LIDOCAINE (Xylocaine®)

Question 1

Drug Classification

Answer 1

Antidysrhythmic

Question 2

Mechanism of Action

Answer 2

Class IB Antiarrhythmic/weak Na+channel blocker →Decreases slope and amplitude of phase 0 depolarization for non-pacemaker action potential

Question 3

Pharmacokinetics

Answer 3

Onset of Action < 3 minutes
Peak Effects = 5-7 minutes
Duration of Effect = 10-20 minutes
Half-Life = 1.5-2 hours

Question 4

Indications

Answer 4

Cardiac Arrest (VF, Pulseless VT)
Stable Wide Complex Tachycardia
Anesthetic effect for IO use

Question 5

Contraindications

Answer 5

None

Question 6

Side effects

Answer 6

Bradycardia, heart block, hypotension, seizures, drowsiness, confusion, nausea & vomiting, sweating, flushing, itching, rash

Question 7

Dose

Answer 7

Cardiac Arrest
(ADULT): 1stdose - 1-1.5mg/kg IV, IO
2nddose - 0.5-0.75mg/kg IV, IO, repeat q 5-10 min up to 3 doses or max total dose 3mg/kg
(PEDI): 1mg/kg IVP, repeat after 15min PRN

Wide Complex Tachycardia
(ADULT): 0.5-1.5mg/kg IV, IO
(PEDI) 1mg/kg IVP, repeat after 15min PRN

Maintenance (ADULT): 1-4mg/min
Maintenance (PEDI): 20-50mg/kg/min

Anesthetic (ADULT): 0.5mg/kg up to max 50mg
Anesthetic (PEDI): 0.5mg/kg up to max 50mg

Question 8

Precautions

Answer 8

Patients 70+ or known hepatic failure reduce maintenance dose by 1/2

Question 9

Drug Interactions

Answer 9

Potentiates procainamide, phenytoin, quinidine, and β blockers