1. Used when Lidocaine is ineffective. (suppresses ventricular ectopy and slows intraventricular conduction)
2. Persistent cardiac arrest due to VF.
3. PVCs or recurrent VT

Mix 2 Gms in 500 ml NS or LR.

1 mg/min=15ml/hr
2 mg/min=30ml/hr
3 mg/min=45ml/hr

Bolus 20-50 mg/min

- Dosing: 20-30mg/min until:
1) arrhythmia suppressed
2) hypotension occurs
3) PR or QRS widens by 50% of its original width or MAX dose of 17mg/kg has been given

- if effective, start drip @ 1-4mg/min
* Monitor BP closely during
administration; may cause precipitous hypotension; infuse cautiously in acute MI
* Contraindicated in patients with preexisting long QT intervals or torsades de points.

* Hypokalemia and hypomagnesemia may exacerbate arrhythmias
Give bolus slowly with patient in supine position.
Bolus 100 mg every 5 minutes at a rate of 20-30mg per minute until:
-Arrhythmia is suppressed.
-Hypotension develops.
-QRS is widened by 50%.
-17mg/kg Gm has been given.
Maintenance infusion - 1-4mg per minute.

Mix 2 Gm in 500ml D5W at 15-60cc/Hr.

May be given orally 1 Gm initially, followed by 250-500mg every 3-4 hours.

a. Complete, second, or third degree heart block.
b. CHF,BBB, hepatic or renal impairment.
c. Myasthenia gravis.

a. Treatment of ventricular arrhythmias, especially when lidocaine has been unsuccessful.
b. May be used to treat atrial arrhythmias.

a. Decreases excitability and slows conduction.
b. Depresses automaticity.

Return to Nurse Bob's Page