HuagongsheHuagongshe Chemie-Druckbericht · Nur für Forschungszwecke
Lidocain
Xylocaine · Xyline · 2-(Diethylamino)-N-(2,6-dimethylphenyl)-acetamide · Mesocain · Anestacon · Ligoncaine · Xylocain · Maricaine
Identifikatoren & physikalische Daten
| CAS No. | 137-58-6 |
|---|---|
| Summenformel | C14H22N2O |
| Durchschnittliche Molmasse | 234,34 g/mol |
| Monoisotopische Masse | 234,17321333 g/mol |
| SMILES | CCN(CC)CC(=O)Nc1c(C)cccc1C |
| InChIKey | NNJVILVZKWQKPM-UHFFFAOYSA-N |
| PubChem CID | 3676 |
| ChEMBL | CHEMBL79 |
| ChEBI | CHEBI:6456 |
| EC No. | 205-302-8 |
| DTXSID | DTXSID1045166 |
| Lokaler Name | Lidocain |
Chemische & physikalische Eigenschaften
| XLogP | 2,3 |
|---|---|
| Polarare Oberfläche (TPSA) | 32,3 |
| H-Brücken-Donoren | 1 |
| H-Brücken-Akzeptoren | 2 |
| Frei drehbare Bindungen | 5 |
| Schwere Atome | 17 |
| Formalladung | 0 |
| Komplexität | 228 |
| LogP (Verteilungskoeffizient) | 2.44log Kow = 2.26 at pH 7.42.1 |
| LogS | -1.76 |
| Geruch | Characteristic odor |
| Color/Form | Needles from benzene or alcoholYellow needles from waterWhite or slightly yellow, crystalline powder |
| Löslichkeit | 4100VERY SOL IN ALCSOL IN CHLOROFORMINSOL IN ETHERWHITE CRYSTALLINE POWDER /LIDOCAINE HYDROCHLORIDE/In water, 410 mg/L at 30 °CVery soluble in alcohol, chloroformfreely soluble in ether, benzene. Dissolves in oilsSoluble in alcohol, ether, or chloroformVery soluble in benzene, ethyl ether, ethanol, and chloroformethanol: 4 mg/mLpractically insoluble |
| Siedepunkt | 159-160 °C at 2.00E+00 mm HgBP: 180-182 °C at 4 mm Hg159-160 °C at 2 mm Hg181 °Cbp4 180-182°bp2 159-160° |
| Decomposition | When heated to decomposition it emits toxic fumes of /nitrogen oxides/. |
| Schmelzpunkt | 68.568 °C68.5 °C66-69°C |
| Caco2 Permeability | -4.21 |
| Physical Description | Solid |
| Stability/Shelf Life | Commercially available solutions of lidocaine hydrochloride in 5% dextrose usually are stable for 18 months after the date of manufacture. Commercially available solutions of lidocaine hydrochloride in 5% dextrose may be provided in plastic containers.Stable under recommended storage conditions. |
| Ionization Efficiency | Positive5.122.7Agilent XCTElectrospray ionizationformic acid (5.3nM) |
| Dichte | 0.9944 (rough estimate) |
| Brechungsindex | 1.5110 (estimate) |
| Flammpunkt | 9℃ |
| Lagerbedingungen | Store at RT |
| Aggregatzustand | powder |
| pKa (Säurekonstante) | pKa 7.88(H2O)(Approximate) |
| Farbe | White to slightly yellow |
| Merck | 14,5482 |
| BCS Class | 1 |
| Stabilität | Stable. Incompatible with strong oxidizing agents. |
| Hauptanwendungen | cleaning productscosmeticsfood and beveragespersonal carepharmaceutical (small molecule) |
| InChI | 1S/C14H22N2O/c1-5-16(6-2)10-13(17)15-14-11(3)8-7-9-12(14)4/h7-9H,5-6,10H2,1-4H3,(H,15,17) |
| InChIKey | NNJVILVZKWQKPM-UHFFFAOYSA-N |
| SMILES | CCN(CC)CC(=O)Nc1c(C)cccc1C |
| LogP (Verteilungskoeffizient) | 2.440 |
| CAS Datenbank | 137-58-6(CAS DataBase Reference) |
| NIST chemische Informationen | Lidocaine(137-58-6) |
| EPA chemische Informationen | Acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)- (137-58-6) |
Sicherheit & Vorschriften
| GHS-Einstufung | This chemical does not meet GHS hazard criteria for 1.2% (2 of 167) of reports.WarningH302 (98.2%): Harmful if swallowed [Warning Acute toxicity, oral]P264, P270, P301+P317, P330, and P501 (click each P-code to see the statement)Aggregated GHS information provided per 167 reports by companies from 10 notifications to the ECHA C&L Inventory.Reported as not meeting GHS hazard criteria per 2 of 167 reports by companies.There are 9 notifications provided by 165 of 167 reports by companies with hazard statement code(s).Information may vary between notifications depending on impurities, additives, and other factors. The percentage value in parenthesis indicates the notified classification ratio from companies that provide hazard codes. Only hazard codes with percentage values above 10% are shown. For more detailed information, please visit ECHA C&L website. |
|---|---|
| Regulatorische Informationen | Status: Active Update: 11-07-2019 https://echa.europa.eu/registration-dossier/-/registered-dossier/24208Lidocaine: Does not have an individual approval but may be used under an appropriate group standard |
| Weitere Sicherheitsinformationen | IMAP assessments - Acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)-: Human health tier I assessmentIMAP assessments - Acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)-: Environment tier I assessment |
| FDA-Anforderungen | External analgesic drug products for over-the-counter human use. Analgesic, anesthetic, and antipruritic active ingredients. The active ingredient of the product consists of any of the following within the specified concentration established for each ingredient: (a) Male genital desensitizers. ... Lidocaine in a metered spray with approximately 10 milligrams per spray.Anorectal drug products for over-the-counter human use. Local anesthetic active ingredients. The active ingredient of the product consists of any of the following when used in the concentration or within the concentration range established for each ingredient: Lidocaine 2 to 5 percent.Drug products containing certain active ingredients offered over-the-counter (OTC) for certain uses. A number of active ingredients have been present in OTC drug products for various uses, as described below. However, based on evidence currently available, there are inadequate data to establish general recognition of the safety and effectiveness of these ingredients for the specified uses: lidocaine is included in oral health care drug products.Drug products containing certain active ingredients offered over-the-counter (OTC) for certain uses. A number of active ingredients have been present in OTC drug products for various uses, as described below. However, based on evidence currently available, there are inadequate data to establish general recognition of the safety and effectiveness of these ingredients for the specified uses: lidocaine hydrochloride is included in oral health care drug products. /Lidocaine hydrochloride/For more FDA Requirements (Complete) data for LIDOCAINE (7 total), please visit the HSDB record page. |
| Special Reports | GREEN L ET ALLIDOCAINE: COUNTERPOINT DISCUSSIONAPPL PHARMACOKINET 392 (1980). A REVIEW ON METABOLISM AND PHARMACOKINETICS OF LIDOCAINE IN RELATION TO THERAPEUTIC & TOXIC EFFECTS.RODMAN JHAPPL PHARMACOKINET 350 (1980). A REVIEW OF METABOLISM AND PHARMACOKINETICS OF LIDOCAINE.WALLER ESPHARMACOKINETIC PRINCIPLES OF LIDOCAINE DOSING IN RELATION TO DISEASE STATEJ CLIN PHARMACOL 21 (4):1 81 (1981). PRINCIPLES OF DOSING WITH LIDOCAINE.ASTRUP J, SORENSEN HRINHIBITION OF CEREBRAL METABOLISM BY LIDOCAINEEUR NEUROL 20 (3): 221 (1981). REVIEW ON EFFECTS IN HIGH DOSES (HIGHER THAN THOSE THAT INDUCE SEIZURES) ON CEREBRAL FUNCTION & METABOLISM.BRUGUEROLLE B ET ALFACTORS AFFECTING LIDOCAINE PHARMACOKINETICSTHERAPIE 38 (1): 27 (1983). A REVIEW WITH 69 REFERENCES OF PHYSIOLOGICAL, PHARMACOLOGICAL, AND PATHOLOGICAL FACTORS AFFECTING THE PHARMACOKINETICS OF LIDOCAINE. |
| Hazard Classes and Categories | Acute Tox. 4 (98.2%)Acute Tox. 4 (100%)Acute toxicity (Oral) - Category 4Skin sensitization - Category 1Specific target organ toxicity - Single exposure - Category 1 (blood, nervous system, cardiovascular system)Specific target organ toxicity - Repeated exposure - Category 1 (nervous system, cardiovascular system, blood) |
| Hazardous Reactivities and Incompatibilities | Incompatible materials: Strong oxidizing agents. |
| Firefighting Hazards | Special hazards arising from the substance or mixture: Carbon oxides, nitrogen oxides (NOx). |
| Brandbekämpfungsverfahren | Suitable extinguishing media: Use water spray, alcohol-resistant foam, dry chemical or carbon dioxide.Advice for firefighters: Wear self contained breathing apparatus for fire fighting if necessary. |
| Lagerbedingungen | Lidocaine hydrochloride injections and commercially available solutions of the drug in 5% dextrose should be stored at 25 °C but may be exposed to temperatures up to 40 °Cthe injection and solutions should not be frozen, and the solutions should be protected from excessive heat.Conditions for safe storage, including any incompatibilities: Keep container tightly closed in a dry and well-ventilated place.Lidocaine hydrochloride injections should be stored at a 20-25 °Csolutions containing epinephrine should be protected from light. |
| Reinigungsverfahren | Accidental Release Measures. Personal precautions, protective equipment and emergency procedures: Use personal protective equipment. Avoid dust formation. Avoid breathing vapours, mist or gas. Ensure adequate ventilation. Avoid breathing dust. Environmental precautions: Do not let product enter drains. Methods and materials for containment and cleaning up: Pick up and arrange disposal without creating dust. Sweep up and shovel. Keep in suitable, closed containers for disposal. |
| Entsorgungsverfahren | SRP: Expired or waste pharmaceuticals shall carefully take into consideration applicable DEA, EPA, and FDA regulations. It is not appropriate to dispose by flushing the pharmaceutical down the toilet or discarding to trash. If possible return the pharmaceutical to the manufacturer for proper disposal being careful to properly label and securely package the material. Alternatively, the waste pharmaceutical shall be labeled, securely packaged and transported by a state licensed medical waste contractor to dispose by burial in a licensed hazardous or toxic waste landfill or incinerator.Waste treatment methods. Product: Offer surplus and non-recyclable solutions to a licensed disposal company. Contact a licensed professional waste disposal service to dispose of this material. Dissolve or mix the material with a combustible solvent and burn in a chemical incinerator equipped with an afterburner and scrubber. Contaminated packaging: Dispose of as unused product. |
| Preventive Measures | Precautions for safe handling: Avoid contact with skin and eyes. Avoid formation of dust and aerosols. Provide appropriate exhaust ventilation at places where dust is formed. Normal measures for preventive fire protection.Appropriate engineering controls: Handle in accordance with good industrial hygiene and safety practice. Wash hands before breaks and at the end of workday.Gloves must be inspected prior to use. Use proper glove removal technique (without touching glove's outer surface) to avoid skin contact with this product. Dispose of contaminated gloves after use in accordance with applicable laws and good laboratory practices. Wash and dry hands. |
| Personal Protective Equipment (PPE) | Eye/face protection: Safety glasses with side-shields conforming to EN166 Use equipment for eye protection tested and approved under appropriate government standards such as NIOSH (US) or EN 166(EU).Skin protection: Handle with gloves.Body Protection: Complete suit protecting against chemicals, The type of protective equipment must be selected according to the concentration and amount of the dangerous substance at the specific workplace.Respiratory protection: For nuisance exposures use type P95 (US) or type P1 (EU EN 143) particle respirator. For higher level protection use type OV/AG/P99 (US) or type ABEK-P2 (EU EN 143) respirator cartridges. Use respirators and components tested and approved under appropriate government standards such as NIOSH (US) or CEN (EU). |
| Körperbelastung | Lidocaine ... is distributed into milkin one lactating women, milk lidocaine concentration was approximately 40% of the serum concentration (from a sample obtained 2 hours earlier). |
| Treatment | The first step in the management of systemic toxic reactions consists of immediate attention to the establishment and maintenance of a patent airway and assisted or controlled ventilation with oxygen and a delivery system capable of permitting immediate positive airway pressure by mask. If convulsions occur, the objective of the treatment is to maintain ventilation and oxygenation and support the circulation. Oxygen must be given and ventilation assisted if necessary (mask and bag or tracheal intubation). Should convulsions not stop spontaneously after 15-20 seconds, an anticonvulsant should be given i.v. to facilitate adequate ventilation and oxygenation. Thiopental sodium 1-3 mg/kg i.v. is the first choice. Alternatively diazepam 0.1 mg/kg bw i.v. may be used, although its action will be slow. Prolonged convulsions may jeopardise the patient's ventilation and oxygenation. If so, injection of a muscle relaxant (e.g. succinylcholine 1 mg/kg bw) will facilitate ventilation, and oxygenation can be controlled. Early endotracheal intubation must be considered in such situations. If cardiovascular depression is evident (hypotension, bradycardia), ephedrine 5-10 mg i.v. should be given and may be repeated, if necessary, after 2-3 minutes. Should circulatory arrest occur, immediate cardiopulmonary resuscitation should be instituted. Continual oxygenation and ventilation and circulatory support as well as treatment of acidosis are of vital importance. (L1712) |
| Wechselwirkungen | EMLA cream is a topical formulation based upon the eutectic mixture of lidocaine and prilocaine and is used in clinical settings to produce local analgesia after application under occlusive dressing. A blanching reaction has been reported to occur locally after application, but it is not clear whether this reaction is caused by the anesthetic mixture, by the vehicle or the occlusion. This blanching reaction was studied in 50 healthy volunteers in a double-blind randomized assay: EMLA versus placebo, under occlusive dressing for 1 hr, each subject being his own control. 33 Cases (66%) of blanching after application of EMLA cream were observed versus 3 cases (6%) after placebo, this difference being highly significant. Blanching was observed without delay, after removal of the dressing, and was very transient, disappearing in less than 3 hr in all cases. It is concluded that the blanching reaction is (1) frequent but very transient, and (2) determined by the anesthetic mixture included in EMLA cream and not by the vehicle alone, nor by the occlusion, since it is not found with the placebo. The precise mechanism of this reaction is unknown.Recent studies have suggested that cytochrome P-450 isoenzyme 1A2 has an important role in lidocaine biotransformation. /This research/ studied the effect of a cytochrome P-450 1A2 inhibitor, ciprofloxacin, on the pharmacokinetics of lidocaine. In a randomized, double-blinded, cross-over study, nine healthy volunteers ingested for 2.5 days 500 mg oral ciprofloxacin or placebo twice daily. On day 3, they received a single dose of 1.5 mg/kg lidocaine intravenously over 60 min. Plasma concentrations of lidocaine, 3-hydroxylidocaine and monoethylglycinexylidide were determined for 11 hr after the start of the lidocaine infusion. Ciprofloxacin increased the mean peak concentration and area under plasma concentration-time curve of lidocaine by 12% (range [-6] to 46%P<0.05) and 26% (8 to 59%P 0.01), respectively. The mean plasma clearance of lidocaine was decreased by ciprofloxacin by 22% (7 to 38%P<0.01). Ciprofloxacin decreased the area under the plasma concentration-time curve of monoethylglycinexylidide by 21% (P<0.01) and that of 3-hydroxylidocaine by 14% (P< 0.01). The plasma decay of intravenously administered lidocaine is modestly delayed by concomitantly administered ciprofloxacin. Ciprofloxacin may increase the systemic toxicity of lidocaine.Epinephrine is commonly added to lidocaine solutions to increase the duration of spinal anesthesia. Despite this common usage, the effect of epinephrine on the neurotoxic potential of this anesthetic is not known. The current experiments investigated whether adding epinephrine increases functional impairment or histologic damage induced by spinal administration of lidocaine in the rat. Eighty rats were divided into four groups to receive an intrathecal injection of normal saline containing either 5% lidocaine, 5% lidocaine with 0.2 mg/mL of epinephrine, 0.2 mg/mL of epinephrine, or normal saline alone. Animals were assessed for persistent sensory impairment using the tail-flick test administered 4 and 7 days after infusion. Animals were then killed, and the spinal cord and nerve roots were prepared for neuropathologic evaluation. Rats given 5% lidocaine developed persistent sensory impairment and histologic damage, and the addition of epinephrine resulted in a further significant increase in injury. Sensory function in animals given epinephrine without anesthetic was similar to baseline and did not differ from saline. Histologic changes in animals treated with epinephrine alone did not differ significantly from saline controls. The neurotoxicity of intrathecally administered lidocaine is increased by the addition of epinephrine. When making clinical recommendations for maximum safe intrathecal dose of this anesthetic, one may need to consider whether the solution contains epinephrine.PURPOSE: During continuous epidural anesthesia with lidocaine, plasma monoethylglycinexylidide (MEGX), an active metabolite of lidocaine, increases continuously. /This study/ assessed the effect of epinephrine on the absorption of lidocaine and the accumulation of MEGX during continuous epidural anesthesia in children. Anesthesia was administered as an initial bolus of 5 mg/kg of 1% lidocaine solution followed by continuous infusion at 2.5 mg/kg/hr. Patients in the control group (n = 8) received lidocaine alone, while patients in the epinephrine group (n = 8) received lidocaine + epinephrine (5 ug/mL). Concentrations of lidocaine and its active metabolite, MEGX, were measured in plasma samples obtained after 15 min, 30 min, and one, two, three, four, and five hours of infusion using high-performance liquid chromatography with ultraviolet detection. Plasma lidocaine concentrations were higher in samples from the control group for the first hourhowever, after two hours the levels were the same in all samples. Plasma MEGX levels increased continuously in both groups and were significantly higher in the control group samples. The sum of lidocaine + MEGX was higher in the control group for the first two hours but there was no significant difference between groups after three hours. Reduction of the potential for systemic toxicity by the addition of epinephrine to lidocaine is limited, because the reduction of the sum of the plasma concentrations of lidocaine and its active metabolite MEGX is small and limited to the initial phase of infusion.For more Interactions (Complete) data for LIDOCAINE (33 total), please visit the HSDB record page. |
| Gesundheitliche Auswirkungen | Systemic exposure to excessive quantities of lidocaine mainly result in central nervous system (CNS) and cardiovascular effects. CNS effects may include CNS excitation(nervousness, tingling around the mouth) followed by depression. [Wikipedia] |
| Ökotoxizitätswerte | EC50Species: Chlorella fusca var. vacuolata (Green Algae) strain 211-15Conditions: freshwater, static, 25 °C, pH 9.5-10.0Concentration: 459 uM for 24 hr (95% confidence interval: 158-1333 uM)Effect: decreased population growth rate /formulation/Conditions: freshwater, static, 25 °C, pH 9.0Concentration: 545 uM for 24 hr (95% confidence interval: 244-1217 uM)Conditions: freshwater, static, 25 °C, pH 6.5-7.2Concentration: 575 uM for 24 hr (95% confidence interval: 52-6365 uM)Conditions: freshwater, static, 25 °C, pH 8.5-8.6Concentration: 608 uM for 24 hr (95% confidence interval: 272-1360 uM)Conditions: freshwater, static, 25 °C, pH 7.5-7.9Concentration: 686 uM for 24 hr (95% confidence interval: 158-2982 uM) |
| Umweltverhalten | TERRESTRIAL FATE: Based on a classification scheme(1), an estimated Koc value of 400(SRC), determined from a structure estimation method(2), indicates that lidocaine is expected to have moderate mobility in soil(SRC). The estimated pKa of lidocaine is 7.5(3), indicating that this compound will exist partially in the cation form in the environment and cations generally adsorb more strongly to soils containing organic carbon and clay than their neutral counterparts(4). Volatilization of the neutral species of lidocaine from moist soil surfaces is not expected to be an important fate process(SRC) given an estimated Henry's Law constant of 1.3X10-10 atm-cu m/mole(SRC), using a fragment constant estimation method(5). Lidocaine is not expected to volatilize from dry soil surfaces(SRC) based upon an estimated vapor pressure of 6.8X10-6 mm Hg at 25 °C(SRC), determined from a fragment constant method(2). Biodegradation data in soil were not available(SRC, 2014).AQUATIC FATE: Based on a classification scheme(1), an estimated Koc value of 400(SRC), determined from a structure estimation method(2), indicates that lidocaine is expected to adsorb to suspended solids and sediment(SRC). Volatilization from water surfaces is not expected(3) based upon an estimated Henry's Law constant of 1.3X10-10 atm-cu m/mole(SRC), developed using a fragment constant estimation method(4). According to a classification scheme(5), an estimated BCF of 3(SRC), from its log Kow of 2.4467) and a regression-derived equation(2), suggests the potential for bioconcentration in aquatic organisms is low(SRC). Half-lives of 0.4 and 1.3 days for laboratory (Hg lamp) and field (natural sunlight), respectively, have been reported in river water media, which take into account photodegradation and biotic degradation(7). Biodegradation data in water were not available(SRC, 2014).ATMOSPHERIC FATE: According to a model of gas/particle partitioning of semivolatile organic compounds in the atmosphere(1), lidocaine, which has an estimated vapor pressure of 6.8X10-6 mm Hg at 25 °C(SRC), determined from a fragment constant method(2), will exist in both the vapor and particulate phases in the ambient atmosphere. Vapor-phase lidocaine is degraded in the atmosphere by reaction with photochemically-produced hydroxyl radicals(SRC)the half-life for this reaction in air is estimated to be 1.2 hours(SRC), calculated from its rate constant of 1.1X10-10 cu cm/molecule-sec at 25 °C(SRC) that was derived using a structure estimation method(3). Particulate-phase lidocaine may be removed from the air by wet and dry deposition(SRC). Lidocaine contains chromophores that absorb at wavelengths >290 nm(4) and, therefore, may be susceptible to direct photolysis by sunlight(SRC). |
| Unerwünschte Wirkungen | Most adverse reactions associated with lidocaine occur when plasma concentrations rise to toxic levels. The drug reaches the intravascular compartment most rapidly when administered into the intercostal space, followed by the caudal, epidural, brachial plexus, femoral, and subcutaneous spaces. The maximum safe dose by body weight may range from 3 mg/kg to 7 mg/kg when using formulations containing epinephrine, although various other doses have been documented. Smaller doses can still result in adverse effects and toxicity if administered intravenously. Lidocaine is thought to be more neurotoxic than other local anesthetics, especially when high concentrations are applied directly to nervous tissue. Use of highly concentrated lidocaine (2.5% to 5%) for spinal anesthesia correlates with a greater incidence of transient radicular irritation syndrome, which is a painful but self-limiting condition affecting the calves, thighs, and buttocks.Drug-Drug Interactions* The administration of lidocaine with propranolol significantly increases lidocaine serum concentration.* Caution is advised when administering lidocaine hydrochloride in patients with digitalis toxicity and atrioventricular block.* Lidocaine is a substrate of CYP1A2, CYP2B6, and CYP2D6 and exerts an inhibitory effect on CYP1A2. Caution is advised when co-administering lidocaine with fluvoxamine.* Patients may be at increased risk of developing methemoglobinemia if co-administered local anesthetics (eg, lidocaine) and other drugs, including nitrates, nitric oxide, hydroxyurea, dapsone, sulfonamides, chloroquine, phenobarbital, and phenytoin. Methemoglobinemia can also occur due to lidocaine metabolism to O-toluidine. This metabolite is more likely to be present when very high doses are given, but it may also occur with lower doses when the patient is taking other medications that can precipitate methemoglobinemia or have a hemoglobinopathy or another cause of anemia. |
| Expositionspfade | Intravenous, Topical, Oral, Buccal, Dental, Intramuscular, or Urethral injection , Infiltration. Information derived from diverse formulations, concentrations and usages reveals that lidocaine is completely absorbed following parenteral administration, its rate of absorption depending, for example, upon various factors such as the site of administration and the presence or absence of a vasoconstrictor agent. |
| Milk Concentrations | EXPERIMENTAL: Lidocaine ... is distributed into milkin one lactating woman, milk lidocaine concentration was approximately 40% of the serum concentration (from a sample obtained 2 hours earlier).EXPERIMENTAL: ... The purpose of this study is to determine the amount of lidocaine and its metabolite monoethyl-glycinexylidide (MEGX) in breast milk after local anesthesia during dental procedures. The study population consisted of seven nursing mothers (age, 23-39 years) who received 3.6 to 7.2 mL 2% lidocaine without adrenaline. Blood and milk concentrations of lidocaine and its metabolite MEGX were assayed using high-performance liquid chromatography. The milk-to-plasma ratio and the possible daily doses in infants for both lidocaine and MEGX were calculated. The lidocaine concentration in maternal plasma 2 hours after injection was 347.6 +/- 221.8 ug/L, the lidocaine concentration in maternal milk ranged from 120.5 +/- 54.1 ug/L (3 hours after injection) to 58.3 +/- 22.8 ug/L (6 hours after injection), the MEGX concentration in maternal plasma 2 hours after injection was 58.9 +/- 30.3 ug/L, and the MEGX concentration in maternal milk ranged from 97.5 +/- 39.6 ug/L (3 hours after injection) to 52.7 +/- 23.8 ug/L (6 hours after injection). According to these data and considering an intake of 90 mL breast milk every 3 hours, the daily infant dosages of lidocaine and MEGX were 73.41 +/- 38.94 ug/L/day and 66.1 +/- 28.5 ug/L/day respectively. ... |
| Toxizitätsübersicht | IDENTIFICATION AND USE: Lidocaine is a white or slightly yellow, crystalline powder or needle with a characteristic odor. It is commonly used as a medication including for local anesthetics, anti-arrhythmia agent, or as a voltage-gated sodium channel blocker. Lidocaine may also be used in the treatment of hypertensive emergencies, or acute coronary syndrome associated with the toxicity of various stimulants and antiarrhythmic agents. A lidocaine transdermal patch is used for relief of pain associated with postherpetic neuralgia. An oral patch is available for application to accessible mucous membranes of the mouth prior to superficial dental procedures. The combination of lidocaine (2.5%) and prilocaine (2.5%) in an occlusive dressing is used as an anesthetic prior to venipuncture, skin graft harvesting, and infiltration of anesthetics into genitalia. Lidocaine in combination with tetracaine in a formulation that generates a "peel" is approved for topical local analgesia prior to superficial dermatological procedures. HUMAN EXPOSURE AND TOXICITY: Adverse effects of the drug mainly involve the CNS because of its rapid entry in the brain. Adverse CNS reactions may be manifested by drowsinessdizzinessdisorientationconfusionlightheadednesstremulousnesspsychosisnervousnessapprehensionagitationeuphoriatinnitusvisual disturbances including blurred or double visionnauseavomitingparesthesiasensations of neat, cold or numbnessdifficulty swallowingdyspneaand slurred speech. Muscle twitching or tremors, seizures, unconsciousness, coma, and respiratory depression and arrest may also occur. Shortly following the CNS effects, patients with lidocaine toxicity may also experience cardiovascular effects. If the patient is supported through this period, the drug rapidly distributes away from the heart, and spontaneous cardiac function returns. Lidocaine, when administered to a baby may induce convulsions. Lidocaine intoxication in the neonate,Signs and Symptoms of OverdoseSigns and symptoms of mild toxicity become apparent at plasma levels greater than 5 μg/mL, beginning with slurred speech, tinnitus, circumoral paresthesia, and lightheadedness. Above 10 μg/mL, the patient may experience seizures or loss of consciousness. The myocardium and central nervous system are further depressed at 15 μg/mL, progressing to cardiac arrhythmias, respiratory arrest, and cardiac arrest above 20 μg/mL. Animal studies suggest that the dose of lidocaine required to cause cardiovascular collapse is 7.1 ± 1.1 times higher than the dose needed to induce central nervous system effects. This so-called "(cardiovascular collapse/CNS (CC/CNS) ratio" is significantly higher than the ratio for other local anesthetic agentsbupivacaine has a CC/CNS ratio of around 2.0. In the event of toxic dosing in the conscious patient, lidocaine may be less likely than other local anesthetics to progress rapidly from neurological effects to complete cardiovascular collapse. By contrast, neurological signs and symptoms can often be masked if the patient is under the concurrent effects of sedation or general anesthesia, meaning that cardiovascular instability or arrhythmias may be the first manifestations.Management of OverdoseLidocaine administration should be stopped immediately if toxicity or overdose is suspected. During cardiorespiratory collapse, airway support and breathing assistance should be prioritized to prevent the development of respiratory acidosis, which may exacerbate toxicity and potentiate lidocaine's negative chronotropic and inotropic effects. Vital function support, including oxygen, IV fluids, and inotropes, should be instituted if required. Intravenous lipid emulsion is indicated as rescue therapy, especially if the cardiovascular collapse is refractory.Lidocaine stabilizes the neuronal membrane by inhibiting the ionic fluxes required for the initiation and conduction of impulses thereby effecting local anesthetic action. Lidocaine alters signal conduction in neurons by blocking the fast voltage gated sodium (Na+) channels in the neuronal cell membrane that are responsible for signal propagation. With sufficient blockage the membrane of the postsynaptic neuron will not depolarize and will thus fail to transmit an action potential. This creates the anaesthetic effect by not merely preventing pain signals from propagating to the brain but by aborting their birth in the first place. |
| Signs and Symptoms | Symptoms of overdose include convulsions, hypoxia, acidosis, bradycardia, arrhythmias and cardiac arrest. |
| Effluent Concentrations | Lidocaine was present at a range of 16 to 102 ng/L in sewage water effluents of the Netherlands, sampled in 2002(1). |
| Wassergefährdungsklasse (WGK) | 3 |
| TSCA-Inventar-Status | TSCA listed |
| UN-Transportnummer | 3249 |
| Zollcode | 29242990 |
| RTECS-Nr. | AN7525000 |
| R-Sätze (R) | 22-39/23/24/25-23/24/25-11 |
| Toxizität | LD50 oral in rat: 317mg/kg |
| Gefahrensymbole | Xn,T,F |
| Sicherheitshinweise (S) | 22-26-36-45-36/37-16-7 |
| Gefahrenklasse | 6.1(b)Acute Tox. 4 Oral |
| Verpackungsgruppe | III |
| Lagerklasse | 11 - Combustible Solids |
| Gefahrstoffdaten | 137-58-6(Hazardous Substances Data) |
Anwendungen & Verwendung
Verwenden
Lidocaine (Alphacaine)is a selective inverse peripheral histamine H1-receptor agonist with an IC50 of >32 μM. [1] Histamine is responsible for many features of allergic reactions. Lidocaine (Alphacaine)is a second-generation antihistamine agent closely st