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