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Diltiazem Hydrochloride


Calcium Channel Blocker or calcium antagonist


    Adult: 0.25 mg/kg IV (over 2 minutes).
    May repeat at 0.35 mg/kg IV (over 2 minutes), if needed.


    Diltiazem inhibits the influx of calcium ions during membrane depolarization of cardiacand vascular smooth muscle. The therapeutic benefits of Diltiazem is supraventricular tachycardias are related to its ability to slow AV nodal conduction time and prolong AV nodal refractoriness. Diltiazem slows ventricular rates, interrupts the reentry circuit in AV nodal re-entrant tachycardias and reciprocating tachycardias (e.g. Wolff-Parkinson-White Syndrome - WPW). Diltiazem also prolongs the sinus cycle length and decreases peripheral vascular resistance.


    - Atrial Fibrillation or Atrial Flutter with rapid ventricular response.
    - Paroxysmal Supraventricular Tachycardia. Unless contraindicated, vagal maneuvers should be attempted prior to administration of Diltiazem.


    - Sick sinus syndrome except in the presence of a functioning ventricular pacemaker.
    - Second- or third-degree AV block except in the presence of a functioning ventricular
    - Severe hypotension or cardiogenic shock.
    - Demonstrated hypersensitivity to Diltiazem.
    - Intravenous Diltiazem and intravenous beta-blockers should not be administered
    together or in close proximity (within a few hours).
    - Wolff-Parkinson-White syndrome or short PR syndrome.
    - Ventricular tachycardia.
    -Patients taking Clarithromycin


    Diltiazem should be used with caution in patients with impaired liver or renal function. Intravenous Diltiazem administered to a patient who is taking oral beta-blockers maycause bradycardia, AV block, and/or depression of contractility. Caution should be used when administering Diltiazem and anesthetics. Caution should also be used in pregnant females and mothers that are nursing. Caution if administered in the presence of CHF.


    Hypotension, itching or burning at injection site, flushing of skin, or junctional rhythm. Other side effects are less frequent (e.g. AV blocks, atrial flutter, chest pain, etc.).

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