Rx Update: February 2001
Mary Ross, R.Ph., M.B.A.
Peer Review Status: Internally Reviewed
Because amiodarone may produce vasodilation and hypotension, have negative inotropic effects, and cause the QT interval to be prolonged, patients should have continuous ECG and blood pressure monitoring during administration.
Amiodarone injection is available as a 50 mg/ml injection in 3 ml ampules. Each emergency drug tray contains three ampules. The dose of amiodarone in a cardiac arrest situation is 300 mg (two ampules) IV push in 20 to 30 ml of D5W, an additional 150 mg dose IV push may be repeated in 3 to 5 minutes. Use of diluents other than D5W is not recommended.
If a continuous infusion is needed, call Pharmacy as soon as possible. Amiodarone is only stable for 2 hours when diluted in a PVC bag. Therefore, additional supplies for maintenance infusions will be prepared by pharmacy in glass bottles that have a 24-hour expiration dating.
The University of Iowa Hospitals and Clinics (UIHC's) Adverse Drug Event Subcommittee has written a document entitled WHITE PAPER 2000: ADVERSE DRUG EVENTS. This paper is being made available to Medical staff, Nursing staff, Pharmacy staff and others involved with medication use systems at UIHC. The paper provides background information on adverse drug events (ADEs) and their prevention, and is intended to stimulate discussion of this important topic. More specifically, this document: defines the various types of occurrences which may be classified as an adverse drug event; examines current methods used to identify and prevent future ADEs; discusses evolving prevention strategies; and reviews research initiatives associated with ADE prevention. WHITE PAPER 2000: ADVERSE DRUG EVENTS is also intended to inform care providers about the UIHC's processes for handling ADEs and serve as a primer for a topic which can have major impact upon patient care and patient outcomes.
You may access the complete text of this document at the following address: http://www.uihealthcare.com/pharmacy/papers/adewp.pdf