Lidocaine HCI (Xylocaine) Flashcards
1
Q
Classification
A
Antidysrhythmic, Class IB
2
Q
Mechanism of Action
A
- Blocks sodium channels
- Increases the recovery period after re-polarization
- Suppresses automaticity of the His-Purkinje system & ventricular depolarization
3
Q
Indications
A
- Ventricular arrythmias when amiodarone is not available
- Cardiac arrest from VF/VT
- Stable monomorphic VT with preserved ventricular function
- Stable polymorphic VT with normal baseline QT interval & preserved left ventricular function (when ischemia & electrolyte imbalance are treated)
- Stable polymorphic VT with baseline QT prolongation suggestive of torsades de pointes
4
Q
Contraindications
A
- AV block
- Bleeding
- Thrombocytopenia
- Known sensitivity to lidocaine, sulfite, or paraben
5
Q
Adverse Effects
A
- Toxicity (signs may include euphoria, apprehension, nervousness, anxiety)
- Seizures without warning
- Cardiac arrythmias
- Hypotension
- Cardiac arrest
6
Q
Administration
A
-
Pulseless V-Tach and V-Fib
- Adult IV/IO: 1-1.5 mg/kg, may repeat at half the original dose every 5-10 minutes to a max of 3 mg/kg. Maintenance dose of 1-4 mg/min
- Peds IV/IO: 1 mg/kg (max 100 mg). Maintenance infusion is 20-50 mcg/kg/min
- Peds ETT: 2-3 mg/kg ETT, followed by 5 mL flush of NSS
-
Perfusing Ventricular Rythms:
- Adult: 0.5-0.75 mg/kg IV/IO (up to 1-1.5 mg/kg). Repeat every 5-10 minutes to a max of 3 mg/kg. Maintenance infusion of 1-4 mg/min.
- Pediatrics: 1 mg/kg IV/IO. May repeat every 5-10 minutes to a max of 3 mg/kg. Maintenance infusion of 20-50 mcg/kg/min.
7
Q
Special Considerations
A
- Use with caution in:
- Bradycardia
- Hypovolemia
- Cardiogenic shock
- Adams-Stokes syndrome
- Wolff-Parkinson-White syndrome
- Half life is approximetaly 90 minutes