Lidocaine
Class Ib
| IV Dose | Loading does: 1 mg/kg, given no faster than 50 mg/min. May repeat twice q 5-10 mins. Drip 20-50 ug/kg/min. Decrease rate by 50% at 24 hours! |
| Oral dose | No PO form (although mexiletine is similar) |
| Levels | 1.5-5 ug/ml. Toxicity (esp. confusion) frequent >6 ug/ml. |
| Kinetics | Elimination half-life 1.8 hours in adults and children aged 6 m- 3 years, 3.2 hours in neonates. Decreased clearance in congestive heart failure. |
| Cautions | Vertigo, paraesthesias, slurred speech and confusion are the first signs of toxicity. |
| Interactions | Propranolol decreases liver blood flow and lidocaine clearance. Isoproterenol, phenobarbital, phenytoin increase clearance. |
| Preparations | Xylocaine injection, 100 mg/5 cc (amps or syringes) |
| FDA approval in children | yes |