lidocaine_hcl.txt

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Author:
papeirce
ID:
77046
Filename:
lidocaine_hcl.txt
Updated:
2011-04-03 22:43:26
Tags:
paramedic medications drugs prehospital lidocaine hcl
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Description:
Prehospital Medication Flashcards for Paramedic School - Massachusetts and Rhode Island
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  1. Lidocaine HCL 2%

    Trade Name
    • Dalcaine
    • Dilocaine
    • Lidoject
    • Octocain
    • Xylocaine
    • Xylocaine-MPF
  2. Lidocaine HCL 2%

    Class
    Antidysrhythmic
  3. Lidocaine HCL 2%

    Mechanism of Action
    Decreases automaticity by slowing the rate of spontaneous Phase 4 depolarization
  4. Lidocaine HCL 2%

    Indications
    • Suppression of ventricular dysrhythmias (VT, VF)
    • Suppression of PVCs
    • Prophylaxis against recurrence after conversion from VT, VF
    • To ease pain pressure that is caused by fluid and/or medications that have been administered IO
    • Prior to intubation of patients with a head injury to counter the rise of ICP (mechanism unknown)
  5. Lidocaine HCL 2%

    Contraindications
    • Second degree and third degree blocks in absence of artificial pacemaker.
    • Hypotension
    • Stokes Adams Syndrome
  6. Lidocaine HCL 2%

    Adverse Reactions
    • Slurred speech
    • Seizures
    • Altered mental status
    • Confusion
    • Lightheadedness
    • Blurred vision
    • Bradycardia
  7. Lidocaine HCL 2%

    Drug Interactions
    • Apnea induced with succinylcholine may be prolonged with high doses of Lidocaine
    • Cardiac depression may occur in conjunction with IV Dilantin
    • Procainamide may exacerbate the CNS effects
    • Metabolic clearance decreased in patients with liver disease or those patients taking beta-blockers
  8. Lidocaine HCL 2%

    How Supplied
    • 100 mg in 5 ml solution prefilled syringes
    • 1 and 2 gram additive syringes
    • 100 mg in 5 ml solution ampules
    • 1 and 2 gram vials in 30 ml of solution
  9. Lidocaine HCL 2%

    Dosage and Administration
    Adult
    • Cardiac arrest VT/ VF: 1.5 mg / kg IV push; repeat q 3-5 minutes to maximum dose of 3 mg/kg.
    • After conversion to NSR, begin drip at 2-4 mg / min (mix 1g in 250cc NS to create infusion)
    • VT with pulse: 1-1.5 mg / kg IV Push; then 0.50-0.75 mg / kg q 5-10 min to max of 3 mg/kg Start drip at 2-4 mg/min ASAP
    • PVCs with pulse: 0.5-1.5 mg/kg IV Push; additional boluses of 0.5-1.5 mg/kg q 5-10 min to max of 3 mg/kg. Start drip at 2-4 mg/ min ASAP
    • VF prophylaxis: 0.5 mg/kg IV Push; additional boluses 0.5 mg/kg in 8-10 minutes up to 2mg/kg Start drip at 2-4 mg/min ASAP (mix 1g in 250cc NS to create infusion)
    • IO Pain/Pressure Management: 20mg IO slow bolus wait 30 sec. then flush w/ 30cc NS
    • Prior to Intubation (Head Trauma): 75-100 mg IV, IO
  10. Lidocaine HCL 2%

    Dosage and Administration
    Pediatric
    • VF or Pulseless V-tach: 1 mg/kg IV / IO per dose.
    • Infusion: 20-50 mcg/kg/min
    • PVCs with pulse: 1 mg/kg IV / IO per dose.
    • Infusion: 20-50 mcg/kg/min
    • IO Pain/Pressure Management: .5mg/kg max 20mg IO slow bolus wait 30 sec. then flush w/ 30cc NS
  11. Lidocaine HCL 2%

    Duration of Action
    • Onset: 1-5 minutes
    • Peak Effect: 5-10 minutes
    • Duration: Variable. (15 min. -2 hours)
  12. Lidocaine HCL 2%

    Special Considerations
    • Pregnancy safety: Category B
    • Lidocaine has been replaced by Amiodarone for issues surrounding Dysrythmias
    • Reduce maintenance infusions by 50% if patient is over 70 years of age, has liver disease, or is in CHF or shock
    • A 75-100 mg bolus maintains levels for only 20 minutes
    • If bradycardia occurs with PVCs, always treat the bradycardia with atropine, Isoproterenol or both
    • Exceedingly high doses of Lidocainecan result in coma or death
    • Avoid Lidocaine for reperfusion dysrhythmias after thrombolytic therapy
    • Cross-reactivity with other forms of local anesthetics

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