Drug Cards

Procainamide

Pronestyl
Class:
Antidysrhythmic Class Ia
Mechanism of Action:
  • Suppresses phase IV depolarization in normal ventricular muscle and Purkinje fibers, reducing automaticity of ectopic pacemakers.
  • Suppresses reentry dysrhythmias by slowing intraventricular conduction.
Indications:
  • Suppress PVCs refractory to Lidocaine.
  • Suppress VT with a pulse refractory to Lidocaine.
  • PSVTs with wide-complex tachycardia of unknown origin (drug of choise when associated with WP).
Contraindications:
  • Second- and Third-Degree block.
  • Torsades de Pointes.
  • Lupus.
  • Digitalis toxicity.
  • Myasthenia gravis.
Adverse reactions:
PR, QRS, and QT widening, AV Block, cardiac arrest, hypotension, seizures.
Nausea, vomiting, reflex tachycardia, PVCs, VT, VF.
CNS depression, confusion.
Adult Dosage and Administration
20-30 mg/min; maximum dose is 17 mg/kg.
Maintenace infusion: 1-5 mg/min.
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Pediatric Dosage and Administration:
2-6 mg/kg IV at less than 20 mg/min; maximum dose is 17 mg/kg.
Maintenace infusion: 20-80 mcg/kg/min (0.02-0.08mg/kg/min).
Duration of Action:
  • Onset: 10-30 minutes.
  • Peak effect: Variable.
  • Duration: 3-6 hours.