Ventricular Tachycardia (with a Pulse) or Pulseless Ventricular Tachycardia/Ventricular Fibrillation
- IV (Adults): 1–1.5 mg/kg bolus; may repeat doses of 0.5–0.75 mg/kg every 5–10 min up to a total dose of 3 mg/kg; may then start continuous infusion of 1–4 mg/min.
- Endotracheal (Adults): Give 2–2.5 times the IV loading dose down the endotracheal tube, followed by a 10 mL saline flush.
- IV (Children): 1 mg/kg bolus (not to exceed 100 mg), followed by 20–50 mcg/kg/min continuous infusion (range 20–50 mcg/kg/min); may administer 2nd bolus of 0.5–1 mg/kg if delay between bolus and continuous infusion.
- Endotracheal (Children): Give 2–3 mg/kg down the endotracheal tube followed by a 5 mL saline flush.
- IM (Adults and Children
50 kg): 300 mg (4.5 mg/kg); may be repeated in 60–90 min.
Local
- Infiltration (Adults and Children): Infiltrate affected area as needed (increased amount and frequency of use increases likelihood of systemic absorption and adverse reactions).
- Topical (Adults): Apply to affected area 2–3 times daily.
- Mucosal (Adults): For anesthetizing oral surfaces — 20 mg as 2 sprays/quadrant (not to exceed 30 mg/quadrant) may be used. 15 mL of the viscous solution may be used every 3 hr for oral or pharyngeal pain. For anesthetizing the female urethra — 3–5 mL of the jelly or 20 mg as 2% solution may be used. For anesthetizing the male urethra — 5–10 mL of the jelly or 5–15 mL of 2% solution may be used before catheterization or 30 mL of jelly before cystoscopy or similar procedures. Topical solutions may be used to anesthetize mucous membranes of the larynx, trachea, or esophagus.
- Mucosal (Children 3 yr): Do not exceed 4.5 mg/kg/dose (or 300 mg/dose) of viscous solution; swish in the mouth and spit out no more frequently than every 3 hr (maximum: 4 doses per 12-hr period).
- Mucosal (Children <3 yr):
1.2 mL applied to area with a cotton-tipped applicator no more frequently than every 3 hr (maximum: 4 doses per 12-hr period); use only if the underlying condition requires treatment with product volume of 1.2 mL. - Transdermal (Adults): Up to 3 patches may be applied once for up to 12 hr in any 24-hr period; consider smaller areas of application in geriatric or debilitated patients.