Lidocaine

Question 1

Lidocaine (xylocaine)

Class and action

Answer 1

Class: Antiarrythmic

Action:

1) Increases fibrillatory threshold
2) Decreases ventricular irritability
3) Suppresses ventricular ectopy

Question 2

Lidocaine

Indication

Answer 2

V-fib
V-tach
Malignant pvc’s

Question 3

Lidocaine

Dose

Answer 3

Ventricular ectopy:
1mg/kg slow IVP/IO. MR 0.5 mg/kg every 5-10 min to a max of 3mg/kg.

V-tach: 1mg/kg slow IVP/IO. MR 0.5 mg/kg every 5-10 min to a max of 3mg/kg.

V-fib: 1-1.5 mg/kg IVP/IO. MR same every 3-5 min to max 3mg/kg.

Infusion: 2 gm in 250 cc D5W. Run at 2-4 mg/min.
2mg/min=15gtts/min

Question 4

Lidocaine

Peds dose

Answer 4

Dose: 1mg/kg slow IV/IO

Question 5

Onset/duration

Answer 5

Onset: 2 min IV
Duration: 10-20 min

Question 6

Lidocaine

Contra

Answer 6

1) PVC’s with bradycardia
2) 2nd and 3rd degree heart blocks
3) Idioventricular rhythm
4) Allergy to amide type local anesthetics

Question 7

Lidocaine

Early S/S of toxicity

Answer 7

Early S/S: 
Restlessness
Anxiety
Disorientation
Combativeness
Twitching
Numbness
Euphoria

Question 8

Lidocaine

Precautions

Answer 8

1) Monitor VS and EKG, Ectopy, CNS toxicity
2) Use supplemental O2
3) Stop infusion at first sign of toxicity
4) Use cautiously and 1/2 dose if patient is over 65 or has history of CHF or liver disease.

Question 9

Lidocaine

Supplied

Answer 9

100mg/10ml preload
100mg/5ml preload
2gms in 250 cc premix bag

Question 10

Lidocaine

Late S/S of toxicity

Answer 10

Late S/S:
Convulsions
Coma
Hypotension
Widening QRS complex
Prolonged PRI
Cardiac Arrest