Lidocaine Hydrochloride

Question 1

Lidocaine- Name

Answer 1

Xylocaine

Xylocard

Question 2

Lidocaine- Class

Answer 2

Suppresses ventricular ectopy and increases VFIB threshold; blocks Na influx through fast Na channels and alters activity of some K channels
2. Decreases depolarization, automaticity, and excitability in the ventricles during the diastolic phase by direct action on the Purkinje network

Question 3

Lidocaine- MoA

Answer 3

Ventricular dysrhythmias: symptomatic PVCs and Monomorphic VTAC
Cardiac arrest: VFIB/ pulseless VTAC
Post conversion from a ventricular dysrhythmia (with pulses or pulseless) into a perfusing rhythm

Question 4

Lidocaine- Indications

Answer 4

Ventricular dysrhythmias: symptomatic PVCs and Monomorphic VTAC
Cardiac arrest: VFIB/ pulseless VTAC
Post conversion from a ventricular dysrhythmia (with pulses or pulseless) into a perfusing rhythm

Question 5

Lidocaine- Contra

Answer 5

23JIV
Second degree heart block, Mobitz II
Third degree heart block
Junctional bradycardia
Ventricular ectopy associated with bradycardia
Idioventricular rhythm

Question 6

Lidocaine- S/E

Answer 6

Cardiovascular: bradycardia, hypotension, arrest
Neurological: paresthesia, disorientation, slurred speech, seizures, light headedness, muscle twitching, tinnitis, blurred vision
Respiratory: dyspnea, depression, apnea

Question 7

Lidocaine- routes

Answer 7

IVP, IO, IVPB

Question 8

Lidocaine- A. Dose

Answer 8

VFIB/PulselessVTAC:
1.0-1.5 mg/kg slow IVP/IO (over 1 min.) 
May repeat 1.5 mg/kg IVP/IO once 
Maximum dose of 3 mg/kg
Ventricular Ectopy/Post Conversion:
1 mg/kg slow IVP/IO (50 mg/min) 
May repeat 0.5 mg/kg slow IVP/IO (50 mg/min) every 5-10 minutes to a maximum of 3 mg/kg

Question 9

Lidocaine- P. Dose

Answer 9

VFIB/Pulseless VTAC:
1 mg/kg slow IVP/IO (over 1 minute) 
May repeat 1 mg/kg IVP/IO every 3-5 minutes 
Maximum dose of 3 mg/kg
Ventricular Ectopy/Post Conversion:
1 mg/kg slow IVP/IO (50 mg/minute) 
May repeat 0.5 mg/kg slow IVP/IO (50 mg/min) 
Maximum dose of 3 mg/kg

Question 10

Lidocaine- Extras

Answer 10

Precautions: Due to reduced ability to excrete the drug and the resulting accumulation of the drug in the body, reduce dose in: suspected liver disease, suspected kidney disease, cardiogenic shock, pulmonary edema and the elderly

Interactions:
Increased effects in patients taking beta blockers, cimetidine (Tagamet®㋿), quinidine, and phenytoin (Dilantin®㋿)
Decreases effects when mixed with barbiturates

Onset in 1-3 minutes and may last 10-20 minutes

Signs of Lidocaine Toxicity: vision disturbances (blurred or double vision), tinnitus, trembling, dyspnea, dizziness/syncope, seizures, chest pain, palpitations and bradycardic dysrhythmias