LIDOCAINE (Xylocaine®)

Question 1

Generic/Trade Name

LIDOCAINE

Answer 1

Xylocaine®

Question 2

Generic/Trade Name

Xylocaine®

Answer 2

LIDOCAINE

Question 3

LIDOCAINE (Xylocaine®)

Drug Classification:

Answer 3

Antidysrhythmic

Question 4

LIDOCAINE (Xylocaine®)

Mechanism of Action:

Answer 4

Na+ channel blocker ⇒ slows phases IV and 0 of cardiac cycle

Question 5

LIDOCAINE (Xylocaine®)

Pharmacokinetics

Answer 5

• Onset of Action < 3 minutes
• Peak Effects = 5-7 minutes
• Duration of Effect = 10-20 minutes
• Half-Life = 1.5-2 hours

Question 6

LIDOCAINE (Xylocaine®)

Indications & Contraindications

Answer 6

Indications/Field Use:
• VF, VT
• Alternative to Amiodarone
• Anesthetic effect for IO use
• Pre-medication for RSI with suspected increased ICP

Contraindications:
• 2° Type II, 3° Heart Block
• Bradycardia
• Stokes-Adams Syndrome, WPN, LGL

Question 7

LIDOCAINE (Xylocaine®)

Side Effects/Adverse Reactions:

Answer 7

Flushing, sweating, hypothermia

decreased deep tendon reflex, drowsiness, seizures, confusion,

itching, rash,

bradycardia, hypotension, N+V,

heart block, respiratory/cardiac arrest

Question 8

LIDOCAINE (Xylocaine®)

Adult & Pedi Dose:

Answer 8

VF, pulseless VT (ADULT):

• *1st dose** - 1-1.5mg/kg IV, IO
• *2nd dose** 0.5-0.75mg/kg IV, IO, then 1-4mg/min maintenance

VT w/ pulse, PVC’s (ADULT):

0.5-1.5mg/kg IV, IO, then 1-4mg/min maintenance

(PEDI):

1mg/kg IVP, repeat after 15min PRN, maintenance 20-50μg/kg/min

Question 9

LIDOCAINE (Xylocaine®)

Precautions:

Answer 9

Pt. 70+yrs/known hepatic failure – reduce maintenance dose by half

Question 10

LIDOCAINE (Xylocaine®)

Drug-Drug Interactions:

Answer 10

May cause drug toxicity when given with

• procainamide
• phenytoin
• quinidine
• β blockers