Diltiazem

Question 1

Diltiazem (Cardizem, Lyo-Ject)

Class

Answer 1

• Calcium channel blocker

Question 2

Diltiazem (Cardizem, Lyo-Ject)

MOA

Answer 2

• Block calcium ions from going into cardiac muscle
• Prevents spasm of coronary arteries
• Arterial and venous vasodilator
• Reduces preload and afterload
• Reduces myocardial oxygen demand

Question 3

Diltiazem (Cardizem, Lyo-Ject)

Indications

Answer 3

• Control of rapid ventricular rates due to:
  
  • A-fib
  • A-flutter
  • Re-entry SVT
• Angina pectoris

Question 4

Diltiazem (Cardizem, Lyo-Ject)

Contraindications

Answer 4

• Hypotension
• Sick sinus syndrome
• 2nd & 3rd deg AV blocks
• Cardiogenic shock
• Wide-complex tachycardias
• Poison & drug induced tachycardia

Question 5

Diltiazem (Cardizem, Lyo-Ject)

Adverse reactions

Answer 5

• Bradycardia
• 2nd or 3rd deg AV blocks
• CP
• CHF
• Syncope, dizziness, dyspnea
• V-fib, V-tach
• N/V, HA, dry mouth

Question 6

Diltiazem (Cardizem, Lyo-Ject)

Drug Interactions

Answer 6

• Beta-blockers
• Use caution with meds that affect contractility

Question 7

Diltiazem (Cardizem, Lyo-Ject)

Dosage

Answer 7

• Adult:
  
  • Initial bolus 0.25 mg/kg IV over 2min
    
    • (average dose 15-20mg)
  • May rebolus in 15 min at 0.35 mg/kg
  • Maintenance infusion 5-15 mg/hr
• Not for peds

Question 8

Diltiazem (Cardizem, Lyo-Ject)

Duration

Answer 8

• Onset: 2-5 min
• Peak: varies
• Duration: 1-3 hrs

Question 9

Diltiazem (Cardizem, Lyo-Ject)

Special Considerations

Answer 9

• Preg Cat: C
• Use caution in pts with:
  
  • renal failure
  • hepatic failure
• PVC’s may be seen during conversion to sinus rhythm