Procainamide

Question 1

Brand name of Procainamide

Answer 1

Pronestyl

Question 2

Drug class of Procainamide

Answer 2

Antidysrhythmic (Sodium Channel Blocker)

Question 3

Indications for Procainamide

Answer 3

Stable monomorphic ventricular tachycardia with normal QT interval, reentry SVT uncontrolled by vagal maneuvers and adenosine, stable wide complex tachycardia of unknown origin, atrial fibrillation with rapid ventricular rate in patients with Wolff-Parkinson-White syndrome.

Question 4

Mechanism of Action of Procainamide

Answer 4

Suppresses phase 4 depolarization in normal ventricular muscle and Purkinje fibers, reducing ectopic pacemaker’s automaticity; suppresses intraventricular conduction.

Question 5

Contraindications for Procainamide

Answer 5

Torsades de pointes, 2nd and 3rd degree heart atrioventricular block (without functioning artificial pacemaker), preexisting QT prolongation, digitalis toxicity, tricyclic antidepressant overdose.

Question 6

Adverse effects of Procainamide

Answer 6

Confusion, seizures, hypotension, bradycardia, reflex tachycardia, ventricular dysrhythmias, AV blocks, asystole, widening of PR, QRS and Q-T intervals, NV, seizures

Question 7

Precautions for Procainamide

Answer 7

Vasodilation & reduced force of contraction
Leading to severe hypotension if given too fast
Caution in patients with cardiac, hepatic or
Renal insufficiency

Question 8

Adult dose of Procainamide

Answer 8

Adult: 20 mg/min slow IV infusion with maximum dose of 17 mg/kg

Question 9

Pediatric dose of Procainamide

Answer 9

Pedi: loading dose of 15 mg/kg IV/IO over 30-60 minutes