I've taken more people off amiodarone than some of you kids 'ave 'ad 'ot
dinnas
luv Rog aged 63 and freequartersandabit forty yers a doc man 'n' boy
-----Original Message-----
From: GP-UK [mailto:[log in to unmask]]On Behalf Of Declan Fox
Sent: 03 March 2004 20:59
To: [log in to unmask]
Subject: Re: Bad drugs
FF asks, re Amiodarone,
<<If AF has reverted after cardioversion, is it usual to keep someone on
this
drug??? Pro tem? For life?
until frizzledor frazzled by side-effects?>>
Not unless high risk of recurrence----risk varies from person to person. If
high-ish risk of recurrence I think most folks would go for rate control
rather than rhythm control long-term (good piece in BMJ a while back) +/-
warfarin. And I think there are safer rate control drugs around than
Amiodarone.
Odd thing I have yet to work out. Here (UK) standard drug for fast acute AF
needing urgent treatment is IV Amiodarone. While across the big ocean, the
august ACLS guidelines say---Diltiazem bolus IV. Mention that to
ALS-certified docs here and they give you a look. So I wonder if fact that
Resus UK have made Amiod drug of choice for emergency has perhaps affected
choice of long-term oral?? An old saw in acute arrhythmia treatment is
maintain the patient on whatever drug brought them out of the arrhythmia.
Not always possible of course.
Declan
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