Diltiazem

Question 1

Class

Answer 1

Nondihydropyridine Calcium Channel Blocker

Question 2

Indications

Answer 2

1. Control of rapid ventricular rates due to narrow complex tachycardia’s
2. First line treatment in A-Fib and A-Flutter
3. May be useful as a second-line treatment in SVT/PSVT if adenosine is unsuccessful

Question 3

Contraindications

Answer 3

1. Hypotension
2. Sick sinus syndrome
3. High-degree heart blocks
4. Wide-complex tachycardia
5. WPW or other accessory-pathway syndromes (i.e. AVRT)
6. Shock

Question 4

Dosing for A-Fib or A-Flutter with rapid ventricular response or PSVT

Answer 4

Initial: 0.25 mg/kg IV/IO bolus over 2 min. If inadequate response after 15 min, may repeat at 0.35 mg/kg IV/IO bolus over 2 min.

Maintenance infusion: For patients who respond to either the first or second dose, consider infusion at 5 mg/hr as needed (max dose: 15 mg/hr)

Question 5

Onset

Answer 5

2 - 5 minutes

Question 6

Duration

Answer 6

1 - 3 hours