Diltiazem

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

• See critical care quick reference for drug doses by weight

Contraindications

• Wide-complex tachycardia due to bypass tract

Indications

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

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

• Antiarrhythmics
• Calcium Channel Blocker Toxicity
• Atrial Fibrillation with RVR