Amiodarone (Pacerone) Nursing Considerations

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Kara Tarr
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Outline

Generic Name

Amiodarone

Trade Name

Cordarone

Indication

a-fib, ventricular arrhythmias, SVT, ACLS protocol for v-fib and v-tach

Action

Prolongs phase 3 of the action potential, makes the heart more tolerant to arrhythmias, inhibits adrenergic stimulation, slows rate, decreases peripheral vascular resistance causing vasodilation

Therapeutic Class

Antiarrhythmic class III, potassium channel blocker

Pharmacologic Class

None

Nursing Considerations

• May lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
• Increases risk for QT prolongation
• Increases digoxin levels
• Increases activity of warfarin
• Monitor EKG continuously while on therapy
• Assess for signs and symptoms of ARDS
• Monitor liver function test
• Check dosage with another RN
• Teach pt to monitor pulse daily and report abnormalities
• Avoid drinking grapefruit juice

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Transcript

Hey guys, let’s talk about amiodarone also known as Pacerone or Cordarone. This is an oral, injectable IV medication. As you can see here, this is an injectable vial. So guys, the therapeutic class or what the drug does to the body is it is a class 3 antiarrhythmic and it’s also a potassium channel blocker, meaning they bind to and block potassium channels, which prolongs repolarization of cell membranes. And as far as the pharmacologic class, well we do not have one. Okay. So the action of amiodarone is that it prolongs phase three of the action potential, and it inhibits aortic stimulation, which slows the heart rate. It decreases peripheral vascular resistance, which causes vasodilation. Amiodarone is used for Afib, ventricular arrhythmias, supraventricular tachycardia, and ACLS protocol for VFib and VTAC.

Okay. So some common side effects seen with amiodarone are nausea, vomiting, hypotension, and bradycardia. Okay. So let, let’s look at a few important things about amiodarone. You should be sure to assess for signs and symptoms of acute respiratory distress syndrome or ARDS, monitor the patient’s liver function, and EKG continuously during therapy. Important to remember that the digoxin levels, the activity of warfarin, and the risk for QT prolongation, all increase with amiodarone. And amiodarone may lead to congestive heart failure and pulmonary toxicity. Teach the patient to avoid grapefruit juice and monitor the pulse daily. Guys with patients on amiodarone, we have to closely assess them for amiodarone toxicity. Listen to your patient’s symptoms, because it could be because of too much of this medication. I know of a patient who lost their life because their symptoms were ignored all due to amiodarone toxicity. That’s it for amiodarone or Pacerone, or Cordarone. Now go out and be your best self today. And as always happy nursing.

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ER

Concepts Covered:

  • Cardiovascular
  • Emergency Care of the Cardiac Patient
  • Cardiac Disorders
  • Circulatory System
  • Fundamentals of Emergency Nursing
  • Emergency Care of the Neurological Patient
  • Emergency Care of the Respiratory Patient
  • Medication Administration
  • Vascular Disorders
  • Emergency Care of the Trauma Patient
  • Shock
  • Intraoperative Nursing
  • Communication
  • Delegation
  • Postoperative Nursing
  • Studying
  • Legal and Ethical Issues
  • Neurological Trauma
  • Neurological
  • Multisystem
  • Neurological Emergencies
  • Musculoskeletal Trauma
  • EENT Disorders
  • Central Nervous System Disorders – Brain
  • Perioperative Nursing Roles
  • Respiratory Emergencies
  • Health & Stress

Study Plan Lessons

02.01 Hypertensive Crisis for CCRN Review
02.08 Cardiac Catheterization & Acute Coronary Syndrome for CCRN Review
02.09 12 Lead EKG- Leads 1, 2, 3, aVL, and aVF for CCRN Review
02.10 12 Lead EKG- Lead V1-V6 for CCRN Review
02.11 12 Lead EKG- Injuries for CCRN Review
06.04 Differentiating Ectopy and Aberrancy for CCRN Review
06.05 Wide Complex Tachycardia for CCRN Review
1st Degree AV Heart Block
2nd Degree AV Heart Block Type 1 (Mobitz I, Wenckebach)
2nd Degree AV Heart Block Type 2 (Mobitz II)
3rd Degree AV Heart Block (Complete Heart Block)
Abuse
Abuse and Neglect for Certified Emergency Nursing (CEN)
Acute Confusion
Acute Coronary Syndrome (ACS)
Acute Coronary Syndrome (ACS) Module Intro
Acute Coronary Syndrome for Certified Emergency Nursing (CEN)
Acute Respiratory Distress
Adenosine (Adenocard) Nursing Considerations
Aggressive & Violent Patients
Amiodarone (Pacerone) Nursing Considerations
Aneurysm & Dissection
Aneurysm and Dissection for Certified Emergency Nursing (CEN)
Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Atrial Fibrillation (A Fib)
Atrial Flutter
AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Bleeding for Certified Emergency Nursing (CEN)
Blunt Abdominal Trauma
Blunt Thoracic Trauma
Calling for RRT, Code Blue
Cardiac Arrest Nursing Interventions for Certified Perioperative Nurse (CNOR)
Cardiopulmonary Arrest
Cardiopulmonary Arrest for Certified Emergency Nursing (CEN)
Cardiovascular Trauma for Certified Emergency Nursing (CEN)
Combative: IV Insertion
Conflict Management (Patient, Perioperative Team, Family) for Certified Perioperative Nurse (CNOR)
Crash Cart
Critical Incident Management
Crush Injuries
Day in the Life of an ICU (Intensive Care Unit) Nurse
Delegation of Tasks to Assistive Personnel for Certified Emergency Nursing (CEN)
Discharge Planning for Certified Emergency Nursing (CEN)
Drugs for Bradycardia & Low Blood Pressure Nursing Mnemonic (IDEA)
Dysrhythmia Emergencies
Dysrhythmias for Certified Emergency Nursing (CEN)
EKG Basics – Live Tutoring Archive
Emergency Drugs Nursing Mnemonic (LEAN)
Emergency Nursing Course Introduction
EMTALA & Transfers
Ethical Dilemmas for Certified Emergency Nursing (CEN)
Fall and Injury Prevention
Flight Nurse
Forensic Nurse
Gastrointestinal Trauma for Certified Emergency Nursing (CEN)
Head and Spinal Cord Trauma for Certified Emergency Nursing (CEN)
Head Trauma & Traumatic Brain Injury
Heart (Heart) Failure Exacerbation
Hypertension (HTN) Concept Map
Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)
Hypertension for Certified Emergency Nursing (CEN)
Hypertensive Emergency
Increased Intracranial Pressure
Increased Intracranial Pressure (ICP) for Certified Emergency Nursing (CEN)
Injection Injuries for Certified Emergency Nursing (CEN)
Intracranial Hemorrhage
Ischemic (CVA) Stroke Labs
Joint Commission
Lacerations for Certified Emergency Nursing (CEN)
Legal & Ethical Issues in ER
Massive Transfusion Protocol
Maxillofacial Trauma for Certified Emergency Nursing (CEN)
Nursing Care Plan (NCP) for Atrial Fibrillation (AFib)
Nursing Care Plan (NCP) for Seizures
Nursing Case Study for Head Injury
Nursing Skills (Clinical) Safety Video
Patient and Healthcare Team Safety (Disasters, Environmental Hazards) for Certified Perioperative Nurse (CNOR)
Patient Safety for Certified Emergency Nursing (CEN)
Patient Satisfaction for Certified Emergency Nursing (CEN)
Penetrating Abdominal Trauma
Penetrating Injuries for Certified Emergency Nursing (CEN)
Penetrating Thoracic Trauma
Premature Atrial Contraction (PAC)
Premature Ventricular Contraction (PVC)
Procainamide (Pronestyl) Nursing Considerations
Pulmonary Embolism
Pulmonary Embolus for Certified Emergency Nursing (CEN)
Rapid Sequence Intubation
Respiratory Distress Syndrome for Certified Emergency Nursing (CEN)
Respiratory Trauma for Certified Emergency Nursing (CEN)
Restraints
Restraints 101
Risk Management for Certified Emergency Nursing (CEN)
Safety Check Nursing Mnemonic (MADLE)
Safety Checks
Seizure Assessment
Seizure Causes (Epilepsy, Generalized)
Seizure Management in the ER
Seizure Therapeutic Management
Seizures Case Study (45 min)
Seizures Module Intro
Sexual Assault and Battery for Certified Emergency Nursing (CEN)
Sinus Bradycardia
Sinus Tachycardia
Stress and Crisis
Stroke (CVA) Management in the ER
Stroke (CVA) Module Intro
Stroke Case Study (45 min)
Supraventricular Tachycardia (SVT)
Transfer and Stabilization for Certified Emergency Nursing (CEN)
Trauma – Complications Nursing Mnemonic (TRAUMATIC)
Trauma Nursing Interventions for Certified Perioperative Nurse (CNOR)
Trauma Surgery – Medical History Nursing Mnemonic (AMPLE)
Trauma Survey
Triage
Triage in the ER
Triage Nursing Mnemonic (START)
Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)
Ventricular Fibrillation (V Fib)
Ventricular Tachycardia (V-tach)
Verapamil (Calan) Nursing Considerations
Wound Bleeding (Uncontrolled External Hemorrhage) for Certified Emergency Nursing (CEN)