DRUG ORDER

(Generic Name, NURSING

Brand Name, MECHANISM OF
Classification, ACTION
Dosage, Route,
Frequency)
Diltiazem (Cardizem) Diltiazem inhibits the inflow
bolus dose of 0.25 mg/kg of calcium ions into the
IV; after 15 minutes, give cardiac smooth muscle
a second dose of 0.35 during depolarization.
Reduced intracellular
mg/kg IV for heart rate
calcium concentrations
greater than 140
equate to increased smooth
muscle relaxation resulting
in arterial vasodilation and,
therefore, decreased blood.
INDICATIONS CONTRAINDICATIONS ADVERSE EFFECTS
OF THE DRUG
Indicated for the • Patients with sick sinus
management of chronic syndrome except in the
stable angina and angina presence of a functioning
due to coronary artery ventricular pacemaker
spasm. • Patients with hypotension
(less than 90 mm Hg
systolic)
• Patients with second- or
third-degree AV block
except in the presence of a
functioning ventricular
pacemaker
• Patients with acute
myocardial infarction and
pulmonary congestion
documented by x-ray on
admission.
• Patients who have
demonstrated
hypersensitivity to the drug
Common adverse effects of •
diltiazem therapy include
edema, bradycardia,
dizziness, headache, and
fatigue. Rarer, yet more
severe adverse effects
include congestive heart •
failure, myocardial
infarction, and
hepatotoxicity
• Continuous blood pressure
RESPONSIBILITES/
PRECAUTIONS
A complete blood count
(CBC) lab test is also
performed at baseline to
track potential changes in
electrolytes and kidney and
liver function.
Assessments of blood
pressure, heart rate, and
electrocardiograms. When
treating hypertension and
arrhythmias, objective
findings serve to assess the
efficacy of therapy, while
subjective findings, such as a
patient's frequency and
severity of chest pain, are
used to evaluate efficacy
when treating chronic angina.
and ECG monitoring are
necessary during the bolus
administration.