Dose: cardiac arrest: 1-1.5 mg/kg IV repeated every 3-5 min up to 3 mg/kg, follow conversion with a drip of 2-4 mg/min. Ped: 1 mg/kg IV, repeat/3-5 min up to 3 mg/kg, follow conversion with a drip of 20-50 mcg/kg/min. ventricular tachycardia (w/ pulse): 1 to 1.5 mg/kg slow IV (consider lower dose for elderly). May repeat at one-half dose every 5-10 min until conversion up to 3 mg/kg. Follow conversion with an infusion of 2 to 4 mg/min. Ped: 1 mg/kg, followed by a drip at 20-50 mg/kg/min.
Des: prolongs ventricular repolarization, slows conduction, and decreases myocardial excitability
Ind: ventricular fibrillation and pulseless ventricular tachycardia refractory to lidocaine.
CI: hypersensitivity to procainamide or procaine, myasthenia gravis, & 2nd- or 3rd-degree heart block.
PC: hypotension, cardiac enlargement, CHF, AMI, ventricular dysrhythmias from digitalis, hepatic or renal impairment, or bronchial asthma.
Dose: 20-30 mg/min IV drip. Stop points: (1) up to 17mg/kg to effect, then 1 to 4 mg/min (2) ectopy resolves (3) QRS complex widens more than 50% from original (4) hypotension ensues. Ped: 15 mg/kg/IV/IO over 30-60 min.