Antiarrhythmics

Lidocaine

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 antiarrhythmic
  • 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

Adverse Drug Rxns

• CNS
  • Abrupt change in MS, drowsiness, confusion, sz

Kinetics

• Onset of action = 45-90s
• Duration of action = 10-20min

Source

Tintinalli