REASONS FOR UNJUSTIFIED ADMINISTRATION OF AMIODARONE IN CORONARY CARE UNIT

Abstract

Although clinical use of amiodarone is supposedly well-known since the drug has been in use for over fifty years, there have been some concerns that it is often used inappropriately. This paper aims to describe clinical and adverse events observed in patients treated in Coronary Care Unit and to check if the drug was being used in proper indication and dose. Also, the purpose of this survey was to determine whether the medical staff is familiar enough with adverse events and right indications of amiodarone administration. This qualitative study was based on three methods: interview with physicians operating in Coronary Care Unit, insight into patient files and observation of the amiodarone prescription. Five physicians operating in Coronary Care Unit were interviewed and patient files of seven patients have been observed. Amiodarone prescription was observed by making rounds together with physicians. Several problems regarding amiodarone administration have been established. Amiodarone was often diluted in physiological solution instead of 5% glucose solution and it was administered via peripheral vein, not the central one. Physicians are using amiodarone more often than they are supposed to, mainly due to lack of other antiarrhythmic agents. It was also noticed that medical staff do not strictly follow the guidelines for atrial fibrillation treatment, often using amiodarone as the first choice antiarrhythmic. Finally, physicians are not fully familiar with adverse events of amiodarone, especially with acute adverse events. It was concluded that inappropriate use is present in some cases. Thus, physicians should follow guidelines more carefully when prescribing the drug and additional education should be implemented.

Key words: antiarrhythmic, atrial fibrillation, inappropriate use, adverse event