Vomiting procainamide

ADMINISTERING PROCAINAMIDE Adverse reactions with procainamide therapy include nausea, loss of appetite, and vomiting. Small meals eaten frequently may be better tolerated than three full meals. Administering the drug with meals may decrease gastrointestinal effects. 

Dantrolene is the mainstay of MH treatment. It has long been available for the treatment of muscle spasm in cerebral palsy and similar diseases. It is a hydantoin derivative that was first synthesized in 1967, and reported to be effective in the treatment of porcine MH in 1975. Also in 1975, dantrolene was shown to be more effective than procainamide in the treatment of human MH, which until that time was the drug of choice. However, the intravenous preparation was not made available until November 1979. It significantly lowered mortality. The half-life of dantrolene is estimated to be 6-8 hr. Dantrolene s primary mode of action is the reduction in calcium release by the sarcoplasmic reticulum. Dantrolene also exerts a primary antiarrhythmic effect by increasing atrial and ventricular refractory periods. Side effects of dentrolene include hepatotoxicity, muscle weakness, ataxia, blurred vision, slurred speech, nausea, and vomiting. Dantrolene is not contraindicated in pregnancy, but it does cross into breast milk and its effect on the neonate is unknown. 

Procainamide Systemic lupus erythematosus, diarrhea, nausea, vomiting, TdP, aggravation of underlying HF, conduction disturbances or ventricular arrhythmias, agranulocytosis... 

IM administration - IM administration may be used as an alternative to the oral route for patients with less threatening arrhythmias but who are nauseated or vomiting, who are ordered to receive nothing by mouth preoperatively, or who may have malabsorptive problems. An initial daily dose of 50 mg/kg may be estimated. Divide this amount into fractional doses of 1/8 to % to be injected IM every 3 to 6 hours until oral therapy is possible. If more than 3 injections are given, assess patient factors such as age and renal function, clinical response and, if available, blood levels of procainamide and NAPA in adjusting further doses for that individual. For treatment of arrhythmias associated with... 

Apart from the lupus-like syndrome, the adverse effects of acecainide are as common as those of procainamide. The commonest affect the gastrointestinal tract and the central nervous system. Anorexia, nausea, vomiting, diarrhea, and abdominal pain are common, as are insomnia, dizziness, light-headedness, tingling sensations, and blurred vision. Other reported unwanted effects include skin rashes, constipation, and reduced sexual function (2-5). 

Nausea, vomiting, and diarrhea in response to procainamide are common with dosages of 4 g/day or more (32). Pseudo-obstruction has been attributed to the use of a modified-release formulation of procainamide, perhaps due to its anticholinergic effects (33). 

A 79-year-old man took about 19 g of procainamide and developed lethargy, vomiting, a wide-complex tachycardia, hypotension, and coma (60). His serum procainamide concentration was 77 pg/ml at 3 hours. He was treated with vasopressors and peritoneal dialysis. 

A 67-year-old woman took about 7 g of procainamide and developed nausea, vomiting, lethargy, a junctional tachycardia, hypotension, and oliguria (61). She was treated with hemodialysis. 

Procainamide and quinidine cdrnmonly cauie Gl upset (nausea, vomiting, diarrhea) and hj otension. Less commonly, procainamide is associated with agranulocytosis end iupus-Uke syndrome Additional side effects of quinidine include thrombocytopenia and cinchonism. ... 

Following the ingestion of PPA, dogs and cats may exhibit hyperactivity, mydriasis, depression, vomiting, hyperthermia, disorientation, and bradycardia. Therapy is directed at prevention of absorption and control of tachyarrhythmias with lidocaine (dogs only) or procainamide (dogs only). Diazepam may be used for control of symptoms of CNS stimulation. 

C. Other effects. Quinidine commonly causes nausea, vomiting, and diarrhea after acute ingestion and, especially with chronic doses, cinchonism (tinnitus, vertigo, deafness, or visual disturbances). Procainamide may cause gastrointestinal upset and, with chronic therapy, a lupus-like syndrome. 

Fever with nausea and vomiting developed in a patient who had taken procainamide for V-k weeks the symptoms persisted for several days, but resolved within 24 hr on withdrawal of the drug (45 ). A further case of agranulocytosis which was thought to be caused by procainamide has been reported however, the patient had received no less than 20 other drugs, at least one of which has been known to cause agranulocytosis, so the case cannot be recorded as proven (46 ). 

Farber, H. I. (1974) Fever, vomiting and liver dysfunction with procainamide therapy. Postgrad. med., 56,155. 

Hypotension. Diarrhea. Dizziness. Liver failure. Lupus erythematosus-like syndrome. Nausea and vomiting. Heart block. Agranulocytosis. Procainamide increases risk of death in patients with non-life-threatening arrhythmias. Use with caution in patients with liver or kidney dysfunction. Tell patient not to crush or break extended-release tablets. 

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