Diltiazem (Cardizem)

Question 1

Classification:

Answer 1

• Calcium channel blocker
• Class IV antiarrhythmic

Question 2

Action:

Answer 2

• Blocks calcium from moving into the heart muscle cell, which prolongs the conduction of electrical impulses through the AV node

Question 3

Indications:

Answer 3

• Ventricular rate control in rapid AF

Question 4

Adverse Effects:

Answer 4

• Flushing
• Headache
• Bradycardia
• Hypotension
• Heart block
• Myocardial depression
• Severe AV block
• At high doses cardiac arrest

Question 5

Contraindications:

Answer 5

• Hypotension
• Heart block
• Heart failure

Question 6

Dosage (Adult):

Answer 6

• Optimum dose is 0.25 mg/kg IV, IO over 2 min period to control rapid AF
• 20 mg is reasonable dose for the average adult Pt. A second higher dose of 0.35 mg/kg IV, IO (25 mg is typical second dose) may be administered over 2 min period

Question 7

Dosage (Adult):

Answer 7

• Not recommended for pediatric Pts

Question 8

Special Considerations:

Answer 8

• Use w/ extreme caution in Pts who are taking beta blockers because these two drug classes potentiate each other’s effects and toxicities
• Pts w/ a hx of heart failure and heart block are at a higher risk for toxicity