Two clinical questions

[Guest guest]

I ask the gurus the following questions which I have been trying to answer

without success.

1. In a patient with an implanted pacemaker, who has either runs of

ventricular tachycardia or sustained tachycardia, is lidocaine contraindicated?

2. Must amiodarone still be mixed with D5W, or can it now be mixed with

normal saline? After administration of a bolus in cardiac arrest (300 mg/mixed

with enough D5W to make a 20 ml bolus), then AHA turns around and recommends a

saline flush. Does that make sense? Most of the sources I can find still

state that amiodarone is incompatible with saline. So, would that cause a

problem when administered in a NS line?

Gene Gandy

[Guest guest]

Just a quick answer on number 2. We mix amiodarone with NS all of the time

without problem and with success. We only carry NS on our trucks.

In a message dated 1/11/2007 11:01:25 PM Central Standard Time,

wegandy1938@... writes:

I ask the gurus the following questions which I have been trying to answer

without success.

1. In a patient with an implanted pacemaker, who has either runs of

ventricular tachycardia or sustained tachycardia, is lidocaine

contraindicated?

2. Must amiodarone still be mixed with D5W, or can it now be mixed with

normal saline? After administration of a bolus in cardiac arrest (300

mg/mixed

with enough D5W to make a 20 ml bolus), then AHA turns around and recommends

a

saline flush. Does that make sense? Most of the sources I can find still

state that amiodarone is incompatible with saline. So, would that cause a

problem when administered in a NS line?

[Guest guest]

We have been carrying only NS for a long time also, but one of our folks

points out that the drug circular for amiodarone requires that it be mixed with

D5W, and I found some references that stated that it is incompatible with saline

solutions.

So, what I want to know is whether or not there is any direction from the

manufacturer or any definitive statement in the literature backing mixing it

with

NS.

Does saline affect it in some way? Is it a pH problem? I need some

" evidence based " help on this.

Gene

>

>

> Just a quick answer on number 2. We mix amiodarone with NS all of the time

> without problem and with success. We only carry NS on our trucks.

>

> In a message dated 1/11/2007 11:01:25 PM Central Standard Time,

> wegandy1938@wegandy writes:

>

> I ask the gurus the following questions which I have been trying to answer

> without success.

>

> 1. In a patient with an implanted pacemaker, who has either runs of

> ventricular tachycardia or sustained tachycardia, is lidocaine

> contraindicated?

>

> 2. Must amiodarone still be mixed with D5W, or can it now be mixed with

> normal saline? After administration of a bolus in cardiac arrest (300

> mg/mixed

> with enough D5W to make a 20 ml bolus), then AHA turns around and recommends

> a

> saline flush. Does that make sense? Most of the sources I can find still

> state that amiodarone is incompatible with saline. So, would that cause a

> problem when administered in a NS line?

>

>

[Guest guest]

You can try it on me.

[Guest guest]

Gene, the MERK shows a flush to be a true statement, but the NS question does

not appear at all......If I see something else I will let you know

http://www.merck.com/mmpe/lexicomp/amiodarone.html

W

wegandy1938@... wrote:

I ask the gurus the following questions which I have been trying to

answer

without success.

1. In a patient with an implanted pacemaker, who has either runs of

ventricular tachycardia or sustained tachycardia, is lidocaine contraindicated?

2. Must amiodarone still be mixed with D5W, or can it now be mixed with

normal saline? After administration of a bolus in cardiac arrest (300 mg/mixed

with enough D5W to make a 20 ml bolus), then AHA turns around and recommends a

saline flush. Does that make sense? Most of the sources I can find still

state that amiodarone is incompatible with saline. So, would that cause a

problem when administered in a NS line?

Gene Gandy