Lidocaine: Difference between revisions
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*Dosage Forms: | *Dosage Forms: | ||
*Common Trade Names: | *Common Trade Names: | ||
==Adult Dosing== | ==Adult Dosing== | ||
===Local Anesthetic=== | ===[[Local anesthetics|Local Anesthetic]]=== | ||
* | *Without epinepherine: 5 mg/kg (max 300mg) | ||
*With epinepherine: 7 mg/kg (max 500mg) | |||
===Antiarrhythmic=== | ===[[Arrythmia|Antiarrhythmic]]=== | ||
*Loading dose = 1-1.5 mg/kg | *Loading dose = 1-1.5 mg/kg | ||
**Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg | **Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg | ||
| Line 21: | Line 20: | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
===Local Anesthetic=== | ===[[Local anesthetics|Local Anesthetic]]=== | ||
* | *Without epinepherine: 5 mg/kg (max 300mg) | ||
*With epinepherine: 7 mg/kg (max 500mg) | |||
===Antiarrhythmic=== | ===[[Arrythmia|Antiarrhythmic]]=== | ||
''See [[critical care quick reference]] for drug doses by weight.'' | ''See [[critical care quick reference]] for drug doses by weight.'' | ||
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*Half-life: | *Half-life: | ||
**Onset of action = 45-90s | **Onset of action = 45-90s | ||
**Duration of action = 10-20min | **Duration of action = 10-20min (antiarrythmic IV); 30-90 min (subcutaneous) | ||
*Metabolism: | *Metabolism: | ||
*Excretion: | *Excretion: | ||
Revision as of 12:14, 22 February 2015
See critical care quick reference for drug doses by weight.
General
- Type: Local anesthetics; Antiarrhythmics
- Dosage Forms:
- Common Trade Names:
Adult Dosing
Local Anesthetic
- Without epinepherine: 5 mg/kg (max 300mg)
- With epinepherine: 7 mg/kg (max 500mg)
Antiarrhythmic
- Loading dose = 1-1.5 mg/kg
- Additional boluses of 0.5-0.75 mg/kg q5-10min up to max of 3mg/kg
- If effective start infusion of 2mg/min
- Indications
- Treatment of ventricular arrhythmias and ectopy
- Considered 2nd-line to amiodarone for treatment of V-fib and pulseless v-tach
- Treatment of ventricular arrhythmias and ectopy
Pediatric Dosing
Local Anesthetic
- Without epinepherine: 5 mg/kg (max 300mg)
- With epinepherine: 7 mg/kg (max 500mg)
Antiarrhythmic
See critical care quick reference for drug doses by weight.
Special Populations
- Pregnancy Rating:
- Lactation:
- Renal Dosing
- Adult
- Pediatric
- Hepatic Dosing
- Adult
- Pediatric
Contraindications
- Allergy to class/drug
- High SA or AV block
Adverse Reactions
Serious
Common
Pharmacology
- Half-life:
- Onset of action = 45-90s
- Duration of action = 10-20min (antiarrythmic IV); 30-90 min (subcutaneous)
- Metabolism:
- Excretion:
- Mechanism of Action:
- Class Ib antiarrythmic
- Binds to fast Na channels in inactive state thereby inhibiting recovery after repolarization
- Acts preferentially on ischemic tissue
- Elevates V-fib threshold
- Suppresses ventricular ectopy
- Little effect on vascular tone, contractility or cardiac output
- Class Ib antiarrythmic
Comments
- For wounds, may use HCO3 (1cc to 10cc Lido) to decr pain
- inject through wound edges NOT intact skin