Drug Cards

Diltiazem HCL

Diltiazem HCL (Cardizem)
Class:
Calcium Channel Blocker
Mechanism of Action:
  • Block influx of calcium ions into cardiac muscle.
  • Arterial and venous vasodilator.
  • Reduces preload and afterload.
  • Reduces myocardial oxygen demand.
Indications:
  • Atrial flutter
  • Atrial fibrillation with rapid ventricular rates.
  • Multifocal Atrial Tachycardia (fast wandering atrial pacemaker)?
Contraindications:
  • Wide-complex tacycardia.
  • Sick sinus syndrome.
  • Cardiogenic shock.
  • Hypersensitivity to any component of Cardizem.
  • Advanced AV Block.
  • Hypotension.
  • Atrial fibrillation / Atrial flutter with WPW (Wolff-Parkinsons-White).
  • Never mix with a beta blocker.
Adverse reactions:
Hypotension, Flushed skin, Bradycardia, second or third degree AV blocks, chest pain, CHF, syncope, V-fib, V-tach, nausea, vomiting, dizziness, dry mouth, dyspnea, headache.
Drug Interactions:
Caution in general patients including medications that affect cardiac contractility.
In general, should not be used in patients on Beta-blockers.
Adult Dosage and Administration
Initial bolus: 0.25 mg/kg (average dose 20 mg) IV over 2 minutes. If inadequate response may re-bolus in 15 minutes: 0.35 mg/kg IV over 2 minutes.
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Pediatric Dosage and Administration:
Not recommended.
Duration of Action:
  • Onset: 2-5 minutes.
  • Peak effect: variable.
  • Duration: 1-3 hours.
Special Considerations:
  • Pregnancy safety: category C.
  • Use in caution in patients with renal or hepatic dysfunction.
  • Administer slowly. Stop administration if therapeutic effect is acheived.
  • Have Calcium on stand-by in case of adverse effects.