A 50-year-old male with a history of hypertension (HTN) and atrial fibrillation (AF) presents to the Emergency Department with complaint of palpitations, which started while mowing the lawn.He is alert and oriented with a Glasgow Coma Scale (GCS) of 15 and no signs of Hypoperfusion.The patient is compliant with his medications and denies any allergies.Atrial fibrillation with rapid ventricular response (RVR) and generalized ST-segment depression indicative of subendocardial ischemia.The patient was treated with 20 mg of diltiazem (Cardizem) over 2 min, followed by 10 mg over 1 hr, and 0.25 mg digoxin (Lanoxin).A rhythm change was noted on the monitor and another 12-lead ECG was recorded.There is a sinus rhythm with left ventricular hypertrophy by limb lead voltage criteria and left atrial enlargement. If high blood pressure is not treated, it can cause serious problems such as heart failure, blood vessel disease, stroke, or kidney disease.

... Diltiazem dosage for atrial fibrillation.

However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. The diltiazem was dosed at 0.25 mg/kg (with a max dose of 30 mg) and the metoprolol was given at 0.15 mg/kg (with a max dose of 10 mg). 2015 Sep 16. pii: S0735-1097(15)06203-8. doi: 10.1016/j.jacc.2015.09.019.Although dosages may vary based on physician orders, protocols and age, a standard initial dose is 0.25 mg/kg, ranging between 10-20 mg over 2 minutes, with a second dose of 0.35 mg/kg, ranging between 20-25 mg over 2 minutes, often followed by a 5-10 mg/hr infusion.Treatment of hemodynamically unstable patients in narrow QRS complex AF with RVR requires synchronized cardioversion at 120-200 J initially, and should not be delayed for administration of an anti-arrhythmic agent.Ivan J Rios is Associate Editor of ACLSMedicalTraining.com (At ACLS Medical Training, we pride ourselves on the quality, research, and transparency we put into our content. For oral dosage form (tablets): The following information includes only the average doses of this medicine. Advertising revenue supports our not-for-profit mission.Check out these best-sellers and special offers on books and newsletters from Mayo Clinic. Diltiazem … These particular pharmacological agents can be further divided into subdivisions based on their molecular composition:There are four specific classes of antiarrhythmics with specific physiological functions divided into classes based on their mechanism of action. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.If you miss a dose of this medicine, take it as soon as possible. You must continue to take it as directed if you expect to lower your blood pressure and keep it down. The patient was treated with 20 mg of diltiazem (Cardizem) over 2 min, followed by 10 mg over 1 hr, and 0.25 mg digoxin (Lanoxin).


All rights reserved. Diltiazem, a non-dihydropyridine calcium channel blocker, is often the medication of choice in the management of AFF due to its ability to be given as an intravenous (IV) push, continuous infusion, and oral (PO) immediate release or extended release tablet.

Some target atrial, AV nodal or ventricular cells, while some have the capacity to address both atrial and ventricular arrhythmias.Diltiazem has a COR I, LOE-b classification, used for rate control of atrial arrhythmias, predominantly Atrial Fibrillation, and COR IIa, LOE-b for treatment of SVT with a reentry pathway mechanism.2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. The mean age was 66 years, and 47 percent were men. Diltiazem is a calcium channel blocker drug and does not usually convert afib to sinus rhythm. If your employer verifies that they will absolutely not accept the provider card, you will be issued a prompt and courteous refund of your entire course fee. It is very important that you take your medicine exactly as directed and that you keep your appointments with your doctor even if you feel well. J Am Coll Cardiol. The dose of this medicine will be different for different patients. 71 patients were started on an IV drip (median rate 10 mg/hr). If your dose is different, do not change it unless your doctor tells you to do so.The amount of medicine that you take depends on the strength of the medicine.
You should check with your doctor before changing your diet. J Am Coll Cardiol. Swallow the extended-release tablet, extended-release capsule, or tablet whole. © 1998-2020 Mayo Foundation for Medical Education and Research (MFMER). For oral dosage form (extended-release tablets): Adults—At first, 180 milligrams (mg) once a day, either in the morning or evening. I’ve talked with some of doctors I work with on this and they use a bit higher doses of metoprolol. Study objective: To compare the effects of i.v. Patients were divided into 3 groups according to diltiazem dosage: low dose (≤0.2 mg/kg), standard dose (>0.2 and ≤0.3 mg/kg), and high dose (>0.3 mg/kg). Exertional Angina Pectoris Due to Atherosclerotic Coronary Artery Disease or Angina Pectoris at Rest Due to Coronary Artery Spasm: Dosage must be adjusted to each patient’s needs. Our editorial team follows strict sourcing guidelines and relies on academic research institutions, government agencies, medical associations, and peer-reviewed medical literature in the field of resuscitation and emergency medical care.Our website services, content, and products are for informational purposes only.

In fact, many may feel normal. Your doctor may adjust your dose if needed. Do not double doses.Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. A rhythm change was noted on the monitor and another 12-lead ECG was recorded. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.Mayo Clinic does not endorse companies or products. It is best to take the extended-release capsule on an empty stomach. Do not open, crush, or chew it. Many patients who have high blood pressure will not notice any signs of the problem.