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George G. Zhanel, PharmD; Barry E. Bleske, PharmD
University of Minnesota College of Pharmacy Minneapolis

JAMA. 1986;255(24):3361-3362.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The efficacy of intravenous lidocaine in the control of ventricular arrhythmias has been documented.¹ However, drawbacks such as short elimination half-life and extensive first-pass hepatic extraction have precluded its use as an oral agent. Tocainide, a lidocaine congener, can be administered orally and is particularly effective for treating ventricular arrhythmias that are responsive to lidocaine.^2,3

Recent encounters with patients requiring conversion from intravenous lidocaine to oral tocainide prompted a review of the literature for an effective conversion procedure.

Upward et al⁴ studied 43 subjects (four of which were not included in data analysis) admitted to the coronary care unit following suspected acute myocardial infarction. Each subject received a 100-mg intravenous loading dose of lidocaine, followed by an intravenous infusion of 2 mg/min. After a minimum of 18 hours, oral tocainide treatment was initiated, with each subject receiving three doses of tocainide using one of . . . [Full Text PDF of this Article]

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