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Lidocaine: |
Class Ib Antiarrhythmic |
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IVP DOSING |
| 0.5-1 mg/kg |
Slow IVP over 2 minutes. This is the dose to give for treatment of PVCs. |
| 1-1.5 mg/kg |
This dose is for the treatment of V Fib & V Tach... Slow IVP over 2 minutes. |
|
3 mg/kg |
MAX bolus dose. |
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INFUSION DOSING |
|
If it worked well, politely ask the patient's mom to stop huging you, and start a drip. Titrate in 1mg increments. PLUS give another bolus dose with any increase. Remember, "good luck" has a short half-life... |
1-4 mg/min |
Lidocaine
is used for the treatment and prevention of
ventricular arrhythmias associated with VF/VT, AMI, cardiac surgery, and
other precipitating events.
It decreases depolarization, automaticity, and tissue excitability in the
ventricles, and works diectly in the ischemic areas of the myocardium.
All class I agents require adequate K+ levels, and this is
especially true with Lidocaine, as it is even more effect in the presence of a
high K+ level.
Hypokalemia needs to be corrected in order for lidocaine to be fully
effective.
Side Effects: Arrhythmias, ¯ BP, ¯ HR, respiratory depression/arrest, and mental status changes. Monitor serum levels for signs of toxicity, normal is 2-5 mcg/ml. Initial signs of toxicity may be dizziness, alterated mental status, slurred speach, somnolence, and paresthesias. Further toxicity can result in seizures and coma. If toxicity develops, stop the infusion, notify the MD, and give O2.
Contraindicated:
in 2°
or 3°
AV block, hypotension, and Stokes-Adams syndrome.
If pt has liver disease, is over 70yo, or is in CHF or shock, reduce
dose/infusion by 50%.
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