Procainamide

1. Therapeutic Effects
   1. Reduce automaticity, reentrant pathways, intraventricular conduction.
   2. Produces profound vasodilation.

2. Indications
   1. Persistant arrest and Ventricular Fibrillation.
   2. Recurring Ventricular Tachycardia.
   3. Suppressing PVC's unresponsive to Lidocaine.
   4. SVT

3. Contraindications/Precautions
   1. Myasthenia gravis
   2. Hypersensitivity to this drug, or procaine and related drugs.
   3. Complete AV heart block, Second and Third-degree AV block, unless an electrical pacemaker is aperative.
   4. Torsade de pointes.
   5. Systemic lupus erythematosus.
   6. Caution in patients with impaired renal or hepatic function.
   7. Patient must have continuous ECG during administration. If QRS widens 50%or more stop administration.

4. Side Effects
   1. Hypotension
   2. Myocardial depression
   3. Heart block, tachyarrhythmias, Torsades de pointes.
   4. Lupus-like reaction, seizures.
   5. May potentiate some other medications.

5. Administration and Dosage
   1. Loading dose is 20-30mg/min until rhythm suppressed or: Hypotension, widening of QRS by 50%, 17 mg/kg maximum is reached.
   2. Lupus-like reaction, seizures.
   3. Infusion dose is 1-4 mg/min. You may see alternative dosing if the patient has severe cardiac or renal disease.