Ketamine.pdf

GENERIC NAME lidocaine TRADE, BRAND, OR PROPRIETARY NAME • Xylocaine® CLASS • Antidysrhythmic STANDARD SUPPLIES • Prefilled syringe • Premix bag MECHANISMS OF ACTION • Suppresses ventricular ectopic activity • Increases the threshold of ventricular fibrillation INDICATIONS • Ventricular fibrillati...

GENERIC NAME lidocaine TRADE, BRAND, OR PROPRIETARY NAME • Xylocaine® CLASS • Antidysrhythmic STANDARD SUPPLIES • Prefilled syringe • Premix bag MECHANISMS OF ACTION • Suppresses ventricular ectopic activity • Increases the threshold of ventricular fibrillation INDICATIONS • Ventricular fibrillation • Ventricular tachycardia • Ventricular dysrhythmias o Frequent premature ventricular complexes and couplets o Monomorphic wide-complex tachycardia CONTRAINDICATIONS • Known hypersensitivity to the drug • Premature ventricular complexes in conjunction with bradycardia • Second-degree and third-degree heart block ADVERSE REACTIONS/SIDE EFFECTS • Drowsiness • Confusion • Anxiety • Dizziness ROUTES OF ADMINISTRATION • IV • IO • ET • Infusion ONSET OF ACTION • 1 to 5 minutes LIDOCAINE 1 ADULT DOSAGES • VF and pulseless VT: 1.0 to 1.5 mg/kg • May repeat the dosage 0.5 to 0.75 mg/kg every 3 to 5 minutes during resuscitation • Maximum dosage 3.0 mg/kg • Ventricular dysrhythmias with a pulse: 1.0 to 1.5 mg/kg • May repeat the dosage 0.5 to 0.75 mg/kg in 5 to 10 minutes • Maximum dosage 3.0 mg/kg • Maintenance infusion: 2.0 to 4.0 mg/minute • ET: 2.0 to 2.5 times the bolus dosage diluted in 10 mL normal saline PEDIATRIC DOSAGES • VF and pulseless VT: 1.0 mg/kg • May repeat the dosage 1.0 mg/kg one time in 3 to 5 minutes during resuscitation • Ventricular dysrhythmias with a pulse: 1.0 mg/kg • May repeat the dosage in 5 to 10 minutes • Maximum dosage 3.0 mg/kg • Maintenance infusion: 20 to 50 mcg/kg/minute • ET: 2.0 to 2.5 times the bolus dosage diluted in 3.0 to 5.0 mL normal saline SPECIAL CONSIDERATIONS • Consider decreased dosages for elderly patients and patients with liver disease due to their slower metabolic function • The peak effect of the drug is 5 to 10 minutes • The duration of the drug is 10 to 20 minutes • An infusion pump should be used to administer the drug when possible LIDOCAINE 2