Lidocaine (Antiarrhythmic)

1. Therapeutic Effects
   1. Increases ventricular fibrillation threshold
   2. Reduces velocity of electrical impulses

2. Indications
   1. Malignant PVC's
   2. Ventricular Tachycardia
   3. Ventricular Fibrillation
   4. Prophylaxis of arrhythmias associated with acute coronary syndromes

3. Contraindications/Precautions
   1. 2-3 rd degree AV Blocks
   2. PVC in conjunction with bradycardia's
   3. Idioventricular rhythms

4. Side Effects
   1. Anxiety, drowsiness, confusion
   2. Widening of QRS
   3. Hypotension
   4. Possible CNS toxic effects
   5. Seizures

5. Administration and Dosage
   1. VT/VF No Pulse:
      1. Adult: 1.5 mg/kg IV push with repeat dosages of 1.5 mg/kg in 3-5 min up to 3.0 mg/kg.
   2. VT/PVC With Pulse:
      1. Adult 1-1.5 mg/kg IVP, additional boluses of 0.5-0.75 mg/kg every 5-10 min with a maximum dose of 3 mg/kg.
      2. * Once dysrhythmia is controlled, follow dosage with IV drip of 1 Gram/500cc D5W (2-4 mg min).
   3. Pediatric:
      1. 1 mg/kg IV/IO push.