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Pronunciation |
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(LYE
doe kane & ep i NEF
rin) |
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U.S. Brand
Names |
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Octocaine® Injection; Xylocaine®
With
Epinephrine |
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Generic
Available |
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Yes |
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Synonyms |
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Epinephrine and Lidocaine |
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Pharmacological Index |
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Local Anesthetic |
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Use |
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Dental: Amide-type anesthetic used for local infiltration anesthesia;
injection near nerve trunks to produce nerve block
Medical: Local infiltration anesthesia; AVS for nerve block
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Pregnancy Risk
Factor |
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B |
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Contraindications |
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Hypersensitivity to local anesthetics of the amide type, myasthenia gravis,
shock, or cardiac conduction disease |
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Warnings/Precautions |
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Do not use solutions in distal portions of the body (digits, nose, ears,
penis); use with caution in endocrine, heart, hepatic, or thyroid
disease |
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Adverse
Reactions |
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Refer to Lidocaine monograph |
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Overdosage/Toxicology |
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Refer to Lidocaine monograph |
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Drug
Interactions |
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Due to epinephrine component, use with tricyclic antidepressants or MAO
inhibitors could result in increased pressor response; use with nonselective
beta-blockers (ie, propranolol) could result in serious hypertension and reflex
bradycardia |
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Stability |
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Solutions with epinephrine should be protected from
light |
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Mechanism of
Action |
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Lidocaine blocks both the initiation and conduction of nerve impulses via
decreased permeability of sodium ions; epinephrine increases the duration of
action of lidocaine by causing vasoconstriction (via alpha effects) which slows
the vascular absorption of lidocaine |
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Pharmacodynamics/Kinetics |
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Peak effect: Within 5 minutes
Duration: ~2 hours, dependent on dose and anesthetic procedure
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Usual Dosage |
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Children: Use lidocaine concentrations of 0.5% to 1% (or even more diluted)
to decrease possibility of toxicity; lidocaine dose should not exceed 7
mg/kg/dose; do not repeat within 2 hours
Adults: Dosage varies with the anesthetic procedure, degree of anesthesia
needed, vascularity of tissue, duration of anesthesia required, and physical
condition of patient |
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Dietary
Considerations |
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No data reported |
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Administration |
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Before injecting, withdraw syringe plunger to ensure injection is not into
vein or artery |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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See individual agents |
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Nursing
Implications |
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Before injecting, withdraw syringe plunger to ensure injection is not into
vein or artery |
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Dosage Forms |
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Injection with epinephrine:
1:100,000: Lidocaine hydrochloride 1% [10 mg/mL] (20 mL, 50 mL); 2% [20
mg/mL] (1.8 mL, 20 mL, 50 mL)
1:50,000: Lidocaine hydrochloride 2% [20 mg/mL] (1.8 mL)
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References |
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Jastak JT and Yagiela JA,
"Vasoconstrictors and Local Anesthesia: A Review and Rationale for Use," J Am
Dent Assoc, 1983, 107(4):623-30.
MacKenzie TA and Young ER, "Local Anesthetic Update," Anesth Prog,
1993, 40(2):29-34.
Wynn RL, "Epinephrine Interactions With Beta-Blockers," Gen Dent,
1994, 42(1):16, 18.
Wynn RL, "Recent Research on Mechanisms of Local Anesthetics," Gen
Dent, 1995, 43(4):316-8.
Yagiela JA, "Local Anesthetics," Anesth Prog, 1991, 38(4-5):128-41.
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Copyright © 1978-2000 Lexi-Comp Inc. All Rights Reserved
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