1
Q
class
A
- Class IA antiarrhythmic
- sodium channel blocker
2
Q
trade names
A
- Pronestyl
- Procanbid
3
Q
routes
A
- PO
- IV
4
Q
other Class IA antiarrhythmics
A
- quinidine gluconate (Quinaflute Dura-Tabs)
- quinidine sulfate (Quinidex Extentabs)
5
Q
action
A
- ↓ electrical conduction
- ↓ automaticity
- ↓ rate of repolarization
6
Q
use
A
- SVT
- ventricular tachycardia
- atrial fib/flutter
7
Q
complications
A
- systemic lupus syndrome
- fever
- painful, swollen joints
- butterfly rash
- neutropenia
- thrombocytopenia
- cardiotoxicity (dysrhythmias)
- hypotension
8
Q
neutropenia and thrombocytopenia interventions/pt ed
A
- monitor CBC weekly x 12, then periodically
- monitor for infection or bleeding
- stop drug for bone marrow suppression
9
Q
systemic lupus syndrome interventions/pt ed
A
- S/Sx resolve with D/C of med
- if no alternative, control S/Sx with NSAIDs
- monitor nuclear antibody titers (ANA)
- if present and ↑, D/C med
10
Q
cardiotoxicity interventions/pt ed
A
- monitor med levels (4–8 mcg/mL)
- monitor VS and ECG
- hold med/notify HCP for dysrhythmias
11
Q
hypotension interventions
A
- monitor BP
- hold med/notify HCP for hypotension
12
Q
contraindications
A
- hypersensitivity to procaine or quinidine
- complete heart block
- atypical v-tach
- myasthenia gravis
- systemic lupus erythematosus
13
Q
precautions
A
- pregnancy (C)
- partial AV block
- liver or renal d/o
- HF
- digoxin toxicity
14
Q
interactions
A
- antidysrhythmics: additive effects, ↑ risk of toxicity
- anticholinergic meds: ↑ anticholinergic effects
- antihypertensives: additive hypotensive effect
15
Q
procainamide + antidysrhythmics =
A
- additive effects, ↑ risk of toxicity
- monitor HR and rhythm
- notify provider of change in or start of new dysrhythmia
16
Q
procainamide + anticholinergics =
A
- ↑ anticholinergic effects
- blurred vision
- dry mouth
- urinary retention
- constipation
- tachycardia
- monitor HR
- suck on hard candy or chew gum
- stool softeners
17
Q
procainamide + antihypertensives =
A
- ↑ hypotension
- monitor BP
- notify provider of significant ↓
18
Q
procainamide admin/pt ed
A
- take as prescribed
- don’t crush or chew sustained-release
2021 Pharm 2
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