Lidocaine & Nitroglycerin Flashcards
Lidocaine
Brand Name
Xylocaine
Lidocaine
Class
Antidysrhythmic
Lidocaine
Supply
-prefilled syringe
-premix bag
Lidocaine
Mechanism of Action
-suppresses ventricular ectopic activity
-increases the threshold of ventricular fibrillation
Lidocaine
Indications
-ventricular fibrillation
-ventricular tachycardia
-ventricular dysrhythmias: frequent premature ventricular complexes and couplets & monomorphic and polymorphic wide-complex tachycardia
Lidocaine
Contraindications
-known hypersensitivity
-premature ventricular complexes in conjunction with bradycardia
-second degree and third degree heart block
Lidocaine
Adverse Reactions
-drowsiness
-confusion
-anxiety
-dizziness
Lidocaine
Routes
-IV
-IO
-ET
-infusion
Lidocaine
Onset
1-5 minutes
Lidocaine
Adult Dose
VFib and Pulseless Vtach
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
Lidocaine
Adult Dose
Ventricular dysrhythmias with a pulse
1.0-1.5 mg/kg
may repeat 0.5-0.75 mg/kg in 5-10 minutes
max dose 3.0 mg/kg
Lidocaine
Adult Dose
Maintenance Infusion
2.0-4.0 mg/minute
Lidocaine
Adult Dose
ET
2.0-2.5 times the bolus dosage diluted in 10mL NS
Lidocaine
Pediatric Dose
Vfib and pulseless Vtach
1.0 mg/kg
may repeat 1.0 mg/kg one time in 3-5 minutes during resuscitation
Lidocaine
Pediatric Dose
Ventricular dysrhythmias with a pulse
1.0 mg/kg
may repeat in 5-10 minutes
max dose 3.0 mg/kg
Lidocaine
Pediatric Dose
Maintenance infusion
20-50 mcg/kg/minute
Lidocaine
Pediatric Dose
ET
2.0-2.5 times the bolus dosage diluted in 3-5 mL NS
Lidocaine
Special Considerations
-consider decreased dosages for elderly patients and patients with liver disease due to reduced metabolic functions
-an infusion pump should be used when possible
Nitroglycerin
Brand Names
- Nitro-Bid
-Nitrolingual
-Nitrostat
-Others
Nitroglycerin
Classes
-vasodilator
-antianginal
-nitrate
Nitroglycerin
Standard Supply
-tablet
- multi-dose spray bottle
Nitroglycerin
Mechanism of Action
-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
Nitroglycerin
Indications
-chest pain and signs/symptoms suggestive of acute coronary syndrome
-congestive heart failure with pulmonary edema
Nitroglycerin
Contraindications
-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
Nitroglycerin
Adverse Reactions
-hypotension
-bradycardia
-tachycardia
-headache
-dizziness
-weakness
-syncope
-nausea, vomiting
Nitroglycerin
Route
sublingual
Nitroglycerin
Onset
1-3 minutes
Nitroglycerin
Adult Dose
-Tablet: 0.4 mg
-single spray: 0.4 mg
-may repeat dose in 3-5 minutes twice after initial dose
Nitroglycerin
Special Consideration
-peak effect is 5-10 minutes
