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PROCAINAMIDE (Pronestyl)

Name/Class: PROCAINAMIDE (Pronestyl)/Anti-arrhythmic (NA+ Blocker)

Description: Procainamide prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability.

Indications: Ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine.

Contraindications: Hypersensitivity to procainamide or procaine, myasthenia gravis, and 2nd- or 3rd-degree heart block.
Precautions: Hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma.

Dosage/Route: 20 to 30 mg/min IV drip @ 6-8mg/kg Stop points: (1) up to 17 mg/kg to effect, then 1 to 4 mg/min (2) ectopy resolves (3) QRS complex widens more than 50% from original (4) hypotension ensues.

Pedi: 15 mg/kg/IV/IO over 30 to 60 min.


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