Amiodarone drug study PDF

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Drug Study by Catherine Espinosa

Generic Name: amiodarone

Trade Name(s): Nexterone, Pacerone

Drug Classification: Therapeutic: antiarrhythmics (class III) Therapeutic Uses: Suppression of arrhythmias

Maximum Dosage/24 hours: PO: 800-1600 mg/day in 1-2 doses for 1-3 wks, then 600800mg/day in 1-2 doses for 1 mo, then 400 mg/ day maintenance dose. IV: 150 mg over 10 min, followed by 360 mg over the next 6 hr and then 540 mg over the next 18 hr (0.5 mg/min)

Possible Routes of Administration: PO, IV

Usual Dosage and Frequency: PO: 400 mg/ day maintenance dose. IV: 540 mg over 18 hours (0.5 mg/min) maintenance infusion This Patient’s Dose and Frequency: 800 mg/day PO

Mechanism of Action: Prolongs action potential and refractory period. Inhibits adrenergic stimulation. Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance (vasodilation)

Adverse Effects: confusional states, dizziness, fatigue, malaise, ADULT RESPIRATORY DISTRESS SYNDROME (ARDS), PULMONARY FIBROSIS, PULMONARY TOXICITY, HF, WORSENING OF ARRHYTHMIAS, QT INTERVAL PROLONGATION, bradycardia, hypotension, anorexia, ataxia, N&V, TOXIC EPIDERMAL NECROLYSIS, (rare), periphral neuropathy

Nursing Implications:

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Monitor ECG continuously during IV therapy.

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Monitor heart rate and rhythm throughout therapy. QT prolongation may be associated with worsening of arrhythmias, monitor closely during IV therapy. Report bradycardia or increase arrhythmias; patient receiving IV therapy may require slowing rate, discontinuing infusion, or inserting temporary pace maker.

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Assess for signs of pulmonary toxicity and signs and symptoms of ARDS. Chest x-ray and pulmonary function tests are recommended before therapy. Report any dyspnea, tachypnea, or rales/crackles

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Lab Test Considerations: Monitor liver and thyroid functions before and every 6 mo during therapy

Patient Teaching: •

Instruct patient to take amiodarone as directed. If a dose is missed, do not take at all. Consult health care professional if more than two doses are missed.

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Advise patient to avoid drinking grapefruit juice during therapy.

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Teach patient to monitor pulse daily and report abnormalities.

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Advise patient that photosensitivity reactions may occur. Protective clothing and sunblock are recommended during and for 4 mo after therapy

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Inform patients that blueish discoloration of the face, neck, and arms is a possible side effect. This is usually reversible and will fade over several mo. Notify health care professional if this occurs.

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Advise patient to notify healthcare professional if thyroid dysfunction occurs

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Advise female patient to notify healthcare professional if pregnancy is planned or suspected and to avoid breast feeding during therapy....