Verapamil hydrochloride injection contraindications: Difference between revisions
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===CONTRAINDICATIONS=== | |||
Verapamil hydrochloride injection is contraindicated in: | |||
1. Severe [[hypotension ]]or [[cardiogenic shock]]. | |||
2. [[Second-|Second-degree AV block]] or [[third-degree AV block]] (except in patients with a functioning artificial ventricular pacemaker). | |||
3. [[Sick sinus syndrome]] (except in patients with a functioning artificial ventricular [[pacemaker]]). | |||
4. Severe [[congestive heart failure]] (unless secondary to a supraventricular tachycardia amenable to verapamil therapy). | |||
5. Patients receiving intravenous[[ beta blockers|beta-adrenergic blocking ]]drugs (e.g., [[propranolol]]). Intravenous verapamil and intravenous beta-adrenergic blocking drugs should not be administered in close proximity to each other (within a few hours), since both may have a depressant effect on myocardial contractility and AV conduction. | |||
6. Patients with[[ atrial flutter]] or [[atrial fibrillation]] and an accessory bypass tract (e.g., [[Wolff- Parkinson-White]], Lown-Ganong-Levine syndromes) are at risk to develop ventricular [[tachyarrhythmia ]]including [[ventricular fibrillation]] if verapamil is administered. Therefore, the use of verapamil in these patients is contraindicated. | |||
7. Ventricular tachycardia: Administration of intravenous verapamil to patients with wide-complex [[ventricular tachycardia]] (QRS ≥ 0.12 sec) can result in marked hemodynamic deterioration and ventricular fibrillation. Proper pretherapy diagnosis and differentiation from wide-complex [[supraventricular tachycardia ]]is imperative in the emergency room setting. | |||
8. Known [[hypersensitivity ]]to verapamil hydrochloride.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = VERAPAMIL HYDROCHLORIDE INJECTION, SOLUTION [CARDINAL HEALTH] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=0c27c868-7eae-4b3e-babf-e89404ea27b7#nlm34090-1 | publisher = | date = | accessdate = }}</ref> | |||
Revision as of 22:51, 4 March 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Abdurahman Khalil, M.D. [2]
CONTRAINDICATIONS
Verapamil hydrochloride injection is contraindicated in:
1. Severe hypotension or cardiogenic shock.
2. Second-degree AV block or third-degree AV block (except in patients with a functioning artificial ventricular pacemaker). 3. Sick sinus syndrome (except in patients with a functioning artificial ventricular pacemaker).
4. Severe congestive heart failure (unless secondary to a supraventricular tachycardia amenable to verapamil therapy).
5. Patients receiving intravenousbeta-adrenergic blocking drugs (e.g., propranolol). Intravenous verapamil and intravenous beta-adrenergic blocking drugs should not be administered in close proximity to each other (within a few hours), since both may have a depressant effect on myocardial contractility and AV conduction.
6. Patients withatrial flutter or atrial fibrillation and an accessory bypass tract (e.g., Wolff- Parkinson-White, Lown-Ganong-Levine syndromes) are at risk to develop ventricular tachyarrhythmia including ventricular fibrillation if verapamil is administered. Therefore, the use of verapamil in these patients is contraindicated.
7. Ventricular tachycardia: Administration of intravenous verapamil to patients with wide-complex ventricular tachycardia (QRS ≥ 0.12 sec) can result in marked hemodynamic deterioration and ventricular fibrillation. Proper pretherapy diagnosis and differentiation from wide-complex supraventricular tachycardia is imperative in the emergency room setting.
8. Known hypersensitivity to verapamil hydrochloride.[1]