Lidocain ppt

1. LIDOCAINE:: THE GOLD STANDARD DRUG PRESENTED BY-VANDITA SINGH

2. Lidocaine Lidocaine, 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

3. Indications Rapid 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 Operative Neuropathic pain

4. Pharmacology Half life: 1.6 hrs(~90 min) Distribution: Lipo-philic, widely distributed into body pH of plain solution-6.5 pH of vasoconstrictor containing solution-5.0-5.5 Onset of action –rapid Pregnancy clissification -B Effective dental concentration-2% Protein binding: 60-80 %

5. 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

6. 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

7. MECHANISM OF ACTION Alters depolarization in neurons by blocking the fast voltage gated sodium (Na+) channels in the cell membrane. With sufficient blockade, the membrane of the presynaptic neuron will not depolarize and so fail to transmit an action potential, leading to its anaesthetic effects

8. 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

9. ROUTES OF ADMINISTRATION Intravenous injection (sometimes combined with epinephrine) Dermal patch (sometimes combined with prilocaine) Nasal instillation/spray (combined with phenylephrine) Topical gel

10. 2% WITHOUT VASOCONSTRICTOR (LIDOCAIN PLAIN) 2% WITH EPINEPHRINE 1:50,000 2% WITH EPINEPHRINE 1:100,000 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

11. Intravenous Lidocaine for Ambulatory Anesthesia Christopher L. Wu, MD ,Inter Anes Research Society ,Dec . 2009 Using 1.5–3 mg kg\ h lidocaine significantly reduced the incidence of nausea and vomiting (32% vs 52%), Marginally reduced pain scores .

12. ADVERSE EFFECTS

13. OVERDOSE

14. CONTRAINDICATIONS

15. EUTECTIC MIXTURE OF LOCAL ANESTHETICS (EMLA)- LIDOCAINE & PRILOCAINE Eutectic mixture refers to lowering of melting point of two solids when they are mixed Lidocaine+Prilocaine at 25 o C Oil emulsified into water to form a cream

16. 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