PROCAINAMIDE
Pronestyl
Classification:
Antidysrhythmic
Indications:
• Stable monomorphic VT with normal QT interval
• Supraventricular arrhythmias especially A-fib and A-flutter
• Control of rapid ventricular rate due to accessory pathway in pre-excited atrial rhythms
• PSVT not controlled by Adenosine
Actions:
• Depresses atrial and ventricular automaticity
• Slows down conduction through all the pacemakers
Dosage:
• 20 – 50mg/min bolus (1gm/50mL @ 60 – 90mL/hr) not to exceed 17mg/kg
Infusion:
• Maint. Infusion: Mix 2gm/500mL D5W (4mg/mL). Infuse @ 1 – 4mg/min (15 – 60 mL/hr)
Side effects:
• Hypotension (especially with rapid injection), widening of QRS complex. Avoid use in
patients with preexisting prolonged QT interval and Torsades de Points
End points of administration:
Arrhythmia suppressed, Hypotension develops, QRS widens by 50%, Max dose is (17mg/kg)