Diltiazem Flashcards
Generic Name:
Diltiazem
Trade Name:
Cardizem
Class:
Antiarrhythmic, Calcium channel blocker, calcium antagonist
Supplied:
25mg/5mL
Mechanism of Action: Pharmacological:
Inhibits calcium ion influx across cell membranes during cardiac depolarization, decreases SA and AV conduction and dilates coronary and peripheral arteries and arterioles.
Mechanism of Action: Clinical:
Slows the rapid ventricular rate associated with atrial fibrillation and atrial flutter, and reduces coronary and peripheral vascular resistance.
Indications and Field Use:
Rapid ventricular rates associated with atrial fibrillation and atrial flutter, and for PSVT refractory to adenosine.
Contraindications:
- Hypotension (less than 90mmHg systolic)
- Acute MI
- Cardiogenic shock
- Ventricular tachycardia or wide-complex VT of unknown origin
- 2nd or 3rd degree AV block
- WPW syndrome
- Sick Sinus Syndrome
- Beta Blocker Use
Adverse Reactions:
CV: Hypotension, bradycardia, heart block, chest pain, and asystole
GI: Nausea and vomiting
CNS: Headache, fatigue, drowsiness
Incompatibilities/Drug Interactions:
- Avoid use in patients with poison- or drug-induced tachycardia.
- Calcium chloride can be used to prevent the hypotensive effects of this drug and treat patients with a calcium channel blocker poisoning.
- Beta blocker use
Adult Dosage:
Initial: 0.25 mg/kg IVP (usually 20 mg) administered over 2 minutes
If response is inadequate, repeat in 15 minutes: 0.35 mg/kg IVP administered over 2 mins
Maintenance infusion:5.0 to 15 mg/hr
Pediatric Dosage:
The safety and efficacy of this drug for use in children has not been established.
Routes of Administration:
- Intravenous bolus(es) followed by a maintenance infusion
- Continuous infusion for maintenance
- Dosage: 5 to 10mg/hr initially; may be adjusted to 15mg/hr if needed
Onset of Action:
IV - immediately
Duration of Action:
IV - 4 to 6 hours
