MED-Lidocaine

Functional Class

Class IB Antidysrhythmic (Sodium Channel Blocker)

Mechanism of Action

Suppresses depolarization and automaticity of His-Purkinje systemSuppresses ventricular ectopyIncreases threshold for ventricular dysrhythmiasHowever, d?ecrases ventricular threshold for fibrillation

Indications

VFPulseless VTVT with pulseMalignant PVCs-More than six unifocal PVCs/minute-Multifocal PVCs-Couplets-R-on-T phenomena

Contraindications

HypersensitivitySupraventricular dysrhythmiasUntreated sinus bradycardia2nd Degree Mobitz II AV block3rd Degree AV BlockStokes-Adams Syndrome

Precautions

CNS depression may occur in doses over 300 mg/hourLiver or renal diseaseCHFHypovolemiaShockMysthenia gravis

Side Effects

AMSConfusionBradycardiasHypotensionSeizures

Interactions

Use caution with Beta Blockers and Procainamide-drug toxicity may result

Dosage/Route

ADULT CARDIAC ARREST 1-1.5 mg/kg IVP repeat at half dose q 5 mins max total dose of 3 mg/kg NOTE: single dose of 1.5 mg/kg acceptable if moving on to Amiodarone 2-4 mg/kg ET q 3-5 mins PEDIATRIC CARDIAC ARREST 1 mg/kg IVP/IO/ET ADULT WITH PULSE 1-1.5 mg/kg IVP repeat at half dose q 5-10 mins max total 3 mg/kg ADULT IV INFUSION 1-4 mg/min

Pharmacokinetics

Absorption: 3 minsDuration: 10-20 hoursHalf-life: 1.5-2 hours