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Indications ⬇

BEERS REMS, High Alert


Unlabeled Use:
  • PO: Supraventricular tachyarrhythmias.
  • IV: As part of the Advanced Cardiac Life Support (ACLS) and Pediatric Advanced Life Support (PALS) guidelines for the management of ventricular fibrillation (VF)/pulseless ventricular tachycardia (VT) after cardiopulmonary resuscitation and defibrillation have failed; also for other life-threatening tachyarrhythmias.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects ⬆ ⬇

CV: bradycardia, hypotension, HF, QT interval prolongation, WORSENING VENTRICULAR ARRHYTHMIAS

Derm: photosensitivity, blue discoloration

EENT: corneal microdeposits, abnormal sense of smell, dry eyes, optic neuritis, optic neuropathy, photophobia

Endo: hypothyroidism, hyperthyroidism

GI: anorexia, constipation, nausea, vomiting, ↑liver enzymes, abdominal pain, abnormal sense of taste, HEPATOTOXICITY

GU: ↓libido, epididymitis

Neuro: ataxia, dizziness, fatigue, involuntary movement, malaise, paresthesia, peripheral neuropathy, poor coordination, tremor, confusional states, disorientation, hallucinations, headache, insomnia

Resp: ACUTE RESPIRATORY DISTRESS SYNDROME, PULMONARY FIBROSIS

Interactions ⬆ ⬇

Drug-drug:

Drug-Natural Products:

Drug-Food:

Availability ⬆ ⬇

(Generic available)

Route/Dosage ⬆ ⬇

Ventricular Arrhythmias

Supraventricular Tachycardia

US Brand Names ⬆ ⬇

Nexterone, Pacerone

Action ⬆ ⬇

  • Prolongs action potential and refractory period.
  • Inhibits adrenergic stimulation.
  • Slows the sinus rate, increases PR and QT intervals, and decreases peripheral vascular resistance (vasodilation).
Therapeutic effects:
  • Suppression of arrhythmias.

Classifications ⬆ ⬇

Therapeutic Classification: antiarrhythmics (class III)

Pharmacokinetics ⬆ ⬇

Absorption: Slowly and variably absorbed from the GI tract (35–65%). IV administration results in complete bioavailability.

Distribution: Distributed to and accumulates slowly in body tissues. Reaches high levels in fat, muscle, liver, lungs, and spleen.

Protein Binding: 96%.

Metabolism/Excretion: Metabolized by the liver; excreted into bile. Minimal renal excretion. One metabolite has antiarrhythmic activity.

Half-Life: 13–107 days.

Time/Action Profile ⬆ ⬇

(suppression of ventricular arrhythmias)

ROUTEONSETPEAKDURATION
PO2–3 days (up to 2–3 mo)3–7 hrwk–mos
IV2 hr3–7 hrunknown

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆ ⬇

am-ee-OH-da-rone

Code ⬆

NDC Code