Amiodarone: Cardiac Medication Mini Series, Part Three

In this episode, I’ll give you the inside scoop on amiodarone so you can truly grasp why it is *the* most prescribed antiarrhythmic medication. We’ll unpack its unique mechanism of action that makes it so effective, share a real-world case that shows amiodarone in action, as well as have a candid talk about its adverse effects. Join me to find out why after 40 years, this versatile antiarrhythmic still has a prime place in the hospital. The story of amiodarone is a fascinating one – and as nurses, we owe it to our patients to know it!

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Mechanism of Action

  • Amiodarone is prodominantly a potassium channel blocker, prolonging the repolarization phase in cardiac and smooth muscle
  • Amiodarone is also a mild calcium, sodium, and beta blocker


  • Widely used in critical care, emergency medicine, and various clinical settings for cardioverting VTach, VFib and new onset AFib, AFlutter into NSR
  • Emergent use during cardiac arrest (ACLS algorithm) for VTach and VFib
  • PO Amiodarone is indicated for maintenance normal sinus rhythm in stable patients as well as rate control for patients with heart failure in AFib

Adverse Effects

  • Pulmonary fibrosis (periodic CXR should be taken for long term use)
  • Hepatic toxicity (liver enzymes should be checked for long term use)
  • Thyroid dysfunction (hypo- or hyperthyroidism)
  • Hypotension
  • Bradycardia

Fascinating Fact about Amiodarone

  • Amiodarone is the most commonly prescribed antiarrhythmic medication in the US.
  • Amdiodarone has been FDA approved for VTach and VFib in 1985. It is a rare decades-old drug that has stood the test of time and remains a frontline therapy.
  • Amiodarone has an incredibly long half-life: 20-45 days for IV, 20-100 days for PO!