Lidocaine*

• Lidocaine

Classification:

• Anti-arrhythmic (Class 1b)

Mechanism of Action:

• Reduces velocity of electrical impulses by blocking the Na channels of the heart cell thus reducing automaticity and excitability of the conduction system.

Indications:

• VFib/VTach
• Stable VTach with a pulse
• Wide-complex tachycardia of unknown origin

Contraindications:

• Hypersensitivity

Precautions:

• Consider ½ dosage for patients > 70 y/o or compromised liver function or CHF
• 3^rd degree heart block
• Bradycardia related PVC’s
• Idioventricular rhythms

Adverse Effects:

• Seizures
• CNS Depression
• Dizziness, drowsiness
• Hypotension
• Bradycardia
• Tremors
• Numbness

Dose:

• VFib/VTach:  1.0 mg/kg with subsequent doses of 0.5 mg/kg q 10 min (max 3.0 mg/kg)
• VTach with pulse:
  • Bolus  1.0 mg/kg with subsequent doses of 0.5 mg/kg q 10 min (max 3.0 mg/kg)
  • Infusion of 1 – 4 mg/min

• IV

• Compendium of Pharmaceuticals and Specialties (CPS)
• Pharmacology for the Prehospital Professional 2^nd Edition