amiodarone on dialysis?

Lacie, BSN, RN · Sep 26, 2009

Here's just a quick listing you can use and amiodarone isnt dialyzed out. I keep this little list in my pocket as it's a quick reference and also states how much of certain drugs are dialyzed out during treatment. Saves toting a small book around :) Hope this helps.

Courtney Nurse Writer, BSN · Sep 26, 2009

oops. There wasn't a link to anything. :) But what I was really wondering is if it was dangerous to give it to the patient while on dialysis. Will it make this patient crash? But a list would be really neat to have as well!!

Tish88 · Sep 26, 2009

I never held the dose of amiodarone.

Amiodarone is used to help keep the heart beating normally in people with life-threatening heart rhythm disorders of the ventricles. Amiodarone is used to treat ventricular tachycardia or ventricular fibrillation.

It does has some dilation effects on the vessels, but I would rather treat the patient for a decrease in their blood pressure, as opposed to treating VT or VF...

If you are still unsure, ask the patient's nephrologist or cardiologist.

Lacie, BSN, RN · Sep 26, 2009

oops. There wasn't a link to anything. :) But what I was really wondering is if it was dangerous to give it to the patient while on dialysis. Will it make this patient crash? But a list would be really neat to have as well!!

Oops sorry about that :imbar I agree with Tish though as I would much rather not have issue related to the cardiac dysrhythmias over the hypotension therefore give the amiodarone as prescribed. It's primarily antihypertensive drugs I request be held prior or during tx. Also I find many times NTG patches are applied prior to dialysis which can affect b/p. If I have pts from SNF etc I know recieve patches I usually check to ensure it's off and request it be held till post tx. Just my 2 cents.

http://www.thedrugmonitor.com/dialysistbl.html It's just kind of a quick list that I inputted into my phone for a quick reference without having to upload a book. Also you can just print it out and it's handy to have in your pocket should you need it. :) Mostly the basics.

Courtney Nurse Writer, BSN · Sep 27, 2009

Great. Thank you so much for the input. It really helps.

chickenmomma · Sep 30, 2009

Just an FYI....if the Joint Comish ever asks what you hold for dialysis the correct answer is

: "whatever the doctor orders to be held" :)

I know that this isn't reality, just wanted to pass this along,its what jcaoh wants to hear.

rninmi · Oct 12, 2009

This has come up a couple of times at my acute unit....Amio is hepatically cleared. I am told it does not dialyze out by several physicians. Including pharmacists. The problem is it seems as though it does at times. Pt's on amio gtts are on it for rate control and rhythm control.....may have chf, myopathy, valves etc...usually unstable pts to begin with....so........put them on tx, try to uf a little bit and bam.....v tach, ectopy, hypotension the works. So it begs the question: is it b/c some of the Amio dialyzes out or b/c the pt allready has a bad heart and cannot handle the stress of dialysis????

One option that has worked on SOME PT'S is to try crrt/sled txs??? If the rhythm stabilizes and you are able to pull fluid than that may be best for these pt's.

Good topic, like I said it has come up a couple of times where I work.

Tish88 · Oct 13, 2009

This has come up a couple of times at my acute unit....Amio is hepatically cleared. I am told it does not dialyze out by several physicians. Including pharmacists. The problem is it seems as though it does at times. Pt's on amio gtts are on it for rate control and rhythm control.....may have chf, myopathy, valves etc...usually unstable pts to begin with....so........put them on tx, try to uf a little bit and bam.....v tach, ectopy, hypotension the works. So it begs the question: is it b/c some of the Amio dialyzes out or b/c the pt allready has a bad heart and cannot handle the stress of dialysis????
One option that has worked on SOME PT'S is to try crrt/sled txs??? If the rhythm stabilizes and you are able to pull fluid than that may be best for these pt's.
Good topic, like I said it has come up a couple of times where I work.

I think the poster was addressing scheduled po amio and not gtts.

I agree with you to use CRRT with the acute patients on gtts though...hard to tell sometimes the cause of their crash!