Drug Cards

Lidocaine HCL

Xylocaine
Class:
Antidysrhythmic
Mechanism of Action:
Decreases automaticity by slowing th rate of spontaneous Phase 4 depolarization.
Indications:
  • Supression of ventricular dysrhythmias (V-tach, VF, PVCs).
  • Prophylaxis against recurrence after conversation from V-tach, VF.
Contraindications:
Second degree and third-degree blocks in absence of artificial pacemaker.
Adverse reactions:
  • Succinylcholine: Induced apnea may be prolonged with high doses of Lidocaine.
  • Dilantin: Cardiac depression may occur in conjuction with IV Dilantin.
  • Beta blockers: Metabolic clearence decresed in patients with liver desease or taking beta-blockers.
Adult Dosage and Administration - MEDICAL CONTROL OPTION
  • Cardiac arrest VT / VF: 1-1.5 mg/kg IV push; repeat dose 0.5-0.75 mg/kg to maximum dose of 3 mg/kg. After conversion to NSR, begin maintenance infusion at 2-4 mg/min.
  • VT with pulse: 1-1.5 mg/kg IV push; then 0.5-0.65 mg/kg q 3-5 min. to max. of 3 mg/kg.
    Begin maintenace infusion at 2-4 mg/min. ASAP.
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Pediatric Dosage and Administration - MEDICAL CONTROL OPTION:
  • Cardiac arrest VT / VF: 1 mg/kg IV / IO per dose. Infusion 20-50 mcg/kg/min.
  • PVCs with pulse: 1 mg/kg IV /IO per dose. Infusion 20-50 mcg/kg/min.
Duration of action
  • Onset: 1-5 minutes.
  • Peak Effect: 5-10 minutes.
  • Duration: Variable. (15 min. - 2 hours)
Special Considerations:
  • Pregnancy safety: Category B.
  • Reduce maintenace infusion by 50% if patient is over 70 years of age, has liver disease, or is in CHF or shock.
  • A 75-100 mg bolus maintains levels for only 20 minutes.
  • If bradycardia occurs with PVCs, always treat the bradycardia with Atropine. Exceedingly high doses of Lidocaine can result in coma or death.
  • Avoid Lidocaine for reperfusion dysrhythmias after thrombolytic therapy.