ACLS Medications Review: Lidocaine

Here are all the key details, dosage, and additional notes on lidocaine you’ll need to know in order to pass your ACLS exam.

ACLS Medications Review: Lidocaine

Overview of Lidocaine:

Lidocaine is one of several ACLS drugs used to treat cardiac arrest from ventricular tachycardia (VT) and Ventricular Fibrillation (VF). Lidocaine is considered a second-line antiarrhythmic drug and should be administered in VF/VT cases where amiodarone is either unavailable or ineffective. While lidocaine is a well-known and established ACLS medication, there is actually no proven short-term or long-term effectiveness following cardiac arrest. Therefore, use is not recommended routinely after cardiac arrest, but rather should be considered following ROSC.

Lidocaine Dosage:

  • When used to treat cardiac arrest from VT/VF, the initial dose should be 1-1.5 mg/kg IV/IO.
  • For refractory VF, an additional 0.5-0.75 mg/kg IV push may be given, then repeated every 5-10 minutes, with a max of 3 doses or a total of 3 mg/kg.
  • In stable VT situations, doses spanning between 0.5-0.75 mg/kg up to 1.5 mg/kg may be administered. Repeat 0.5-0.75 mg/kg to a max of 3 mg/kg.
  • If maintenance infusion is needed, administer a dose of 1-4 mg/min.

Additional Notes on Lidocaine Usage:

  • Prophylactic use in acute myocardial infarction contraindicated
  • Reduce maintenance doses when there are signs of left ventricular dysfunction or impaired liver function
  • If signs of toxicity materialize, immediately cease lidocaine infusion

For a brief review of all the ACLS medications you should be familiar with, check out the article below. It acts as a great visual reference that will help you study more efficiently and effectively.

Related Article: ACLS Drugs Video Review

Additional ACLS Medications:


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