💥AMIODARONE is a class III antiarrhythmic drug which is widely used in ER for treating arrhythmias.
A 🧵 on situations where blind use of amiodarone in emergency can be counterproductive ⚠️⚠️⚠️
With alternate therapeutic options
Read on...👇
#MedTwitter #MedEd #MedX
A 🧵 on situations where blind use of amiodarone in emergency can be counterproductive ⚠️⚠️⚠️
With alternate therapeutic options
Read on...👇
#MedTwitter #MedEd #MedX
❌️Arrhythmias secondary to prolonged QT interval.
Amiodarone can furthur prolong QT resulting in asystole or VF.
✅️Use DC shock in unstable , MgSO4 in stable TdP, treat underlying cause of prolonged QT.
image @LITFLblog
Amiodarone can furthur prolong QT resulting in asystole or VF.
✅️Use DC shock in unstable , MgSO4 in stable TdP, treat underlying cause of prolonged QT.
image @LITFLblog
❌️Atrial Fibrillation associated with Left atrial thrombus or AF with unknown onset
Amiodarone can chemically cardiovert an AF to sinus rhythm leading to disbursement of the clot to arterial circulation
✅️Use beta blockers/CCBs/Digoxin for rate control
Image @LITFLblog
Amiodarone can chemically cardiovert an AF to sinus rhythm leading to disbursement of the clot to arterial circulation
✅️Use beta blockers/CCBs/Digoxin for rate control
Image @LITFLblog
❌️Atrial fibrillation in preexcitation
Amiodarone increases AV nodal refractoriness leading to preferential conduction of fibrillatory impulses via the accessory pathway ➡️ uninhibited propagation through the ventricles ➡️ high ventricular rate ➡️ degeneration into VT or VF.
Amiodarone increases AV nodal refractoriness leading to preferential conduction of fibrillatory impulses via the accessory pathway ➡️ uninhibited propagation through the ventricles ➡️ high ventricular rate ➡️ degeneration into VT or VF.
✅️ In preexcited AF with or without hemodynamic stability , DC synchronized electrical cardioversion (biphasic) can be used.
✅️ In stable patient intravenous procainamide if available can be used.
image @LITFLblog
✅️ In stable patient intravenous procainamide if available can be used.
image @LITFLblog
❌️ Arrhythmias due to digoxin toxicity
Amiodarone can increase digoxin levels in blood by decreasing digoxin excretion which furthur potentiates digitoxicity.
✅️ Lignocaine can be used to treat arrhythmias due to digitoxicity
image @LITFLblog
Amiodarone can increase digoxin levels in blood by decreasing digoxin excretion which furthur potentiates digitoxicity.
✅️ Lignocaine can be used to treat arrhythmias due to digitoxicity
image @LITFLblog
❌️Atrial fibrillation in hyperthyroidism
Iodine load in amiodarone can precipitate accelerated thyroid hormone synthesis in a patient of hyperthyroidism leading to thyroid storm and furthur deterioration of hemodynamic status.
✅️Use beta blockers to control ventricular rate
Iodine load in amiodarone can precipitate accelerated thyroid hormone synthesis in a patient of hyperthyroidism leading to thyroid storm and furthur deterioration of hemodynamic status.
✅️Use beta blockers to control ventricular rate
❌️ VT mimics like hyperkalemia, Na channel blocker toxicity and accelerated idioventricular rythm can all have broad complexes in ECG which if misdiagnosed as VT & amiodarone administration can be catastrophic.
✅️Recognition of these VT mimics in emergency & proper Rx
✅️Recognition of these VT mimics in emergency & proper Rx
The following videos by doctor @amalmattu can help with proper understanding of this topic👇
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