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Ibutilide Fumarate

Ibutilide Fumarate

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Published by: api-3797941 on Oct 17, 2008
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ibutilide fumarate
(eyeb yu' ti lyed)
Pregnancy Category C
Drug class
Antiarrhythmic (predominately class III)
Therapeutic actions
Prolongs cardiac action potential, increases atrial and ventricular refractoriness; produces
mild slowing of sinus rate and AV conduction.
Rapid conversion of atrial fibrillation or flutter of recent onset to sinus rhythm;
most effective in arrhythmias of < 90 days' duration
Contraindications and cautions
Contraindicated with hypersensitivity to ibutilide; second- or third-degree AV
heart block, prolonged QTc intervals.
Use cautiously with ventricular arrhythmias, pregnancy, lactation, renal and
hepatic impairment.
Available forms
Solution\u20140.1 mg/mL
< 60 kg: 0.1 mL/kg (0.01 mg/kg) infused over 10 min; may be repeated after 10 min if
arrhythmia is not terminated.
> 60 kg (132 lb): 1 vial (1 mg) infused over 10 min; may be repeated after 10 min if
arrhythmia is not terminated.
Not recommended.
10 min

Metabolism: Hepatic; T1/2: 6 hr
Distribution: Crosses placenta, may be excreted in breast milk
Excretion: Urine and feces

IV facts
Preparation: May be diluted in 50 mL of diluent, 0.9% sodium chloride, or 5% dextrose
injection; one 10-mL vial added to 50 mL of diluent yields a concentration of
0.017 mg/mL; may also be infused undiluted; diluted solution is stable for 24 hr at room
temperature or for 48 hr refrigerated.
Infusion: Infuse slowly over 10 min.
Compatibilities: Compatible with 5% dextrose injection, 0.9% sodium chloride
Incompatibilities: Do not mix in solution with any other drugs.
Adverse effects
CNS: Headache, light-headedness, dizziness, tingling in arms, numbness
CV: Ventricular arrhythmias, hypotension, hypertension
Increased risk of serious to life-threatening arrhythmias with disopyramide,
quinidine, procainamide, amiodarone, sotalol; do not give together
Increased risk of proarrhythmias with phenothiazines, TCAs, antihistamines
Use cautiously with digoxin because ibutilide may mask digoxin cardiotoxicity
Nursing considerations
History: Hypersensitivity to ibutilide; second- or third-degree AV heart block,
time of onset of atrial arrhythmia; prolonged QTc intervals; pregnancy, lactation;
ventricular arrhythmias
Physical: Orientation; BP, P, auscultation, ECG; R, adventitious sounds

Determine time of onset of arrhythmia and potential benefit before beginning therapy. Conversion is more likely in patients with arrhythmias of short (< 90 days') duration.

Ensure that patient is adequately anticoagulated, generally for at least 2 wk, if
atrial fibrillation lasts > 2\u20133 days.

Monitor ECG continually during and for at least 4 hr after administration. Be alert
for possible arrhythmias, including PVCs, sinus tachycardia, sinus bradycardia,
varying degrees of block at time of conversion.

Keep emergency equipment readily available during and for at least 4 hr after

Provide appointments for continued follow-up, including ECG monitoring;
tendency to revert to atrial arrhythmia after conversion increases with length of
time patient was in abnormal rhythm.

Teaching points
This drug can only be given by IV infusion. You will need ECG monitoring
during and for 4 hours after administration.

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