Articaine Flashcards
Articaine was originally synthesised as …
carticaine
In what form is articaine available in?
4% solution
containing 1:100 000 or 1:120 000 adrenaline
What characteristic of articaine is responsible for its increased lipid solubility and thus increased potency?
contains a thiophene ring as opposed to a benzene ring
Briefly outline how articaine is inactivated
- articaine is an amide LA with an ester sidechain hence it can be inactivated by serum esterases; 90% of articaine is hydrolysed
- the amide linkaage undergoes liver transformation
How is articaine excreted?
- articaine following hydrolysis produces inactive articainic acid
- it is then excreted via the liver as articainic acid glucoronide
What is the elimination serum half life of articaine?
20 minutes
What is the elimination serum half-life of articainic acid?
64 minutes
Suggest the reason why articaine is permitted to be used in higher concentrations compared to other amide LAs
- equal analgesic efficacy
- lower systemic toxicity (a wide therapeutic range)
Suggest a reason for increased duration of activity of articaine
high degree of protein binding
There is no correlation between the serum concentration and the local anaesthetic effect of articaine. True or false
True
What is anaesthetic success of sound teeth defined as?
(in healthy volunteers) it is defined as the ability to achieve 2 or more consecutive EPT readings of 80
EPT- electric pulp testing
What supplemental injection increases the success rate of an IANB for articaine when compared to lidocaine ?
a supplemental buccal infiltration
(specifically adjacent to the mandibular 1st molar)
With regards to maxillary extractions, what type of LA may be forgone?
palatal infiltrations
Following a meta-analysis, what LA is most likely to achieve anaesthetic succes in the first molar region? What are the issues with this meta-analysis ?
articaine
(over lidocaine)
However, the meta-analysis did not take into account
* local inflammation
* varying LA administration techniques e.g. IANB
Why are teeth with irreversible pulpitis more difficult to anaesthetise?
- this is because nerves arising from inflammed tissue have altered resting potentials and decreased excitability thresholds