LA Pharmacology Flashcards
What are the pharmacological properties of Lido/ligncaine?
Highly lipophillic therefore rapidly absorbed and short onset of action
Which group does lidocaine/lignocaine belong too?
amid
How is lidocaine/lignocaine metabolised?
Hepatic (95%)
What is the elimination half life of lidocaine/lignocaine?
90-120 min
What is the onset of action for lidocaine/lignocaine?
2-3 min
What is the ‘duration of action for lidocaine/lignocaine in Pulp and Soft tissues?
Pulp: 60-90min
Soft tissue: 60-120min
Which LA is most commonly used?
lidocaine/lignocaine
What is the max dose for lidocaine/lignocaine?
7mg/kg/ absolute max for 2% lignocaine with 1:80 000 adrenaline
What are the pharmacological properties of Prilocaine?
Slightly slower that lignocaine.
Less vasodilatory, distrubuted more rapidly,
What group does Prilocaine belong too?
Amides
How is Prilocaine metabolised?
By product of metabolism can exert effect on tisues in large doses
What is the elimination half life of Prilocaine ?
Highest clearance of all amides.
Rapid metabolisim in the liver.
Additional clearance in lungs and kidneys.
What is the duration of action in Prilocaine in Pulp and ST?
Pulp 40-90min
Soft tissues: 150-210 (with vasoconstrictor)
Which LA is used when preparation with adrenaline is contraindicated?
Prilocaine (citanist)
What is the max does for Prilocaine ?
9.0mg/kg, absolute max (600mg adult). 3% prilocaine HCI w fennypressin
How is Articaine metabolised?
Articaine undergoes biotransformation in the blood plasma + liver
What group does Articaine belong too?
Amide
What is the elimination half life of Articaine ?
20min
What is the onset of action for Articaine ?
2 min
What is the duration of action for Articaine ? Pulp and tissue?
Pulp: 60-75
Tissue 180-360
What category is Articaine ?
Category C drug
What is the max dose for Articaine ?
7mg/kg absolute max (500mg adult).
What are the indications for lignocaine?
Majority of dental LA
What are medical contraindications for lido/lignocaine?
Adrenal tumors
Uncontrolled diabetes
What are the indications for articaine?
Maxillary infiltrations
What are the contraindications for articaine?
Avoid in preg.
impaired renal function
Elderly
Children
What is the indication for prilocaine?
When adrenaline is too be avoided
What are the contraindications for prilocaine?
Coronary artery conditions.
Renal impairment
What are the pharmacological properties of Mepivacaine?
Least vasodilatory of all amides.
Similar to lignocaine, but short duration of action.
Used when need vasoconstrictor free sol.
Extremely low incidence of allergy
What is the proprietary name of Mepivacaine?
Scandonest (gold).
What is the metabolisim of Mepivacaine?
Hepatic
What is the elimination half life of Mepivacaine?
114-192min
What is the Onset of Action for Mepivacaine?
1.5-2min
What is the duration of action for Mepivacaine; pulp and soft tissue?
Pulp: 20-40min
Soft tissue: 120-180
What category is Mepivacaine?
Cat C.
What are the pharmacological properties of Bupivacaine?
Long last and high protein binding.
Used at low concerntrations due to its cardiotoxic effects
Would you use Bupivacaine as an OHT?
NO!
Should you use articaine for IAN?
No
What is the effect of vasoconstrictor?
Duration of action longer, keeping LA localised for longer
What is the effect of vasodilator?
Increases perfussion, LA si caried away
What precaution does 1. renal function and 2. liver disease require?
Dose reduction
What precaution does cardiovascular disease require?
Adrenaline does reduction
What precaution does Atypical pseudocholinesterase require?
Avoid articaine and esters
What precaution does pregnancy require?
Avoid cat B3, C, D and X medications
What do children general require?
Dose reduction?
What do elderly generally requie?
Dose reduction?
