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Lidocaine Hydrochloride
trade name
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Lidocaine Hydrochloride
class
- Antidysrhythmic Agent
- Local Anesthetic
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Lidocaine Hydrochloride
mechanism of action
- Suppresses ventricular ectopy
- Increases ventricular fibrillation threshold
- Decreases speed of electrical impulse through the conduction system
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Lidocaine Hydrochloride
indications
- Ventricular dysrhythmias: symptomatic PVCs and VTach
- Cardiac arrest: VFib/pulseless VTach
- Post conversion from a ventricular dysrhythmia (with pulses or pulseless) into a perfusing rhythm
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Lidocaine Hydrochloride
contraindications
- Second degree heart block, Mobitz II
- Third degree heart block
- Junctional bradycardia
- Ventricular ectopy associated with bradycardia
- Idioventricular rhythm
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Lidocaine Hydrochloride
side effects
- Cardiovascular: bradycardia, hypotension, arrest
- Neurological: paresthesia, disorientation, slurred speech, seizures, lightheadedness, muscle twitching, tinnitis, blurred vision
- Respiratory: dyspnea, depression, apnea
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Lidocaine Hydrochloride
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
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Lidocaine Hydrochloride
interactions
- Increased effects in patients taking beta blockers, cimetidine (Tagamet), quinidine, and phenytoin (Dilantin)
- Decreases effects when mixed with barbiturates
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Lidocaine Hydrochloride
routes
IVP, IO, IVPB, ET
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Lidocaine Hydrochloride
onset and duration
Onset in 1-3 minutes and may last 10-20 minutes
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Lidocaine Hydrochloride
dosages
- Adult:
- VFib/Pulseless VTach: 1.0-1.5 mg/kg slow IVP/IO (over 1 minute) or 3 mg/kg ET. May repeat 1.5 mg/kg IVP/IO once (no repeat for ET). Maximum dose of 3 mg/kg
Ventricular Ectopy/Post Conversion:1 mg/kg slow IVP/IO (50 mg/minute) or 2 mg/kg ET. May repeat 0.5 mg/kg slow IVP/IO (50 mg/minute) every 5-10 minutes to a maximum of 3 mg/kg. May repeat 1 mg/kg ET once
- Pediatric:
- VFib/Pulseless VTach:1 mg/kg slow IVP/IO (over 1 minute) or 2 mg/kg ET. May repeat 1 mg/kg IVP/IO every 3-5 minutes or 1 mg/kg ET. Maximum dose of 3 mg/kg
Ventricular Ectopy/Post Conversion:1 mg/kg slow IVP/IO (50 mg/minute) or 2 mg/kg ET. May repeat 1 mg/kg slow IVP/IO (50 mg/minute) or 1 mg/kg ET Maximum dose of 3 mg/kg
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Lidocaine Hydrochloride
notes
Signs of Lidocaine Toxicity: vision disturbances (blurred or double vision), tinnitus, trembling, dyspnea, dizziness/syncope, seizures, chest pain, palpitations and bradycardic dysrhythmias
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