These adverse experiences are, in general, dose-related and may result from high plasma levels caused by excessive dosage, rapid absorption or inadvertent intravascular injection, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature.
The unused portion should be discarded after initial use. Each mL contains 20 mg of lidocaine HCI. Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses, thereby effecting local anesthetic action.
The onset of action is 3 to 5 minutes. It is ineffective when applied to intact skin. Excessive blood levels may cause changes in cardiac output, total peripheral resistance, and mean arterial pressure.
These changes may be attributable to a direct depressant effect of the local anesthetic agent on various components of the cardiovascular system.
Lidocaine may be absorbed following topical administration to mucous membranes, its rate and extent of absorption depending upon concentration and total dose administered, the specific site of application, and duration of exposure. In general, the rate of absorption of local anesthetic agents following topical application occurs most rapidly after intratracheal administration.
Lidocaine is also well-absorbed from the gastrointestinal tract, but little intact drug may appear in the circulation because of biotransformation in the liver. Lidocaine is metabolized rapidly by the liver and metabolites and unchanged drug are excreted by the kidneys.
Biotransformation includes oxidative N-dealkylation, ring hydroxylation, cleavage of the amide linkage, and conjugation. N-dealkylation, a major pathway of biotransformation, yields the metabolites monoethylglycinexylidide and glycinexylidide.
The primary metabolite in urine is a conjugate of 4-hydroxy-2, 6-dimethylaniline. The plasma binding of lidocaine is dependent on drug concentration, and the fraction bound decreases with increasing concentration.
At concentrations of 1 to 4 mcg of free base per mL, 60 to 80 percent of lidocaine is protein bound. Binding is also dependent on the plasma concentration of the alpha-I-acid glycoprotein.
Lidocaine crosses the blood-brain and placental barriers, presumably by passive diffusion. Studies of lidocaine metabolism following intravenous bolus injections have shown that the elimination half-life of this agent is typically 1.
Because of the rapid rate at which lidocaine is metabolized, any condition that effects liver function may alter lidocaine kinetics. The half-life may be prolonged twofold or more in patients with liver dysfunction.
Renal dysfunction does not affect lidocaine kinetics but may increase the accumulation of metabolites. Factors such as acidosis and the use of CNS stimulants and depressants affect the CNS levels of lidocaine required to produce overt systemic effects.
Objective adverse manifestations become increasingly apparent with increasing venous plasma levels above 6 mcg free base per mL. When used for endotracheal tube lubrication care should be taken to avoid introducing the product into the lumen of the tube.
Do not use the jelly to lubricate the endotracheal stylettes.
|The unused portion should be discarded after initial use. Each mL contains 20 mg of lidocaine HCI.|
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If allowed into the inner lumen, the jelly may dry on the inner surface leaving a residue which tends to clump with flexion, narrowing the lumen.
There have been rare reports in which this residue has caused the lumen to occlude. The safety and effectiveness of lidocaine depend on proper dosage, correct technique, adequate precautions, and readiness for emergencies.WHO Model List of Essential Medicines 20th edition 20th WHO Model List of Essential Medicines (March ) page 2 Medical gases oxygen* Inhalation For use in the management of hypoxaemia.
*No more than 30% oxygen should be used to initiate. Interactive timeline of the history of anesthesia and the profession of anesthesiology.
Learn about Xylocaine Viscous (Lidocaine Hydrochloride Solution) may treat, uses, dosage, side effects, drug interactions, warnings, . ASHP's Interactive Handbook on Injectable Drugs References.
References. 1. Package insert (for brands listed after the nonproprietary name heading a monograph; date of package insert given as part of citation). Sep 25, · While generally safe, local anesthetic agents can be toxic if administered inappropriately, and in some cases may cause unintended reactions even when properly administered.
Adverse effects are usually caused by high plasma concentrations of the agent, which may result from one of the following: Inadvertent intravascular injection . The effect of Sodium Thiopental in pain reduction was accorded with other studies (8, 35, 38, 39).
Fentanyl is also diminishes such pain but not as much as lidocaine and thiopental that is consistent in diminishing pain with others investigations ().