Lidocaine Flashcards
Lidocaine Class
antidysrhythmic: Class IB sodium channel blocker; local anesthetic (B)
Lidocaine Indications
ventricular dysrhythmias including v-fib, v-tach with or without a pulse, malignant premature ventricular contractions, wide QRS complexes, tachycardia of unknown origin, postconversion management of v-tach and v-fib
Lidocaine Mechanism
antidysrhythmic: increases v-fib threshold; decreases automaticity and dromotropy, thereby suppressing ventricular ectopy and dysrhythmias
anesthetic: prevents conduction of nerve impulses
Lidocaine Side Effects
- Bradycardia
- Hypotension
- Headache
- Dizziness
- Lightheadedness
- Drowsiness
Lidocaine Contraindications
- hypersensitivity
- 2nd- and 3rd-degree heart blocks
- Wolff-Parkinson-White syndrome
- Adams-Stokes syndrome
- bradycardic, junctional, and idioventricular rhythms
Lidocaine Precautions
Reduce doses (initial and subsequent) by 50% in patients older than 70 years old and those who have hepatic or renal disease, CHF, or are in shock
Lidocaine Interactions
beta-blockers, quinidine, phenytoin (Dilantin), cimetidine (Tagamet), and H2 blockers potentiate the effects of lidocaine; barbiturates decrease its effects
Lidocaine Routes
slow IVP (50 mg/min), IO, IVPB, ET (rare)
Lidocaine Onset
1–3 minutes
Lidocaine Duration
15 minutes to 2 hours
Lidocaine Adult dose arrest/malignant PVC’s:
1–1.5 mg/kg, repeat at 0.5–0.75 every 3–5 minutes (3 mg/kg total max)
Lidocaine Pedi dose arrest/malignant PVC’s:
1 mg/kg, repeat at 0.5–0.75 every 3–5 minutes (100 mg total max)
Lidocaine Adult dose postconversion IVPB:
1–4 mg/min IVPB (mix 1 g into 250 mL NaCl for a solution of 4 mg/mL)
Lidocaine Pedi dose postconversion IVPB:
20–50 mcg/kg/min IVPB
