Mindanao State University – Iligan Institute of Technology Student: Dosdos, Bianca Mikaela F.

Block: CCC
COLLEGE OF NURSING

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: Pacerone, Cordarone, and Nexterone Generic Name: __Amiodarone_____________ Drug Classification: CARDIOVASCULAR AGENT; ANTIARRHYTHMIC, CLASS III

Dosage, Route &

Frequency Drug-Drug & Drug-Food Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommen Prescrib Interactions (By System) (By System)
ded ed
Adult:  Amiodaro Prolongs action Drug:  Life-threatening ventricular Hypersensitivity to CNS: confusional CNS:
ne 150 potential and arrhythmias unresponsive to amiodarone, or benzyl states, disorientation, dizziness, fatigue, m
PO Loading mg/3ml refractory period. Significantly increases digoxin levels; less toxic agents.  alcohol; cardiogenic hallucinations, alaise
Dose  vial Inhibits enhances pharmacologic effects and shock, severe sinus headache, insomnia
adrenergic toxicities Unlabeled Use: bradycardia, advanced EENT: corneal
800–1600 of disopyramide, procainamide, quini EENT: abnormal sense microdeposits
stimulation. AV block unless a
mg/d in 1–2 dine, flecainide, lidocaine, lovastatin,  PO: Management of of smell, dry eyes, optic
Slows the sinus pacemaker is
doses for 1– simvastatin; anticoagulant effects supraventricular neuritis, optic CV: bradycardia, hyp
rate, increases available, severe
3 wk  of ORAL tachyarrhythmias.  neuropathy, otension
PR and QT sinus-node dysfunction
intervals, and ANTICOAGULANTS enhanced;  or sick sinus photophobia
PO IV: As part of the Advanced GI:
decreases verapamil, diltiazem, BETA- syndrome,
Maintenance Cardiac Life Support (ACLS) Resp: ADULT anorexia, constipatio
peripheral ADRENERGIC BLOCKING bradycardia,
Dose 400– and Pediatric Advanced Life RESPIRATORY n, nausea, vomiting
vascular AGENTS may potentiate sinus congenital or acquired
600 mg/d in Support (PALS) guidelines for DISTRESS
resistance bradycardia, sinus arrest, or AV QR prolongation Derm:
1–2 doses  the management of ventricular SYNDROME (ARDS),
(vasodilation).  block; may increase phenytoin levels syndromes, or history
fibrillation/pulseless ventricular PULMONARY
IV Loading 2- to 3-fold; cholestyramine may of torsade de pointes; Photosensitivity
tachycardia after FIBROSIS,
Dose  Therapeutic decrease amiodarone severe liver disease,
cardiopulmonary resuscitation PULMONARY  Endo: hypothyroidis
Effects: Suppres levels; fentanyl may cause children. Safety during
and defibrillation have failed; TOXICITY.  m
150 mg over sion of bradycardia, hypotension, or pregnancy (category
also for other life-threatening
10 min arrhythmias. decreased output; may D) or lactation is not
tachyarrhythmias. CV: CHF, WORSENING Neuro: ataxia, involu
followed by increase cyclosporine levels and established. OF ARRHYTHMIAS ntary
360 mg over toxicity; cimetidine may increase
movement, paresthe
next 6 h amiodarone levels; ritonavir may GI: LIVER FUNCTION sia, peripheral
increase risk of amiodarone toxicity, ABNORMALITIES,
IV neuropathy, poor
including cardiotoxicity.  abdominal pain,
Maintenance coordination, tremor.
abnormal sense of taste
Dose  Herbal: Echinacea possible increase
540 mg over in hepatotoxicity.
18 h (0.5
mg/min),
may
continue at
0.5 mg/min 

Convert IV
to PO 

Duration of
infusion <1
wk use 800–
1600 mg
PO, 1–3 wk
use 600–800
mg PO, >3
wk use 400
mg PO

Child: 

PO Loading
Dose 

10–15
mg/kg/d or
600–800
mg/1.73
m2/d, in 1–2
divided
doses for 4–
14 d cycle or
until
adequate
control of
arrhythmia 

PO
Maintenance
Dose 

5 mg/kg/d or
200–400
mg/1.73
m2/d once
daily, may
be able to
reduce to 2–
5 mg/kg/d 5
d per week

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment: Implementation:

 Auscultate chest periodically or when patient complains of respiratory  Assess blood pressure periodically, and compare to normal values.
symptoms.
 Check for diminished breath sounds, rales, pleuritic friction rub; observe
breathing pattern.  Report low blood pressure (hypotension), especially if patient experiences dizziness or syncope.
 Drug-induced pulmonary function problems must be distinguished from CHF
or pneumonia.
 Assess heart rate, ECG, and heart sounds, especially during exercise Although intended to treat
 Keep physician informed.
certain arrhythmias, this drug can unmask or precipitate new arrhythmias (proarrhythmic effect).
Diagnoses:
 Report any rhythm disturbances or symptoms of increased arrhythmias, including palpitations,
 Risk for pulmonary edema
 Risk for pneumonia chest pain, shortness of breath, fainting, and fatigue/weakness.

Evaluation:

Planning:
 No signs of arrythmias
 Check pulse daily once stabilized, or as prescribed. Report a pulse <60.
 Take oral drug consistently with respect to meals.  Stable pulse rate
 Become familiar with potential adverse reactions and report those that are
bothersome to the physician.
 Use dark glasses to ease photophobia; some patients may not be able to go
 outdoors in the daytime even with such protection.
 No signs of photophobia
 Follow recommendation for regular ophthalmic exams, including funduscopy
and slit-lamp exam.
 Wear protective clothing and a barrier-type sunscreen that physically blocks
penetration of skin by ultraviolet light