Lidocaine, Dig

Front 1

Lidocaine
A/M

Back 1

Suppresses ventricular dysrhythmias by depressing depolarization in the ventricles, but does not slow AV conduction nor depress myocardial contractility.

Increases ventricular fibrillation threshold and lowers defib/cardioversion threshold.

Front 2

Lidocaine
Use

Back 2

VT, VF, and malignant PVCs.

Prior to intubation when signs of increased ICP exist.

Front 3

Lidocaine
Contra

Back 3

Hypersensitivity to amide type local anesthetics.
High degree heart blocks, other decreased conduction abnormalaties, bradycardias, junctional or ventricular escape rythms.
Dosage should not exceed 300 mg/hr.

Front 4

Lidocaine
SE

Back 4

CNS: Seizure, confusion, twitching, numbness in mouth.
CV: Hypotension, bradycardia, heart block.
R: Dyspnea, respiratory depression/arrest
GI: N+ V

Front 5

Lidocaine
Interactions

Back 5

Caution: w/concurrent admnin of procainamide, quinidine, phenytoin, and beta blockers because of toxicity. Should not be used with amiodarone.

Front 6

Lidocaine
Dose

Back 6

To convert V dysrythmias (PVCs etc):
1.0 - 1.5 mg/kg IV. May repeat q 3-5m.

To convert VT with pulse, or pulseless VT/VF:
1.0 - 1.5 mg/kg slow IVP. May repeat 1/2 initial q 5-10m.
Maximum bolus: 3 mg/kg. Adult maintenance: 2-4 mg/min.

Front 7

Lidocaine
Admin/Notes

Back 7

Re-bolus or establish continuous IV infusion to maintain app. blood level.

Monitor for CNS toxicity. Rapid IVP may cause grand mal seizures.
Discontinue if signs of cardiac depression occur, especially in pt with slow metabolization (CHF, cardiogenic shock, hepatitis, renal disease)

Front 8

Digoxin
A/M

Back 8

+ inotrophy by its effects on the sodium pump. Dig significantly increases stroke volume increasing cardiac output. Decreases AV nodal conduction, -chronotrophy.

Front 9

Digoxin
Use

Back 9

CHF and SVT, especially A Flutter and A Fib.

Front 10

Digoxin
Contra

Back 10

Pt. exhibiting any signs of dig toxicity.
Not used for VFib.
Extreme Caution: MI

Front 11

Digoxin
SE

Back 11

CNS: Dizz., headache, delirium, paresthsias
R: Dyspnea
GI: N + V, diarrhea

Front 12

Digoxin
Interaxions

Back 12

Potentiation: Hypokalemia, hypercalcemia, hypomagnesemia. Other +inotropes and -chronotropes.
Quinidine and calcium channel blockers increase dig levels.

Front 13

Digoxin
Dose

Back 13

0.25-0.5 mg slow IVP

Front 14

Digoxin
Admin/notes

Back 14

IV, PO for less emergent.

Many negative drug interactions. Avoid field use.

Front 15

Digitalis toxicity
S/S

Back 15

CNS: confusion, dizziness, agitation, delirium, hallucinations, headache,paresthesias and naturopathic pain.
Ocular: Disturbance of color vision
GI: N + V, anorexia, diarrhea, abd. pain.
CV: Palp, syncope
R: Dyspnea