Lidocaine

Question 1

Lidocaine Hydrochloride (Xylocaine)
Class

Answer 1

Antidysrhythmic

Question 2

Lidocaine Hydrochloride (Xylocaine)
Mechanism of Action

Answer 2

Decreases automaticity by slowing rate of phase 4 depolarization, suppresses ventricular ectopy, and increases the fibrillation threshold

Question 3

Lidocaine Hydrochloride (Xylocaine)
Indications

Answer 3

Malignant PVCs, V-tach (w/ or w/o a pulse), v-fib, occasionally as a pre-med for RSI

Question 4

Lidocaine Hydrochloride (Xylocaine)
Contraindications

Answer 4

Hypersensitivity, second- and third-degree heart blocks, wide complex ventricular escape beats with bradycardia

Question 5

Lidocaine Hydrochloride (Xylocaine)
Adverse Reactions

Answer 5

Slurred speech, seizures (high doses), AMS, confusion, lightheadedness, blurred vision, and bradycardia

Question 6

Lidocaine Hydrochloride (Xylocaine)
Drug Interactions

Answer 6

Apnea induced with succinylcholine may be prolonged with high doses of Lidocaine.

Question 7

Lidocaine Hydrochloride (Xylocaine)
Dosage and Administration
Adult
( PVCs or unstable V- Tach )

Answer 7

Initial:1 – 1.5 mg/kg IV, IO may repeat in 5-10 min w/ 0.5 – 0.75 mg/kg; to a max dose of 3 mg/kg

Question 8

Lidocaine Hydrochloride (Xylocaine)
Dosage and Administration
Stable V-Tach

Answer 8

0. 5 – 0.75 mg /kg and up to 1 – 1.5 mg/kg. Repeat

0. 5 – 0.75 mg/kg; to a max dose of 3 mg/kg

Question 9

Lidocaine Hydrochloride (Xylocaine)
Maintenance Infusion

Answer 9

1 – 4 mg/min diluted in either NS or D5W

Question 10

Lidocaine Hydrochloride (Xylocaine)
Onset

Answer 10

1-3 Minutes

Question 11

Lidocaine Hydrochloride (Xylocaine)
Peak Effect

Answer 11

5-10 Minutes

Question 12

Lidocaine Hydrochloride (Xylocaine)
Duration

Answer 12

Variable

Question 13

Lidocaine Hydrochloride (Xylocaine)
Special Consideration

Answer 13

Reduce maintenance infusions by 50% if the patient is over 70 years of age, has liver or renal disease, or is in CHF or shock.