Tuesday, September 6, 2022

Lidocaine toxicity

Q: How can lidocaine-induced cardiovascular (CVS) toxicity be minimized?

Answer: By reducing the rate of administration

This question aims to highlight the difference between lidocaine-induced neurologic and CVS toxicity. The neurologic toxicity is usually dose-dependent, while CVS toxicity occurs with overdosing and/or due to rapid administration of lidocaine. 

The first warning sign of neurologic toxicity is usually tremors, which can lead to dysarthria, slurred speech, ataxia, agitation, change in sensorium, nystagmus, hallucinations, and seizures. The CVS toxicity is marked by bradycardia which may proceed to asystole.

#pharmacology
#neurology
#cardiology


References:

Rademaker AW, Kellen J, Tam YK, Wyse DG. Character of adverse effects of prophylactic lidocaine in the coronary care unit. Clin Pharmacol Ther 1986; 40:71.

DeToledo JC. Lidocaine and seizures. Ther Drug Monit 2000; 22:320.

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