Diltiazem

Question 1

Diltiazem Class

Answer 1

• Calcium channel blocker
• Antidysrhythmic
• Antianginal

Question 2

Diltiazem Mechanism of Action

Answer 2

• Inhibits extracellular calcium ion influx across membranes of myocardial cells and vascular smooth muscle cells
• No effect on serum calcium concentrations
• Substantial inhibitory effects on the cardiac conduction system
• Less-negative inotropic effects than verapamil

Question 3

Diltiazem Indications

Answer 3

• Stable narrow QRS tachycardia
• To control the ventricular rate in patients with AF or atrial flutter without preexcitation

Question 4

Diltiazem Containdications

Answer 4

• Hypotension
• Cardiogenic shock
• Wide-complex tachycardia

Question 5

Diltiazem Dosage and Administration

Answer 5

Initial dose: 15 - 20 mg (0.25 mg/kg) IV/IO slowly over 2 min
After 15 min, a second bolus of 20 to 25 mg (0.35 mg/kg) IV/IO can be given slowly over 2 min
Patients older than 65 require a max initial dose of 10 mg IV/IO and second dose of 20 mg IV/IO
Maintenance infusion: 5 - 15 mg/h titrated to a physiologically appropriate heart rate