Lidocaine


Thông tin thuốc gốc
Chỉ định và Liều dùng
Epidural
Epidural anaesthesia
Adult: 2-3 mL administered for each dermatome to be anaesthesised. Recommended doses are: Lumbar epidural 250-300 mg (as 1% soln) for analgesia and 225-300 mg (as 1.5% soln) or 200-300 mg (as 2% soln) for anaesth; for thoracic epidural: 200-300 mg (as 1% soln). For obstetric caudal analgesia, 200-300 mg (as 1% soln); for surgical caudal anaesth: 225-300 mg (as 1.5% soln). For continuous epidural or caudal anaesth, not to repeat max doses more frequently than 1.5 hrly.

Intramuscular
Emergency treatment of ventricular arrhythmias
Adult: 300 mg injected into the deltoid muscle, repeat after 60-90 min if necessary.

Intraspinal
Spinal anaesthesia
Adult: As hyperbaric soln of 1.5% or 5% lidocaine in 7.5% glucose soln. Normal vaginal delivery: Up to 50 mg (as 5% soln) or 9-15 mg (as 1.5% soln). Caesarian operation: Up to 75 mg (as 5% soln). Other surgical procedures: 75-100 mg.

Intravenous
Pulseless ventricular fibrillation or ventricular tachycardia
Adult: 1-1.5 mg/kg repeated as necessary. Max: 3 mg/kg. For ventricular arrhythmias in more stable patients: Usual loading dose: 50-100 mg as an IV inj at 25-50 mg/min, may repeat once or twice up to a max of 200-300 mg in 1 hr, followed by 1-4 mg/min via continuous IV infusion. May need to reduce dose if the infusion is longer than 24 hr.

Intravenous
Intravenous regional anaesthesia
Adult: As 0.5% soln w/o epinephrine: 50-300 mg. Max: 4 mg/kg.

Mouth/Throat
Surface anaesthesia
Adult: As 2% soln: For pain: 300 mg rinsed and ejected for mouth and throat pain; or gargled and swallowed if necessary for pharyngeal pain. Not to be used more frequently than every 3 hr. Max (topical oral soln): 2.4 g/day. As 4% soln: Before bronchoscopy, bronchography, laryngoscopy, oesophagoscopy, endotracheal intubation, and biopsy in the mouth and throat: 40-200 mg. As 10% soln: For dentistry and otorhinolaryngology procedures: 10-50 mg sprayed to mucous membrane. As 4% soln: For laryngotracheal anaesth: 160 mg sprayed or instilled as a single dose into the lumen of the larynx and trachea.

Ophthalmic
Surface anaesthesia
Adult: Apply 2 drops to ocular area where procedure will take place; may reapply to maintain effect.

Parenteral
Percutaneous infiltration anaesthesia
Adult: As 0.5% or 1% soln: 5-300 mg.

Parenteral
Sympathetic nerve block
Adult: As 1% soln: 50 mg for cervical block or 50-100 mg for lumbar block.

Parenteral
Peripheral nerve block
Adult: As 1.5% soln: For brachial plexus block: 225-300 mg. As 2% soln: For dental nerve block: 20-100 mg. As 1% soln: For intercostal nerve block: 30 mg; for paracervical block: 100 mg on each side, repeated not more frequently than every 90 min; for paravertebral block: 30-50 mg; for pudendal block: 100 mg on each side. As 4% soln: For retrobulbar block: 120-200 mg.

Rectal
Haemorrhoids, Perianal pain and itching
Adult: Apply topically or using applicator insert rectally, up to 6 times daily.
Child: ≥12 yr Apply topically or using applicator insert rectally, up to 6 times daily.

Topical/Cutaneous
Surface anaesthesia
Adult: As 5% oint: Max: 20 g in 24 hr for skin and mucous membrane. As 2% gel: Approx 120-220 mg into urethra several min before examination. As 4% foam: Apply 3-4 times daily for pain relief. As soln: Apply 40-200 mg to affected area. As patch: Apply patch to painful area for up to 12 hr w/in a 24-hr period. Max: 1 patch/24 hr.

Transdermal
Postherpetic neuralgia
Adult: As 5% patch: Apply to most painful area once daily for up to 12 hr w/in a 24-hr period. Max: Up to 3 patches in a single application.

Urethral
Surface anaesthesia
Adult: As 2% gel: Female: 60-100 mg inserted into the urethra several min before examination. Male: 100-200 mg before catheterisation and 600 mg before sounding or cystoscopy.
Hepatic Impairment
Parenteral:
Dosage reduction may be needed.
Tương kỵ
Amphotericin B, sulfadiazine Na, methohexital Na, cefazolin Na, phenytoin Na, pantoprazole, metoprolol.
Chống chỉ định
Hypovolaemia, complete heart block, Adam-Stokes syndrome, Wolff-Parkinson-White syndrome. Must not be applied to inflamed or injured skin.
Thận trọng
Patient w/ pseudocholinesterase deficiency, resp depression. Hepatic and renal impairment. Elderly or debilitated patients. Pregnancy and lactation.
Phản ứng phụ
Arrhythmia, bradycardia, arterial spasms, CV collapse, oedema, flushing, hert block, hypotension, sinus node suppression, agitation, anxiety, coma, confusion, drowsiness, hallucinations, euphoria, headache, hyperaesthesia, hypoaesthesia, lightheadedness, lethargy, nervousness, psychosis, seizure, slurred speech, unconsciousness, somnolence, nausea, vomiting, metallic taste, tinnitus, disorientation, dizziness, paraesthesia, resp depression and convulsions. Patch: Bruising, depigmentation, petechiae, irritation. Ophth: Conjunctival hyperaemia, corneal epithelial changes, diplopia,visual changes.
Buccal/Dental/Endotracheal/Epidural/IM/Intradermal/IV/Mouth/Throat/Ophth/Parenteral/Perineural/Rectal/SC/Topical/Transdermal/Urethral: B
Thông tin tư vấn bệnh nhân
May cause temporary loss of sensation and motor activity.
MonitoringParameters
Monitor CV and resp vital signs, LFTs and careful ECG observation.
Quá liều
Symptoms: Severe hypotension, asystole, bradycardia, apnoea, seizures, coma, cardiac arrest, resp arrest and death. Management: Maintain oxygenation, stop convulsion and support the circulation.
Tương tác
May increase serum levels w/ cimetidine and propranolol. Increased risk of cardiac depression w/ β-blockers and other antiarrhythmics. Additive cardiac effects w/ IV phenytoin. Hypokalaemia caused by acetazolamide, loop diuretics and thiazides may antagonise effect of lidocaine. Dose requirements may be increased w/ long-term use of phenytoin and other enzyme-inducers.
Food Interaction
Decreased levels w/ St John's wort.
Lab Interference
IM admin of lidocaine increases creatine phosphokinase levels interfering w/ diagnosis of MI.
Tác dụng
Description: Lidocaine is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.
Onset: 45-90 sec (IV); approx 4 hr (transdermal); 20 sec to 5 min (ophth). .
Duration: 10-20 min (IV); 5-30 min (ophth).
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract, mucous membranes, damaged skin, inj sites, including muscle; poor absorption through intact skin.
Distribution: Crosses the placenta, blood-brain barrier and enters breast milk. Protein-binding: 66% (α1-acid glycoprotein).
Metabolism: Undergoes rapid metabolism and approx 90% is dealkylated to monoethylglycinexylidide and glycinexylidide. First-pass metabolism is extensive.
Excretion: Via urine (<10% unchanged). Elimination half-life: biphasic; initial: 7-30 min; terminal: 1.5-2 hr.
Bảo quản
Store below 25°C.
References
Anon. Lidocaine (Ophthalmic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/07/2014.

Anon. Lidocaine (Systemic). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/07/2014.

Anon. Lidocaine (Topical). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/07/2014.

Buckingham R (ed). Lidocaine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/07/2014.

Lidocaine Hydrochloride Injection, Solution (AuroMedics Pharma LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 30/07/2014.

Lidocaine Patch (Qualitest Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 30/07/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Lidocaine. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 30/07/2014.

Wickersham RM. Lidocaine HCl (Injection). Facts and Comparisons [online]. St. Louis, MO. Wolters Kluwer Clinical Drug Information, Inc. https://www.wolterskluwercdi.com/facts-comparisons-online/. Accessed 30/07/2014.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Lidocaine từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
  • Lidocain 10% Egis
  • Lidocain 2% Egis
  • Lidocain Bidiphar
  • Lidocain Pymepharco 1%/2%
  • Lidocain Thephaco
  • Lidocain Uphace
  • Lignopad
  • Rotexmedica Lignocaine
  • Xylocaine Inj
  • Xylocaine jelly
  • Xylocaine Naphtazoline
  • Xylocard
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in