Amiodarone Vs. Lidocaine

[AMESEMT]

I am doing a paper on Amiodarone for my paramedic class. I wanted to include some of the reasons services do not or did not carry amiodarone. Links to sites would be great so that way I can cite them (if there are any). Any help would be greatly appreciated!

Ames

[usapride2004]

Well, I don't have any sources for you, sorry, but I can tell you that one of the bog reasons for not using it is because it is inconvenient. Having to worry about PVC bags and the like...

[chbare]

$$$

Take care,

chbare.

[AnthonyM83]

Don't know much about it, but LACoFD recently switched over from Lidocaine to Amiodarone. Heard it was cheaper, harder to screw up...but also less effective and fewer indications for it. But that's just what people were talking about...no idea if it's valid.

[AZCEP]

Look for the retail price of the two drugs. Amiodarone was significantly more expensive than lidocaine, but I believe that now the two are closer in price. The need for PVC is only if amiodarone is being used for a continuous infusion over 24 hours. In the prehospital environment, the "leeching" effect is much less of a problem.

Amiodarone has much more clinical indications than lidocaine due to it's broader mechanism of action. A standard drug profile of both will give you this information.

[AMESEMT]

It helps a lot. Thanks for the info/ideas. USAPride2004 - Is this before it started to come in premixed glass (forgot the true name for them) syringes?

[jmp6753]

My agency carries both. I have used both with no differences seen for outcome. Last time I saw Amiodarone was significantly more, around $300 per dose. Good luck!

[Kaisu]

Amidodarone has a significantly higher rescusitation rate in the field, however, survival rates to discharge are not different from lidocaine.

Amidiodarone can be used for most tachy arrythmias, not just ventricular dysrhythmias. The dosing is pretty easy - but it does have to go in over 10 minutes or so - and sometimes you don't have 10 minutes. Pretty good drug really.

[usapride2004]

It helps a lot. Thanks for the info/ideas. USAPride2004 - Is this before it started to come in premixed glass (forgot the true name for them) syringes?

We just got it in RI pretty recently, and my company gives us enough for a one time 300 mg bolus. We have 2- 150 mg vials. We are required to have PVC everything to give it as a drip by protocol, and we need a pump for it as well. We don't have the PVC free stuff, or the pumps... so no drips for us. We can give the bolus through a standard IV line, however.

I haven't seen the premixed glass vials thus far, but as I said, it's still pretty new around here, and it's still a med-control option, which is code for everyone is still going to use Lido.

[backinboston]

To use amiodarone you are supposed to have two lines going and one dediacted for amiodarone because it can crystalize up. Last time I checked crystals going into the blood stream are frowned upon.