Procainamide Indications for Use: Stable monomorphic ventricular tachycardia with normal QT interval. Atrial fibrillation with a rapid ventricular rate response in patients with Wolff-Parkinson-White (WPW) syndrome and recurrent ventricular fibrillation or pulseless ventricular tachycardia.

How do you make a procainamide infusion?

Intravenous Administration Each 100 mg of procainamide must be diluted in 10 ml of sterile water for injection or D5W injection. Inject by slow IV push at a rate not to exceed 50 mg/minute. Intravenous infusion: NOTE: According to the manufacturer, procainamide injection is compatible in D5W.

What is a contra indication to the use of procainamide infusion in the management of stable wide complex tachycardia?

Other contraindications would include third degree heart block or preexisting prolongation of the QRS complex and Q-T intervals. Procainamide should be avoided in patients with prolonged Q-T intervals and associated CHF.

For which of the following is administration of procainamide indicated?

SLIDESHOW. PRONESTYL (procainamide hydrochloride) is indicated for the treatment of documented ventricular arrhythmias, such as sustained ventricular tachycardia, that, in the judgment of the physician, are life-threatening.

How is procainamide metabolized?

Procainamide is eliminated by hepatic metabolism and renal excretion. It is metabolized to N-acetyl procainamide (NAPA), by conjugation by N-acetyl transferase.

What does procainamide treat?

Procainamide is used to treat abnormal heart rhythms. It works by making your heart more resistant to abnormal activity.

How do you monitor procainamide?

How should I monitor my patient? A. Initiate procainamide while your patient is hospitalized and monitor cardiac rate and rhythm, including QTc interval; BP; and monitor for hypersensitivity reactions. Also monitor his complete blood cell count, ANA titer, and kidney and liver function for blood abnormalities.

Why is procainamide used in WPW?

The use of intravenous procainamide is a reliable and rapid method of identifying patients with the Wolff-Parkinson-White syndrome who may be at risk for circulatory insufficiency or sudden death in case of atrial fibrillation.

What is the brand name for procainamide?

Clinical dataTrade namesPronestyl, Procan, Procanbid, othersAHFS/Drugs.comMonographRoutes of administrationIV, IM, by mouthATC codeC01BA02 (WHO)

How does procainamide work on the heart?

Procainamide injection is used to treat irregular heartbeats and to slow an overactive heart. When the heart has a normal heartbeat (rhythm), it will work more efficiently. Procainamide works by slowing the nerve impulses in the heart and reducing the sensitivity of heart tissues.

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What is the most common adverse effect of procainamide *?

Common side effects of Pronestyl (procainamide hydrochloride) include nausea, vomiting, loss of appetite, diarrhea, bitter taste in the mouth, dizziness, tired feeling, flushing (warmth, redness, or tingly feeling), and itching or rash.

How is procainamide toxicity treated?

In overdose, charcoal can be considered after securing the airway but the mainstay treatment for toxicity is treatment of underlying rhythms using sodium bicarbonate, magnesium, and overdrive pacing. In chronic toxicity, procainamide has been linked to a drug-induced systemic lupus erythematosus syndrome.

How do you mix amiodarone?

To prepare Amiodarone for an IV infusion, mix with D5W and give through an in-line filter. Alternatively, it is NOT necessary to dilute amiodarone for IV push administration and a filter is not necessary. When infusions exceed 2 hours, amiodarone can absorb into the plastic used for standard IV bags.

What is procainamide challenge?

Procainamide challenge is a pro- cedure to detect typical ECG patterns suggestive of Brugada syndrome. This procedure was historically performed in cardiac intensive care unit due to the need of rigorous monitoring and advanced skill to respond to an adverse event.

When do you give adenosine?

Adenosine is indicated for: narrow-complex supraventricular tachycardia or SVT, unstable narrow-complex reentry tachycardia, regular and monomorphic wide-complex tachycardia, or as a diagnostic maneuver for stable narrow-complex SVT.

Is 500mg of Depakote a lot?

Depakote ER is indicated for prophylaxis of migraine headaches in adults. The recommended starting dose is 500 mg once daily for 1 week, thereafter increasing to 1000 mg once daily.

What would you monitor when administering an antiarrhythmic?

Assess your patient’s apical pulse rate and rhythm before administering an antiarrhythmic. Monitor his cardiac rate and rhythm continuously when therapy starts or any time the dosage is adjusted. Check his vital signs frequently.

Is procainamide a sodium channel blocker?

Procainamide is class Ia Na(+) channel blocker that may prolong ventricular repolarization secondary to inhibition of IK r , the rapid component of the delayed rectifier K(+) current.

How does procainamide cause lupus?

For example, whereas some drugs can cause DILE, others may cause a flare of preexisting SLE. Drugs such as procainamide, chlorpromazine, and quinidine cause the production of antinuclear antibodies against the histone dimer H2A-H2B.

How long does procainamide stay in your system?

Pharmacokinetics. Procainamide is rapidly eliminated (half-life, 3 to 4 hours) by hepatic metabolism and renal excretion of unchanged drug.

Is oral procainamide available?

Procainamide hydrochloride is available as 250 mg, 375 mg, or 500 mg capsules for oral administration and contains the following inactive ingredients: anhydrous lactose, glacial acetic acid, magnesium stearate, methylparaben, pregelatinized starch, propylparaben, silicon dioxide, sodium lauryl sulfate, stearic acid and …

Is procainamide the same as lidocaine?

A comparison of the QRS width and QT interval before and at the end of the injection revealed significant lengthening of these values after procainamide but no change after lidocaine. In conclusion, procainamide is superior to lidocaine in terminating spontaneously occurring monomorphic VT.

What is Ron T phenomenon?

The “R-on-T phenomenon” is the superimposition of an ectopic beat on the T wave of a preceding beat. Early observations suggested that R-on-T was likely to initiate sustained ventricular tachyarrhythmias.

What kind of drug is adenosine?

Adenosine is a prescription drug used for conversion to sinus rhythm of paroxysmal supraventricular tachycardia (PVST), including that associated with accessory bypass tracts (Wolff-Parkinson-White Syndrome).

How does procainamide treat WPW?

Procainamide, a class 1A antiarrhythmic, increases effective refractory period and reduces impulse conduction velocity and excitability in the atria, His-Purkinje fibers, ventricular muscle, and the AP of the heart.

Why dont you give adenosine to WPW?

The concern with using adenosine in patients with WPW is that if the AV node is blocked than impulses from the atria will be able to reach the ventricles at a very rapid rate, since they are not slowed down through the accessory pathway as they are at the AV node.

How do you treat pre excitation syndrome?

There are both invasive and non-invasive methods of diagnosing preexcitation syndromes. Therapeutic treatment includes pharmacotherapy and ablation, which makes it possible to permanently remove the cause of the arrhythmia.

What is the half life of procainamide?

The therapeutic concentration of procainamide is 4-8 µg/mL. The half-life is 3-5 hours. The toxic concentration is 16 µg/mL or greater, although symptoms may develop at 8-10 µg/mL. The therapeutic concentration of NAPA is also 4-8 µg/mL, and its half-life is approximately 7 hours.

Is procainamide contraindicated in heart failure?

Although blockers are important antiarrhythmic drugs in patients with HF, other antiarrhythmic drug therapies have been disappointing. The class I sodium channel-blocking drugs (mexiletine, tocainide, procainamide, quinidine, disopyramide, flecainide, and propafenone) should be avoided.

Can you use procainamide long term?

Introduction. Procainamide is an oral antiarrhythmic agent that has been in use for more than 60 years. Long term procainamide therapy is known to induce hypersensitivity reactions, autoantibody formation and a lupus-like syndrome but is a rare cause of clinically apparent acute liver injury.

What is amiodarone used for?

Amiodarone is used to treat life-threatening heart rhythm problems called ventricular arrhythmias.