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Questions and Answers
What therapeutic range is considered safe for lidocaine?
Which of the following conditions is a contraindication for the use of lidocaine?
What is a common side effect of lidocaine?
In patients with hepatic disease, what might be necessary when administering lidocaine?
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What serious effect can occur with lidocaine toxicity?
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Which scenario might require careful monitoring when using lidocaine due to its potential effects on the QRS duration?
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What possible effect does lidocaine have on the clearance of other drugs?
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What major concern is associated with the metabolites of lidocaine in relation to toxicity?
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In which condition is lidocaine particularly contraindicated due to safety concerns?
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Which factor is likely to necessitate a dose reduction when administering lidocaine?
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What distinguishes lidocaine's effectiveness as an antiarrhythmic from mexiletine?
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Which statement about the elimination half-life of lidocaine and mexiletine is accurate?
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Why is lidocaine ineffective when administered orally?
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What was the primary goal in the development of mexiletine?
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How does the metabolism of mexiletine compare to that of lidocaine?
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Study Notes
Lidocaine Therapeutic Range
- The safe therapeutic range for lidocaine is 1.5-5.0 mcg/mL.
Lidocaine Contraindications
- Known allergy to amides is a contraindication to lidocaine use.
Lidocaine Side Effects
- A common side effect of lidocaine is neurotoxicity, which presents with symptoms like dizziness, tinnitus, and paresthesia.
Lidocaine and Hepatic Disease
- Patients with hepatic disease may require a reduced dose of lidocaine due to decreased metabolism.
Lidocaine Toxicity
- Severe lidocaine toxicity can result in cardiac arrhythmias and even cardiac arrest.
Lidocaine
- Lidocaine is an anti-arrhythmic drug used to treat life-threatening ventricular arrhythmias.
- It is administered intravenously.
- The therapeutic range for lidocaine is 1.5-5 mcg/mL.
- Lidocaine is metabolized in the liver (high extraction – first pass) which means that patients with hepatic disease may require dose reduction.
- Toxicity can occur in patients with renal dysfunction.
- Lidocaine is contraindicated in patients with sensitivity to local anesthetics and Wolf-Parkinson-White syndrome.
- Precautions should be taken with lidocaine use in patients with prolonged QRS duration, 2nd or 3rd degree heart block.
- Common side effects include CNS symptoms like dizziness, headache, lightheadedness, numbness, blurred vision, slurred speech, and paresthesia.
- Serious side effects can include hypotension, QRS widening, tremor, and seizures.
- Drug interactions can decrease the clearance of Amiodarone and Propranolol.
- Lidocaine metabolites also contribute to toxicity.
- Both loading and maintenance doses are required for lidocaine therapy
- Lidocaine is also used for nerve block and is available in formulations for epidural administration.
Lidocaine vs Mexiletine
- Lidocaine is an antiarrhythmic drug effective when administered intravenously
- Lidocaine is ineffective orally due to rapid metabolism in the liver
- Mexiletine is an orally active antiarrhythmic
- Mexiletine has a slower metabolic rate compared to lidocaine
- Lidocaine has an elimination half-life of 1.5 to 2 hours
- Mexiletine has an elimination half-life of 10 to 12 hours
- Mexiletine was developed to overcome the rapid hydrolysis seen with Lidocaine
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Description
This quiz covers important aspects of lidocaine, including its use in treating ventricular arrhythmia, metabolism, contraindications, and adverse effects. Understand the therapeutic range, necessary precautions, and dosing strategies for effective and safe lidocaine administration in clinical practice.
