PROCAINAMIDE (Pronestyl®)

Question 1

Generic/Trade Name

PROCAINAMIDE

Answer 1

Pronestyl®

Question 2

Generic/Trade Name

Pronestyl®

Answer 2

PROCAINAMIDE

Question 3

PROCAINAMIDE (Pronestyl®)

Drug Classification:

Answer 3

Antidysrhythmic

Question 4

PROCAINAMIDE (Pronestyl®)

Mechanism of Action:

Answer 4

Na+ channel blocker ⇒ slows phases IV and 0 of the cardiac cyle

Question 5

PROCAINAMIDE (Pronestyl®)

Pharmacokinetics

Answer 5

• Onset of Action = 10-30 minutes
• Peak Effects = 15-20 minutes
• Duration of Effect = 3-6 hours
• Half-Life = 3 hours

Question 6

PROCAINAMIDE (Pronestyl®)

Indications & Contraindications

Answer 6

Indications/Field Use:
• Persistent cardiac arrest secondary to VF, PVC’s, and VT all refractory to lidocaine

Contraindications:
• Severe conduction disturbances, especially 2°/3° Heart Blocks
• PVC’s with bradycardia

Question 7

PROCAINAMIDE (Pronestyl®)

Side Effects/Adverse Reactions:

Answer 7

N+V, Drowsiness, seizures, confusion,

hypotension, bradycardia, heart blocks,
respiratory and cardiac arrest

Question 8

PROCAINAMIDE (Pronestyl®)

Adult & Pedi Dose:

Answer 8

(ADULT): 100mg q5min @20mg/min; maintenance 1-4mg/min

(PEDI): 15mg/kg IV, IO over 30-60 min

Question 9

PROCAINAMIDE (Pronestyl®)

Precautions:

Answer 9

• Monitor BP
• D/C if:
  
  • Dysrhythmia is suppressed
  • Hypotension occurs
  • QRS complex widens by 50%
  • 17mg/kg has been given

Question 10

PROCAINAMIDE (Pronestyl®)

Drug-Drug Interactions:

Answer 10

May increase chance of hypotension when taken with antihypertensives

Chance of neurotoxicity increases if given with lidocaine