Amiodarone

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So I have looked in the search function, can't find it :glare:
I am looking for some documentation as to the interaction between
amiodarone and lidocaine... i.e. can use lido.. then switch to amiodarone
secondary.... but can't use amiodarone THEN lidocaine.
Is this somewhere I can find this? I have read
it here somewhere but can't find it.

I am referring to pulseless arrest
 
Lidocaine is a Class 1B anti-arrythmatic whereas amiodarone is a class III.

Lidocaine blocks the Fast Na channels, and amiodarone the K+ channels.

If it is one thing I understand poorly it is the cardiac action potential but I have to ask, why would you want to switch betwee one and the other?
 
I've heard of both being tried at the same time as well as other anti-arrythmics but this was a while ago by physicians in the ED, so no guarantees it was correct or if it was, that it still is.

The prescribing information sheets are probably the place to look, the ones that the drug companies make for physicians. They're generally googlable.

Or maybe MIMMS....
 
Never heard that you can't use both.

Protocols I'm under say use one, max it out, then if Vtach or Vfib is refractive after the original drug is maxed, go ahead and use the other drug.
 
our protocols say Ami OR Lido
I swear I read here somewhere that if you use Ami to start 300mg IVP
that you couldn't use Lido after the second 150mg dose
BUT if you used Lido first, the you could go to Ami later if no response
from the Lido, I could be very well wrong.
I am thinking if they are dead and one doesn't work.... go to the other.

thanks!
 
i'm pretty sure that amiodarone blocks more than just potassium. In fact i'm pretty sure it affects sodium and calcium as well. I'm just going off the cuff, i'll do some research and respond more, if someone doesn't beat me to it.
 
8jimi8 said:
i'm pretty sure that amiodarone blocks more than just potassium. In fact i'm pretty sure it affects sodium and calcium as well. I'm just going off the cuff, i'll do some research and respond more, if someone doesn't beat me to it.
Click to expand...

Hooray! Glad someone came to it. Amiodarone, whilst nominally a Vaughan-Williams Class III drug, is really a Vaughan-Williams Class Everything drug. It has a wide range of effects across potassium, calcium, sodium channels (although K is most pronounced) as well as beta-blocker effects.

Given that neither of them has been shown to have a particularly useful effect in cardiac arrest I don't see why you would waste more time and/or money in pouring bad drugs after worse :P
 
Smash said:
Hooray! Glad someone came to it. Amiodarone, whilst nominally a Vaughan-Williams Class III drug, is really a Vaughan-Williams Class Everything drug. It has a wide range of effects across potassium, calcium, sodium channels (although K is most pronounced) as well as beta-blocker effects.

Given that neither of them has been shown to have a particularly useful effect in cardiac arrest I don't see why you would waste more time and/or money in pouring bad drugs after worse :P
Click to expand...

Exactly, to stop working a cardiac arrest we are not required to have even given drugs and they are not listed in the table of factors to consider in determining whether to stop or not.

What is listed is bystander CPR, early defib/AED, response time, primary vs secondary arrest and VT/VF vs asystole/PEA
 
MrBrown said:
...primary vs secondary arrest ...
Click to expand...
Is this arrest secondary to another cause? Like an OD or trauma?

Don't recall hearing that phrase before.
 
Jon said:
Is this arrest secondary to another cause? Like an OD or trauma?

Don't recall hearing that phrase before.
Click to expand...

Yes secondary arrest is non cardiac in origin eg trauma, OD, asthma, Hs & Ts
 
I can tell you that I have personally given both Amio and Lido at the same time. Now for the disclaimer: this was in the ICU with two CT surgeons standing there. It was a post op multi vessel CABG (possibly a valve also). I like amio better just because of the previous poster said it's an "everything blocker."
 
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