Anticoagulation, endocrine and GI
Lidocaine (Xylocaine) drip
Xylocaine
Dosing
| Start | After a 1–1.5 mg/kg bolus, 1–4 mg/min |
|---|---|
| Titrate | By rhythm response; rebolus 0.5–0.75 mg/kg for recurrence |
| Maximum | 4 mg/min |
| Common bags | 2,000 mg in 500 mL (4 mg/mL); 1,000 mg in 250 mL (4 mg/mL) |
| Dose units | mg/min |
Line and administration
- Peripheral or central
Watch for
- Toxicity: perioral numbness, tinnitus, confusion, seizures
- Lower doses in liver failure, heart failure and older adults
Lidocaine: full drug monographIndications, mechanism, pharmacokinetics, cautions and every dose the app lists.
In the one-pagers
- ACLS Algorithms in BriefCardiac arrest: two tracks: Exam order: shock, CPR, shock, epinephrine, shock, amiodarone or lidocaine. Epinephrine every 3–5 min is about every other 2-minute cycle.
- Pediatric Assessment and EmergenciesCardiac arrest and choking (2025): Antiarrhythmic: Amiodarone 5 mg/kg (max 300 mg; up to 3 doses, repeats max 150 mg) or lidocaine 1 mg/kg
- CEN: HEENT EmergenciesEar: Live insect: Kill it first (lidocaine 2%, mineral oil or alcohol), then remove under vision: Instill anything if the eardrum may be perforated
- Chest Tubes and PneumothoraxHemothorax, effusions and pleural infection: Measure pH at once in a blood-gas analyzer: heparin or lidocaine in the syringe lowers it, delay and air raise it. BTS 2023 drains pleural infection with tubes of 14 F or less, flushed with about 30 mL saline every 6–8 hours, plus antibiotics and nutrition. Up to 20% die within a year; the RAPID score (urea, age, purulence, infection source, albumin) st
- Spinal Motion RestrictionAutonomic dysreflexia: Bladder first: trace the catheter for kinks or a full bag, irrigate gently with 10–15 mL of body-temperature saline and replace it if blocked, or catheterize with 2% lidocaine jelly. No Credé.
- Toxidromes and AntidotesCardiotoxic drugs: TCAs, β-blockers, CCBs, digoxin, LAST: Hypertonic sodium bicarbonate works through the sodium load and the alkalemia: AHA 2023 class 1 for TCAs, 2a for other sodium channel blockers (diphenhydramine, flecainide, lamotrigine, venlafaxine). Bolus until the QRS narrows, within AHA's ceilings (pH 7.50–7.55, sodium 150–155). Treat seizures with benzodiazepines, not phenytoin, and nev
Practice ACLS Algorithms in Brief questions free153 exam-style questions with rationales on the topic where lidocaine comes up most. No account or download needed.
Other anticoagulation, endocrine and gi
- Heparin
- Insulin (regular)
- Amiodarone
- Diltiazem
- Octreotide
- Pantoprazole
- Furosemide
- Argatroban
- Bivalirudin
- Procainamide
- Magnesium sulfate
- Naloxone
- Eptifibatide
- Bumetanide
Practice free in your browser3,800+ exam-style questions with rationales. No account, no ads. Also free on the App Store and Google Play.
For education and exam preparation only. Follow your institution’s protocols. Study aid: check every dose against the order, the bag label, your pump library and your institution's protocol.