Pharmacology - Lidocaine
Effect of Lidocaine Blocks the conduction of action potentials in nerves. At lower concentrations, it blocks pain fibers with smaller diameters. Action Mechanism The blocking of intracellular voltage-gated Na+ channels occurs in a dose-dependent manner. Transports itself across cell membranes in its uncharged, lipid-soluble state. Weakly basic local anesthetics (LAs) are more effective at ionizing in tissues with inflammation because of the lower pH. Injection or topical administration (gel, solution, patch). Goes through membranes with ease. The liver is the primary site of amide LA metabolism for lidocaine and other similar drugs.The half-life is measured in hours. Application in Clinical Practice Various types of anesthesia, including surface and injection anesthesia, nerve blocks (used in dental procedures), and epidural and spinal anesthesia (occasionally paired with opioids). It is possible to add adrenaline to decrease blood loss. Eutectic mixture of lidocaine and prilocaine, or EMLA for short, is a popular topical formulation. Heart rhythm abnormalities Unwanted Effects Very few side effects. Seizures and heart depression can be caused by a high plasma concentration. When compared to bupivacaine, lidocaine is associated with a higher incidence of transient neurologic symptoms after epidural administration.
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