Antidysrhythmics lidocaine

Can be considered oral lidocaine antidysrhythmic drugs have not been shown to improve survival in patients with ventricular dysrhythmias class I antidysrhythmic drugs (e.g., tocainide) have increased the risk of death when used in patients with nondife-threatening dysrhythmias... 

Cardiovascular effects due to enhanced sympathetic activity include tachycardia, increased cardiac output, vasoconstriction, and increased arterial pressure. Myocardial infarction is the most common adverse cardiac effect (43), and there is an increased risk of myocardial depression when amide-type local anesthetics, such as bupivacaine, levobupivacaine, lidocaine, or ropivacaine are administered with antidysrhythmic drugs. 

Lidocaine is the most widely used aminoamide local anesthetic agent, with a low toxic potential its effects are mostly typical for this class of drug. It can be given by injection or topically and is also combined with prilocaine in Emla for topical administration. It is also used as an antidysrhythmic drug and has occasionally been used in other conditions, such as multiple sclerosis, chronic daily headache, migraine and cluster headaches, and neuropathic pain, such as postherpetic neuralgia. 

The pharmacokinetics and safety of the 5% lidocaine patches have been studied in 20 healthy volunteers, who applied four patches to the skin either every 24 hours or every 12 hours for 3 days (67). Mean steady-state plasma concentrations were 186 and 225 ng/ml respectively, well below those required for an antidysrhythmic effect (1500 ng/ml) or a risk of toxicity (5000 ng/ml). The patches were well tolerated, with no major cutaneous adverse effects. This is in line with data from postmarketing surveillance studies, which have shown that since the availability of lidocaine patches in 1999, no adverse cardiac or other serious adverse events have been reported (68). 

Mexiletine is a class Ib antidysrhythmic drug, similar in action to lidocaine, but it can be given orally. Its adverse effects occur in up to 50% of patients (1) and withdrawal is often necessary (2). The most common adverse effects are on the cardiovascular and central nervous systems. The pharmacokinetics, clinical use, and adverse effects and interactions of mexiletine have been reviewed widely (3-8). 

The nurse is preparing to administer 2 g/500 mL of lidocaine, an antidysrhythmic, after administering a 100 mg intravenous bolus to a client with multifocal premature ventricular contractions (PVC). Which intervention should the nurse implement ... 

Lidocaine, an antidysrhythmic, is a drug of choice for treating ventrienlar dysrhythmias. 

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