Cardiology | Antiarrhythmic Drug Guide | Class Ib | Lidocaine

Lidocaine

IV Dose Loading does: 1 mg/kg, given no faster than 50 mg/min.
May repeat twice q 5-10 mins.
Drip 20-50 ug/kg/min.
Decrease rate by 50% at 24 hours!
Oral dose No PO form (although mexiletine is similar)
Levels 1.5-5 ug/ml.
Toxicity (esp. confusion) frequent >6 ug/ml.
Kinetics Elimination half-life 1.8 hours in adults and children aged 6 m- 3 years, 3.2 hours in neonates.
Decreased clearance in congestive heart failure.
Cautions Vertigo, paraesthesias, slurred speech and confusion are the first signs of toxicity.
Interactions Propranolol decreases liver blood flow and lidocaine clearance.
Isoproterenol, phenobarbital, phenytoin increase clearance.
Preparations Xylocaine injection, 100 mg/5 cc (amps or syringes)
FDA approval in children yes

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