Lidocaine

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Class:

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Antiarrhythmic

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Actions:

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1. Suppress ventricular ectopy
2. Increase VF threshold
3. Reduce electrical impulse through heart

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Indications:

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1. Malignant PVC'S w/ suspected ischemia
a. >6 / min
b. myocardial infarction
c. couplets / salvos or runs of VT
d. R-on-T phenomenon
e. multifocal
f. symptomatic
2. VT, VF
3. wide complex tachycardias of unknown origin

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Contraindications:

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1. high degree heart blocks (2nd and 3rd)
2. PVC's w/ bradycardia
3. allergy to med or any "-caines"
4. idioventricular rhythms
5. do not give w/ Beta-blockers or Dopamine

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Precautions:

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1. Dosage not to exceed 300 mg/hr
2. Monitor for CNS toxicity
3. reduce dose by 50% in pt's > 70 y.o. or who have liver disease
4. use bolus theraphy in cardiac arrest only

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Side Effects:

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1. Anxiety, drowsiness,dizziness and confusion
2. nausea, vomiting and convulsions
3. widening of QRS
4. hypotension, numbness, slurred speech and parasthesias

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Dosage:

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Pt's > 70 y.o. OR w/ Liver disease - reduce dose by 50%
PVC's, VF, and wide complex tachycardia:
Inital dose: 1.0 - 1.5 mg/kg
Subsequent Dose:
0.5 - 0.75 mg/kg every 5-10 min to max of 3.0 mg/kg
Drip:
2-4 mg/kg - mix 1 gm in 250 ml

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Route:

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ET (max is 6.0 mg/kg total when all doses are delivered ET)IV bolus or infusion or IM bolus of 300 mg

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How Supplied:

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Prefilled syringe: 100 mg / 5 ml
Ampule: 100 mg / 5ml
Premixed 1 or 2 gm in 500 ml of d5w

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Pediatric Dosage:

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1 mg/kg