Alternate Name(s):
Pronestyl
Classification:
Antiarrhythmic Agent, class 1-A
Original Date:
April 1996
Revised Date:
May 2014
Indications:
- Ventricular arrhythmias, atrial fibrillation or flutter
- Paroxysmal atrial fibrillation
Administration:
- IV intermittent infusion
- Loading dose: over 60 minutes
- IV continuous infusion
Dosage:
-
- Load: 7 - 10 mg/kg over 1 hour followed by a continuous infusion
- Continuous infusion: 20 - 80 mcg/kg/min; titrate dose to effect
Side Effects:
- CVS: hypotension, tachycardia, arrhythmias, increase or decrease AV block, QT prolongation, widening of QRS complex
- GI: nausea, vomiting
- Hematologic: neutropenia, thrombocytopenia, agranulocytosis
Parameters to Monitor:
- ECG, (attention to QRS & QT duration), BP
- CBC with differential, platelet count
Reconstitution and Stability:
- Procainamide 100 mg/mL
- Take 1 mL (100 mg) and add to 49 mL 0.9% NaCl
- Final concentration: 2 mg/mL
- Procainamide 100 mg/mL
- Take 2 mL (200 mg) and add to 48 mL of 0.9% NaCl
- Final concentration: 4 mg/mL
Compatibility:
- Solution Compatible: 0.9% NaCl
References:
- Chang PM, Silka MJ, Moromisato DY, et al. Amiodarone Versus Procainamide for the Acute Treatment of Recurrent Supraventricular Tachycardia in Pediatric Patients. Circ Arrhythm Electrophysiol. 2010;3: 134-40
- Moffett BS, Cannon BC, Friedman RA, et al. Therapeutic Levels of Intravenous Procainamide in Neonates: A Retrospective Assessment. Pharmacotherapy, 2006; 26 (12): 1687-93
- Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 20th Edition. Hudson: Lexi-Comp Inc; 2013
- Trissel LA. Handbook on Injectable Drugs. 16th Edition: Bethesda: American Society of Health-System Pharmacists: 2011