Cardiovascular Medicine Book

Congestive Heart Failure

Coronary Artery Disease

Electrocardiogram

Examination

Hyperlipidemia

Hypertension

Miscellaneous

Pericardial Disorders

Obstetrics Chapter related topics

http://www.fpnotebook.com/

ProcainamideAka: Pronestyl

Advertisement

  1. Mechanism
    1. Suppresses ventricular ectopy
      1. Suppresses Phase 4 diastolic depolarization
      2. Reduces automaticity of all Pacemakers
    2. Slows intraventricular conduction
      1. May terminate reentrant arrhythmias
  2. Indications
    1. Ventricular Tachycardia (refractory to Lidocaine)
    2. Ventricular Fibrillation
    3. Atrial Fibrillation Rate Control and cardioversion
      1. Time to Cardioversion: 1 hour
      2. Conversion Rate: 20%
      3. Chronic Efficacy: 50%
  3. Relative Contraindications
    1. Acute Myocardial Infarction
    2. Hypokalemia
    3. Hypomagnesemia
  4. Preparation
    1. Blood Pressure monitoring
    2. Electrocardiogram Monitoring
  5. Endpoints to Dosing
    1. Arrhythmia is suppressed
    2. Hypotension
    3. QRS Complex widening over 50% of original width
    4. PR interval or QT Interval lengthening over 50%
    5. Max total dose reached: 17 mg/kg administered
  6. Dose: Child
    1. Load: 15 mg/kg in D5W IV over 30 minutes
    2. Maintenance: 20 to 80 ug/kg/minute
  7. Dose: Adult
    1. Load: 20-30 mg/min until any above endpoint reached
      1. Max Total Dose: 17 mg/kg
    2. Maintenance: 1-4 mg/min
      1. Start after effect is achieved with loading dose
  8. Adverse Effects
    1. Hypotension
    2. Electrocardiogram changes
      1. QRS Complex widening
      2. PR interval lengthening
      3. QT Interval lengthening
    3. Atrioventricular conduction disturbance
      1. AV Block
      2. Cardiac Arrest
    4. Malignant Ventricular arrhythmia

Procainamide (C0033216)

Definition (MSH)A derivative of PROCAINE with less CNS action. It also acts as a non-nucleoside inhibitor of DNA METHYLATION and has led to SYSTEMIC LUPUS ERYTHEMATOSUS.
Definition (CSP)derivative of procaine, cardiac depressant used in treatment of cardiac arrhythmias.
ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD011342
EnglishProcainamide, PROCAINAMIDE PREPARATION, Procaine Amide
Spanishprocainamida
Parent Concepts4-Aminobenzoic Acid (C0000473), Anti-Arrhythmia Agents (C0003195), phenylamide (C0597215), Benzamides (C0005029), Class Ia antiarrhythmic drug (C0304503), Drug allergen by structure (C1532645), Antiarrhythmics - Classes IA, B, and C (C1579436)
SourcesAOD, CSP, LNC, MSH, MTH, NCI, NDFRT, RXNORM, SCTSPA, SNOMEDCT, USPMG, VANDF
Derived from the NIH UMLS (Unified Medical Language System)


Pronestyl (C0392424)

ConceptsOrganic Chemical (T109) , Pharmacologic Substance (T121)
MSHD011342
EnglishApothecon Brand of Procainamide Hydrochloride, Bristol-Myers Squibb Brand of Procainamide Hydrochloride, Pronestyl
SourcesMSH, NCI, RXNORM
Derived from the NIH UMLS (Unified Medical Language System)



Navigation Tree