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Procainamide Pronestyl Class
class 1-A antiarrhythmic
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Procainamide Pronestyl Action
- 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 .
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Procainamide Pronestyl Use
- 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)
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Procainamide Pronestyl Contraindications
high degree heart blocks, PVCs in conjuction w/ brady, QT prolongation, torsade de pointes, digitalis toxicity, TCA induced arrhythmia
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Procainamide Pronestyl Side effects
- 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
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Procainamide Pronestyl special notes
too rapid admin increases the probability of severe hypotension or life threating arrhythmias
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Procainamide Pronestyl preparations
1 g/ 10ml vial
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Procainamide Pronestyl Adult dose
- 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
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Procainamide Pronestyl Pedi dose
- 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
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Procainamide Pronestyl Route
IVP, IV infusion
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