Amiodarone Hydrochloride and Vivotif Berna

• Generic Name: amiodarone
• Dosage Forms: n.a.
• Other Brand Names: Pacerone, Cordarone, Nexterone

Treatment to suppress or prevent the recurrence of documented life-threatening ventricular arrhythmias (e.g., recurrent VF; recurrent, hemodynamically unstable VT) that do not respond to documented adequate dosages of other currently available antiarrhythmic agents or when alternative antiarrhythmic agents are not tolerated.

Used during cardiac arrest for treatment of refractory (i.e., unresponsive to CPR, defibrillation, and a vasopressor [e.g., epinephrine]) VF or pulseless VT. Considered the preferred antiarrhythmic drug for this use in current ACLS guidelines in adults; lidocaine may be used as an alternative. In pediatric patients, current evidence supports use of either amiodarone or lidocaine.

Also may be used for treatment of wide-complex tachycardias during periarrest period; included in current ACLS guidelines for both adult and pediatric tachycardia.

Treatment of sustained monomorphic VT not associated with angina, pulmonary edema, or hypotension, or hemodynamically stable monomorphic VT.

Treatment of polymorphic (irregular) VT associated with myocardial ischemia in the absence of QT interval prolongation.

Has been used for primary prevention of sustained VT (i.e., VT lasting >30 seconds and/or associated with hemodynamic compromise), VF, or sudden cardiac death in patients with nonsustained ventricular arrhythmia following MI.

Has been used in a limited number of patients for life-threatening ventricular arrhythmias associated with post-infarction aneurysm or with chronic myocarditis induced by Chagas’ disease.

Used for suppression and prevention of various supraventricular tachycardias (SVTs).

Because of higher risk of toxicity and proarrhythmic effects, antiarrhythmic agents generally reserved for patients who do not respond to or cannot be treated with AV nodal blocking agents (β-adrenergic blocking agents, diltiazem, verapamil).

Some experts state amiodarone may be useful when ventricular rate control is needed but AV nodal blocking agents are contraindicated (e.g., patients with preexcited atrial arrhythmias associated with an accessory pathway).

May be effective for conversion of atrial fibrillation to normal sinus rhythm (i.e., rhythm control); however, other antiarrhythmic agents (e.g., flecainide, dofetilide, propafenone, ibutilide) are preferred.

Used to maintain sinus rhythm in patients with atrial fibrillation or flutter.

Termination of paroxysmal supraventricular tachycardia (PSVT), including atrioventricular nodal reentrant tachycardia (AVNRT) and atrioventricular reentrant tachycardia (AVRT) (e.g., Wolff-Parkinson-White syndrome); generally reserved for use when other therapies are ineffective or contraindicated. Avoid IV use in patients with Wolff-Parkinson-White syndrome who have preexcited atrial fibrillation; may accelerate ventricular rate and potentially cause life-threatening ventricular arrhythmias.

Also used for long-term prevention of PSVT, including those refractory to other antiarrhythmic agents.

Has been used in the treatment of atrial tachycardia.

Has been effective in the prevention of supraventricular arrhythmias associated with bradycardia-tachycardia syndrome.

Has been used in treatment of chronic stable angina pectoris and Prinzmetal variant angina; because of potential toxicity, generally not considered a first-line agent but may have beneficial antianginal effect in patients receiving the drug for the management of arrhythmias.

Has been used in the management of ventricular and supraventricular arrhythmias associated with hypertrophic cardiomyopathy.

• Generic Name: typhoid vaccine, live
• Dosage Forms: n.a.
• Other Brand Names: Vivotif Berna

Typhoid (also called "typhoid fever") is a serious disease caused by Salmonella typhi bacteria. Untreated typhoid infection may lead to kidney failure, or intestinal bleeding, which can be fatal. If the infection spreads to your gallbladder, you could become a chronic carrier of the bacteria that causes typhoid. A carrier may have no symptoms but is capable of spreading the infection to others.

Typhoid is spread through contact with the stool (bowel movements) of a person infected with the bacteria. This usually occurs by eating food or drinking water that has become contaminated with feces from an infected person. Once in the digestive tract, typhoid infection can spread to the blood and other parts of the body.

Typhoid can cause high fever, muscle aches, severe headache, weakness, confusion or agitation, loss of appetite, stomach pain, diarrhea or constipation, and rose-colored spots on the skin.

Typhoid vaccine is used to help prevent this disease in adults and children who are at least 6 years old. Although not part of a routine immunization schedule in the U.S., typhoid vaccine is recommended for:

• people who travel to area where typhoid fever is common (non-industrialized parts of the world, especially Asia, Africa, and Central or South America);

• people who live with someone who is a typhoid carrier; and

• laboratory workers who may come into contact with Salmonella typhi in a work setting.

This vaccine works by exposing you to a small amount of the bacteria, which causes your body to develop immunity to the disease.

Typhoid vaccine will not treat an active infection that has already developed in the body, and will not prevent any disease caused by bacteria other than Salmonella typhi.

Like any vaccine, the typhoid vaccine may not provide protection from disease in every person.