Pharm
Procainamide
search
Procainamide
, Pronestyl
Mechanism
Suppresses ventricular ectopy
Suppresses Phase 4 diastolic depolarization
Reduces automaticity of all
Pacemaker
s
Slows intraventricular conduction
May terminate reentrant
Arrhythmia
s
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%
Relative Contraindications
Acute
Myocardial Infarction
Hypokalemia
Hypomagnesemia
Preparation
Blood Pressure
monitoring
Electrocardiogram
Monitoring
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
Dose
Child
Load: 15 mg/kg in D5W IV over 30 minutes
Maintenance: 20 to 80 ug/kg/minute
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
Adverse Effects
Hypotension
Electrocardiogram
changes
QRS Complex
widening
PR Interval
lengthening
QT Interval
lengthening
Atrioventricular conduction disturbance
AV Block
Cardiac Arrest
Malignant Ventricular
Arrhythmia
Type your search phrase here