I'm curious what everyone's experience is here with either medication. I have both as standing orders for wide complex tachycardia and have seen procainamide work wonders. I also have verapamil for NCT and that has worked like a charm. A lot of older medics prefer lidocaine for WCT and say it works better or procainamide takes too long to set up, any opinions on either medication?
Procainamide vs Lidocaine
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MS Medic
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We don't carry procainamide. Our options are lidocaine or amiodarone.
NomadicMedic
I know a guy who knows a guy.
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We have both. My last service was Amio only. Lido is my go to. It's easy to calculate and seems to be (anecdotally) effective. I've not used Procainamide since paramedic school.
akflightmedic
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Have neither carried nor used procainamide since about 1998 or so...
I think most people have ditched procainamide. Shame, because (aside from giving people lupus) it has really good utility for weird situatons like WPW/A-fib. Amio seems to be the favorite most of the time, and some systems have even ditched lidocaine entirely for money reasons.
Only thing is, (other than better renal clearance and no pulmonary stenosis) lidocaine is the only sodium channel blocker that seems to "prefer" ischemic tissue. It's not a "shotgun" drug like amio or procainamide.
Only thing is, (other than better renal clearance and no pulmonary stenosis) lidocaine is the only sodium channel blocker that seems to "prefer" ischemic tissue. It's not a "shotgun" drug like amio or procainamide.
We were talking about multiple antiarrhythmic drugs: lidocaine, procainamide, and amiodarone.