Drug Reference
Rhythm
Lidocaine
Class IB antiarrhythmic (Na⁺ channel blocker)
IndicationAdultPediatric
Cardiac arrestAdult1–1.5 mg/kg IV/IO; then 0.5–0.75 mg/kg every 5–10 min, max 3 mg/kgPeds1 mg/kg loading dose
Maintenance (after ROSC)Adult1–4 mg/min infusionPeds20–50 mcg/kg/min
Indications
- VF / pVT (alternative to amiodarone)
- Stable monomorphic VT
- TCA-related ventricular arrhythmias refractory to bicarbonate
Contraindications & cautions
- High-degree AV block without pacer
- Prophylactic use in AMI
Key pearls
- Toxicity: perioral numbness, tinnitus, confusion, seizures
- Reduce maintenance in liver disease and heart failure