MEDICATIONS: T A C T I S DRUG NAME: TRADE / GENERIC__AMIODARONE_________________________________________________________________________ DOSE / ROUTE / FREQUENCY___200mg/PO______________________________________________________________________________ PHARMACOLOGICAL CLASSIFICATION_____ANTIARRHYTHMICS (CLASS III)_________________________________________________ Why is THIS client receiving THIS drug?____ Life-threatening ventricular arrhythmias unresponsive to less toxic agents. T Therapeutic Classification - Antiarrhythmics (class III) A C T I S Action Cautions / Contraindications Toxic / Adverse Effects Interventions Safety (list only if contraindicated for THIS patient) (Most serious frequent) (Include NI / considerations (VS, labs, etc.) (Include MSI *& MSD* for all IV Meds) - Prolongs action - Use Cautiously in: potential and refractory period. Inhibits adrenergic stimulation. Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance (vasodilation). History of HF -Dizziness -Fatigue -Bradycardia -Hypotension -Constipation -Nausea -Vomiting - Contraindicated in: Patients with cardiogenic shock -Therapeutic Effects: Suppression of arrhythmias. - Monitor ECG continuously during IV therapy or initiation of oral therapy. Monitor heart rate and rhythm throughout therapy - IV: Assess for signs and symptoms of ARDS throughout therapy. Report dyspnea, tachypnea, or rales/crackles promptly. Bilateral, diffuse pulmonary infiltrates are seen on chest x-ray. -Monitor BP frequently. Hypotension usually occurs during first several hours of therapy and is related to rate of infusion. If hypotension occurs, slow rate. - PO: May be administered with meals and in divided doses if GI intolerance occurs or if daily dose exceeds 1000 mg. ** MSI – minimum safe infusion; MSD – minimum safe dilution Safe dose: □Yes □ No Crushable: □Yes □ No □N/A Ventricular Arrhythmias -PO (Adults): 800– 1600 mg/day in 1– 2 doses for 1– 3 wk, then 600– 800 mg/day in 1– 2 doses for 1 mo, then 400 mg/day maintenance dose. - IV (Adults): 150 mg over 10 min, followed by 360 mg over the next 6 hr and then 540 mg over the next 18 hr. Continue infusion at 0.5 mg/min until oral therapy is initiated. If arrhythmia recurs, a small loading infusion of 150 mg over 10 min should be given; in addition, the rate of the maintenance infusion may be increase.