Amiodarone

Question 1

Drug Class

Answer 1

Antiarrhythmics

Question 2

Active

Answer 2

Amiodarone

Question 3

Indications

Answer 3

Treatment and prophylaxis of serious tachyarrhythmias refractory to other treatment (including ventricular tachycardia, AF and SVT)

Question 4

Dose Range

Answer 4

Initially 200-400mg tds for 1 week,

then 200-400mg bd for 1 week,

then 200-400mg daily if appropriate according to TDM

Question 5

SE’s

Answer 5

• anorexia
• n/v
• constipation
• taste disturbance (metallic taste, loss of taste)
• photosensitivity
• blue skin pigmentation
• neurotoxicity
• HYPO/HYPER THYROID (contains iodine)
• PULMONARY TOXICITY
• vivid dreams and nightmares

long t1/2 (35 – 40 days) means that side effects/DI persist for a while after amiodarone is ceased

Question 6

Counselling

Answer 6

Labels: 5, 8, 18

• While taking amiodarone avoid sun exposure, wear protective clothing whenever outdoors, use sunscreen (broad spectrum, factor 30+ sunscreen containing titanium dioxide is recommended)
• Amiodarone interacts with grapefruit juice and many other drugs; avoid grapefruit and tell your doctor or pharmacist that you are taking amiodarone before starting any new medication.
• You will need regular blood tests, ECGs and chest x-rays while taking amiodarone.
• Tell your doctor if you develop shortness of breath or a dry cough, problems with your vision, weight loss, muscle weakness or worsening of your heart symptoms.

Question 7

Monitoring

Answer 7

• BP (severe hypotension and circulatory collapse can occur)
• concentration
• before starting, check baseline:
  • clinical status
  • serum electrolyte
  • thyroid and liver function
  • lung function (including chest x-ray)
  • ECG
• every 6 months, check:
  • thyroid function
  • liver function
  • serum electrolyte
• annually:
  • chest x-ray
  • ECG