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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 use: or 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: (INCLUDING ANAPHYLAXIS)HYPERSENSITIVITY REACTIONS .

Interactions

Drug-Drug:

Availability

(Generic available)

Route/Dosage

see Calculator

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

Therapeutic Effects:

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

lidocaine (Parenteral): LYE-doe-kane