TY - CHAP M1 - Book, Section TI - Cardiovascular Drugs A1 - Rozenfeld, Ranna A. Y1 - 2018 N1 - T2 - The PICU Handbook AB - Table Graphic Jump Location|Download (.pdf)|PrintAntiarrhythmic MedicationsClassDoseMechanismProcainamideIaIV: Loading dose: 10–15 mg/kg over 30–60 min; in adults, maximum dose range: 1000–1500 mgMaintenance: Continuous IV infusion: 20–80 mcg/kg/minute; maximum daily dose: 2000 mg/24 hrDecreases atrial and ventricular automaticity, vagolytic effectLidocaineIbIV: Loading dose: 1 mg/kg/dose; follow with continuous IV infusion; may administer second bolus if delay between initial bolus and start of infusion is >15 minContinuous IV infusion: 20–50 mcg/kg/minAffects ventricular tissueMexiletinePO: 1.4–5 mg/kg/dose (mean: 3.3 mg/kg/dose) given every 8 hrPhenytoinIV/PO: Loading dose: 15–20 mg/kgMaintenance therapy: Initial: 5 mg/kg/day in divided dosesFlecainideIcPO: Initial: 1–3 mg/kg/day or 50–100 mg/m2/day in three divided dosesSlows conduction velocities throughout the myocardiumPropafenonePO: Initial 200–300 mg/m2/24 hr divided in three or four equal doses or 8–10 mg/kg/24 hr in three or four equal dosesEsmololIIInitial IV bolus: 100–500 mcg/kg over 1 minContinuous IV infusion: Initial rate: 25–100 mcg/kg/minLowers heart rate, decreases automaticity, slows AV nodal conductionPropranololPO: Initial: 0.5–1 mg/kg/day in divided doses every 6–8 hr; max 16 mg/kg/dayMetoprololPO: Initial: 0.5–1 mg/kg/dose (maximum initial dose: 25 mg/dose) twice dailyIbutilideIII<60 kg: 0.01 mg/kg over 10 min≥60 kg: 1 mg over 10 minProlongs repolarization and refractoriness of atrial, nodal, and ventricular tissueSotalolInitial: Infants, children, and adolescents: 2 mg/kg/day divided every 8 hrAmiodaroneIV: Loading dose: 5 mg/kg (maximum: 300 mg/dose) given over 60 minContinuous IV infusion (if needed): Initial: 5 mcg/kg/min; increase incrementally as clinically neededVerapamilIVIV:0.1–0.3 mg/kg/dose (usual dose: 2–5 mg/dose); maximum dose: 5 mg/dose; may repeat dose in 15–30 min if response inadequateSlows conduction in sinus and AV nodesDiltiazemAdults:Initial bolus dose: 0.25 mg/kg actual body weight over 2 minDigoxinMiscPlease consult pharmacy for patient-specific dosingDirectly suppresses AV node conductionAdenosineMiscRapid IV, IO: Initial: 0.1 mg/kg (maximum initial dose: 6 mg/dose)MagnesiumMiscIV, IO: 25–50 mg/kg/doseAtropineMiscIV, IO: 0.02 mg/kg/dose; minimum dose recommended by pediatric advanced life support (PALS): 0.1 mg; is not recommended in patients <5 kgIsoproterenolMiscContinuous IV infusion:0.05–2 mcg/kg/min; titrate to effect SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/29 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1152487491 ER -