Lidocaine 2%

Question 1

Class / Action

Answer 1

Anti-arrhythmic. Anesthetic. / Suppresses Ventricular Arrhythmias. Local Anesthetic.

Question 2

Onset / Duration of Action

Answer 2

Onset IV/IO/ET: Immediate / IV/IO/ET: 10-20min Duration

Question 3

Indications

Answer 3

1. Cardiac Arrest from V-Fib/V-Tach
2. Stable VT, wide-complex Tachycardias of uncertain type, wide complex PSVT (Indeterminate)
3. As anesthetic flush prior to IO infusion for adult pts that are awake

Question 4

Contraindications

Answer 4

1. Known Hypersensitivity
2. Heart Blocks
3. Wolf-Parkinson-White Syndrome (WPW)

Question 5

Precautions

Answer 5

1. Liver Disease
2. CHF
3. Severe Respiratory Depression
4. Hypovolemia
5. Shock

Question 6

Dosages / Administration

Answer 6

1. Cardiac Arrest from V-Fib/V-Tach, use as follows:
   a. Initial Dose: 1-1.5mg/kg IV/IO bolus
   b. For Refractory V-Fib: May give additional 0.5-0.75mg/kg IV/IO bolus, repeat q 5-10min; Max Dose is 3 Doses OR Max TOTAL of 3mg/kg
   c. ET Dose: 2-3mg/kg in 10mL NS
2. Perfuming Arrhythmia of Stable V-Tach, Wide-Complex Tach of uncertain type, use as follows:
   a. Initial Dose: 1mg/kg IV/IO
   b. Repeat 0.5mg/kg IV/IO q 5-10min; Max TOTAL Dose is 3mg/kg
3. Maintenance Infusion: Mix 1gm in 150mL NS = 4mg/mL OR use Premixed Solution at 1-2mg/min

MICRODROPS/MIN		mg/min
		60						4
		45						3
		30						2
		15						1

NOTES: In pts with Liver Disease or Severe CHF, administer half of the above doses for maintenance dose (not initial).

4. PEDS: 1mg/kg IV/IO, OR 2-3mg/kg in 5mL NS ET
5. IO Anesthesia: ADULT: 20-50mg IO prior to infusion. PEDS: CONTRAINDICATED!

Question 7

Adverse Reactions

Answer 7

1. CNS: Dizziness, Somnolence, Confusion, Paresthesias, Muscle Twitching, Seizures, Slurred Speech
2. CV: Hypotension, Bradycardia
3. EENT: Tinnitus, Blurred Vision