Drug information of Lidocaine

Lidocaine

Drug group:

A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine.

Mechanism of effect

Lidocaine hydrochloride is reported to increase the electrical stimulation threshold of the ventricle during diastole and, thereby, exert an antiarrhythmic effect.

Pharmacodynamic

Lidocaine is an anesthetic agent indicated for production of local or regional anesthesia and in the treatment of ventricular tachycardia occurring during cardiac manipulation, such as surgery or catheterization, or which may occur during acute myocardial infarction, digitalis toxicity, or other cardiac diseases.

Pharmacokinetics

lidocaine is completely absorbed following parenteral administration. Protein binding: 60-80%.Approximately 90% of an administered dose of lidocaine hydrochloride is metabolized in the liver. Less than 10% of the drug is excreted unchanged via the kidneys. Lidocaine and its metabolites are excreted by the kidneys. Half life: 109 minutes.

Dosage

Usual Adult Dose for Arrhythmias
Initial dose: 1 to 1.5 mg/kg/dose intravenously (IV) given over 2 to 3 minutes.
May repeat with 0.5 to 0.75 mg/kg/dose IV given over 2 to 3 minutes in 5 to 10 minutes until a total of 3 mg/kg.
Continuous IV infusion: 1 to 4 mg/min.
Prehospital post-myocardial infarction (MI) antiarrhythmic prophylaxis: 300 mg intramusculary once.
May be administered endotracheally (loading dose only) if IV access unavailable at a dose of 2 to 2.5 times the IV dose. Dilute in 10 mL NS or distilled water.
Usual Adult Dose for Anesthesia
Anesthesia, local injectable: Dose varies with procedure, degree of anesthesia needed, vascularity of tissue, duration of anesthesia required, and physical condition of patient; maximum dose: 4.5 mg/kg/dose; do not repeat within 2 hours.

Alerts

1-EVERY EFFORT SHOULD BE MADE TO AVOID POSSIBLE INADVERTENT INTRAVASCULAR ADMINISTRATION THROUGH APPROPRIATE SELECTION OF INJECTION SITE SUCH AS THIGH OR DELTOID. DO NOT INJECT INTO BUTTOCK.
2-Monitoring with an electrocardiograph is recommended when lidocaine hydrochloride is administered by the intramuscular route
3-Occasional acceleration of ventricular rate may occur when lidocaine hydrochloride is administered to patients with atrial fibrillation.
4-Caution should be employed in the repeated use of lidocaine hydrochloride in patients with severe liver or renal disease

Points of recommendation

Unless absolutely necessary, do not attempt to operate a motor vehicle after use.

Pregnancy level

B


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