Paramedic Drug Administration diltiazem

Diltiazem Overview

• Trade name: Commonly known as Cardizem.
• Class: Calcium channel blocker, specifically a non-dihydropyridine type.

Mechanism of Action

• Inhibits calcium ions from entering cardiac and smooth muscle cells.
• Causes relaxation of vascular smooth muscle, leading to vasodilation.
• Decreases heart rate and contractility.

Indications

• Management of hypertension (high blood pressure).
• Treatment of angina pectoris (chest pain).
• Control of certain types of arrhythmias (irregular heartbeats).

Contraindications

• Severe hypotension (low blood pressure).
• Atrioventricular block (unless a pacemaker is present).
• Patients with sick sinus syndrome (unless receiving a permanent pacemaker).
• Known hypersensitivity to diltiazem.

Routes of Administration

• Available in oral tablets and capsules.
• Injectable formulation for intravenous use.

Pharmacokinetics

• Onset of action: Varies; generally within 30 to 60 minutes for oral forms, and immediate for IV administration.
• Typical duration of action: Ranges from 6 to 8 hours; can be longer with extended-release formulations.

Typical Adult Dose

• Initial doses vary based on indication, typically starting at 30 to 60 mg taken three times daily for oral administration; IV dosing can differ and is adjusted based on response.

Adverse Reactions/Side Effects

• Common side effects include dizziness, fatigue, headache, and gastrointestinal discomfort.
• May cause hypotension, bradycardia (slow heart rate), and peripheral edema.

Special Considerations in Prehospital Setting

• Assess blood pressure and heart rate before administration.
• Monitor for signs of adverse reactions during transport.
• Consider interactions with other medications the patient may be taking.

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