What is the dosage of Amiodarone for persistent VF/pVT?

• A. 300 mg IV/IO, consider repeat 150 mg once
• B. 150 mg IV/IO, repeat 300 mg
• C. 450 mg IV/IO, no repeat
• D. 1 mg/kg IV/IO

Answer: (A)

In persistent VF or pulseless VT, amiodarone is used as an antiarrhythmic to improve the chance of returning a perfusing rhythm when shocks alone aren’t enough. The recommended approach is to give a loading dose of 300 mg IV or IO, and if the rhythm remains VT/VF or recurs after defibrillation, administer an additional 150 mg IV or IO. This keeps the total dose within about 450 mg during the arrest. A single larger dose or weight-based dosing isn’t the standard in this scenario, and a 150 mg first dose or a 1 mg/kg dose doesn’t align with the ACLS protocol for this situation.