DILTIAZEM (Cardizem)

Question 1

Drug Classification

Answer 1

Calcium Channel Blocker

Question 2

Mechanism of Action

Answer 2

SMC* Ca2+channel blocker →inhibits calcium entry and the subsequent interaction between actin and myosin in smooth muscle cells →smooth muscle relaxation and dilation of blood vessels
Cardiac Ca2+channel blocker →negative chronotropy, inotropy, dromotropy

Question 3

Pharmacokinetics

Answer 3

Onset of Action = 3 minutes
Peak Effects = 7 minutes
Duration of Effect = 1-3 hours
Half-Life = 2 hours

Question 4

Indications

Answer 4

Stable Narrow Complex Tachycardia (A-Fib, A-Flutter)

Stable SVT refractory to adenosine

Question 5

Contraindications

Answer 5

Hypotension
Decompensated cardiogenic shock
Ventricular tachycardia
WPW

Question 6

Side Effects

Answer 6

Bradycardia, hypotension, heart block, dizziness, headache, nausea & vomiting

Question 7

Dose

Answer 7

(ADULT): 1stdose - 0.25mg/kg slow IV, IO over 2 min (max dose 20mg)
2nddose - 0.35mg/kg slow IV, IO over 2 min (max dose 20mg)
Maintenance dose: 5-15mg/hr IV, IO infusion

(PEDI): Not recommended

Question 8

Precautions

Answer 8

Must be discarded after 1 month without refrigeration

Question 9

Drug Interactions

Answer 9

Do not give to patient receiving IV beta blockers, will increase risk of profound bradycardia