Paramedic Drug Cards

Procainamide


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Trade – Pronestyl 


Class – Antiarrhythmic – NA+ blocker


MOA – Blocks influx of sodium through membrane pores, consequently suppresses atrial and ventricular arrhythmias by slowing conduction in myocardial tissue.


Indication – Alternative to amiodarone for stable monomorphic VT with normal QT interval. Reentry SVT if uncontrolled by adenosine and vagal maneuvers if BP is stable. Rapid Afib in WPW


Contraindications – AV block, QT prolongation, torsades de pointes,


Side effects – Asystole, VF, flushing, hypotension, PR prolongation, QRS widening, QT prolongation.


Dosing 

Adult – 500-600mg over 25-30 mins or 20-50mg/min ( max dose of 17mg/kg until one of the following occurs; arrhythmia resolves, hypotension, QRS widens > 50% of original width. )


Pedi 10 to 15 mg/kg slow IV,IO over 30-60 mins. 

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Paramedic Drug CardsBy Michael Egan

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