Lidocaine: Difference between revisions
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== | ==Anesthetic== | ||
== | ===Precautions=== | ||
*For wounds, may use HCO3 (1cc to 10cc Lido) to decr pain | *For wounds, may use HCO3 (1cc to 10cc Lido) to decr pain | ||
*inject through wound edges NOT intact skin | *inject through wound edges NOT intact skin | ||
== Theraputic Doses == | === Theraputic Doses === | ||
MAX DOSE (mg/kg) | MAX DOSE (mg/kg) | ||
| Line 27: | Line 27: | ||
|} | |} | ||
== Diagnosis == | ==Antiarrhythmic== | ||
=== Adult Dosing === | |||
*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 | |||
=== Contraindications === | |||
*High SA or AV block | |||
=== Indications === | |||
*Treatment of ventricular arrhythmias and ectopy | |||
**Considered 2nd-line to amiodarone for tx of V-fib and pulseless v-tach | |||
=== Mechanism of Action === | |||
*Class Ib | |||
**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 | |||
=== Kinetics === | |||
*Onset of action = 45-90s | |||
*Duration of action = 10-20min | |||
== Toxicity== | |||
===Diagnosis === | |||
Symptoms: | Symptoms: | ||
# CV | # CV | ||
| Line 33: | Line 59: | ||
###Tx w/ epi per ACLS | ###Tx w/ epi per ACLS | ||
#CNS | #CNS | ||
##lightheaded, | ##lightheaded, ringing in ears | ||
##Seizure | ##Seizure | ||
##Abrupt change in MS, drowsiness, confusion | |||
==See Also== | ==See Also== | ||
[[Incision and Drainage]] | *[[Antiarrhythmic]] | ||
*[[Incision and Drainage]] | |||
[[Category:Drugs]] | [[Category:Drugs]] | ||
[[Category:Cards]] | |||
[[Category:Tox]] | [[Category:Tox]] | ||
Revision as of 22:03, 18 November 2011
Anesthetic
Precautions
- For wounds, may use HCO3 (1cc to 10cc Lido) to decr pain
- inject through wound edges NOT intact skin
Theraputic Doses
MAX DOSE (mg/kg)
| Agent | With Epi | Without Epi |
| Lidocaine | 7 | 3-5 |
| Mevipicaine | 8 | 7 |
| Bupivicaine | 3 | 1.5 |
Antiarrhythmic
Adult Dosing
- 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
Contraindications
- High SA or AV block
Indications
- Treatment of ventricular arrhythmias and ectopy
- Considered 2nd-line to amiodarone for tx of V-fib and pulseless v-tach
Mechanism of Action
- Class Ib
- 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
Kinetics
- Onset of action = 45-90s
- Duration of action = 10-20min
Toxicity
Diagnosis
Symptoms:
- CV
- (brady/arrest)
- Tx w/ epi per ACLS
- (brady/arrest)
- CNS
- lightheaded, ringing in ears
- Seizure
- Abrupt change in MS, drowsiness, confusion