LIDOCAINE (Xylocaine®)

Question 1

Generic/Trade Name

LIDOCAINE

Answer 1

Xylocaine®

Question 2

Generic/Trade Name

Xylocaine®

Answer 2

LIDOCAINE

Question 3

LIDOCAINE (Xylocaine®)

Drug Classification:

Answer 3

Antidysrhythmic

Question 4

LIDOCAINE (Xylocaine®)

Mechanism of Action:

Answer 4

Na+ channel blocker ⇒ slows phases IV and 0 of cardiac cycle

Question 5

LIDOCAINE (Xylocaine®)

Pharmacokinetics

Answer 5

Onset of Action < 3 minutes

Peak Effects = 5-7 minutes

Duration of Effect = 10-20 minutes

Half-Life = 1.5-2 hours

Question 6

LIDOCAINE (Xylocaine®)

Indications/Field Use:

Answer 6

• VF, VT
• Alternative to Amiodarone
• Anesthetic effect for IO use
• Pre-medication for RSI with suspected increased ICP

Question 7

LIDOCAINE (Xylocaine®)

Contraindications:

Answer 7

• 2° Type II, 3° Heart Block
• Bradycardia
• Stokes-Adams Syndrome
• WPW (Wolff Parkinson White Syndrome)
• LGL (lown-ganong-levine syndrome)

Question 8

LIDOCAINE (Xylocaine®)

Side Effects/Adverse Reactions:

Answer 8

• Flushing
• sweating
• decreased deep tendon reflex
• itching, rash
• hypothermia
• bradycardia
• drowsiness
• seizures
• confusion
• hypotension
• N+V
• heart block
• respiratory/cardiac arrest

Question 9

LIDOCAINE (Xylocaine®)

ADULT DOSE:

Answer 9

VF, pulseless VT (ADULT):

• 1st dose - 1-1.5mg/kg IV, IO
• 2nd dose 0.5-0.75mg/kg IV, IO, then 1-4mg/min maintenance

VT w/ pulse, PVC’s (ADULT):

• 0.5-1.5mg/kg IV, IO, then 1-4mg/min maintenance

Question 10

LIDOCAINE (Xylocaine®)

PEDI DOSE:

Answer 10

(PEDI): 1mg/kg IVP, repeat after 15min PRN, maintenance 20-50μg/kg/min

Question 11

LIDOCAINE (Xylocaine®)

Precautions:

Answer 11

Pt. 70+yrs/known hepatic failure – reduce maintenance dose by half

Question 12

LIDOCAINE (Xylocaine®)

Drug-Drug Interactions:

Answer 12

May cause drug toxicity when given with procainamide, phenytoin, quinidine, and β blockers