Lidocaine (Xylocaine)

Question 1

Pharm. and Actions

Answer 1

Depresses automaticity in Purkinje fibers thus increasing ventricular fibrillation threshold; Decreases conduction rate and force of contraction mainly at toxic levels; Single bolus effect disappears in 10-20 minutes due to redistribution in the body; Metabolic half-life is about 2 hours, toxicity develops with repeated doses

Question 2

Indications

Answer 2

Possible treatment of warning PVCs in suspected AMI with doctors orders only; V-Tach or suspected V-Tach if clinical condition is not rapidly deteriorating; recurrent V-Fib; Following successful defiblrillation; preparalytic in RSI

Question 3

Contraindication

Answer 3

SVT/PSVT; A-Fib or A-Flutter; 2nd and 3rd degree blocks; Hypotension

Question 4

Administration

Answer 4

Adult in cardiac arrest or VT with a pulse- 1-1.5 mg/kg IV, may be repeated with 0.5-0.75 mg/kg every 5 to 10 minutes up to 3 mg/kg; Drip- use premixed bags and use lidocaine clock; PVCs- 0.5-1.5 mg/kg, repeat with 1-1.5 mg/kg max dose 3 mg/kg; RSI adult 1.5 mg/kg; RSI Pediatric 1.5-2 mg/kg up to 6 years old

Question 5

Side Effects and Special Notes

Answer 5

Seizures, slurred speech, AMS; Reduce maintenance infusion by 50% if patient is over 70 years old, hepatic failure, CHF, or shock; Routine use of lidocaine for prophylaxis and prevention of ventricular dysrhythmias in patients having a suspected AMI is not recommended

Question 6

Class

Answer 6

A