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10 Cards in this Set
- Front
- Back
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Class |
Antidysrhythmic, anesthetic |
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Mexh |
As an antidysrhythmic, lidocaine suppresses automaticity, excitability, and spontaneous depolarization of the ventricles. Has little effect on atria. As an anesthetic, lidocaine produces local anesthesia by inhibiting transport of ions across neuronal membranes, preventing initiation and conduction of normal nerve impulses. |
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Pharma |
Onset: under 3 min
Duration: 10-20 min |
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Indications |
Ventricular fibrillation, pulseless ventricular tachycardia1Wide complex regular tachycardia with pulse (This includes VT and WCT of uncertain origin.) 2Pre-medication in RSI for patients with suspected ICP (e.g.head trauma or suspected CVA)Local anesthetic for IVs and suturing. Viscous form is used as local anesthetic prior to nasal intubation or NG tube placement |
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Contra |
(Viscous form is exempt) High degree AVBs (2nd degree type II or 3rd degree), Relative: heart rate < 50, BP < 90 |
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Precautions |
Patients with hepatic failure, CHF, age > 70 |
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Side effects |
At standard doses, serious adverse reactions are uncommon. High doses can produce bradycardia, hypotension, AV block, and cardiovascular collapse. Signs of toxicity include tinnitus, perioral twitching, slurred speech, altered mental status, and seizures (higher incidence in geriatric patients). |
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Interactions |
Except for v-fib and pulseless v-tach, lidocaine should not be given concurrently with other antidysrhythmics |
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Dosage |
Pulseless v-tach/v-fib: 1.5 mg/kg IV every 3-5 min, max: 3 mg/kg. V-tach with a pulse: 1-1.5 mg/kg slow IV, may repeat at 1⁄2 dose in 5-10 min, max: 3 mg/kg. If patient is >70 years, has hepatic failure, or CHF decrease second dose to 1⁄4 of first dose.Post conversion: 1-4 mg/min Intubation: 1 mg/kg |
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Lidocaine is an alternative antiarrhythmic of long-standing and widespread familiarity with fewer immediate side effects than other antiarrhythmics. (However) Lidocaine has no proven short or long-term efficacy in cardiac arrest. Lidocaine may be considered (for cardiac arrest) if amiodarone is not available. |
2. Lidocaine is less effective in terminating VT than procainamide, sotalol, and amiodarone.... While occasionally effective, lidocaine should be considered second-line antiarrhythmic therapy for monomorphic VT. |
