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41. Myocardial contractility in patients with ischemic heart disease during long-term administration of quinidine and procainamide. Direct measurement of segmental shortening with radiopaque epicardial markers. (PubMed)

Myocardial contractility in patients with ischemic heart disease during long-term administration of quinidine and procainamide. Direct measurement of segmental shortening with radiopaque epicardial markers. The purpose of this investigation was to determine whether long-term oral administration of commonly prescribed doses of quinidine sulfate and procainamide hydrochloride to patients with ischemic heart disease affects myocardial contractility. Segmental contractility, assessed (...) by the systolic shortening fraction, the relative change in interclip distance from diastole to systole, was measured by cineradiography of metal clips that had been sutured to the epicardium at the time of coronary artery bypass surgery. Global contractility was assessed by gated blood-pool scintigraphy. Systolic shortening fraction determinations and scintigraphy were obtained following five to seven days' administration of procainamide (500 mg every four hours), quinidine (200 mg every six hours

1979 Chest

42. Certain People With Atrial Fibrillation May Have Changes on Ecg When Given Procainamide That May be Related to a Genetic Difference

Certain People With Atrial Fibrillation May Have Changes on Ecg When Given Procainamide That May be Related to a Genetic Difference ST-segment Elevation as an AF Endophenotype - Full Text View - Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies (...) Center Collaborator: National Heart, Lung, and Blood Institute (NHLBI) Information provided by (Responsible Party): Dan Roden, Vanderbilt University Medical Center Study Details Study Description Go to Brief Summary: The purpose of this study is to look for a similarity in people's genes that may help understand which people could benefit from certain drugs for the treatment of atrial fibrillation (AF). Condition or disease Intervention/treatment Phase Atrial Fibrillation Drug: Procainamide

2010 Clinical Trials

44. Cardiac arrhythmias in coronary heart disease

procainamide was more effective than IV amiodarone in terminating wide complex tachycardia (22 of 33 participants, (67%) v 11 of 29 participants (38%), respectively; p=0.026). Intravenous procainamide was associated with fewer major cardiac adverse events (9% v 41%, odds ratio (OR) 0.1, 95% CI 0.03 to 0.6), the main one being severe hypotension, and total adverse events (24% v 48%, OR 0.34, 95% CI 0.12 to 1.00) in the acute study period (40 minutes from infusion initiation). 156 There were a number (...) of uncertainties in the sample size calculation for this trial as the anticipated adverse event rates were 20% and 5% in the procainamide and amiodarone groups, respectively, requiring a sample of 302 patients to detect a difference of 15% in major adverse events between groups. After six years, only 74 patients had been recruited with a decline in inclusion rates noted over time. At this point, recruitment was stopped and consequently the study is underpowered. The 2010 CoSTR guidance on advanced life support

2018 SIGN

45. Amiodarone: Wonder Drug or Wonder Why?

was recommended as a "first line anti arrhythmic agent" in refractory VF/pulseless VT, based on limited evidence for improved rates of ROSC and hospital admission. In addition, amiodarone been recommended for use in recent-onset AF for over twenty years ( ). Given the rise in prominence of procainamide use in AF (see ), and an increased focus on , we decided to review evidence for a variety of amiodarone indications frequently seen in the ED. Stable Ventricular Tachycardia , a small, multicenter randomized (...) controlled trial conducted at several hospitals in Spain enrolled 74 patients with hemodynamically stable, wide-complex tachycardia and randomized them to receive either IV amiodarone or IV procainamide over twenty minutes. Major cardiac events (clinical signs of hypoperfusion, dyspnea, hypotension, or acceleration of heart rate) occurred less frequently among patients receiving procainamide (OR 0.1' 95% CI 0.03 to 0.6). These patients also had a much higher rate of cardioversion (OR 3.3, 95% CI 1.2

2018 Washington University Emergency Medicine Journal Club

47. Steroids in Sepsis and Septic Shock

-onset AF for over twenty years ( ). Given the rise in prominence of procainamide use in AF (see ), and an increased focus on , we decided to review evidence for a variety of amiodarone indications frequently seen in the ED. Intranet Locations Contact Us Follow Us: F: (314) 362-0478 EM Statistics Adult ED Visits: 95,600 Pediatric ED Visits: 55,000 Trauma Center: Level 1 Residency Type: 1-4 Fellowship Programs: 5 FT Faculty: 46 Residents: 53 | | | | © 2019 by Washington University in St. Louis One

2018 Washington University Emergency Medicine Journal Club

49. Chiefs’ inquiry corner

of pseudo right bundle branch block features. Type 1, and not Type 2, Brugada pattern is considered the diagnostic pattern. Brugada patterns or resulting ventricular arrhythmias can be unmasked by several provoking factors, including fever, electrolyte abnormalities, and medications with sodium channel blocking properties. Provocative testing of candidates for Brugada Syndrome can be performed with sodium channel blocking ant arrythmics, such as flecanide and procainamide. Candidates for provocative

2019 Clinical Correlations

51. Practicing emergency medicine in New Zealand: A Canadian’s perspective

and avoided opioids in a tremendous number of patients. They did not have a few drugs, most notably Procainamide, so I had to cardiovert my Atrial Fibrillation patients electrically. I was considered ‘aggressive’ in my management of these patients, and it was one of the few conditions where there was a significant practice difference between Canada and New Zealand. I saw some interesting infectious disease cases. Varicella vaccinations are relatively new in NZ, so I would regularly see cases of chicken

2018 CandiEM

52. CRACKCast E171 – Pediatric Cardiac Disorders

, blowing on an occluded straw, or blowing on the tip of a syringe) – don’t attempt carotid massage in children (it doesn’t work). Adenosine (0.1-0.2 mg/kg) – max 12 mg 3rd line drugs for stable SVT: Amiodarone Amiodarone may be given at a loading dose of 5 mg/kg over 60 minutes, then continued at 5 mcg/kg/min Procainamide Look for signs on ECG for WPW! *****If the pt is known to have an underlying Wolff-Parkinson-White syndrome, the four medications that should be avoided are the A-B-C-D medications (...) (adenosine, beta-blockers, calcium channel blockers, and digoxin); All of these medications preferentially block conduction down the atrioventricular node, leaving the accessory pathway open to conduct the atrial tachycardia to the ventricles at a potentially lethal rate. Under these circumstances, physicians should use amiodarone, procainamide, or cardioversion as safer alternatives [11] Describe procedures and conditions for which prophylaxis for bacterial endocarditis is recommended Predisposing

2018 CandiEM

55. CRACKCast E140 – Accidental Hypothermia

there is a rapid ventricular response. No clear consensus on administering antiarrhythmics – probably safer not to. The ideal approach to ventricular dysrhythmias in the hypothermic patient has not been well studied. Lidocaine and propranolol have minimal hemodynamic effects during hypothermia. Their efficacy in the treatment of ventricular dysrhythmias appears limited. The efficacy of amiodarone is not supported either In hypothermia, at least one Group 1 antidysrhythmic agent, procainamide, increases

2018 CandiEM

56. Tiny Tips: “TREADMILLS” Peripheral Neuropathy mnemonic

, glucose, urea, creatinine), and thyroid stimulating hormone (TSH) 2 . There are many causes for peripheral neuropathy, so when considering the etiology, think “TREADMILLS.” T oxins Ethanol, Heavy metals, Tetanus, Organophosphates, Diphtheria R enal Failure E ndocrine Diabetes, Hypothyroidism A cquired Immunodeficiency Syndrome (AIDS) D rugs/ D eficiency Amiodarone, Procainamide, Digoxin, Hydralazine, Statins, Isoniazid, Chloroquine, Misoprostol, Metronidazole, Nitrofurantoin Vitamin B6 deficiency

2018 CandiEM

57. CRACKCast E151 – Antidepressants

channel blockade ***Basically, all of the ANTI- anything drugs*** Rosen’s list / As per / WikiEM: Tricyclic antidepressants (= most common) class IA antidysrhythmics (eg, procainamide, disopyramide, quinidine) class II antiarrhythmics (eg sotalol or metoprolol) & propranolol class IC antidysrhythmics (eg, flecainide, encainide, and propafenone) local anaesthetics (bupivacaine, ropivacaine) Antimalarials (chloroquine, hydroxychloroquine) Antispasmodics (eg cyclobenzaprine) Antipsychotics (1st (...) meds to avoid in TCA overdoses Avoid anything with Na+ channel blocking effects! Physostigmine Class IA IC drugs Ia – Quinidine, procainamide, disopyramide (depress phase 0, prolonging repolarization) Ic – Flecainide, propafenone, moricizine (markedly depress phase 0, minimal effect on repolarization) Dilantin (phenytoin) [3] List the 2 common situations for NMS High Potency antipsychotics Abrupt cessation of Parkinson’s meds [4] Expand on the hot & bothered ddx MAOI toxicity sympathomimetic drugs

2018 CandiEM

58. CRACKCast E179 – Drug Therapy in Pregnancy

Doxycycline Tetracyclines Fluoroquinolones Trimethoprim Sulfonamides Nitrofurantoin [5] List 2 safe anti-dysrhythmics in pregnancy Adenosine Digoxin Verapamil Procainamide Some beta blockers The top four are definitely the most widely supported. Electrical cardioversion is very safe! Emergent or elective electrical cardioversion can be performed at all stages of pregnancy, and should be used for any sustained arrhythmia with hemodynamic compromise and can be considered for drug-refractory arrhythmias

2018 CandiEM

59. CRACKCast E118 – SLE and Vasculitides

levels · Direct coombs test positive Table 108.1 is very busy – Remember the only mnemonic from med school SOAP BRAIN MD Serositis Oral Ulcers Arthritis Photosensitivity & Pulmonary Fibrosis Blood cells (pancytopenia) Renal, Raynauds ANA Immunologic (anti-Sm, anti-dsDNA) Neuropsych Malar Rash Discoid Rash [3] List drugs that induce lupus See Box 108.2 from Rosens 8 th Edition – SLE and Vasculitides Drugs Definitively Implicated in Causing Drug-Induced Lupus Procainamide Hydralazine Methyldopa

2017 CandiEM

60. CRACKCast E110 – Thought Disorders

ANTICONVULSANTS Ethosuximide Phenobarbital Phenytoin Primidone ANTIDEPRESSANTS Amitriptyline Doxepin Imipramine Protriptyline Trimipramine CARDIOVASCULAR DRUGS Captopril Digitalis Disopyramide Methyldopa Procainamide Propranolol Reserpine DRUGS OF ABUSE Alcohol Amphetamines Cannabis Cocaine Hallucinogens Opioids Phencyclidine Sedative-hypnotics MISCELLANEOUS DRUGS Antihistamines Antineoplastics Bromides Cimetidine Corticosteroids Disulfiram Heavy metals Acute Psychosis: Antihistamines Cocaine, cannabis

2017 CandiEM

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