Procainamide


 
General Principles: Indications Precautions  

Useful for treatment of a wide variety of arrhythmias.

 May use for treatment of PSVT uncontrolled by adenosine and vagal maneuvers if blood pressure stable.
Stable wide-complex tachycardia of unknown origin.
Atrial fibrillation with rapid rate in Wolff-Parkinson-White syndrome.		 If cardiac or renal dysfunction is present, reduce maximum total dose to 12 mg/kg and maintenance infusion to 1 to 2 mg/mm.
  
 
Proarrhythmic, especially in setting of AMI, hypokalemia, or hypomagnesemia.  
    May induce hypotension in patients with impaired LV function.  
    Use with caution with other drugs that prolong QT interval (eg, amiodarone,
sotalol).		  
 

Cardiac Arrest (VF or VT)

 Stable VT  

20 mg/mm IV infusion (maximum total dose: 17mg/kg).

 20 mg/mm IV infusion (maximum total dose: 17mg/kg).  
  In refractory VF/VT, 100 mg IV push doses given every 5 minutes are
acceptable.		 Maintenance Infusion: 1 to 4 mg/mm.  
  Maintenance Infusion: 1 to 4 mg/mm.    
 

Wide-Complex Tachycardia (Stable) or SVT

20 mg/mm IV infusion until one of the
following occurs:
· Arrhythmia suppression.
· Hypotension.
· QRS widens by >50%.
· Total dose of 17 mg/kg is given.

· Maintenance Infusion 1 to 4 mg/mm.