LA Characteristics Flashcards
Lidocaine trade name
Xylocaine
mepivicaine trade name
Carbocaine
prilocaine trade name
Citanest
Articaine trade name
Septocaine
Bupivicaine trade name
Marcaine
Need for hemostasis
1:50,000 Epi (Lidocaine)
most commonly used LA in dentistry for nerve block
Lidocaine
Lidocaine pulpal anesthesia without Epi
5-10 minutes (not available in US)
Lidocaine time for pulpal anesthesia
1:100,000
1:50,000
both 60 minutes
Lidocaine dosage
3.2 mg/lb
500 mg MRD
Lidocaine available formulations
2% Lidocaine 1:50,000 Epi (green)
2% Lidocaine 1:100,000 Epi (red)
LAs with anticonvulsant properties
Lidocaine and Mepivicaine
LAs without anticonvulsant properties
Prilocaine, Articaine, Bupivicaine
allergic rxn risk of LAs
No risk: Lidocaine, Mepivicaine
Low risk: Prilocaine, Articaine, Bupivicaine
Toxicity risk of LAs
Very low risk: Prilocaine (caution w/ plain)
Low risk: Lidocaine, Mepivicaine, Articaine,
High risk: Bupivicaine
LA vasoactivity
Potent vasodilator: Lidocaine, Articaine, Bupivicaine (most potent)
Weak vasodilator: Mepivacaine, Prilocaine
LAs and ability to be topical anesthetic
Topical: Lidocaine, Prilocaine when combined with Lidocaine
LA metabolism
Lidocaine: liver
Mepivicaine: liver
Prilocaine: lungs (small amt in liver)
Articiane: 90% plasma, 10% liver
Bupivicaine: liver
LA excretion
All in kidney to varying degree excreted unchanged in urine
LAs pregnancy category
Category B: Lidocaine, Prilocaine
Category C: Mepivicaine, Bupivicaine, Articaine
Lactation Safety LAs
Lactation safe: Lidocaine, Mepivicaine
Unknown: Prilocaine, Articaine, Bupivicaine
Good choice if vasoconstrictor is contraindicated
Mepivacaine
Mepivacaine pulpal anesthesia without Epi
20-40 minutes
Mepivacaine pulpal anesthesia 1:20,000 Levo
60 minutes
Mepivacaine dosage
3.0 mg/lb
400 mg MRD
Mepivacaine available formulations
2% Mepivacaine 1:20,000 Levo
3% Mepivacaine PLAIN
LA never used for hemostasis
Mepivacaine
Least toxic LA in dentistry today
Prilocaine
LA best choice for pregnancy and CV patients
Prilocaine
Prilocaine pulpal anesthesia 1:200,000
60-90 minutes
Prilocaine pulpar anesthesia without Epi
40-60 minutes
Risk for methemoglobin if over MRD
Prilocaine
Prilocaine dosage
4.0 mg/lb
600 MRD
Prilocaine available formulations
4% Prilocaine plain
4% Prilocaine 1:200,000 Epi
LA highly lipid soluble with high diffusion through bone
articaine
LA good choice for re-administration or CV disease or liver disease
articaine
articaine pulpal anesthesia
(not available without vasoconstrictor)
1:100,000 Epi = 60-75 minutes
1:200,000 Epi = 45-60 minutes
Possible risk for IA nerve injury (paresthesia)
articaine
Articaine dosage
3.2 mg/lb
MRD = none
Articaine available formulations
4% articaine 1:100,000 Epi
4% articiane 1:200,000 Epi
Most potent and most toxic LA, high lipid soluble + binds strongly
Bupivacaine
LA best choice for long treatment plus post-op pain control
Bupivacaine
bupivacaine pulpal anesthesia
(not available without Epi)
1:200,000 Epi = 1.5-3 hours
Bupivacaine dosage
No mg/lb
90 mg MRD
Bupivacaine available formulations
0.5% Bupivacaine 1:200,000 Epi
