Of note during cardiac arrest code: Although both Epinephrine and Amiodarone are recommended per ACLS to be given between CPR and defibrillations for Vfib/Vtach, Amiodarone is the only one to improve survival.
- Epinephrine does NOT improve patient survival to hospital admission.
- Amiodarone DOES improve survival to hospital admission but has not been proven to improve survival to hospital discharge.
Amiodarone: Initiation and transfer to PO.
– Complete Amiodarone loading dose IV: 150 mg IV x1 over 10 minutes. Then 1 mg/min IV x 6hr. Then 0.5 mg/min IV x18 hour. Loading dose administered over 24 hour total.
– Start PO Amiodarone at 400 mg BID for 1 week. Will then give Amiodarone 400 mg daily for another week. Then follow with Amiodarone 200 mg daily from there. Patient may need to be on Amiodarone indefinitely. Will assess in future if he can be tapered off.
– Patient will need PFT, TFT, LFT, and eye exam annually if on Amiodarone long term.
– PT/INR continues to remain therapeutic. On warfarin and amiodarone (Amiodarone increases INR). Needs monitoring.