Mindanao State University – Iligan Institute of Technology Student: _________________________

COLLEGE OF NURSING Block: ___________

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: Cordarone Generic Name: Amiodarone Pharmacologic Classification: Antiarrhythmics (class III)

Dosage, Route & Frequency Drug-Drug & Adverse

Side Effects
Drug Action Drug-Food Indications Contraindications Reactions (By
Recommended Prescribed (By System)
Interactions System)
IV (Adults): 150 Amiodarone 150 Prolongs action Drug: inc risk of Life-threatening Contraindicated CNS: confusional CNS: dizziness,
mg over 10 min, mg/3 mL vial potential and QT prolongation ventricular in: Pts with states, fatigue, malaise
followed by 360 refractory period. with arrhythmias cardiogenic disorientation,
mg over the next fluoroquinolones, unresponsive to shock; Severe hallucinations, EENT: corneal
6hr and then 540 Inhibits macrolides, and fewer toxic sinus node headache, microdeposits
mg over the next adrenergic azole antifungals agents. dysfunction; 2nd- insomnia
stimulation. CV: bradycardia,
18 hr. Continue (undertake and 3rd degree
Slows the sinus EENT: abnormal hypotension
infusion at 0.5 concurrent use AV block;
mg/min until oral rate, increases with caution). Inc Bradycardia; sense of smell,
GI: anorexia,
therapy is PR and QT levels of digoxin Hypersensitivity dry eyes, optic
constipation,
initiated. If intervals, and (dec dose of to amiodarone or neuritis, optic
nausea, vomiting
arrhythmia decreases digoxin by 50%). iodine; OB: Can neuropathy,
recurs, a small peripheral Inc levels of class cause fetal hypo- photophobia Derm:
loading infusion vascular I antiarrhythmics or photosensitivity
resistance Resp: ARDS,
of 150 mg over (quinidine, hyperthyroidism;
(vasodilation). PULMONARY Endo:
10 min should be mexiletine, Lactation: Enters
FIBROSIS, hypothyroidism
given; in addition, lidocaine, or breast milk and
Therapeutic PULMONARY
the rate of the flecainide—dec can cause harm
Effects: TOXICITY Neuro: ataxia,
maintenance doses of other to the neonate;
Suppression of involuntary
infusion may be drugs by 30– use an alternative CV: CHF,
arrhythmias. movement,
inc. 50%). Inc levels to breast milk; WORSENING OF paresthesia,
Pharmacokinetics of cyclosporine, Pedi: Safety not ARRHYTHMIAS
Conversion to peripheral
dextromethorpha established;
initial oral therapy neuropathy, poor
A: Slowly and n, methotrexate, products GI: abdominal
—If duration of IV coordination,
variably absorbed phenytoin, containing benzyl pain, abnormal
infusion was <1 tremor
from the GI tract carvedilol, and alcohol should sense of taste,
wk, oral dose (35–65%). IV theophylline. not be used in increased liver
should be 800– administration Phenytoin dec
1600 mg/day; if results in amiodarone neonates. enzymes
IV infusion was complete levels. Inc activity
1–3 wk, oral dose bioavailability. of warfarin (dec Use Cautiously GU: decreased
should be 600– dose of warfarin in: History of HF; libido,
800 mg/day; if IV D: Distributed to by 33–50%). Inc Thyroid epididymitis
infusion was >3 and accumulates risk of disorders;
slowly in body Corneal refractive Derm: TOXIC
wk, oral dose bradyarrhythmias
tissues. Reaches laser surgery; EPIDERMAL
should be 400 , sinus arrest, or
high levels in fat, Severe NECROLYSIS
mg/day. AV heart block
muscle, liver, pulmonary or liver (rare), blue
with beta
lungs, and disease; Geri: discoloration
blockers or
spleen. Crosses calcium channel Initiate therapy at
Endo:
the placenta and blockers. the low end of the
hyperthyroidism
enters breast dosing range due
milk. Cholestyramine to dec hepatic,
may dec renal, or cardiac
Protein Binding: amiodarone function;
96% bound to levels. Cimetidine comorbid
plasma proteins. and ritonavir inc disease; or other
amiodarone drug therapy.
M & E:
levels.
Metabolized by
the Risk of
myocardial
liver, excreted
depression is inc
into bile. Minimal
by volatile
renal excretion.
anesthetics. Inc
On metabolite
risk of myopathy
has
with lovastatin
antiarrhythmic
and simvastatin
activity
(do not exceed
40 mg/day of
lovastatin or 20
mg/day of
simvastatin).

Natural Products:
St. John’s wort
induces enzymes
that metabolize
amiodarone; may
 dec levels and

effectiveness.
Avoid concurrent
use.

Food: Grapefruit
juice inhibits
enzymes in the
GI tract that
metabolize
amiodarone
resulting in inc
levels and risk of
toxicity; avoid
concurrent use.

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment:  Use dark glasses to ease photophobia; some patients may not be able
to go outdoors in the daytime even with such protection.
 Auscultate chest periodically or when patient complains of respiratory  Follow recommendations for regular ophthalmic exams, including
symptoms. fundoscopy and slit-lamp exam.
 Check for diminished breath sounds, rales, pleuritic friction rub;  Wear protective clothing and a barrier-type sunscreen that physically
observe breathing pattern. blocks penetration of skin by ultraviolet light.
 Drug-induced pulmonary function problems must be distinguished from
CHF or pneumonia. Implementation:
 Keep the physician informed.
 Assess blood pressure periodically, and compare to normal values.
Diagnoses:  Report low blood pressure (hypotension), especially if patient
experiences dizziness or syncope.
 Risk for pulmonary edema  Assess heart rate, ECG, and heart sounds, especially during
 Risk for pneumonia exercise. Although intended to treat certain arrhythmias, this drug
can unmask or precipitate new arrhythmias (proarrhythmic effect).
Planning:
 Report any rhythm disturbances or symptoms of increased
 Check pulse daily once stabilized, or as prescribed. Report a pulse arrhythmias, including palpitations, chest pain, shortness of breath,
<60. fainting, and fatigue/weakness.
 Take oral drugs consistently with respect to meals.
Evaluation:
 Become familiar with potential adverse reactions and report those that
are bothersome to the physician.  No signs of arrhythmias
 Stable pulse rate
 No signs of photophobia