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What is the mechanism of action of Amiodarone? - ANSWER-
Blockade of calcium, sodium and potassium channels as well
as blocking beta receptors
- prolongs refractory period
- slows sinus rate, increases PR and QT intervals
**suspends arrhythmias
What are the clinical indications for Amiodarone? - ANSWER-
Life-threatening
ventricular arrhythmias (SVT, Vfib,
pulseless Vtach)
- post defibrillation in cardiac arrest with
persistent VT or VF
- hemodynamically stable VT or
torsades
- as an adjunct to electrical
cardioversion
- supraventicular tachyarrhythmias (A. fib with RVR or
rapid A. flutter)
,Who is amiodarone contraindicated in? - ANSWER--
cardiogenic shock
- 2nd- and 3rd-degree AV block
- bradycardia
- recent use of another anti-arrhythmic (such as lidocaine)- may
cause QT prolongation or cardiotoxicity
- hepatic failure (extensively metabolized by the liver with an
extremely long half-life)
What are common side effects of taking amiodarone? -
ANSWER-- hypotension - bradycardia
- heart block
What dose of amiodarone is given for the varying indications?
- ANSWER-300
mg - cardiac arrest (pulseless VT
and VF)
150 mg - hemodynamically stable VT or Torsades
What are the administration considerations for Amiodarone? -
ANSWER-- must be administered through a 0.22-micron in-line
filter
- infusions lastly more than 2 hours should be administered via
glass bottle or polyolefin bags
- central line administration is preferred
- IV amioderone is not recommended for longer than 3 weeks -
extremely long half-life!!!!
, How many and what are the various indications for TPA at
BMC? - ANSWER-1.
peripheral arterial occlusions
2. pleural effusions
3. catheter occlusions
4. acute ischemic stroke
5. acute pulmonary embolism
6. acute STE myocardial infarction
What are contraindications to TPA administration? - ANSWER-
ACTIVE internal
bleeding
- intracranial neoplasm, AVM, or
aneurysm
- recent intracranial/intraspinal trauma/surgery or
previous stroke
- known bleeding
diathesis
- severe uncontrolled HTN (SBP
>200)
What is the process for the utilization of TPA for catheter
occlusions? - ANSWER-- instill 1mg/2mL of TPA into occluded
IV catheter
- clamp catheter and allow the drug to instill for 30 minutes
- attempt to aspirate blood from the catheter after 30 minutes; if
catheter is still occluded allow the drug to instill for remaining
90 minutes