Lidocaine

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Lidocaine Trade Name

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-Xylocaine

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Lidocaine Classification

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-Class Ib antiarrhythmic

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Lidocaine Mechanism of Action

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-inhibits influx of sodium through fast channels of myocardial cell membrane and decreases conduction in ischemic cardiac tissue without adversely affecting normal conduction.
-no change in SA node recovery or conduction time, AV node conduction time is unchanged or shortened.
-doesn't affect BP, cardiac output or myocardial contractility.
-No effect on autonomic tone

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Lidocaine Indications

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-Pulseless VT/VF that persists after defib and vasopresser admin

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Lidocaine Dosing

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-1 to 1.5mg/kg IV bolus
-possible repeat dose in 5 to 10 minutes
-Dose should not exceed 3mg/kg
-Bolus only used in Cardiac arrest
-may do infusion with return of spontaneous infusion
-Maintenance infusion: 1-4mg/min.
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Lidocaine Precautions

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-maintenance 1 to 4 mg/min
-1-2 mg/min with altered metabolism (chf, hepatic dysfuncion, MI with hypotension, or shock)
-Elimination half life 1.5 to 2 hours
-half life prolonged with liver dysfunction

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Lidocaine Contraindications

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-Hypersenitivity to or amide type local anesthetics
-severe degrees of sinoartial, AV Node or intraventricular block in the absence of an artifical pacer
-Stokes Adams syndrome (recurring episodes of loss of conc caused by transient interruption of cardiac output)
-WPW

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Lidocaine Special Considerations

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-Maybe lethal in bradycardia with ventricular escape rhythm

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Lidocaine Onset and Duration

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-IV 45 to 90 seconds
-IV 10 to 20 minutes