Amiodarone is used frequently in the critical care units. I learned from the article that Amiodarone does not have the risk of torsodes de pointes that the other antiarrythmics have. Amiodarone also is only FDA approved for ventricular dysrythmias but the use of atrial cardioversion is off label use that is well recognized by the Society of Cardiology practice and the American College of Cardiology and the American Heart Association. We see alot of issues with coumadin and Amiodarone due to the protein binding (96%) of amiodarone which displaces coumadin receptor sites. Therefore we readjust our coumadin dosing based on that fact. We do see bradycardia secondary to amiodarone but not much QT prolongation. Another fact I learned that I didn''t realize was that amiodarone causes visual distrubances such as halo and can cause permenant blindness (rare). The pulmonary, liver and thyroid toxicity are monitored for very closely. Blue man syndrome was something else I learned from the article. Excellent article, very informative.

Great article. We use amiodarone with so many of our patients that it is easy to forget how dangerous this drug can be. And even though it is not FDA approved for afib, it is the first drug I think of when a patient goes into afib! This article reminded me of several important side effects that I need to be monitoring for and taught me about one that I don''t remember hearing about before- "Blue man syndrome".