Pregnancy Classes

• Suppresses automaticity of myocardial tissue by raising the threshold required for depolarization

• Acute treatment of ventricular arrhythmias (eg, due to acute myocardial infarction)

• Hypersensitivity to another local anesthetic
• Adam-Stokes syndrome
• Wolff-Parkinson-White syndrome
• Sick sinus syndrome, second- or third-degree atrioventricular block without a functioning artificial pacemaker
• Premixed injection may contain corn-derived dextrose and its use is contraindicated in patients with allergy to corn or corn-related products

Adult

Ventricular Arrhythmias

IV, IO: 1 to 1.5 mg/kg bolus. If refractory ventricular fibrillation or pulseless ventricular tachycardia, repeat 0.5 to 0.75 mg/kg bolus every 5 to 10 minutes (maximum cumulative dose: 3 mg/kg). Follow with continuous infusion after return of perfusion.

Pediatric

Ventricular Arrhythmias

IV, IO: 1 mg/kg/dose; follow with continuous IV infusion

45 seconds

10 to 20 minutes

• Monitoring: Constant ECG monitoring is necessary during IV administration
• Disease-related concerns: Use cautiously in hepatic impairment, heart failure, hypoxia, severe respiratory depression, hypovolemia, history of malignant hyperthermia, or shock.
• Amiodarone vs lidocaine: There is no significant difference between lidocaine and amiodarone in terms of the patient-important outcomes of survival to hospital discharge and neurologically intact survival. The 2020 AHA guidelines state that either lidocaine or amiodarone can be administered during cardiac arrest for VT/VF refractory to shocks and epinephrine

• Respiratory
  • Bronchospasm
• Cardiovascular
  • Cardiac arrest
  • Arrhythmias
  • Bradycardia
  • Heart block
  • Hypotension
• Gastrointestinal
  • Nausea and vomiting
• Central nervous system
  • Seizures
  • Confusion
  • Drowsiness
  • Blurred vision
  • Dizziness
  • Nervousness
  • Slurred speech