Lidocaine (Xylocaine)

Question 1

Class

Answer 1

Antidysrhythmic

Question 2

Actions

Answer 2

Decreases automaticity of Purkinje pacemaker cells by reducing the slope of Phase 4 diastolic depolarization.
Decreases the potential for reentrant pathways.
Increases the fibrilatory threshold for myocardial cells in the setting of acute MIs.

Question 3

Indications

Answer 3

Symptomatic PVCs.
VF and VT that persist after defib and Epi
Wide complex tachycardias of unknown origin

Question 4

Contraindications

Answer 4

Conduction system disorders (ie 2nd and 3rd degree blocks)
Stokes adams syndrome.
wpw
ventricular escape rhythms
hypersensitivity

Question 5

Side effects

Answer 5

Early signs:
tinnitus
twitching
slurred speech
confusion
paresthesias
seizures
Later signs:
hypotension
heart block.
Lidocaine takes about 2 minutes to reach central circulation.

Question 6

Precautions

Answer 6

Dose should be reduced in decreased cardiac output states (ami, chf, shock), in pts over 70 yo, and in those with hepatic dysfunction, but not the initial dose in cpa situations.
In code resuscitation, AC IV preferred and after each med should elevate the arm and give 20 or 30cc bolus