Indicated for use for persistent VF/VT, but only after 3 defibrillation attempts, after IV epinephrine, and after the fourth shock that follows epinephrine administration. The drug is difficult to administer in a timely fashion because of the current formulation in "TWEEN"-a soap-like substance that foams easily with ampule movement. After syringe aspiration the drug must be mixed with 20 to 30 mL of saline or dextrose before it can be administered. Any advantage of amiodarone over lidocaine to facilitate defibrillation could be lost by potentially long delays in administration.

Amiodarone is an excellent agent for the stable and unstable tachycardias. It has turned out to be the first drug to use, the drug of choice, specifically for
tachycardias in patients with impaired heart function, stable monomorphic VT with poor cardiac function, narrow-complex junctional tachycardias that failed to respond to adenosine and vagal stimulation, and narrow-complex ectopic or multifocal atrial tachycardia

May produce vasodilation and hypotension.
May have negative inotropiçeffects.
When multiple doses are administered, cumulative doses >2.2 g/24 hours are associated with significant hypotension in clinical trials.
May prolong QT interval. Do not routinely administer with other drugs that prolong QT interval (eg, procamnamide). Use with caution if renal failure is present.
Terminal elimination is extremely long (half-life lasts up to 40 days).

Cardiac Arrest

IV, Given rapidly 300mg IVP, may repeat 150mg

Wide-Complex Tachycardia (Stable)
Maximum cumulative dose: 2.2 g IV over 24 hours.

May be administered as follows:
Rapid infusion: 150 mg IV over first 10 minutes (15 mg/mm). May repeat rapid infusion (150 mg IV) every 10 minutes as needed.
Slow infusion: 360 mg IV over 6 hours (1 mg/mm).
Maintenance infusion: 540 mg IV over 18 hours (0.5 mg/mm).