LIDOCAINE (Systemic)

Indications & Dose:

Cardiopulmonary resuscitation (as an alternative if amiodarone is not available) l

• BY INTRAVENOUS INJECTION

Adult: 1 mg/kg, do not exceed 3 mg/kg over the first hour

Ventricular arrhythmias, especially after myocardial infarction in patients without gross circulatory impairment l

• INITIALLY BY INTRAVENOUS INJECTION l


• Adult:100 mg, to be given as a bolus dose over a few minutes, followed immediately by (by intravenous infusion) 4 mg/minute for 30minutes, then (by intravenous infusion) 2 mg/minute for 2 hours, then (by intravenous infusion) 1 mg/minute, reduce concentration further if infusion continued beyond 24 hours (ECG monitoring and specialist advice for infusion), following intravenous injection lidocaine has a short duration of action (lasting for 15–20 minutes). If an intravenous infusion is not immediately available the initial intravenous injection of 100mg can be repeated if necessary once or twice at intervals of not less than 10 minutes 

  Ventricular arrhythmias, especially after myocardial infarction in lighter patients or those whose circulation is severely impaired l

• INITIALLY BY INTRAVENOUS INJECTION l 


• Adult: Initially 50 mg, to be given as a bolus dose over a few minutes, followed immediately by (by intravenous infusion) 4 mg/minute for 30 minutes, then (by intravenous infusion) 2 mg/minute for 2 hours, then (by intravenous infusion) 1 mg/minute, reduce concentration further if infusion continued beyond 24 hours (ECG monitoring and specialist advice for infusion), following intravenous inje of 100mg can be repeated if necessary once or twice at intervals of not less than 10 minutes  

Contraindications:

All grades of atrioventricular block . severe myocardial depression . sino-atrial disorders

Side Effects:

CNS: Apprehension, confusion, dizziness, drowsiness, euphoria, hallucinations, lightheadedness, mood changes, nervousness, seizures, tremors, twitching, unconsciousness

]CV: Bradycardia, cardiovascular collapse, edema, heart block, hypotension

EENT: Blurred or double vision, tinnitus

GI: Vomiting

RESP: Respiratory depression and arrest

SKIN: Rash, swelling, urticaria

MISC: Febrile response, malignant hyperthermia, phlebitis at inj site 

Cautions:

Acute porphyria (consider infusion with glucose for its anti-porphyrinogenic effects) . congestive cardiac failure (consider lower dose) . post cardiac surgery(consider lower dose) 

Precautions:

Interaction:

Drugs

Disopyramide: Induction of dysrhythmia or heart failure in predisposed patients

Metoprolol, nadolol, propranolol,

cimetidine: Increased serum lidocaine concentrations 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C; compatible with breast feeding 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: