amiodarone administration

[brock8024]

Very simple really. You can figure out gtt/min is you are given mg/min, but you can't really figure out mg/min when given gtt/min, thenfore it's always best to describe in mg/min. Everything else is variable, but mg/min should always be constant.

Ok I will say sorry again. I guess when I said 150mg in 25ml in 10 mins but this time I will say with a 60drop drip set. You have the amount to be infused and the time to infuse it. I would hope that if you are giving a drug and the doctor asked how much was given you could look at the amount left and tell him.

I will admit that I did not know we was giving 6mg/min. I know realise that it is easy to figure up the amount given. I will agree with that. I guess my thing was that wether I give it 150mg/25ml over 10 min or he gives it 150mg/30ml ivp in 10 min there is really no difference.

I would also hope that all paramedics are taught to give all drugs through a 60 drop micro set.

I guess the point I was trying to make was that sometimes we have to be able to figure out drip rates and be able to use micro drop sets sometimes. And your reply makes no real sense to me. I was able to figure out that I am giving 6mg/ml is 15mg/min because you give 2.5ml a min which is 150mg over 10 mins. you just have to do the math to figure it out.

[OVeractiveBrain]

Amiodarone should be used when the focus of disrythmia cannot be established, when there is sufficient time (10 minute push) and when there is not significant hypotension.

Amiodarone is given for any tachycardia, narrow or wide and given 150mg IVP over 10 minutes backed up by an infusion. Some protocols say 1.0mg/min for 6hrs then 0.5mg/min for 12, others just say 0.5mg/min. A simple way of making it is taking your 150mg dose (which is approximately 125mg) in 250mL in a 60 gtts set running at ~60gtts/min

Math: 250cc x 0.5mg x 60gtts = 60gtts/min (250/125 = 2, 2 * 0.5 = 1 both fractions multiply out to 1)

125mg 1.0min cc

Amiodarone is given in Vfib/Pulseless Vtach arrest by administering 300mg IVP.

Amiodarone DOES NOT HAVE the side effect of lidocaine (seizures) and is safer to use in the acute setting. Though it may cause more profound hypotension than lido, and therefore should be used with caution in patients with less than 100 systolic (i know hard numbers are often misleading), its incidence of adverse side effects is less. Much talk of amiodarone's problematic toxicity comes from its chronic use and the toxicity comes from its preparation, not the drug itself (though may). Therefore, if the patient is stable enough to sit around for 10 minutes (i.e. is throwing up runs of PVCs opposed to a full on VTach at 220, and yes, i know to assess my patient fully) give them Amio. Otherwise, give them lido.

It really comes down to your own preference and the stability of the patient. Amio is a great drug to make the problem go away. If they are stable and mildly symptomatic (palpitations, mild dyspnea, sweats, no AMS, no N/V, no CP) then Amio is the way to go. If they are starting to crap out on you, but cardioversion is not indicated (high hr, dropping BP, mentation still established, again still no CP) then go for Lido. When the patient finally starts to die (i.e. AMS, CP, N/V, Syncope, Pulselessness) light that sucker up. Recommended 200J biphasic or 360J monophasic Ventricular, 100J monophasic atrial (for your PSVTs which amio can also help with).

-Overactive

[vs-eh?]

Amiodarone is given for any tachycardia, narrow or wide and given 150mg IVP over 10 minutes backed up by an infusion. Some protocols say 1.0mg/min for 6hrs then 0.5mg/min for 12, others just say 0.5mg/min. A simple way of making it is taking your 150mg dose (which is approximately 125mg) in 250mL in a 60 gtts set running at ~60gtts/min

Math: 250cc x 0.5mg x 60gtts = 60gtts/min (250/125 = 2, 2 * 0.5 = 1 both fractions multiply out to 1)

125mg 1.0min cc

Well I guess it would be simple if you added one weight of medication and said it was approximately another. Just so it appears to make your math easier.

People are making this way more difficult than needed.

Instead of adding 150mg to 250ml and saying that it is approx. 125mg in 250ml, why not simply ADD 125mg? Or 250mg for that matter? Actually making it 0.5mg or 1mg/ml and allowing infusion to be more accurate. Not the 0.6mg per ml that 150mg in 250 is...

I assume you use 150mg in 3ml (50mg/ml). 125mg = 2.5ml = 0.5mg/ml (250ml volume). Or add 250mg (5ml) to make 1mg/ml (250ml volume).

Not hard, and more accurate. I'm sure your physicians would appreciate that.

[OVeractiveBrain]

People find it easier to be repetitive, and the mL volume comes up a bit off if you draw up 125mg. Thusly ~60gtts /min in the set up i gave it pretty good. If youre concerned at all, and the first fraction is a little more than 1/2, drop it to 52gtts/ min which is really not going to matter, since your gtts/min are never precise preceise, in the area of 50-60gtts/min is appropriate. If youhad a pump you could do it directly irrelevant of the concentration. However, it is difficult to choose arbitrary (such as 125 over 150) dosage amounts as the packaging comes preset mLs. Its easier for peopel to understand how to draw up the 150 (since they JUST gave it) and a drop count thats off by 10% really isnt that bad, as youre eyeballign the drip rate anyway.

-Overactive