Ditiazem

Question 1

What is another name for Diltiazem?

Answer 1

Cardizem

Question 2

What drug class is Diltiazem/Cardizem?

Answer 2

Calcium channel blocker

Calcium channel antagonist

Question 3

How does Diltiazem work?

Answer 3

It is a Ca channel blocker so it slows conduction, increases refractoriness in the AV node and causes coronary and peripheral vasodilation.
It is usually used to control ventricular response rates in patients with A-fib or A-flutter, multifocal atrial tachycardias.
Use AFTER Adenosine to treat refractory reentry SVT in patients with narrow QRS complex and adequate blood pressure.

Question 4

What is the onset of Diltiazem?

Answer 4

2-5 minutes

Question 5

What is the duration of Diltiazem?

Answer 5

1-3 hours

Question 6

What are the indications for Cardizem?

Answer 6

• control ventricular rate in A-fib and A-flutter
• multifocal atrial tachycardias
• paroxysmal SVT

Question 7

What are the contraindications for Cardizem?

Answer 7

• wide complex tachycardias of unknown origin
• poison/drug induced tachycardias
• sick sinus syndrome
• 2nd or 3rd degree AV block (except with a functioning pacemaker)
• hypotension
• cardiogenic shock
• hypersensitivity
• WPW syndrome or short PR syndrome
• ventricular tachycardias
• acute MI

Question 8

What are adverse reactions of Diltiazem?

Answer 8

• A flutter
• 1st and 2nd degree AV block
• bradycardia
• hypotension
• chest pain
• CHF
• peripheral edema
• syncope
• ventricular dysrhythmias
• dyspnea
• sweating, N/V, dizziness, dry mouth, headache, rash

Question 9

What are some drug interactions with Diltiazem?

Answer 9

• use caution with patients receiving medications that affect cardiac contractility and/or SA or AV node conduction
• Diltiazem is incompatible with simultaneous Furosemide injection

Question 10

How is Diltiazem supplied?

Answer 10

25mg (5mL vial)

50mg (10mL vial)

Question 11

What is the dose of Diltiazem for acute rate control?

Answer 11

0.25mg/kg IV over 2 minutes

may be repeated in 15 minutes IV over 2 minutes

Question 12

What is the dose of Diltiazem for a maintenance infusion?

Answer 12

dilute 125mg in 100mL of solution (NS or D5W)

infuse 5-15mg/hr, titrated to heart rate

Question 13

What are some special considerations for Cardizem?

Answer 13

• pregnancy safety category C
• use cautiously with patients with impaired renal or hepatic function
• use cautiously with patients who take oral beta blockers; it can cause severe hypotension or AV block
• shelf life at room temperature is 1 month