Procainamide

Question 1

Procainamide- Name

Answer 1

Pronestyl

Procan

Question 2

Procainamide- Class

Answer 2

Antidysrhythmic

Question 3

Procainamide- MoA

Answer 3

Decreases myocardial excitability

Slows conduction of the heart

Suppresses ventricular ectopy and increases refractory period

May depress myocardial contractility

Increase fibrillation threshold

Question 4

Procainamide- Indications

Answer 4

VFIB/Pulseless VTAC

Symptomatic PVC’s

Monomorphic VTAC

Question 5

Procainamide- Contra

Answer 5

2nd and 3rd degree heart blocks

Digitalis toxicity

Torsade de Pointes

Question 6

Procainamide- S/E

Answer 6

Cardiovascular: hypotension, ventricular dysrhythmias, heart blocks, widening QRS complex, lengthened QT interval

Question 7

Procainamide- Routes

Answer 7

IV, IO, IVPB

Question 8

Procainamide- A. Dose

Answer 8

100 mg IV/IO

over 5 minutes

maximum of 17 mg/kg

Question 9

Procainamide- P. Dose

Answer 9

15.0 mg/kg

IV/IO over 30-60 minutes

Question 10

Procainamide- EXTRAS

Answer 10

Precautions:

Myasthenia gravis

Hepatic or renal disease

Possible MI,

hypotension

CHF Asthma

Interactions: Increases the affects of neuromuscular blockers, anticholinergics, and antihypertensives

Onset is immediate and may last 3-4 hours

Therapeutic endpoints for procainamide:

• rhythm resolves
• max dose of 17mg/kg is reached
• hypotension results
• QT interval widens by 50% or more