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Download IV-29 9.01 R. Lidocaine Hydrochloride (Xylocaine®)
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Transcript
9.01 R. Lidocaine Hydrochloride (Xylocaine®) I. Classification •Antidysrhythmic agent II.Actions •Suppresses ventricular dysrhythmias by stabilizing the myocardial cell membrane III.Indications A. Ventricular dysrhythmias •Symptomatic PVCs •Ventricular tachycardia B. Cardiac arrest •Ventricular fibrillation •Pulseless ventricular tachycardia C. Post cardioversion/defibrillation of ventricular rhythms IV.Contraindications •Second degree heart block (Mobitz II) •Third degree heart block •Junctional rhythms •Idioventricular rhythm •Ventricular ectopy associated with bradycardia V. Adverse Effects A.Cardiovascular •Bradycardia •Hypotension •Cardiac arrest B.Neurological •Light-headedness •Drowsiness •Paresthesias •Restlessness •Confusion •Slurred speech •Seizures •Blurred vision •Tinnitus •Muscle twitching C.Respiratory •Dyspnea •Respiratory depression •Respiratory arrest D.Gastrointestinal •Nausea/vomiting SUBJECT : PATIENT CARE GUIDELINES AND STANDING ORDERS FOR BLS AND ALS UNITS REFERENCE NO. III-01 PUBLICATION : 10/1/16 IV-29 VI. Adult Administration A. Ventricular dysrhythmias, Post cardioversion/defibrillation of ventricular rhythm [by online MD order only] •1.5 mg/kg slow IV/IO at 50 mg/minute or 3 mg/kg ET (Maximum dose is 3 mg/kg). B. Cardiac arrest •1.5 mg/kg slow IV/IO over 1 minute or 3 mg/kg ET. Repeat 1.5 mg/kg IVP once if indicated, do not repeat ET (Maximum 3 mg/kg). C.Drips •Mix 200 mg in a 50 ml bag of NS (remove 10 cc of NS prior to addition of lidocaine) and run at a rate of 2 - 4 mg/minute (30 to 60 drops/minute) IV/IO. VII. Pediatric Administration A. Ventricular dysrhythmias, Cardiac arrest, Post cardioversion/defibrillation of ventricular rhythm [by online MD order only] •1 mg/kg slow IV/IO over 1 minute or 2 mg/kg ET. If no conversion, repeat 1 mg/kg IV/IO two times or 1 mg/kg ET one time in 3-5 minutes. (Maximum 3 mg/kg). VIII.Onset •30-90 seconds IX.Duration •10 - 20 minutes X.Note •Lidocaine is metabolized in the liver and excreted in the kidneys. A reduced dosage should be considered for patients with suspected liver or kidney disease, cardiogenic shock, congestive heart failure, and in the elderly. The initial dose does not need to be reduced, however, repeat boluses (maintenance dose) should be decreased to 0.25 mg/kg. IV-30 SUBJECT : PATIENT CARE GUIDELINES AND STANDING ORDERS FOR BLS AND ALS UNITS REFERENCE NO. III-01 PUBLICATION : 10/1/16
