Locals

Question 1

Lidocaine dose

Answer 1

1 - 1.5 mg/kg

Question 2

Lidocaine max dose with and without the addition of epinephrine

Answer 2

4.5 mg/kg without epi

7 mg/kg with epi

OR 300mg, which ever comes first

Question 3

Lidocaine onset

Answer 3

1 minute

Question 4

Lidocaine peak

Answer 4

2 minutes

Question 5

Lidocaine duration

Answer 5

10 - 20 minutes

Question 6

Lidocaine MOA

Answer 6

antiarrhythmic and local anesthetic

(antiarrhythmic - suppresses automaticity of ventricular cells, decreasing diastolic depolarization and increasing the ventricular fibrillation threshold

local anesthetic - produces local anesthesia by reducing sodium permeability of sensory nerves, which blocks impulse generation and conduction)

Question 7

Lidocaine metabolism

Answer 7

hepatic metabolism

renal elimination

Question 8

Toxic effects of lidocaine occur when plasma levels reach what amount?

Answer 8

plasma levels > 5 mcg/mL

Question 9

Toxic effects of lidocaine…

Answer 9

respiratory depression / arrest and CNS depression (PL > 10 mcg/mL)

hypotension and bradycardia (PL > 8 mcg/mL)

tinnitus and seizures (PL 5-10 mcg/mL);

[PL = plasma level]

Question 10

Lidocaine is contraindicated in patients with this…

Answer 10

an amide allergy

Question 11

Lidocaine should be used cautiously in these patients…

Answer 11

liver disease

taking other antidysrhythmics