Diltiazem (Cardizem)

Question 1

Diltiazem Class?

Answer 1

Calcium channel blocker

Question 2

Diltiazem Action?

Answer 2

Inhibits calcium ion influx through slow channels into the cell of myocardial and arterial smooth muscle. Slows SA and AV nodal conduction. Dilates coronary arteries and arterioles thus inhibits coronary artery spasms.

Question 3

Diltiazem Indications?

Answer 3

A-Fib and A-Flutter. Multifocal atrial tachycardias. SVT/PSVT refractory to Adenosine.

Question 4

Diltiazem Contraindications?

Answer 4

Hypersensitivity, 2nd and 3rd degree heart block, hypotension, cardiogenic shock, ventricular rhythms, sick sinus syndrome, Wolf-Parkinson-White syndrome, AMI, V-Tach.

Question 5

Diltiazem Onset/Duration?

Answer 5

Onset: 2-5 min
Duration: 1-3 hours

Question 6

Diltiazem Dose/Route?

Answer 6

Adult: 15-20 mg IV over 2 min, may be repeated in 15 min at 20-25 mg IV over 2 min. Maintenance infusion 5-15 mg/hr titrated to HR.

Peds: Not recommended in the prehospital setting

Question 7

Diltiazem Side Effects?

Answer 7

Headache, dizziness, hypotension, 1st and 2nd degree heart block, bradycardia, palpitations, CHF, chest pain, ventricular rhythms.

Question 8

Diltiazem Note*

Answer 8

Use caution with renal/liver impaired pt’s and those taking beta blockers.