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procainamide

procainamide
  • Restricted Medications Cardiac Monitor (IV)
Brand names: Pronestyl
Form Strength
SOLUTION, INJECTABLE 100 mg/mL
Display Class Ia Antiarrhythmics Class: 24040404
Medication comments:
Warning: Pump Care Area Special Med!
procainamide should generally not be interrupted during procedures unless there is a specific physician order.
Per policy, these medications require cardiac and/or special monitoring.
(KEY: "Y" = may be given as described on chart. "N" = may NOT be given except in Rapid Response/Code Blue situations or as otherwise described in Exceptions section of Policy.
generic (Brand) / Notes CCU, OR, PACU, CCL, ED PCU 2N (Tele) 1N (Tele), 3N (Tele) Med/Surg (1N w/o Tele, 3N w/o Tele, 4N, 5N) BirthPlace SNF ICS OPS
procainamide (Pronestyl)
IV Infusion		 Y N N N N N N N N
Iredell Memorial Hospital ICU Adult Infusion Guidelines  
The following orders are intended to provide a specific, safe, and effective means of initiating and titrating medications for critically ill patients. Physicians may modify doses and/or parameters as necessary pending patients' status.For all medications listed below, the responsible LIP is to be notified if unable to titrate or the maximum dose is reached and goals of therapy are not met.
Drug Name Onset Preparation Compatible fluids
procainamide (Pronestyl) seconds LD: 1,000 mg/50 mL D5W (20 mg/mL)
1,000 mg/250 mL D5W (4 mg/mL)		 D5W ONLY
Starting Dose for ICU Sedation Titration Guidelines (for increasing and decreasing doses) with Maximum dose
LD: 20 mg/min (max 15 mg/kg) or 1 gm total
Begin infusion at 1 mg/min		 titrate by 0.5mg/min every 20 min to goal conversion to normal sinus rhythm.
Max = 6 mg/min. HOLD for SBP < 95 or MAP < 65. Adjust for altered renal and liver function. Caution in CHF. Monitor QRS interval.
Do not use for more than 24 hours.
Last updated: Aug. 27, 2025
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