Lidocaine

Question 1

Lidocaine - Classification

Answer 1

Ventricular Antidysrhythmic (Na channel blocker), local anesthetic

Question 2

Lidocaine - Indications (1)

Answer 2

Acute ventricular dysrhythmias

Question 3

Lidocaine - MoA

Answer 3

Decreases phase 4 diastolic depolarization and suppresses PVC’s. Raises the fibrillatory threshold (minimum electrical value able to trigger fibrillation)

Question 4

Lidocaine - Contraindications (6)

Answer 4

Hypersensitivity, 2nd or 3rd degree HB in the absence of an artificial pacemaker, Idioventricular rhythms, ventricular escape rhythms, Don’t use with Amiodarone.

Question 5

Lidocaine - Dosage

Answer 5

Adult: CA - 1-1.5 mg/kg IV bolus q 5-10 min -> 0.5-0.75 mg/kg with a total max of 3mg/kg. bolus is followed by a maintenance infusion drip of 1-4mg/min post CA.
PVC’s / VTach w pulse - 0.5 - 0.75 mg/kg IV up to 1-1.5 mg/kg with a max dose of 3mg/kg
Peds: 1mg/kg IV bolus followed by maintenance infusion drip of 20-50 mcg/kg/min IV post CA
PVC’s or VTach w pulse - 1 mg/kg IV