Drugs: Procainamide Hydrochloride

Antiarrhythmic (atrial and ventrical)

IV Piggyback

Adult: 20 mg/min IV piggyback (maximum total dose of 17mg/kg)

50 mg/min IV push in urgent situations (maximum total dose of 17 mg/kg).

STOP the medication when one of the following occurs:

Maximum dose is achieved (17 mg/kg or bag is empty)
Arrhythmia is suppressed
QRS widens by greater than 50 percent
Hypotension occurs

15 mg/kg IV piggyback over 30 to 60 minutes

Depresses depolarization which slows automaticity and /or conduction veloity

Stable V-tach
PSVT unresponsive to vegal maneuvers and adenosine (with stable B/P).
Stable wide-comples tachycardia of unknown origin
Pts. in wolff-parkinson-white syndrome with rapid a-fib

for pts with acardiac or renal dysfunction, reduce maximal total dose to 12 mg/kg and maintenance infusion to 1 to 2 mg/min.

continually monitor QRS, PR and QT intervals for widening; Stop the druf if the QuS widens by more than 50 percent.

Use with caution with other drugs that cause QRS to widen.

Can create arrhythmias in the presence of AMI, hypokalemia, and hypomagnesemia

Bradycardia
Hypotension
Conduction delays which prolong the PR or QT intermals or widen the QRS
Heart Blocks
In overdoseage- CNS depresion, confusion, seizures, myalgia (muscle pain).

Second and third degree blocks
Preexisting hypotension
Digitalis toxicity
Torsades de pointe ("twisting of the ECG")
Tricyclic antidepressang toxicity