Procainamide
(Pronestyl, Pronestyl-SR, Procan SR)
Category:
Description:
Indications:
-
Life
threatening ventricular dysrhythmias, less severe but symptomatic
ventricular dysrhythmias in select patients
-
Maintenance
of sinus rhythm following cardioversion in atrial fibrillation and/or
flutter (non FDA approved)
-
Suppression
of recurrent paroxysmal atrial fibrillation (non FDA approved)
Contraindications:
Precautions:
-
Pregnancy
category C; compatible with breast feeding; long-term effect on
nursing infant unknown
-
Post
MI, 1st degree AV block (unless ventricular rate controlled
by pacemaker)
-
Asymptomatic
premature ventricular contractions, digitalis intoxication
-
CHF,
myasthenia gravis, renal insufficiency, children
Adverse
Reactions (Side Effects):
-
CNS:
depression, dizziness, giddiness, hallucinations, headache, psychosis,
weakness
-
CV:
hypotension, 2nd degree heart block, ventricular
arrhythmias
-
GI:
abdominal pain, anorexia, bitter taste, diarrhea, hepatomegaly,
nausea, vomiting
-
HEME:
agranulocytosis, hemolytic anemia (rare), neutropenia,
thrombocytopenia
-
SKIN:
angioneurotic edema, flushing, pruritus, rash, urticaria
-
MISC:
lupus erythematosus-like syndrome (arthralgia, plueral or abdominal
pain, arthritis, pleural effusion, pericarditis, fever, chills, rash)
in up to 30% on long-term therapy
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Dosage:
Administered
orally, intravenously, intramuscularly
-
Adult: PO 250-500mg every 3-6 hours; PO SR 500-1000mg every 6 hours,
usual dose 50 mg/kg/day, max 4g daily; IM 0.5-1g every 4-8 hours until
PO therapy possible; IV 1g INF over 25-30 minutes or 100-200mg daily
repeated every 5 minutes as needed to total dose of 1g as a loading
dose, followed by continuous INF of 1-6 mg/min, titrate to patient
response
-
Child: PO 15-50 mg/kg/day divided every 3-6 hours, max 4g daily; IM
20-30 mg/kg/day divided every 4-6 hours, max 4g daily; IV 3-6 mg/kg
INF over 5 minutes not to exceed 100mg daily as a loading dose, then
20-80 mcg/kg/minute as a continuous INF, max 4g daily
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The information contained here is an
abbreviated summary. For more detailed and complete information, consult the
manufacturer's product information sheets or standard textbooks
Source: Operational Medicine 2001, Health
Care in Military Settings, NAVMED P-5139, May 1, 2001, Bureau
of Medicine and Surgery, Department of the Navy, 2300 E Street NW, Washington,
D.C., 20372-5300
This information is provided by The Brookside Associates. The Brookside
Associates, LLC. is a private organization, not affiliated with any governmental
agency. The opinions presented here are those of the author and do not
necessarily represent the opinions of the Brookside Associates or the Department
of Defense. The presence of any advertising on these pages does not constitute
an endorsement of that product or service by either the US Department of Defense
or the Brookside Associates. All material presented here is unclassified.
C. 2009, 2014, All Rights Reserved
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