PROCAINAMIDE (Pronestyl®)

Question 1

Drug Classification

Answer 1

Antidysrhythmic

Question 2

Mechanism of Action

Answer 2

Class IA Antiarrhythmic/moderate Na+channel blocker →Decreases slope and amplitude of phase 0 depolarization for non-pacemaker action potential

Question 3

Pharmacokinetics

Answer 3

Onset of Action = 10-30 minutes
Peak Effects = 15-20 minutes
Duration of Effect = 3-6 hours
Half-Life = 3 hour

Question 4

Indications

Answer 4

Cardiac Arrest (VF, Pulseless VT) 
Stable Wide Complex Tachycardia

Question 5

Contraindications

Answer 5

Severe conduction disturbances, especially 2°/3°Heart Blocks

PVC’s with bradycardia

Question 6

Side effects

Answer 6

Bradycardia, heart blocks, hypotension, seizures, drowsiness, confusion, nausea & vomiting, respiratory and cardiac arrest

Question 7

Dose

Answer 7

(ADULT): 20mg/min infusion until one of D/C precautions observed

(PEDI): 15mg/kg IV, IO over 30-60 min

Maintenance (ADULT): 1-4mg/min

Question 8

Precautions

Answer 8

D/C if: Dysrhythmia is suppressed, hypotension occurs, QRS complex widens by 50%, or 17mg/kg of procainamide has been administered

Question 9

Drug Interactions

Answer 9

Chance of neurotoxicity increases if given with lidocaine