Lack of a hypotensive effect with rapid administration of a new aqueous formulation of intravenous amiodarone

Part 8: Adult Advanced Cardiovascular Life Support

“…In blinded randomized controlled clinical trials in adults with refractory VF/pulseless VT in the out-of-hospital setting, 134,136 paramedic administration of amiodarone (300 mg 134 or 5 mg/kg 136 ) improved hospital admission rates when compared with administration of placebo 134 or 1.5 mg/kg of lidocaine. 136 Additional studies [283][284][285][286][287] documented consistent improvement in termination of arrhythmias when amiodarone was given to humans or animals with VF or hemodynamically unstable VT. A higher incidence of bradycardia and hypotension was reported for amiodarone in one out-of-hospital study. 134 A canine study 288 noted that administration of a vasoconstrictor before amiodarone prevented hypotension.…”

Intravenous amiodarone bolus for treatment of atrial fibrillation in patients with advanced congestive heart failure or cardiogenic shock

“…No direct hemodynamic comparisons between the two different formulations are yet available. Given that aqueous amiodarone without any carrier has minor effects on blood pressure [35,36], it is likely that the different formulation of intravenous amiodarone used in our study population played a major role in the attenuated hemodynamic effects observed, compared with the data of others. Nevertheless, in our opinion, the possible vasodilating effects should be kept in mind, especially when other drugs with vasodilating properties are administered at the same time.…”

Antiarrhythmic Properties of a Prior Oral Loading of Amiodarone in In Vivo Canine Coronary Ligation/Reperfusion-Induced Arrhythmia Model: Comparison With Other Class III Antiarrhythmic Drugs

“…One of the possible reasons for this discrepancy is the acute hypotensive effect of intravenous administration of amiodarone. The excess hypotensive effects of intravenous amiodarone have been reported both in animals and humans (15,26). Acute disruption of hemodynamics by intravenous amiodarone might worsen the cardiac ischemia and cardiac dysfunction induced by coronary ligation and might cancel out the antiarrhythmic effects of amiodarone.…”