Initially, 1 to mg/kg IV. If ventricular fibrillation or pulseless ventricular tachycardia persist, additional to mg/kg IV doses can be given every 5 to 10 minutes up to a total loading dose of 3 mg/kg. The same dose may be given via the intraosseous route when IV access is not available. There is inadequate evidence to support the routine use of lidocaine after cardiac arrest; however, the initiation or continuation of lidocaine may be considered after return of spontaneous circulation (ROSC) from cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia. If a maintenance lidocaine infusion is warranted for an individual patient, administer 1 to 4 mg/minute (30 to 50 mcg/kg/minute) IV. Use lower infusion rates for patients who are elderly, have heart failure or hepatic disease, or are debilitated. Lidocaine is considered an alternative antiarrhythmic to amiodarone for this indication, particularly when amiodarone is not available. Lidocaine is convenient to administer but is not as effective as amiodarone for improving ROSC or survival to hospital admission among adult patients with VF refractory to a shock and epinephrine. Neither drug has been shown to improve survival to hospital discharge in cardiac arrest patients with VF.
Some side effects associated with spinal puncture include bruising, bleeding, infections, headaches, and blood clots. Cortisone side effects may cause weight gain, water retention, hot flashes, mood swings or insomnia, and elevated blood sugar levels in people with diabetes. Epidural steroid injections can provide diagnostic and therapeutic benefits. ESIs have been endorsed by the North American Spine Society and the Agency for Healthcare Research and Quality of the Department of Health and Human Services. Discuss this procedure with your friendly and caring doctor at the Florida Spine Institute to determine whether it is the right treatment for you.
Dexamethasone has also been used during pregnancy as an off-label prenatal treatment for the symptoms of congenital adrenal hyperplasia (CAH) in female fetuses. CAH causes a variety of physical abnormalities, notably ambiguous genitalia in girls. Early prenatal CAH treatment has been shown to reduce some CAH symptoms, but it does not treat the underlying congenital disorder . This use is controversial: it is inadequately studied, only around one in ten of the foetuses of women treated are at risk of the condition, and serious adverse events have been documented.  Experimental use of dexamethasone in pregnancy for foetal CAH treatment was discontinued in Sweden when one in five cases suffered adverse events.