Procainamide (Pronestyl)

Question 1

Procainamide Classification

Answer 1

Antidysrhythmic

Question 2

Procainamide Mechanism

Answer 2

Class 1A antidysrhythmic/moderate Na+ channel blocker -> decreased slope and amplitude of Phase 0 depolarization for non-pacemake action potential

Question 3

Procainamide Pharmacokinetics

Answer 3

Onset: 10-30min
Peak Effects: 15-20min
Duration: 3-6 hours
Half Life: 3h

Question 4

Procainamide Indications

Answer 4

Persistent Cardiac arrest secondary to VF/VT refractory to lidocaine

Question 5

Procainamide contraindications

Answer 5

• PVCs with bradycardia

- Severe conduction disturbances, 2/3 degree Heart Blocks

Question 6

Procainamide Side effects/adverse reactions

Answer 6

Drowsiness, seizures, confusion, hypotension, bradycardia, n/v, heartblocks, respiratory & cardiac arrest

Question 7

Procainamide dose

Answer 7

Adult:
100mg infusion over 5 min; maintenance 1-4 mg/min

Pedi:
15 mg/kg iv io over 30-60 min

Question 8

Procainamide precautions

Answer 8

D/C use if: dysrhythmia is suppressed, hypotension occurs, QRS complex widens by 50%, or 17 mg/kg procainamide has been administered.

Question 9

Procainamide drug interactions

Answer 9

Chance of increase neurotoxicity if given with lidocaine