- useful in the treatment of ventricular arrhythmias
- may be used to inhibit cough reflex during intubation or suctioning with raised intracranial pressure
- Loading Dose:
- 1mg/kg, up to 1.5 mg/kg over 1 min, may repeat X 1 to a maximum total dose of 3.0 mg/kg
- Maintenance Infusion:
- Circulatory Failure:
- 50 mg, then 1 mg/min as continuous infusion
- Pre-suctioning with raised ICP:
- 1.5 mg/kg (max 100 mg) 1 - 2 minutes prior to suctioning; maximum dose per hour 4.5 mg/kg
- dose must be decreased in hepatic or renal failure.
- infusion beyond 36 hours may necessitate a reduction in dose
- Bolus dose:
- IV Infusion:
- underlying causes for ventricular ectopy, such as low potassium or magnesium, hypoxemia, ischemia should be corrected concurrently with initation of therapy
- heart block
- decreased cardiac output
- reports of cardiac arrest ollowing IV administration
- in complete heart block or type II second degree heart block unless functional pacemaker in place (can suppress a ventricular escape rhythm)
- lidocaine + cimetidine = increased lidocaine toxicity
- lidocaine + propranolol = increased lidocaine toxicity
- lidocaine + procainamide = increased lidocaine toxicity
- lidocaine + amiodarone = severe sinus bradycardia (especially in sick sinus syndrome)
- lidocaine + neuromuscular blockers = increased neuromuscular blockade
- HR and rhythm
- neurological status
- cardiac index
- electrolytes: potassium, magnesium, phosphate
- May be administered at a dose of 1 mg/kg IV direct followed by an infusion of 2 g/500 ml at 2 mg/min without a physician's order, by a certified nurse in the CCTC for symptomatic ventricular tachycardia or ventricular fibrillation.
- May be administered IV direct by an approved nurse in CCTC.
- May be titrated by an approved nurse in CCTC.