PROCAINAMIDE (generic name) PRONESTYIL (brand name)

Question 1

PROCAINAMIDE

Drug class

Answer 1

DRUG CLASS

Antidysrhythmic (Sodium Channel Blocker)

Question 2

PROCAINAMIDE

Indications

Answer 2

INDICATIONS
Stable monomorphic ventricular tachycardia with normal QT interval, reentry SVT uncontrolled by vagal maneuvers and adenosine, stable wide complex tachycardia of unknown origin, atrial fibrillation with rapid ventricular rate in patients with Wolff-Parkinson-White syndrome.

Question 3

PROCAINAMIDE

Mechanism of Action

Answer 3

MECHANISM OF ACTION
Suppresses phase 4 depolarization in normal ventricular muscle and Purkinje fibers, reducing ectopic pacemaker’s automaticity; suppresses intraventricular conduction.

Question 4

PROCAINAMIDE

Contraindications

Answer 4

CONTRAINDICATIONS
Torsades de pointes, 2nd and 3rd degree heart atrioventricular block (without functioning artificial pacemaker), preexisting QT prolongation, digitalis toxicity, tricyclic antidepressant overdose.

Question 5

PROCAINAMIDE

Adverse Effect

Answer 5

ADVERSE EFFECT
Confusion, seizures, hypotension, bradycardia, reflex tachycardia, ventricular dysrhythmias, AV blocks, systole, widening of PR, QRS and Q-T intervals, NV, seizures

Question 6

PROCAINAMIDE

Precautions

Answer 6

PRECAUTIONS
Vasodilations and reduced force of contraction leading to severe hypotension if given to fast. Caution in patients with cardiac, hepatic or renal insufficiency

Question 7

PROCAINAMIDE

Dose and Administration

Answer 7

DOSE AND ADMINISTRATION
ADULT
20 mg/min slow IV infusion with maximum dose of 17 mg/kg
PEDI
loading dose of 15 mg/kg IV/IO over 30-60 minutes