CodeBlue
Drug Reference

Rhythm

Procainamide

Class IA antiarrhythmic

LoadAdult20–50 mg/min IV until arrhythmia suppressed, hypotension, QRS ↑ > 50%, or 17 mg/kg; maintenance 1–4 mg/minPeds15 mg/kg over 30–60 min

Indications

  • Stable wide-complex tachycardia
  • Pre-excited AFib (WPW)

Contraindications & cautions

  • Prolonged QT
  • Heart failure
  • Torsades
  • TCA overdose

Key pearls

  • Avoid with amiodarone (additive QT prolongation)
  • Monitor BP and QRS every few minutes

Used in

Adult Tachycardia with a Pulse Pediatric Tachycardia AFib with RVR