lidocain ppt
DESCRIPTION
TRANSCRIPT
LIDOCAINE::THE GOLD STANDARD DRUG
PRESENTED BY-VANDITA SINGH
LidocaineLidocaine, the first amino amide-type local anesthetic,
was first synthesized under the name Xylocaine by Swedish chemist Nils Löfgren in 1943.
FDA Approved-November 1948
IndicationsRapid acting local anesthetic for procedures
ranging from infiltration to regional nerve block Antiarrhythmic in the treatment of vent.
arrhythmias Treatment of status epilepticus (INVESTIGATIONAL)
Treatment of pain OperativeNeuropathic pain
PharmacologyHalf life: 1.6 hrs(~90 min)Distribution: Lipo-philic, widely distributed into
bodypH of plain solution-6.5pH of vasoconstrictor containing solution-5.0-5.5Onset of action –rapidPregnancy clissification-BEffective dental concentration-2%Protein binding: 60-80 %
MAXIMUM RECOMMENDED DOSE
The max. manufactures recommended dose of lidocaine with epinephrine is 7.0mg/kg body weight for adult patient,not to exeed dose of 500mg.
4.4mg/kg body weight dose of lidocaine without a vasoconstrictor
ACTIONS
ON CNS
(i) Blocks conduction around a nerve
Anaesthesia(ii) Initially causes drowsiness & lethargy(iii) Higher doses cause excitation followed by depression
ON CVS
Heart Blood vessels
Abbreviates Vasodilatation in Effective the injected area Refractory Period
MECHANISM OF ACTION
Alters depolarization inneurons by blocking the fastvoltage gated sodium (Na+)channels in the cellmembrane. With sufficientblockade, the membrane ofthe presynaptic neuron willnot depolarize and so fail totransmit an action potential,leading to its anaestheticeffects
PHARMACOKINETICS
Absorption:Absorbed rapidly after parenteral administration & from GIT & Respiratory Tract
Metabolism: Metabolized in the liver Excretion: Metabolites and
unchanged drug are excreted by the kidneys in the urine
ROUTES OF ADMINISTRATION
Intravenous injection (sometimes combined with epinephrine)
Dermal patch (sometimes combined with prilocaine)
Nasal instillation/spray (combined with phenylephrine)
Topical gel
Its vasodilating effect limits
pulpal anesthesia to
only 5-10min.
This leads to higher blood
levels& increased
risk of adverse reaction
The inclusion of
epinephrine produces a decrease in blood flow leading to
decrease in bleeding at the site of injection.Increased duration-~60min of
pulpal anesthesia
Decreases blood flow .Increases
duration of action~60min of pulpal anesthesia.
2% WITHOUT VASOCONSTRICTOR(LIDOCAIN PLAIN)
2% WITH EPINEPHRINE1:50,000
2% WITHEPINEPHRINE1:100,000
The duration &depth obtained with both lidocaine-epinephrine solution are equivalent although not the same level of hemostasis.{2%lidocaine with 1:50,000
epinephrine is recommended because it decrease bleeding by 50% as compared with 1:100,000
epinephrene dilution}
DIFFERENT FORMS OF LIDOCAINE
Intravenous Lidocaine for AmbulatoryAnesthesia
Christopher L. Wu, MD ,Inter Anes Research Society,Dec. 2009
Using 1.5–3 mg kg\ hlidocaine significantly reduced the incidence of nausea and vomiting (32% vs 52%), Marginally reduced pain scores .
ADVERSE EFFECTS
OVERDOSE
CONTRAINDICATIONS
EUTECTIC MIXTURE OF LOCAL ANESTHETICS (EMLA)- LIDOCAINE &
PRILOCAINEEutectic mixture refers to
lowering of melting point of two solids when they are mixed
Lidocaine+Prilocaine at 25oC
Oil emulsified into water to form a cream
CLINICAL USES/ INDICATIONS
Dermal anaesthesia, specifically applied to prevent pain associated with intravenous catheter insertion, blood sampling, superficial surgical procedures on intact skin & mucous membranes
Topical anaesthesia for cleansing or debridement of ulcers, to numb the skin before tattooing as well as laser hair removal