Procainamide: Difference between revisions
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== | ==General== | ||
* | *Type: | ||
*Dosage Forms: | |||
*Common Trade Names: | |||
* | |||
* | |||
== Adult Dosing == | ==Adult Dosing== | ||
*20 - 50 mg/min intravenously over 25 - 30 minutes | *20 - 50 mg/min intravenously over 25 - 30 minutes | ||
*Give until: | *Give until: | ||
| Line 19: | Line 13: | ||
*If effective, start continuous infusion at 1-4 mg/min | *If effective, start continuous infusion at 1-4 mg/min | ||
**Continuous infusion has fewer adverse effects than bolus | **Continuous infusion has fewer adverse effects than bolus | ||
==Pediatric Dosing== | |||
==Special Populations== | |||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | |||
*[[Lactation risk categories|Lactation risk]]: | |||
*Renal Dosing | |||
**Adult | |||
**Pediatric | |||
*Hepatic Dosing | |||
**Adult | |||
**Pediatric | |||
== Indications == | == Indications == | ||
| Line 25: | Line 31: | ||
== Contraindications == | == Contraindications == | ||
*Allergy to class/drug | |||
*Not recommended for ventricular fibrillation or pulseless ventricular tachycardia, as it takes too long to dose | *Not recommended for ventricular fibrillation or pulseless ventricular tachycardia, as it takes too long to dose | ||
*2nd or 3rd atrioventricular block | *2nd or 3rd atrioventricular block | ||
| Line 31: | Line 38: | ||
*Myasthenia gravis | *Myasthenia gravis | ||
== Adverse | ==Adverse Reactions== | ||
*Myocardial depression | *Myocardial depression | ||
*Watch for QRS/QT segment prolongation, ventricular tachycardia, ventricular fibrillation, complete atrioventricular block, torsades de pointes | *Watch for QRS/QT segment prolongation, ventricular tachycardia, ventricular fibrillation, complete atrioventricular block, torsades de pointes | ||
==Pharmacology== | |||
*Half-life: | |||
*Metabolism: | |||
*Excretion: | |||
*Kinetics: Onset of action 5 - 10 minutes | |||
=== Mechanism of Action === | |||
[[File:iPad_image_2015-5-25-1435238186649_0.jpg|thumbnail]] | |||
*Class Ia | |||
**Binds to fast sodium channels in inactive state inhibiting recovery after repolarization | |||
**Prolongs action potential and reduces speed of impulse conduction | |||
***Depresses myocardial conduction | |||
**May act as negative inotrope, causing hypotension through peripheral vasodilation | |||
==Comments== | |||
==See Also== | ==See Also== | ||
*[[Antiarrhythmics]] | *[[Antiarrhythmics]] | ||
==References== | |||
<references/> | |||
[[Category:Drugs]] | [[Category:Drugs]] | ||
Revision as of 17:46, 25 June 2015
General
- Type:
- Dosage Forms:
- Common Trade Names:
Adult Dosing
- 20 - 50 mg/min intravenously over 25 - 30 minutes
- Give until:
- arrhythmia is suppressed
- patient develops hypotension
- QRS segment prolongs by >50% of baseline
- maximum dose of 17mg/kg is given
- If effective, start continuous infusion at 1-4 mg/min
- Continuous infusion has fewer adverse effects than bolus
Pediatric Dosing
Special Populations
- Pregnancy Rating:
- Lactation risk:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Indications
- Wide-complex tachycardia of unknown type (in patient with preserved left ventricular function)
- Stable ventricular tachycardia
Contraindications
- Allergy to class/drug
- Not recommended for ventricular fibrillation or pulseless ventricular tachycardia, as it takes too long to dose
- 2nd or 3rd atrioventricular block
- Severe glycoside intoxication
- Prolonged QT segment
- Myasthenia gravis
Adverse Reactions
- Myocardial depression
- Watch for QRS/QT segment prolongation, ventricular tachycardia, ventricular fibrillation, complete atrioventricular block, torsades de pointes
Pharmacology
- Half-life:
- Metabolism:
- Excretion:
- Kinetics: Onset of action 5 - 10 minutes
Mechanism of Action
- Class Ia
- Binds to fast sodium channels in inactive state inhibiting recovery after repolarization
- Prolongs action potential and reduces speed of impulse conduction
- Depresses myocardial conduction
- May act as negative inotrope, causing hypotension through peripheral vasodilation