| Name: |
PROPAFENONE (RytmonormR) |
| Classification: |
antiarrhythmic:Class IC; emergency special access agent
- prolongs refractory period in atria and ventricles thus effective for arrhythmias of various origins
- has weak beta receptor antagonist and calcium channel blocking activity
|
| Dose: |
- Loading Dose:
- 0.5-2.5 mg/kg IV direct over a minimum of 3-5 minutes
- Maintenance Dose:
- 0.5-2.5 mg/kg IV direct q8h (maximum 560 mg/day)
OR
- continuous infusion up to 23 mg/hr
- may need to reduce dose in renal or hepatic failure
|
| Administration: |
- IV Direct:
- administer undiluted over at least 3-5 minutes into the tubing of a freely flowing compatible IV
- IV Infusion:
- concentration 70 mg/70 ml D5W (remove volume from 100 mL minibag)
|
| Adverse Effects: |
- bradycardia, SA or AV block
- heart failure
- arrhythmias
- fatigue, headache
- allergic skin reactions
- anorexia, nausea/vomiting, bitter taste
- cholestasis
- blurred vision or vertigo
- agranulocytosis (rare)
|
| Drug Interactions: |
- propafenone + digoxin = increased digoxin levels
- propafenone + theophylline = increased theophylline levels
- propafenone + warfarin = increased warfarin effect
- propafenone + beta blockers = increased negative inotropic effect
- propafenone + calcium channel blockers = increased negative inotropic effect
|
| Monitoring Therapy: |
- ECG, rhythm, QRS complex
- cardiac index
- breath sounds, chest xray
- WBC
- liver enzymes
|
| CCTC Protocol: |
- Must be administered IV and titrated by a physician.
- Continuous infusion must be administered via an infusion pump.
|
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