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
    • 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

Adverse Drug Rxns

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

Kinetics

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

Procainamide

Esmolol

Labetalol

Sotalol

Amiodarone

Ibutilide

Diltiazem

Atropine

Adenosine

Digoxin

Isoproterenol

Magnesium

Source

Tintinalli