| Drug/Class | Description | Onset and Duration | Indications | Contraindications | Adverse Reactions | Drug Interactions |
| Drug: Lidocaine
Class: Antidysrythmic (Class I-B), local anesthetic | 1. Decreases phase 4 diastolic depolarization(which decreases automaticity)
2. Suppresses premature ventricular complexes
3. Used to treat v-tach and in some cases v-fib
4. Raises v-fib threshold | Onset: 30-90 sec
Duration: 10-20 min | 1. v-tach
2. v-fib
3. Wide-complex tachycardia of uncertain origin
4. Significant ventricular ectopy in the setting of myocardial ischemia/infarction | 1. Hypersensitivity
2. Adams-Stokes syndrome
3. 2nd or 3rd degree heart block w/o an artificial pacemaker | 1. Light-headedness
2. Confusion
3. Blurred vision
4. Cardiovascular collapse
5. Bradycardia
6. Altered level of conciousness,irritability, muscle twitches, seizureswith high doses | 1. Beta-adrenergic blockers
2. Succyinylcholine
3. IV phenytoin
4. Procainamide and tocainide |
| Drug: Midazolam
Class: Short-acting benzodiazepine | A water soluble benzodiazepine that may be administered for concious sedation to relieve apprehension or impair memory before tracheal intubation or cardioversion | Onset: 1-3 min(IV); dose dependent
Duration: 2-6 hr; dose dependant | Premedication for tracheal intubation, cardioversion, or other painful procedures | 1. Hypersensitivity to midazolam
2. Glaucoma (relative)
3. Shock
4. Coma
5. Alchohol intoxication(relative; may be used for alchohol withdrawal)
6. Depressed vital signs
7.Contaminant use of barbituates, alchohol, narcotics, or other CNS depressants | 1. Respiratory depression
2. Hiccup
3. Cough
4. Oversedation
5. Pain at injection site
6. Nausea/vomiting
7.Headache
8. Blurred vision
9. Fluctuations in vital signs
10. Hypotension
11. Respiratory arrest | Sedative effect may be accentuated by contaminant use of barbituates, alchohol, or narcotics( and therefore should not be used in patients who have taken CNS depressants) |
| Drug: Succinylcholine
Class: Neuromuscular blocker (depolarizing) | Has the quikest onset and briefest duration of all neuromuscular blocking drugs.Binds to the receptors for acetylcholine. Often leads to fasciculations and some muscular contractions | Onset: Less than 1 minute
Duration: 5-10 min after single IV dose | 1. To facilitate intubation
2. Terminating laryngospasm
3. Muscle relaxation | 1. Burns or injuries in the first 12 hours
2. Hypersensitivity 3. Skeletal muscle myopathies
4. Inability to control airway and/or support ventilations with oxygen and positive pressure
5. Personal or family history of malignant hyperthermia | 1. HTN
2. Respiratory depression
3. Bradycardias
4. Dysrythmias
5. Initial muscle fasciculation
6. Excessive salvation
7. Malignant hyperthermia
8. Allergic reaction
9. May exacerbate hyperkalemia in trauma patients | 1. Oxytocin, beta-blockers,chronic contraceptive use, and organophosphates may potentiate effects
2. Diazepam may reduce duration of action
3. Cardiac glyosides may induce dysrythmias |
