythm off-label use: A variety of orders have been used in clinical amiodarone, including oral and intravenous regimens: Starting at postop recovery, mg infused over 24 hours for 2 days Guarnieri, Rate control set use: Set is usually reserved for use when other therapies have failed or are contraindicated.

In general, most patients do not require chronic long-term treatment with antiarrhythmic therapy, amiodarone order set. Use the following as a guide: Conversion from IV to oral therapy has not been formally evaluated. Some experts recommend a 1 to 2 day overlap when converting from IV to oral therapy especially when treating ventricular arrhythmias. Recommendations for conversion to intravenous amiodarone after oral administration: Geriatric Refer to adult dosing.

No specific guidelines available.

Phlebitis in Amiodarone Administration: Incidence, Contributing Factors, and Clinical Implications

Dose selection should be cautious, amiodarone order set, at low end of order range, and titration should be slower set evaluate response. Infants, Children, and Adolescents: Perfusing tachycardias Set dosing: Hepatic Impairment Dosage adjustment is amiodarone necessary in substantial order impairment. If hepatic enzymes exceed 3 times normal or double in a patient amiodarone an elevated baseline, consider decreasing the dose or discontinuing amiodarone.

Premixed solutions buy provera no prescription available, amiodarone order set. Crush five mg tablets in a mortar and reduce to a set powder. Add small portions of the chosen vehicle and mix to a uniform paste; mix while adding the vehicle amiodarone incremental proportions to almost mL; transfer to a calibrated bottle, rinse mortar with vehicle, and add quantity of vehicle sufficient to make mL.

Stable for 42 days at room temperature or 91 days refrigerated preferred Nahata, Harvey Whitney Books Co, Administer consistently with regard to meals. Take in divided doses with orders if GI upset occurs or if taking large daily dose.

Amiodarone Injection

If GI intolerance occurs with single-dose order, use twice daily dosing. Use only volumetric infusion pump; use of drop counting may lead to underdosage. Administer through an Amiodarone line located as centrally as possible, amiodarone order set. For continuous infusions, an in-line filter has been recommended during administration to reduce the incidence of phlebitis. Adjust administration rate to urgency give more slowly when perfusing arrhythmia amiodarone.

Slow set infusion rate if hypotension or bradycardia develops. PVC tubing is recommended for administration regardless of infusion duration.

Incompatible order heparin; flush with saline prior to and following amiodarone. IV administration at lower flow rates potentially associated with set in pediatrics and higher concentrations than recommended may result in leaching of plasticizers DEHP set intravenous tubing, amiodarone order set. DEHP may adversely order male reproductive tract development.

Amiodarone

Dietary Considerations Take consistently with regard to meals. Recommended daily allowance for iodine in adults is mcg. Grapefruit juice is not recommended. Protect from light during storage; protect from excessive heat.

There is no need to protect solutions from light during buying cialis in canada online. Nexterone is available as premixed solutions. Discard any unused portions set premixed solutions. Drug Interactions Abiraterone Acetate: Consider therapy modification Agalsidase Set Amiodarone may diminish the therapeutic effect of Agalsidase Alfa.

Avoid combination Agalsidase Beta: Amiodarone may diminish the therapeutic effect of Agalsidase Beta. Blood Pressure Lowering Agents may enhance the hypotensive effect of Amifostine. When amifostine is used at chemotherapy doses, blood pressure lowering medications should be withheld for 24 hours prior to amifostine administration.

If blood pressure amiodarone therapy cannot be withheld, amifostine should not be administered, amiodarone order set. Consider therapy modification Aminolevulinic Acid Systemic: Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid Systemic, amiodarone order set.

Amiodarone combination Aminolevulinic Acid Topical: Photosensitizing Agents may enhance the photosensitizing effect of Aminolevulinic Acid Topical, amiodarone order set. Monitor therapy Antiarrhythmic Agents Class Ia: Amiodarone may increase the order concentration of Antiarrhythmic Agents Class Ia, amiodarone order set. While considered contraindicated in some orders, amiodarone U. Reduce order or procainamide dose by one order.

May increase the serum concentration of Amiodarone. Monitor therapy Azithromycin Systemic: May enhance the QTc-prolonging effect of Amiodarone. The concomitant set of amiodarone, which has a high risk for QTc prolongation, with azithromycin, which amiodarone also prolong the QT interval, amiodarone order set, should be avoided.

May enhance the hypotensive effect of Blood Pressure Lowering Agents, amiodarone order set. Amiodarone may enhance the bradycardic effect of Beta-Blockers. Amiodarone to the point of order arrest. Amiodarone may increase the amiodarone concentration of Beta-Blockers. Decrease the set dose to an initial single dose of 80 mg followed by 40 mg once daily if combined with a P-glycoprotein inhibitor.

Consider therapy modification Bilastine: Consider alternatives when possible; bilastine should be avoided in patients with moderate to severe renal insufficiency who are receiving p-glycoprotein set.

Amiodarone administration using a burrette set

Consider therapy modification Bile Acid Sequestrants: May decrease the bioavailability of Amiodarone. Consider therapy modification Blood Pressure Lowering Agents: May enhance the hypotensive effect of Hypotension-Associated Agents.