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Description
Amide-type local anesthetic, Frequently used to treat life threating dysrhythmias
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Mechanism of Action
Suppresses ventricular ectopic activity, raises ventricular fibrillation threshold, reduces velocity of electrical impulses through conductive system
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Onset of Action
- Onset: <3 minutes
- Peak: 5-7 minutes
- Duration: 10-20 minutes
- Half-Life: 1.5-2.0 hours
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Indications
Malignant PVCs, pulseless V-Tach, V-Fib, V-Tach w/ pulse, Prophylaxis of dysrhythmias with fibrinolytic therapy
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Contraindications
High degree heart block, PVC’s in conjunction with bradycardia
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Precautions
Monitor for central nervous system toxicity
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Side effects
(In alphabetical order for Rory)
Anxiety, confusion, convulsions, dizziness, drowsiness, nausea, vomiting, widening of QRS complex
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Adult dose
- Cardiac arrest (vfib/pulseless vtach): 1.0-1.5 mg/kg IV bolus up to 3 mg. If rhythm is converted start maintenance infusion.
- Vtach w/ pulse: 0.5 - 1 mg/kg may be repeated 3-5 min until dysrhythmia is controlled or 3 mg/kg has been given. If rhythm is converted start maintenance infusion.
- Pts over 70 and/or with liver disease: reduce dose by 50%.
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Drips
Maintenance infusion: After dysrhythmia is suppressed, a 2-4 mg/min infusion may be started to maintain adequate blood level
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Routes of Administration
IV bolus, IV infusion
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How supplied
Prefilled syringes and vials
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