Procainamide
Class
Antiarrhythmic
Description
Procainamide is an ester-type local anesthetic. It is frequently used to treat
ventricular dysrhythmias refractory to Lidocaine.
Mechanism of Action
1. Procainamide reduces the automaticity of the various pacemakers sited in the
heart.
2. Procainamide slows intraventricular conduction to a greater degree than does
Lidocaine.
Indications
PVCs and ventricular tachycardia, and persistent cardiac arrest due to
ventricular fibrillation, and refractory of Lidocaine.
Contraindications
Severe conduction system disturbances, especially second and third degree heart
blocks, ventricular escape beats, Torsades de Pointes, tricyclic antidepressant
overdose, dioxin toxicity, lupus, myasthenia gravis, CNS depression.
Adverse Reactions
Drowsiness, seizures, confusion, hypotension, bradycardia, heart blocks, nausea,
vomiting, and respiratory and cardiac arrest, PVCs, reflex tachycardia, VT, VF,
asystole, widening QRS complex, prolonged PR or QT interval.
Drug Interactions
The hypotensive effects of Procainamide may be increased if administered with
antihypertensive drugs. The chance of neurological toxicity by both Lidocaine
and Procainamide increases when the medications are administered together.
Precautions
1. Hypotension is common.
2. Use with caution with asthmatics, dioxin induced arrhythmias, acute MI;
cardiac, renal, hepatic insufficiency/failure
Note: Feel free to discuss this medication and your experiences in administering it in an emergency or hospital based setting on our message board
