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15 Cards in this Set

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Lidocaine
A/M
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.
Lidocaine
Use
VT, VF, and malignant PVCs.

Prior to intubation when signs of increased ICP exist.
Lidocaine
Contra
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.
Lidocaine
SE
CNS: Seizure, confusion, twitching, numbness in mouth.
CV: Hypotension, bradycardia, heart block.
R: Dyspnea, respiratory depression/arrest
GI: N+ V
Lidocaine
Interactions
Caution: w/concurrent admnin of procainamide, quinidine, phenytoin, and beta blockers because of toxicity. Should not be used with amiodarone.
Lidocaine
Dose
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.
Lidocaine
Admin/Notes
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)
Digoxin
A/M
+ inotrophy by its effects on the sodium pump. Dig significantly increases stroke volume increasing cardiac output. Decreases AV nodal conduction, -chronotrophy.
Digoxin
Use
CHF and SVT, especially A Flutter and A Fib.
Digoxin
Contra
Pt. exhibiting any signs of dig toxicity.
Not used for VFib.
Extreme Caution: MI
Digoxin
SE
CNS: Dizz., headache, delirium, paresthsias
R: Dyspnea
GI: N + V, diarrhea
Digoxin
Interaxions
Potentiation: Hypokalemia, hypercalcemia, hypomagnesemia. Other +inotropes and -chronotropes.
Quinidine and calcium channel blockers increase dig levels.
Digoxin
Dose
0.25-0.5 mg slow IVP
Digoxin
Admin/notes
IV, PO for less emergent.

Many negative drug interactions. Avoid field use.
Digitalis toxicity
S/S
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