Procainamide

Question 1

Procainamide Trade Name

Answer 1

Pronestyl

Question 2

Procainamide Classification

Answer 2

Medscape:
Class I antidysrhythmic; sodium channel blocker

Question 3

Procainamide Mechanism

Answer 3

Medscape:
Class IA (membrane stabilizing) antiarrhythmic agent; inhibits recovery after repolarization resulting in decreasing myocardial excitability and conduction velocity. Direct membrane depressant that decreases conduction velocity, prolongs refractoriness, decreases automaticity and reduces repolarization abnormalities.

Capital:
Blocks sodium channels to prolong Phase 0 of the action potential thus decreasing ventricular automaticity more so than lidocaine. Little effect on atrial tissue. Suppresses intraventricular conduction

Question 4

Procainamide Onset of Action

Answer 4

Capital: 10-30 minutes

Question 5

Procainamide Duration of Action

Answer 5

Capital: 3-6 hours

Question 6

Procainamide Indications

Answer 6

CT Protocols:
Treatment of wide complex tachycardia

Capital:
Ventricular fibrillation (VF) or ventricular tachycardia (VT) cardiac arrest refractory to defibrillation. Hemodynamically stable regular wide-complex tachycardia (VT), Malignant PVCs, Atrial fibrillation with rapid ventricular response in patients with Wolff-Parkinson-White (WPW) Syndrome

Question 7

Procainamide Contraindications

Answer 7

Capital:
Pre-existing prolonged QT interval, High degree heart block, Hypersensitivity,
Hypotension, Torsades de Pointes, Digitalis toxicity

Question 8

Procainamide Side Effects/ Precautions/ Comments

Answer 8

Capital:
Widening of PR, QRS, and QT intervals, Bradycardia, Heart block, Hypotension,
Confusion, Dysrhythmias, Reflex tachycardia, Nausea, Dizziness, Asystole

Question 9

Procainamide Adult Dose

Answer 9

CT Protocols:
Wide Complex Tachycardia
25-50 mg/minute infusion until arrhythmia is suppressed, hypotension ensues, QRS duration increases by > 50% or the maximum dose of 17 mg/kg is given

Question 10

Procainamide Pediatric Dose

Answer 10

CT Protocols:
15 mg/kg slow IV/IO infusion until any one of following occur: Dysrhythmia is suppressed, Hypotension, QRS widens by > 50%

Question 11

Procainamide
Max Dose Adult (Pediatric)

Answer 11

CT Protocols:
17 mg/kg

Question 12

Procainamide Routes of Administration

Answer 12

IV/IO

Question 13

Procainamide How Supplied

Answer 13

100 mg and 500 mg vials