Page 101 - 2026 SMOG

AMIODARONE (NEXTERONE/PACERONE)
Class/Mechanism of Action
• Antiarrhythmic Agent, Class III
Inhibits adrenergic stimulation (alpha and beta blocking), prolongs action potential and
refractory period (prolongs PR and QT intervals); decreases AV conduction and sinus node
function (decreases sinus rate).
Indications
• Labeled Indications
˚ Management of life-threatening recurrent ventricular fibrillation (VF) or recurrent
hemodynamically unstable ventricular tachycardia (VT) refractory to other antiarrhythmic
agents
• Off-Label Indications
˚ Recurrent, hemodynamically unstable VT after other drugs have failed
˚ Ventricular tachyarrhythmias (ALS/PALS): VF/VT Cardiac arrest unresponsive to CPR,
shock, and vasopressor
Contraindications
• Hypersensitivity to amiodarone, iodine, or any component of the formulation
• Severe sinus-node dysfunction
• 2nd and 3rd degree atrioventricular block (except in patients with a functioning artificial
pacemaker)
• Bradycardia causing syncope (except in patients with a functioning artificial pacemaker)
• Cardiogenic shock
• Pre-excited atrial fibrillation/flutter
Adverse Reactions/Precautions
• Complex drug with multiple complex drug reactions! Do not use with other drugs that
prolong the QT interval (do not administer with procainamide)
• Hypotension
• Dizziness, fatigue, headache, poor coordination, neuropathy
• Nausea, vomiting
• Dysrhythmias, asystole, AF, bradycardia, AV block, conduction abnormalities, SA node
dysfunction
• Pulmonary toxicity may occur. Acute events include pneumonitis, pulmonary alveolar
hemorrhage, and acute respiratory distress syndrome (ARDS)
• May be a vesicant; ensure proper needle or catheter placement prior to infusion.
• Pregnancy: Category D
• Lactation: Not Recommended
(continues)

2026 Standard Medical Operating Guidelines (SMOG) • 93