• Class: Antiarrhythmic. Calcium Channel blocker

• Action: blocks calcium from moving into the heart muscle cells, which prolongs the conduction of electrical impulses through the AV node

• Indications: Atrial fibrillation (rapid ventricular rate - RVR), Atrial flutter

• Adverse Effects: flushing, headache, bradycardia, hypotension, heart block, myocardial depression, AV block, cardiac arrest.

• Contraindications: Acute MI, cardiogenic shock, Wolfe-Parkinson White syndrome, 2nd or 3rd degree AV block, sick sinus syndrome, pulmonary edema, SBP < 90mmHg, WIDE complex V-Tach.

• Special Considerations: Pregnancy Category C

Dosages:

Adults:

SLOW IV push - too fast could lead to quick drop in BP

• 20 mg IV over 2 mins

• 2nd dose of 20 mg IV over 2 mins if HR>140 after 15 mins

Pediatrics:

• NONE