Amiodarone Vs. Lidocaine

[AMESEMT]

Anyone have access or know where to find the price of IV amiodarone when it first came out vs. the cost now? I tried searching online but nothing, just tablets. Thanks!

Ames

P.S. And if possible the cost of lidocaine at the time amiodarone came out and the cost now. Thanks!

[lemming12]

I was confused between the two since when we learned ACLS, all of our scenarios included amiodarone, but in all our class scenarios and in the field, we only use lido. I asked my instructor once why we don't use amiodarone in our area, and he said while it is extremely effective, it is very expensive, but also pt's who receive amiodarone in a resuscitative situation are stuck taking it for the rest of their life. As expensive it is, and also the fact that being dependent on the drug for the rest of your life is just kinda inconvenient; i suppose that is not a very desirable outcome. I have never been able to research it for more details, it seems kinda interesting that amiodarone has such an impact and works in such a way. I wonder just what it screws up.

[AZCEP]

I asked my instructor once why we don't use amiodarone in our area, and he said while it is extremely effective, it is very expensive...

When it was first introduced, it was quite pricey but the cost has come down significantly. Especially when you consider that it can replace several medications cost should not be the determining factor in having it or not.

...but also pt's who receive amiodarone in a resuscitative situation are stuck taking it for the rest of their life.

Please tell me that your instructor did not tell you this. This is a complete fabrication. Patients need to be on the anti-dysrhythmic that is effective for the situation they find themselves in. Amiodarone, due to it's wide range of indications, is extremely useful to have available. Patients will remain on it until something better becomes available. Typically this means admission for ICD placement.

I have never been able to research it for more details, it seems kinda interesting that amiodarone has such an impact and works in such a way. I wonder just what it screws up.

You really need to look this information up as there is valuable insight to be gained from knowing it. If your instructor hasn't already guided you in this direction, it would be a good idea for you to show some initiative on your own to find out.

[Scaramedic]

When it was first introduced, it was quite pricey but the cost has come down significantly.

Significantly, now it's down to about $5 an amp. Not much more than Lido. Dirt cheap compared to Glucagon that goes for over $100 an amp.

[akroeze]

What is a good place to find prices for all the different drugs we carry?

[Scaramedic]

What is a good place to find prices for all the different drugs we carry?

Life Assist

[AMESEMT]

THANK YOU!!!!!!!!!!!!! That was extremely helpful and a pretty cool site. Thanks scaramedic!

[bryan20w]

Well there are a couple of reasons, first of all it has been mentioned by everyone that it is more costly, while the cost has come down it is still more expensive. the main reason for the change form lido to amio is two fold, first of all the new AHA guildlines recomend Amio. also even though the only studies that i am aware of were done by the manufacture of amio it has been clinically proven to work where lido is evidence based practice, the other reason is more technical in that lido decreased ventricular ectopy where amio supresses both atrial and ventricular ectopy.

[AZCEP]

More reading needs to be done on the few studies that claimed that amiodarone was more effective.

1. Because they were driven by the manufacturer, the articles that got amiodarone placed in the 2000 guidelines were at best suspect in accuracy.

2. Amiodarone has been shown to have more patients survive to hospital admission, but no more survive to hospital discharge. The parameters for this are suspect as well, as the definitions are poorly adhered to, or non-existant.

3. Long term survival for both agents is identical. Amiodarone has more deleterious side effects, and lidocaine is more commonly mis-dosed. At one years time, no patients survived no matter which antidysrythmic was used.

4. The use of research to guide practice is evidence based practice. Your description of the use of lidocaine seems to suggest that you are discussing anectdotal evidence, not true evidence based recommendations.

[tniuqs]

More reading needs to be done on the few studies that claimed that amiodarone was more effective.

1. Because they were driven by the manufacturer, the articles that got amiodarone placed in the 2000 guidelines were at best suspect in accuracy.

2. Amiodarone has been shown to have more patients survive to hospital admission, but no more survive to hospital discharge. The parameters for this are suspect as well, as the definitions are poorly adhered to, or non-existant.

3. Long term survival for both agents is identical. Amiodarone has more deleterious side effects, and lidocaine is more commonly mis-dosed. At one years time, no patients survived no matter which antidysrythmic was used.

4. The use of research to guide practice is evidence based practice. Your description of the use of lidocaine seems to suggest that you are discussing anectdotal evidence, not true evidence based recommendations.

Another point for a "paper" presentation sake would be that Lido is CLASS 1b, and Amnio is Class 3 so different mechanisms of action.

A time frame could be introduced as well, Lido has been around for quite some time where as Amnio has not .... I bet the next NEW standards will change the fuzzy warm protocols that we all must "consider". :roll:

Just what ever happened to Procainamide its still classified as 1a ?

cheers