pharmacology question

[firefly101]

I have a medication administration test out this week and we (nursing students) were asked to make medication cards for a list of drugs that we are going to be asked about on test out day (include uses, adverse effects, drug interactions ect). The first drug on the list is Lidocaine 1% (used as dilutant). I am in my first semester of nursing school and have never heard of Lidocaine 1% before. I looked it up in my pharmacology book and drug book and it states that it is used as an antidysrhythmic and local anesthetic. It never mentions using it as a dilutant. I started googling it and am seeing results like "for ceftriaxone in the treatment of gonorrhea" and " administering with benzathine penicillin - may reduce discomfort" but have no idea if this is the kind of information I need. I was wondering if I could have some guidance?

[hodgieRN]

Lido is basically a medication that causes numbness. If you are gonna get sutures, injecting Lido will numb the area. If given in a high enough dose iv, it can help with arrythmias (but there are better meds these days).

But to answer your question as a dilutant...When injected, ceftraxone and PCN can burn really, really bad. If you mix it with saline or water for injection, pts will immediately grimace upon injection. Plus, they will be really, really sore afterwards. But, if you mix with lidocaine, the lido will numb the injected area and the burn will immediately go away. Most ER nurses know this trick. So, a pt in ER that needs gonorrhea treatment will get one of the antibiotics...But the pt that leaves limping had the nurse who didn't use lidocaine to dilute the Rocephin. (And if this is the pt's 5th time getting an STD in 3 months, the lido might not have used on purpose!) Plus, PCN is super thick....like toothpaste. Just the displacement of an intramuscular injection can hurt. Then, throw in the burning once the medicine sets in.

FYI, there are other uses for Lido. You can get it in gel form and use it as lubrication for foley cath instead of normal KY jelly. The cath goes in and the urethra goes numb! No pain. You can also put lidocaine in a nebulizer and have the pt inhale it to decrease the gag reflex during foreign body removal in the throat or during a bronoscopy. You can use Lido gel to use as lubricant for inserting NG tubes. Any mucous membranes exposed to the Lido will instantly go numb and the pt won't even notice the huge NG sticking in the back of the throat. When a pt needs to be intubated and place on a ventilator, giving Lidocaine 100 mg IV push right before intubation causes a temporary decrease in intracranial pressure (ICP). New sports medicine surgeons use continuous Lido infusions locally for acute surgical pain. So, if you get your shoulder re-done, instead of flooding your body with narcotics, they place a small cateter inside the wound with a pump, which acts a regional blockade. PO pain meds are not needed. They have better outcomes, better mobility, and recover faster without the side effects of pain meds. If your shoulder hurts, they simply increase the lido infusion and there is zero pain locally.

There is a Lido solution made specifically for the eye (eye drops). A pt with pink eye, conjunctivitis, or corneal abrasion can use Lido drops if there is any eye pain and the area will become numb. Pediatrics uses lido gel/ patches to topically numb the skin before starting and IV.

Just make sure the pt doesn't have a lidocaine allergy :)

Hope this helps!

hodgie

[nurseprnRN, BSN, RN]

More commonly used for regional anesthesia or analgesia than lidocaine 1%-- marcaine, for example, will last up to 24-36 hours, whereas lido wears off in a few hours. I'd shoot an anesthesiologist who put 1% lido in my pain management infusion grenade-- marcaine is your friend.

[firefly101]

thank you this was very helpful!

[Esme12, ASN, BSN, RN]

https://allnurses.com/pharmacology-flashcards-drug-cards-t394218/