Procainamide
Episode description
Trade – Pronestyl
Class – Antiarrhythmic – NA+ blocker
MOA – Blocks influx of sodium through membrane pores, consequently suppresses atrial and ventricular arrhythmias by slowing conduction in myocardial tissue.
Indication – Alternative to amiodarone for stable monomorphic VT with normal QT interval. Reentry SVT if uncontrolled by adenosine and vagal maneuvers if BP is stable. Rapid Afib in WPW
Contraindications – AV block, QT prolongation, torsades de pointes,
Side effects – Asystole, VF, flushing, hypotension, PR prolongation, QRS widening, QT prolongation.
Dosing
Adult – 500-600mg over 25-30 mins or 20-50mg/min ( max dose of 17mg/kg until one of the following occurs; arrhythmia resolves, hypotension, QRS widens > 50% of original width. )
Pedi 10 to 15 mg/kg slow IV,IO over 30-60 mins.