Lidocaine (Xylocaine)

Question 1

Lidocaine Class?

Answer 1

Class 1B Antidysrhythmic

Question 2

Lidocaine Action?

Answer 2

Lidocaine is a sodium channel blocker that acts primarily on the ventricles of the heart
during phase 4 diastolic depolarization which decreases automaticity, suppresses premature
ventricular complexes, and raises the V-Fib threshold.

Question 3

Lidocaine Indications?

Answer 3

Significant ventricular ectopy with ischemia/MI, pulseless V-tach or V-Fib cardiac
arrest, stable V-tach with a pulse

Question 4

Lidocaine Contraindications?

Answer 4

Hypersensitivity, prophylactic use in an acute MI, 2nd or 3rd degree heart
block in the absence of a pacemaker, Stokes-Adams syndrome

Question 5

Lidocaine Onset/Duration?

Answer 5

Onset: 30-90 sec
Duration: 10-20 min

Question 6

Lidocaine Dose/Route?

Answer 6

Adult: Cardiac arrest - 1-1.5 mg/kg IV/IO bolus may be repeated in 5-10 mins at 0.5-0.75
mg/kg with a total max of 3 mg/kg. Bolus is followed by a maintenance infusion drip of
1-4 mg/min post-cardiac arrest. For PVC’s or V-tach with a pulse – 0.5-0.75 mg/kg IV/IO
up to 1-1.5 mg/kg IV/IO and may be repeated with a total max dose of 3 mg/kg

Peds: 1 mg/kg IV/IO bolus followed by maintenance infusion drip of 20-50 mcg/kg/min
IV/IO post-cardiac arrest. For PVC’s or V-tach with a pulse – 1 mg/kg IV/IO.

Question 7

Lidocaine Side Effects?

Answer 7

Blurred vision, dizziness, hypotension, bradycardia, seizures, altered LOC

Question 8

Lidocaine Note*

Answer 8

Use caution in patients with impaired liver/renal function and the elderly. May half initial
dose for pts >70 y/o.