USMLE

Lidocaine

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Neuro Drugs
  1. Levodopa, Carbidopa
  2. Levetiracetam
  3. Valproic Acid
  4. Anticholinergic Syndrome
  5. Cholinergic Crisis
  6. Benztropine / Trihexyphenidyl
  7. Lidocaine
  8. Opioids
  9. Pyridostigmine, Neostigmine, Edrophonium
  10. Naltrexone
  11. Pregabalin
  12. Scopolamine
  13. Phenytoin
  14. Ethosuximide
  15. Succinylcholine
  16. Memantine
  17. Donepezil
  18. Halothane / Flurane
  19. Propofol
  20. Ergotamine
  21. Triptans
  22. Selegiline / Rasagiline
  23. Entacapone / Tolcapone
  24. Gabapentin
  25. Lamotrigine
  26. Carbamazepine
  27. Ramelteon

Summary

Lidocaine, and related drugs ending in “-caine”, like bupivacaine, mepivacaine, and tetracaine, are local analgesics used to numb pain felt in local areas. Clinically, these drugs are usually administered as local injections prior to painful procedures. In rare cases, lidocaine is administered intravenously to enter the bloodstream, where it acts as an antiarrhythmic, effective in treating ventricular arrhythmias.

Key Points

  • Lidocaine
    • Mechanism
      • Sodium channel blocker
        • Blocks sodium channels and sodium influx into cardiac and nerve cells, thereby preventing depolarization and action potentials
        • Suppresses nervous activity and cardiac activity
    • Clinical Uses
      • Local analgesia
        • Has short onset and long duration
        • Only numbs the surrounding area (compared to fentanyl patches that gives systemic analgesia)
        • Viscous oral form can be used to treat oral pain due to mucositis
        • May be given in a patch, intradermal injection, or oral solution
      • Arrhythmias
        • Treats ventricular dysrhythmias such as ventricular fibrillation, ventricular tachycardia, and premature ventricular contractions (PVCs)
        • Given as an IV infusion
    • Side Effects and Adverse Reactions
      • When given via IV for arrhythmias
        • Headache
        • Bradycardia
        • Hypotension
        • Dizziness
        • Tremors