Diltiazem Contraindications Quiz and Flashcards

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Questions and Answers

What is the main indication for using diltiazem?

Myocardial infarction

Atrial fibrillation with rapid ventricular response (correct)

Hypertension

Sinus tachycardia

Which of the following is NOT a contraindication for diltiazem use?

Systolic blood pressure < 90mmHg

History of Wolff-Parkinson-White (WPW) syndrome

Sinus bradycardia (correct)

Myocardial infarction and pulmonary congestion

How does diltiazem affect the AV node refractory periods?

Prolongs them (correct)

Causes arrhythmias in the AV node

Shortens them

Does not affect them

What is the pregnancy category of diltiazem?

Category C Signup and view all the answers

What is the class of diltiazem based on its mechanism of action?

Calcium channel blocker Signup and view all the answers

Which of the following adverse effects is NOT commonly associated with diltiazem use?

Hyperactivity Signup and view all the answers

How does diltiazem affect serum calcium concentrations?

No effect on them Signup and view all the answers

What is the route of excretion of diltiazem?

Kidneys and bile Signup and view all the answers

What are the possible additive effects when diltiazem is used concurrently with beta-blockers or digitalis?

Increased cardiac conduction effects Signup and view all the answers

What is the main indication for using diltiazem in patients?

A-fib with RVR Signup and view all the answers

In patients with which condition should diltiazem NOT be used unless they have a functioning ventricular pacemaker?

Sick sinus syndrome Signup and view all the answers

What is the concentration of diltiazem?

5 mg/mL Signup and view all the answers

Which of the following is a precaution associated with diltiazem use?

Cardiac Conduction Signup and view all the answers

How does diltiazem affect AV node refractory periods in patients without sick sinus syndrome?

Prolongs them significantly Signup and view all the answers

Which of the following is an adverse effect commonly associated with diltiazem use?

Headache Signup and view all the answers

What is the route of excretion for diltiazem after metabolism?

Urine and bile Signup and view all the answers

What effect does diltiazem have on the recovery time of the sinus node in patients without sick sinus syndrome?

No significant effect Signup and view all the answers

what is the initial dose when the pt is experiencing Afib with RVR or Paroxysmal SVT?

0.25mg/kg max dose: 20mg or 4ml slow IVP over 2 mins SBP must remain >90 mmHg Signup and view all the answers

what is the 2nd dose when the pt is experiencing Afib with RVR or Paroxysmal SVT and do you need permission and how mins after the first dose?

0.35mg/kg max dose 25mg or 5ml slow IVP over 2 mins only after getting approval from OLMC after 15mins of the original administration Signup and view all the answers

Study Notes

Indications and Contraindications

Main indication for using diltiazem: AFib with RVR or Paroxysmal SVT
Contraindication: Sick sinus syndrome without a functioning ventricular pacemaker

Effects on AV Node

Diltiazem prolongs AV node refractory periods
In patients without sick sinus syndrome, diltiazem prolongs AV node refractory periods

Pharmacology

Class of diltiazem based on its mechanism of action: Calcium channel blocker
Route of excretion: Primarily excreted in the urine and bile
Route of excretion after metabolism: Renal elimination

Adverse Effects and Interactions

Adverse effect commonly associated with diltiazem use: Bradycardia
Not commonly associated with diltiazem use: Changes in serum calcium concentrations
Additive effects when used concurrently with beta-blockers or digitalis: Increased risk of bradycardia and AV block
Precaution associated with diltiazem use: Patients with sick sinus syndrome require a functioning ventricular pacemaker

Dosage

Initial dose for AFib with RVR or Paroxysmal SVT: 0.25 mg/kg
2nd dose for AFib with RVR or Paroxysmal SVT: 0.35 mg/kg, given 15 minutes after the first dose, with permission from a physician

Pregnancy and Concentration

Pregnancy category: C
Concentration of diltiazem: Not specified

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Description

Test your knowledge on the indications, contraindications, and precautions associated with Diltiazem. Learn about its use in A-fib with RVR, Paroxysmal SVT, and more.

Diltiazem Indications, Contraindications, and Precautions