LIDOCAINE HYDROCHLORIDE (generic name) XYLOCAINE (brand name)

Question 1

LIDOCAINE HYDROCHLORIDE

Drug Class

Answer 1

DRUG CLASS

Antidysrhythmic (Sodium channel blocker)

Question 2

LIDOCAINE HYDROCHLORIDE

Indications

Answer 2

INDICATIONS
Alternative to Amiodarone in cardiac arrest from ventricular tachycardia, ventricular fibrillation, stable wide complex tachycardia (poly-or monomorphic) with normal base line QT interval, stable monomorphic VT with preserved ventricular function.

Question 3

LIDOCAINE HYDROCHLORIDE

Mechanism of Action

Answer 3

MECHANISM OF ACTION
Decreases automaticity by slowing the rate of spontaneous phase 4 depolarization: Block Na+ channels in the cardiac myocyte, slows depolarization, suppresses automaticity, results in stabilizing ectopic foci by increasing the threshold needed for depolarization.

Question 4

LIDOCAINE HYDROCHLORIDE

Contraindications

Answer 4

CONTRAINDICATIONS
Hypersensitive, 2nd or 3rd degree AV heart block in the absence of an artificial pace maker, Stokes Adam Syndrome, wide complex ventricular scape beats with bradycardia.

Question 5

LIDOCAINE HYDROCHLORIDE

Adverse Effects

Answer 5

ADVERSE EFFECTS
Anxiety, drowsiness, confusion, seizures, slurred speech, respiratory arrest, hypotension, bradycardia, dysrhythmias, cardiac arrest, AV block, NV

Question 6

LIDOCAINE HYDROCHLORIDE

Precautions

Answer 6

PRECAUTIONS
Caution in Wolf Parkinson White Syndrome
Cardiac depression seen in Phenytoin
Metabolic clearance reduced with liver disease
Or use of Beta blockers

Question 7

LIDOCAINE HYDROCHLORIDE

Dose and Administration

Answer 7

DOSE AND ADMINISTRATION
ADULT
Pulseless V-Tach/V-Fib - 1.0 to 1.5 mg/kg IV/IO
May be repeated in 5 to 10 minutes
Dose 0.5 to 0.75 mg/kg IV/IO
Maximum total dose of 3 mg/kg
Stable V-Tach 0.5 to 0.75 mg/kg IV/IO
May repeat dose in 5 to 10 minutes with maximum dose of 3 mg/kg
PEDI
1 mg/kg IV/IO push with maximum dose of 100 mg