利多卡因

用途

• Antiarrhythmic
• Antiarrhythmic
• Epidural
• Ventricular tachyarrhythmias
• Ventricular tachyarrhythmias
• Postoperative ileus
• Colic patients
• Immediate treatment of ventricular tachycardia
• Rapid conversion of life-threatening, incessant, unstable ventricular tachycardia
• Ventricular arrhythmias
• Analgesic agent (CRI)
• Analgesic agent (MLK mixture)
• Analgesic agent
• Analgesic agent

給藥方式

可能的副作用

• CNS toxicity (dose-related): drowsiness, depression, ataxia, nystagmus, muscle tremors, seizures
• Gastrointestinal: nausea and vomiting (usually transient)
• Cardiovascular: hypotension (especially with rapid IV bolus), bradycardia, PR and QRS interval prolongation, circulatory collapse at toxic doses
• Cats: heightened risk of severe cardiodepression and CNS signs
• Depression
• Seizures
• Muscle fasciculations
• Vomiting
• Bradycardia
• Hypotension
• Laryngeal oedema (in cats, associated with CFC propellants in unlicensed aerosols)

注意事項與禁忌

• Known hypersensitivity to amide-class local anesthetics
• Severe SA, AV, or intraventricular heart block (unless artificially paced)
• Adams-Stokes syndrome
• Intravenous use of lidocaine products containing epinephrine
• Continuous rate infusion (CRI) in cats during the perioperative period (due to negative haemodynamic effects)
• Intravenous administration of lidocaine solutions containing adrenaline
• Use of adrenaline-containing solutions for complete ring block of an extremity (danger of ischaemic necrosis)
• Use with extreme caution in cats due to heightened sensitivity to CNS and cardiodepressant effects. Use cautiously in patients with liver disease, congestive heart failure, shock, hypovolemia, severe respiratory depression, or marked hypoxia. Patients susceptible to malignant hyperthermia require intensified monitoring. NEVER administer lidocaine containing epinephrine intravenously.

藥物相互作用

• Gas Anesthetics (Isoflurane, Sevoflurane): Lidocaine infusions reduce MAC requirements. Additive cardiodepression may occur, especially in cats.
• Other Antiarrhythmics (Procainamide, Quinidine, Propranolol): May cause additive or antagonistic cardiac effects; enhanced risk of toxicity.
• Cimetidine: May decrease lidocaine clearance, increasing lidocaine levels and effects.
• Furosemide: Diuretic-induced hypokalemia may reduce the antiarrhythmic efficacy of lidocaine.
• Phenobarbital / Phenytoin: May induce hepatic enzymes, increasing lidocaine metabolism and decreasing its serum levels.
• Propranolol: May decrease hepatic blood flow and lidocaine clearance, increasing lidocaine levels.
• Succinylcholine: Large doses of lidocaine may prolong succinylcholine-induced apnea.
• Other antiarrhythmics: May cause increased myocardial depression

常見問題