Procainamide Pronestyl

class 1-A antiarrhythmic

• 1. supresses phase 4 depolarization in normal ventricular muscle and purkinje fibers, reducing the automaticity of ectopic pacemakers bt decreasing sodium influx.
• 2. supresses reentry of dysrhythmias by slowing intraventricular conduction .

• 1. PVCs when refractory to lidocaine
• 2. ventricular tachycardia with pulse when refractory to lidocaine
• 3. PSVT's wide complex tach of unknown origin (drug of choice when associated w/ WPW)

high degree heart blocks, PVCs in conjuction w/ brady, QT prolongation, torsade de pointes, digitalis toxicity, TCA induced arrhythmia

• CNS- cns depression, hallucinations, seizures
• CARDIO- asystole, brady, ectopics, hypotension, heart blocks, reflex tach, v-fib, v-tach, wide QRS complex
• GASTRO- n/v
• OTHER- fever

too rapid admin increases the probability of severe hypotension or life threating arrhythmias

1 g/ 10ml vial

• 20mg/min until the arrhythmia is abolished, hypotension ensures, the QRS widens by 50% of it's original width, or a total of 1g or 17mg/kg has been given
• Maintenance infusion: mix 1g in 250ml to yeild 4mg/ml run @ 1-4 mg/min

• 2-6mg/kg @ 20mg/min until you see any of the four qualifiers as seen in the adult
• Maintenance infusion: mix 100mg in 250ml to yeild 400ug/ml run @ 20-80 ug/min

IVP, IV infusion