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Lidocaine(Lignocaine) 💊
💉 Lignocaine (Lidocaine) is widely used as both a local anaesthetic and an antiarrhythmic drug. It should only be administered by, or under the direct supervision of, trained personnel with skills in anaesthesia and airway management. ⚠️ It must not be given parenterally without adequate resuscitation facilities available.
About: Always check the BNF link here
- ⚡ Class Ib antiarrhythmic agent.
- 🧪 Rapidly hydrolysed in the gut and undergoes extensive first-pass metabolism in the liver → therefore given IV (not orally).
Indications
- 🚑 Ventricular tachycardia (VT).
- 🚑 Ventricular fibrillation (VF).
- ❌ Not used in supraventricular tachycardia (SVT).
- ❌ Not recommended for non-sustained VT or ventricular ectopics (generally no treatment needed).
Cautions
- ⚠️ Heart block.
- ⚠️ Severe hepatic impairment (reduced metabolism → toxicity risk).
Interactions
- 💊 See BNF for full list (notably interacts with other antiarrhythmics and drugs affecting hepatic metabolism).
Side Effects
- ❤️ Bradycardia, hypotension, asystolic arrest (with toxicity).
- 🤢 Nausea, vomiting, paraesthesia.
- ⚡ Neurological: seizures, confusion, coma.
Dose
- CPR (when amiodarone unavailable or contraindicated): Lidocaine 1–2 mg/kg IV bolus (do not exceed 3 mg/kg in the first hour). Typical dose: 50–100 mg IV over 2–5 minutes (≈1 mg/kg), followed by further boluses up to 200 mg within 30 min, then infusion.
- Ventricular Arrhythmias:
100 mg IV bolus over a few minutes → followed by:
- IV infusion 4 mg/min for 30 min
- then 2 mg/min for 2 hours
- then 1 mg/min (reduce further if continued >24 hrs).
References
| The content on this website is provided for educational and informational purposes only to support exam preparation (e.g., MLA, MRCP, USMLE) and learning. This is NOT medical advice, diagnosis, treatment, or professional guidance. It does not replace consultation with a qualified healthcare professional, official guidelines (e.g., NICE, GMC, BNF), or supervised clinical practice. Always verify information with current, authoritative sources. Makindo and its contributors accept no liability for any reliance on this content, including errors, omissions, or any resulting harm, loss, or consequences. By using this site, you agree to these terms. |
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