💥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 hyperthyroidism
Iodine load in amiodarone can precipitate a thyroid storm and furthur deterioration of hemodynamic status.
✅️Use beta blockers to control ventricular rate
Iodine load in amiodarone can precipitate a thyroid storm and furthur deterioration of hemodynamic status.
✅️Use beta blockers to control ventricular rate
❌️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.
❌️ 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
❌️ 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
Antiarrhythmic drugs are double edge swords.
One should be aware of the adverse effects and only should be used when properly indicated.
Thanks for reading till the end🙏
One should be aware of the adverse effects and only should be used when properly indicated.
Thanks for reading till the end🙏
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