【藥品性質提示】 根據 2019 AGS Beers Criteria，本藥品為【潛在不適當用藥 (PIM)】，不建議用於老年人第一線治療。 #建議持續輸注 (IV pump) 之高警訊藥品

治療心律不整 Recurrent ventricular fibrillation and tachycardia (unresponsive to adequate dose of other antiarrhythmic agents); refractory supraventricular arrhythmias

Class III Antiarrhythmic Agent
Amiodarone HCl is an antiarrhythmic drug with effects of lengthening cardiac action potential and blocking myocardial potassium channels leading to slowed conduction and prolonged refractoriness.

Absorption:
Bioavailability: approximately 50% (35% to 65%)
Distribution:
1. Vd: about 60 L/kg
2. Protein binding: approximately 96%
Metabolism:
Hepatic: extensive; P450 CYP3A4 and CYP2C8
Excretion:
1. Bile: primary excretion site
2. Renal: negligible amount (less than 1%)
3. Dialyzable: no
Elimination Half Life:
IV, single-dose: 9 to 36 days

1. Bradycardia, impairment of A-V conduction, heart failure
2. Patient with iodine sensitivity, disorders of the thyroid gland
3. Do not expose to sunlight
4. Can't be used with MAO inhibitors, beta-blockers or calcium antagonists

D/C in controversy

Avoided, amiodarone present significant concentration in breast milk. An accumulation of this drug in the lung and liver has been reported. Also each 200mg of amiodarone contains 75mg of iodine.

Benign yellowish-brown corneal microdepositis, photosensitivity, severe bradycardia, conduction disturbances, hypotension, hypo- or hyperthyroidism, peripheral neuropathy, tremor, ataxia, paresthesia, anorexia, nausea, vomiting, constipation, nightmares, and fatigue. The most common adverse effects requiring discontinuance of oral amiodarone are pulmonary infiltrates or fibrosis, paroxysmal ventricular tachycardia, congestive heart failure, and elevations of serum hepatic enzyme concentrations.

IV loading dose:
150 mg at rate of 15 mg/min over 10 min, then 360 mg at rate of 1mg/min (over 6 hrs).
IV maintenance dose:
540 mg at rate of 0.5 mg/min (over 18 hrs), after first 24 hrs the maintenance infusion rate of 0.5 mg/min (720 mg over 24 hrs) should be continued.

Use only dextrose solution as solvent. Concentrations weaker than 300 mg in 500 ml are not stable. Amiodarone injection infusions exceeding 2 hours must be administered in glass or polyolefin bottles containing D5W.