patient on IV Amidorone and PO Amiodorone at the same time?

[raindrop]

The patient was in Afib and the MD ordered a bolus of Ami followed by a continious drip. The patient was also started on PO amiodorone 400mg BID. The drip has been infusing for almost 24 hours and the patient had not yet converted. Patient had also received 3 doses of PO Amio in addition to the drip in the 24 hours. The resident for the evening was upset that the patient had received so much Amio over the course of 24 hours. He said PO should only be given if the drip is going to be turned off within 4-6 hours????

[delphine22]

We just had this the other day and I confirmed with the cards and he said he wanted the drip to stay on for 48 hrs past the initial PO dose.

[ashleigh_0804]

I don't know if this is right or now...but if a patient doesn't convert from amiodarone, should you consider switching to cardizem or another drug??

[delphine22]

I don't know if this is right or now...but if a patient doesn't convert from amiodarone, should you consider switching to cardizem or another drug??

Amio is a last resort for us, it's not the nicest of drugs. We try cardizem first, then PO or maybe betapace depending on the doc. If the amio doesn't work we wait and keep it on a little while to see if it does. But usually we've already tried cardizem and failed. If amio still doesn't work we consult EP and consider ablation.

[StayLost, BSN, RN]

Amio bolus of 150 mg IV over 10 min and then started on a drip at 1 mg/min X 6 hours, then decreased to 0.5 mg/min continuously. When transitioning to PO, the drip is turned off after the second PO dose.