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Indications

High Alert


Local

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV: arrhythmias, bradycardia, CARDIAC ARREST, heart block, hypotension

EENT: mucosal useor absent gag reflex

GI: nausea, vomiting

Hemat: methemoglobinemia

Local: stinging, burning, contact dermatitis, erythema

MS: chondrolysis

Neuro: confusion, drowsiness, agitation, blurred vision, dizziness, paresthesia, SEIZURES, slurred speech, tremor

Resp: bronchospasm

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS)

Interactions

Drug-drug:

Availability

(Generic available)

Route/Dosage

Ventricular Tachycardia (with a Pulse) or Pulseless Ventricular Tachycardia/Ventricular Fibrillation

Local

US Brand Names

lidocaine (parenteral): Xylocaine,

lidocaine (local anesthetic): Xylocaine,

lidocaine (mucosal): Xylocaine Viscous,

lidocaine (topical): Glydo, Lidoderm, L-M-X 4, L-M-X 5, Xylocaine, ZTLido

Action

  • IV: Suppresses automaticity and spontaneous depolarization of the ventricles during diastole by altering the flux of sodium ions across cell membranes with little or no effect on heart rate.
Local
  • Produces local anesthesia by inhibiting transport of ions across neuronal membranes, thereby preventing initiation and conduction of normal nerve impulses.
Therapeutic effects:
  • Control of ventricular arrhythmias.
  • Local anesthesia.

Classifications

Therapeutic Classification: anesthetics (topical/local), antiarrhythmics (class IB)

Pharmacokinetics

Absorption: IV administration results in complete bioavailability; some absorption follows local use.

Distribution: Widely distributed. Concentrates in adipose tissue. Crosses the blood-brain barrier.

Metabolism/Excretion: Mostly metabolized by the liver; <10% excreted in urine as unchanged drug.

Half-Life: Biphasic—initial phase, 7–30 min; terminal phase, 90–120 min; in HF and hepatic impairment.

Canadian Brand Names

lidocaine (parenteral): Xylocard,

lidocaine (mucosal): Jampocaine Viscous,

lidocaine (topical): Betacaine, Cathejell, Lidodan, Lyracaine, Maxilene, Stallion, Topicaine

Time/Action Profile

(IV = antiarrhythmic effects; local = anesthetic effects)

ROUTEONSETPEAKDURATION
IVimmediateimmediate10–20 min (up to several hr after continuous infusion)
Localrapidunknown1–3 hr



Patient/Family Teaching

Pronunciation

LYE-doe-kane