Lidocaine HCI (Xylocaine) Flashcards

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1
Q

Classification

A

Antidysrhythmic, Class IB

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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
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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
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4
Q

Contraindications

A
  • AV block
  • Bleeding
  • Thrombocytopenia
  • Known sensitivity to lidocaine, sulfite, or paraben
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5
Q

Adverse Effects

A
  • Toxicity (signs may include euphoria, apprehension, nervousness, anxiety)
  • Seizures without warning
  • Cardiac arrythmias
  • Hypotension
  • Cardiac arrest
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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.
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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
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