Cardizem

Question 1

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Class

Answer 1

Calcium channel blocker

Question 2

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Mechanism of Action

Answer 2

Block influx of calcium ions into cardiac muscle
Prevents spasm of coronary arteries
Decreases the rate of ventricular response.
Arterial and venous vasodilator.
Reduces preload and afterload.
Reduces myocardial oxygen demand.

Question 3

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Indications

Answer 3

Control of rapid ventricular rates due to atrial flutter, atrial fibrillation, and re-entry SVT; angina pectoris.

Question 4

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Contraindications

Answer 4

Hypotension, conduction system disturbances (sick sinus syndrome, second- or third-degree AV block), cardiogenic shock, wide-complex tachycardias, poison/drug-induced tachycardia

Question 5

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Adverse Reactions

Answer 5

Bradycardia, second- or third-degree AV block, chest pain, CHF, syncope, V-fib, V-tach, nausea, vomiting, dizziness, dry mouth, dyspnea, and headache.

Question 6

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Drug Interactions

Answer 6

Caution in patients using medications that affect cardiac contractility (inotropic).
In general should not be used in patients taking beta-blockers.

Question 7

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Dosage and Administration
Adult

Answer 7

Initial bolus: 0.25 mg/kg (average does of 15 – 20 mg) IV over 2 minutes. If inadequate response, may repeat bolus in 15 minutes: 0.35 mg/kg (average dose 20 – 25 mg) IV over 2 minutes. Maintenance infusion of 5 – 15 mg/hr

Question 8

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Dosage and Administration
Pediatric

Answer 8

Not recommended

Question 9

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Onset

Answer 9

Onset: 2 – 5 minutes IV

Question 10

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Peak Effect

Answer 10

Peak effect: Varies

Question 11

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Duration

Answer 11

Duration: 1 -3 hours

Question 12

Diltiazem Hydrochloride
(Cardizem, Lyo-Ject)
Special considerations

Answer 12

Use with caution in patients with renal or hepatic dysfunction. PVCs may be noted at the time of conversion of PSVT to sinus rhythm.