Lidocaine & Nitroglycerin

Question 1

Lidocaine

Brand Name

Answer 1

Xylocaine

Question 2

Lidocaine

Class

Answer 2

Antidysrhythmic

Question 3

Lidocaine

Supply

Answer 3

-prefilled syringe
-premix bag

Question 4

Lidocaine

Mechanism of Action

Answer 4

-suppresses ventricular ectopic activity
-increases the threshold of ventricular fibrillation

Question 5

Lidocaine

Indications

Answer 5

-ventricular fibrillation
-ventricular tachycardia
-ventricular dysrhythmias: frequent premature ventricular complexes and couplets & monomorphic and polymorphic wide-complex tachycardia

Question 6

Lidocaine

Contraindications

Answer 6

-known hypersensitivity
-premature ventricular complexes in conjunction with bradycardia
-second degree and third degree heart block

Question 7

Lidocaine

Adverse Reactions

Answer 7

-drowsiness
-confusion
-anxiety
-dizziness

Question 8

Lidocaine

Routes

Answer 8

-IV
-IO
-ET
-infusion

Question 9

Lidocaine

Onset

Answer 9

1-5 minutes

Question 10

Lidocaine

Adult Dose
VFib and Pulseless Vtach

Answer 10

1.0-1.5 mg/kg
may repeat 0.5-0.75 mg/kg every 3-5 minutes during resuscitation
max dose 3.0 mg/kg

Question 11

Lidocaine

Adult Dose
Ventricular dysrhythmias with a pulse

Answer 11

1.0-1.5 mg/kg
may repeat 0.5-0.75 mg/kg in 5-10 minutes
max dose 3.0 mg/kg

Question 12

Lidocaine

Adult Dose
Maintenance Infusion

Answer 12

2.0-4.0 mg/minute

Question 13

Lidocaine

Adult Dose
ET

Answer 13

2.0-2.5 times the bolus dosage diluted in 10mL NS

Question 14

Lidocaine

Pediatric Dose
Vfib and pulseless Vtach

Answer 14

1.0 mg/kg
may repeat 1.0 mg/kg one time in 3-5 minutes during resuscitation

Question 15

Lidocaine

Pediatric Dose
Ventricular dysrhythmias with a pulse

Answer 15

1.0 mg/kg
may repeat in 5-10 minutes
max dose 3.0 mg/kg

Question 16

Lidocaine

Pediatric Dose
Maintenance infusion

Answer 16

20-50 mcg/kg/minute

Question 17

Lidocaine

Pediatric Dose
ET

Answer 17

2.0-2.5 times the bolus dosage diluted in 3-5 mL NS

Question 18

Lidocaine

Special Considerations

Answer 18

-consider decreased dosages for elderly patients and patients with liver disease due to reduced metabolic functions
-an infusion pump should be used when possible

Question 19

Nitroglycerin

Brand Names

Answer 19

• Nitro-Bid
  -Nitrolingual
  -Nitrostat
  -Others

Question 20

Nitroglycerin

Classes

Answer 20

-vasodilator
-antianginal
-nitrate

Question 21

Nitroglycerin

Standard Supply

Answer 21

-tablet
- multi-dose spray bottle

Question 22

Nitroglycerin

Mechanism of Action

Answer 22

-relaxes vascular smooth muscle
-dilates coronary arteries resulting in increased blood flow to the myocardium
-decreases workload on the heart
-decreases myocardial oxygen demand
-decreases preload and afterload

Question 23

Nitroglycerin

Indications

Answer 23

-chest pain and signs/symptoms suggestive of acute coronary syndrome
-congestive heart failure with pulmonary edema

Question 24

Nitroglycerin

Contraindications

Answer 24

-hemodynamically significant hypotension
-hypovolemia
-patient has taken ED drug in last 24 hours including: sildenafil (viagra), tadalafil (cialis), vardenafil (levitra), or other phosphodiesterase-5 inhibitor medications
-not recommended for pediatrics

Question 25

Nitroglycerin

Adverse Reactions

Answer 25

-hypotension
-bradycardia
-tachycardia
-headache
-dizziness
-weakness
-syncope
-nausea, vomiting

Question 26

Nitroglycerin

Route

Answer 26

sublingual

Question 27

Nitroglycerin

Onset

Answer 27

1-3 minutes

Question 28

Nitroglycerin

Adult Dose

Answer 28

-Tablet: 0.4 mg
-single spray: 0.4 mg
-may repeat dose in 3-5 minutes twice after initial dose

Question 29

Nitroglycerin

Special Consideration

Answer 29

-peak effect is 5-10 minutes