Lidocaine

• Trade- Xylocaine
• Class – Antiarrhythmic / NA+ blocker
• MOA – blocks sodium channels increasing the recovery period after repolarization. Suppresses automaticity in the His-Purkinje system and depolarization in the ventricles.
• Indication – Ventricular arrhythmias
• Contraindications - AV block, Bleeding, thrombocytopenia, Use caution in bradycardia, hypovolemia, cardiogenic shock, adams stokes syndrome, WPW
• Side effects – Toxicity ( signs may include anxiety, apprehension, euphoria, nervousness, disorientation, dizziness, blurred vision, facial paresthesias, tremors, hearing disturbances, slurred speech, seizures, sinus bradycardia.) Seizures without warning, cardiac arrhythmias, hypotension, cardiac arrest, pain at injection site. 
• Dosing 

Pulseless v- tach and v-fib

Adult: – 1-1.5mg/kg IV/IO may repeat at half the original dose (0.5 to 0.75mg/kg) every 5-10 mins to a max dose of 3mg/kg. 

Maintenance drip 1-4mg/min

Pedi:  1mg/kg IV/IO (max 100mg) 

Maintenance

20-50 mcg/kg/min

Perfusing ventricular rhythms 

Adult: 0.5-0.75mg/kg IV/IO repeat every 5-10mins to a max dose of 3mg/kg

Pedi: 1mg/kg IV/IO may repeat every 5-10 mins to a max of 3mg/kg