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