Pharmacology: Procainamide Flashcards
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Questions and Answers

What is the classification of Procainamide?

  • Antihypertensive
  • Analgesic
  • Antidysrhythmic (Class IA - Sodium Channel Blocker) (correct)
  • Antibiotic
  • What is the mechanism of action of Procainamide?

    Depresses myocardial excitability, slows conduction of the heart, suppresses ventricular automaticity, increases refractory period, and increases fibrillation threshold.

    Which of the following are indications for Procainamide? (Select all that apply)

  • SVT associated with WPW (correct)
  • Atrial Fibrillation
  • Hypertension
  • V-Tach/Wide Complex Tachycardia (correct)
  • What are some contraindications for Procainamide? (Select all that apply)

    <p>2nd or 3rd degree heart blocks</p> Signup and view all the answers

    What are the neurological side effects of Procainamide?

    <p>Seizures, confusion, dizziness, weakness, irritability.</p> Signup and view all the answers

    What precautions should be taken when using Procainamide?

    <p>Myasthenia gravis, hepatic or renal disease, myocardial infarction, congestive heart failure, hypotension, asthma.</p> Signup and view all the answers

    What can happen if Procainamide is administered too quickly?

    <p>Hypotension.</p> Signup and view all the answers

    Class IA sodium channel blockers slow the propagation of impulses down the conduction of the atria and ventricles without affecting the ______ node.

    <p>AV</p> Signup and view all the answers

    Procainamide decreases the rate of repolarization which results in a widened _______ and prolonged ______ interval.

    <p>QRS, PR</p> Signup and view all the answers

    What is the first line drug in the treatment of Ventricular Tachycardia with Pulses?

    <p>Procainamide.</p> Signup and view all the answers

    When is Procainamide considered a third line drug?

    <p>In the treatment of SVT associated with WPW.</p> Signup and view all the answers

    Generally used for ____________ stable monomorphic VT or WPW.

    <p>hemodynamically</p> Signup and view all the answers

    In general, Class I antiarrhythmics slow conduction in non-_______ tissue and inhibit depolarization.

    <p>nodal</p> Signup and view all the answers

    Study Notes

    Procainamide Overview

    • Classification: Antidysrhythmic (Class IA - Sodium Channel Blocker)
    • First line treatment: Ventricular Tachycardia with Pulses

    Mechanism of Action

    • Depresses myocardial excitability and slows heart conduction
    • Suppresses ventricular automaticity and increases refractory period, prolonging QRS and QT intervals
    • Raises the fibrillation threshold

    Indications for Use

    • Supraventricular Tachycardia (SVT) associated with Wolff-Parkinson-White (WPW) syndrome
    • Ventricular Tachycardia (V-Tach) or Wide Complex Tachycardia

    Contraindications

    • Hypersensitivity to Procainamide
    • Second or third-degree heart blocks
    • Digitalis toxicity
    • Torsades de Pointes

    Side Effects

    • Neurological: Seizures, confusion, dizziness, weakness, irritability
    • Respiratory: No significant effects noted
    • Cardiovascular: Heart blocks, hypotension, ventricular dysrhythmias, widening of QRS, prolonged QT interval
    • Other: Nausea and vomiting (N/V)

    Precautions

    • Patients with myasthenia gravis
    • Those with hepatic or renal disease
    • Recent myocardial infarction (MI)
    • Congestive heart failure (CHF)
    • Hypotension and asthma

    Drug Interactions

    • Concomitant use with antihypertensives may lead to severe hypotension
    • Increases effects of neuromuscular blockers, anticholinergics, and antihypertensives

    Onset and Duration

    • Immediate onset of action, with effects lasting 3-4 hours

    Dosage Guidelines

    • Administer 20 mg/min IV; maximum of 17 mg/kg, or until symptomatic hypotension or QRS widening by 50% occurs
    • Infuse at 2 mg/min if arrhythmia is suppressed

    Additional Information

    • Class IA sodium channel blockers slow impulse propagation in atria and ventricles without affecting the AV node
    • Procainamide decreases rate of repolarization, resulting in widened QRS and prolonged PR interval
    • Generally used for hemodynamically stable monomorphic VT or WPW
    • Too rapid administration may lead to hypotension

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    Test your knowledge of Procainamide with these flashcards. Explore its classification, mechanism of action, and clinical indications. Perfect for students mastering pharmacology concepts and antidysrhythmic medications.

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