Lidocaine

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Author:
dunks406
ID:
15661
Filename:
Lidocaine
Updated:
2010-04-22 17:46:51
Tags:
Lidocaine
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Description:
Lidocaine
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  1. Class
    Antiarrhythmic, Class 1 B Sodium Channel Blocker
  2. Pharmacology and Actions
    • - Depresses automaticity of Purkinje Fibers; therefore, RAISES stimulation threshold in the ventricular fibers (makes fibers less likely to fibrillate).
    • - Little antidysrhythmic effect on atrial muscle at subtoxic levels

    • - Cardiovascular effects:
    • - Decreased conduction rate and force of contraction, mainly at toxic levels
    • - Prolongs phase 4 depolarization and shortens action portential
    • - CNS stimulation
    • - Tremors, restlessness, clonic convulsions followed by respiratory depression and respiratory failure at higher doses

    - Onset of action: less than 4 minutes
  3. Indications
    • - Ventricular tachycardia or wide-complex tachycardia with pulses
    • - Recurrent or refractory ventricular fibrillation/pulseless v-tach
    • - Following successful defibrillation
    • - Pre-intubation in head injuries (minimizes the rise in ICP)
  4. Contraindications
    • - Not used for Supraventicular Rhythms or Bradycardias
    • - Hypersentivity to any of the caines
  5. Precautions and Side Effects
    • - CNS disturbances
    • - Sleepiness, dizziness, disorientation, confusion, and convulsions

    • - Cardiovascular
    • - Hypotension, bradycardia, decreased myocardial contractility and increased AV blocks at toxic levels only
  6. Dosage (Adult)
    • - V-Fib / pulseless V-Tach: 1-1.5mg/kg IV / IO, repeat in 3-5 minutes at 0.5-0.75mg/kg (half of initial dose). Max dose 3 mg/kg
    • - Pulsing V-Tach: 1mg/kg IV / IO, repeat every 5-10 minuets at 0.5mg/kg to a max dose of 3 mg/kg.
    • - Maintenance drip (hang after successful conversion of rhythm with lidocaine to a pulsing sinus rhythm >60bpm: 2-4mg.min (usally start at 2mg/min - titrate up as needed). USE 4 mg/ML concentration.
    • - Pre-intubation head injury only: 1mg/kg IV / IO
  7. Dosage (pediatric)
    • - V-Fib / pulseless V-Tach: 1mg/kg IV / IO, repeat in 3-5 minuets. Max dose 3mg/kg
    • - Pulsing V-Tach: 1mg/kg IV / IO, repeat at 0.5mg/kg every 5-10 minuets to a max dose of 3 mg/kg
    • - Maintenance Drip (hang after successful conversion of rhythm with lidocaine to a pulsing sinus rhythm > 60bpm): 20-50 mcg/kg/min.
    • - Pre-intubation head injury only: 1mg/kg IV / IO
  8. How Supplied
    • - 100 mg in 5 mL pre-load syringe (2% solution)
    • - 1g in 250ml pre-mixed bag OR 2g in 500 mL pre-mixed bag (20% solution)
    • - 1g in 5cc vials (20% solution) for mixing - NOT TO BE USED AS BOLUS

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