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Amiodarone Improper Rapid Intravenous Injection Can Be Ended with Serious Complications and Even Death

Journal of Pharmacy and Pharmacology 2015年第4期3卷 191-193页

作者： Hasan Ali Farhan Israa Fadhil Yaseen Department of Cardiology Baghdad Teaching Hospital-Medical City Iraqi Board for Medical Specializations Scientific Councilof Cardiology Baghdad 00964 Iraq Department of Cardiology Baghdad Teaching Hospital-Medical City lraqi Board for Medical Specializations Scientific Councilof Clinical Pharmacy Baghdad 00964 Iraq

Amiodarone is one of the widely used antiarrhythmic drugs related to class III, used in the treatment of SVT （supraventricular） and ventricular arrhythmias. However, improper use of this drug such as pushing high concentration with rapid injection can increase the rate of adverse effects. The most common adverse effects associated with intravenous amiodarone are hypotension （16%）, heart block or bradycardia （4.9%）, and peripheral phlebitis （8-55%）, this can be treated by diluting the drug and slowing the rate of infusion or discontinuing the drug. In addition, hypotension can be refractory and lead to a fatal outcome and death. Because phlebitis may occur, the drug should be given through a central line when possible. Some literatures refer to the administration of intravenous amiodarone in the treatment of arrhythmias such as in SVT, as ＂given over 10 minute＂ without focusing on the dilution and rate of infusion, therefore many residents give it with rapid direct intravenous injection without dilution and even during less than 10 minutes. From currently daily practice we are reporting two cases of amiodarone improper administration, first case ＂amiodarone-associated refractory hypotension＂ and second case ＂amiodarone-associated death＂.

关键词： Amiodarone hypotension phlebitis pulseless electrical activity CCU.

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