Diltiazem: Difference between revisions

Revision as of 00:29, 21 September 2019

Administration

Type: Calcium channel blocker
Dosage Forms:
Routes of Administration: IV, PO
Common Trade Names: Cardizem

Indications

Conversion of PSVT to NSR
Slow RVR in a-fib/flutter

Adult Dosing

Loading dose = 0.25mg/kg (max=20mg) IV bolus over 2min
- If ineffective after 15min: 0.35mg/kg (max=25mg) over 2min
- If effective: Start infusion at 5-15mg/hr

Pediatric Dosing

Contraindicated in pediatric patients <1yo
See critical care quick reference for drug doses by weight

Special Populations

Pregnancy Rating: C
Lactation:
Renal Dosing: Not studied, use caution
Hepatic Dosing: Not studied, use caution

Contraindications

Allergy to drug/class
Infants <1yo
Wide-complex tachycardia due to bypass tract (e.g. WPW)
Symptomatic severe hypotension
Sick sinus syndrome/2nd or 3rd degree heart block if no pacemaker
PO: acute MI and pulmonary congestion
Ventricular tachycardia
Caution if:
- Hypertrophic cardiomyopathy
- LV dysfunction
- Concomitant beta-blockade
- Hepatic/renal impairment
- Heart failure

Adverse Reactions

Serious

Bradycardia, AV block, BBB
Hypotension
CHF
SJS/TEN

Common

Peripheral edema
Elevated LFTs
Headache
Dizziness
Nausea/vomiting, diarrhea, contipation
Flushing, vasodilation
Gingival hyperplagia
Myalgia
Bronchitis, sinus congestion, dypsnea
Hemolytic anemia, thrombocytopenia
Extrapyramidal symptoms

==Pharmacology

Onset of action = 2-3min (IV)
Duration of action = 1-3hr (IV)
Half life: 3-5h
Metabolism: Hepatic
Excretion: Urine/feces

Mechanism of Action

Class IV - Inhibits Ca influx
- Slows AV nodal conduction

@@ Line 1: / Line 1: @@
+==Administration==
+*Type: [[Calcium channel blocker]]
+*Dosage Forms:
+*Routes of Administration: IV, PO
+*Common Trade Names: Cardizem
+==Indications==
+*Conversion of PSVT to NSR
+*Slow RVR in a-fib/flutter
 ==Adult Dosing==
 *Loading dose = 0.25mg/kg (max=20mg) IV bolus over 2min
@@ Line 9: / Line 20: @@
 ==Special Populations==
-* Pregnancy Rating:
+* Pregnancy Rating: C
 * Lactation:
-* Renal Dosing
+* Renal Dosing: Not studied, use caution
-** Adult
+* Hepatic Dosing: Not studied, use caution
-** Pediatric
-* Hepatic Dosing
-** Adult
-** Pediatric
 ==Contraindications==
-*Wide-complex tachycardia due to bypass tract
+*Allergy to drug/class
+*Infants <1yo
+*Wide-complex tachycardia due to bypass tract (e.g. WPW)
+*Symptomatic severe hypotension
+*Sick sinus syndrome/2nd or 3rd degree heart block if no pacemaker
+*PO: acute MI and pulmonary congestion
+*Ventricular tachycardia
+*Caution if:
+**Hypertrophic cardiomyopathy
+**LV dysfunction
+**Concomitant beta-blockade
+**Hepatic/renal impairment
+**Heart failure
+==Adverse Reactions==
+===Serious===
+*Bradycardia, AV block, BBB
+*Hypotension
+*CHF
+*SJS/TEN
+===Common===
+*Peripheral edema
+*Elevated LFTs
+*Headache
+*Dizziness
+*Nausea/vomiting, diarrhea, contipation
+*Flushing, vasodilation
+*Gingival hyperplagia
+*Myalgia
+*Bronchitis, sinus congestion, dypsnea
+*Hemolytic anemia, thrombocytopenia
+*Extrapyramidal symptoms
-==Indications==
+==Pharmacology
-*Conversion of PSVT to NSR
+*Onset of action = 2-3min (IV)
-*Slow RVR in a-fib/flutter
+*Duration of action = 1-3hr (IV)
+*Half life: 3-5h
+*Metabolism: Hepatic
+*Excretion: Urine/feces
 ==Mechanism of Action==
 *Class IV - Inhibits Ca influx
 **Slows AV nodal conduction
-==Adverse Drug Reactionss==
-Bradycardia, CHF, AV block, BBB, hypotension
-==Kinetics==
-*Onset of action = 2-3min (IV)
-*Duration of action = 1-3hr (IV)
 ==See Also==
@@ Line 42: / Line 77: @@
 [[Category:Pharmacology]]
+[[Category:Cardiology]]