Lignocaine

Lignocaine is a sodium channel blocking agent, used as a local anesthetic and antiarrhythmic agent. It stabilizes nerve cell membranes to prevent impulse conduction. Used topically or by injection for local anaesthesia in minor operations.Intravenous injection or infusion used to treat abnormal heart rhythms. Excessive doses also block motor impulses and normal cardiac conduction. It has a low incidence of toxicity and a high degree of effeciveness in arrhythmias. Lignocaine is one of the least cardiotoxic drug of the currently used sodium channel blocker.


Adult Dose
Dose: 2 to 4 mg/min
Single Dose: 3 (3)
Frequency: As recommended.
Route: IV Inf
Instructions: As Required
Neonatal
Dose: 20 to 50 ug/kg.min
Single Dose: 35 (35)
Frequency: As recommended.
Route: IV Infusion
Instructions: Maintenance, As Required
Paedriatic
Dose: 20 to 50 ug/kg.min
Single Dose: 35 (35)
Frequency: As recommended.
Route: IV Infusion
Instructions: Maintenance, As Required
Characteristics
Lignocaine also known as Lidocaine. Lidocaine (HCl), Lidocaine (HCl) are the derivatives of Lignocaine. It is of Synthetic origin and belongs to Amide. It belongs to Na-Channel Local Anesthetic antagonist pharmacological group on the basis of mechanism of action and also classified in Analgesic pharmacological group.The Molecular Weight of Lignocaine is 234.30. It is weakly acidic drug, 4.00% solution of the drug is isotonic and Its pKa is 7.86.
Contraindications
Lignocaine is contraindicated in conditions like Heart block,Bradycardia,Congestive heart failure,Hypersensitivity.
Effects
The severe or irreversible adverse effects of Lignocaine, which give rise to further complications include Allergy, Hypotension, Bronchospasm, Coma, Seizures, Hypertension, Tissue necrosis, Angina, Sinus bradycardia, Respiratory depression, Blurred vision, Tremors, Malignant hyperthermia, Neonatal depression, Cardiovascular depression.Lignocaine produces potentially life-threatening effects which include Respiratory depression, Bradycardia, Convulsions, Hypersensitivity, Cardiac Arrest, CNS toxicity, Medullary depression, Tonic & clonic convulsion. which are responsible for the discontinuation of Lignocaine therapy.The signs and symptoms that are produced after the acute overdosage of Lignocaine include Bradycardia, Hypotension, Death, Apnea, Seizures, Respiratory arrest, Cardiovascular collapse, Decrease cardiac output.The symptomatic adverse reactions produced by Lignocaine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Dizziness, Headache, Drowsiness, Nausea, Vomiting, Anxiety, Restlessness, Palpitation, Nervousness, Tinnitus, Abdominal pain, Confusion, Tremor, Nystagmus, Abdominal discomfort, Twitching, nervousness.
Indications
Lignocaine is primarily indicated in conditions like Anesthesia, Caudal anaesthesia, Epidural anaesthesia, Headache associated with migraine, Infilteration anaesthesia, Intravenous regional anaesthesia, Local anaesthesia, Neuropathic pain, Obstetric anaesthesia, Severe hiccup, Toothache, Transtracheal anaesthesia, Urethral anesthesia, Ventricular arrhythmias, Ventricular arrhythmias, especially after myocardial infarction, Ventricular fibrillation, and can also be given in adjunctive therapy as an alternative drug of choice in Itching, Pain.
Interactions
Lignocaine is known to interact with other drugs, the details of drug interactions is as follows:DrugDetailsSeverityOnsetManagementAlcuronium (Cl)Amphotericin BAmprenavirAmprenavir possibly increases plasma concentration of Lignocaine; increased risk of ventricular arrhythmias. ADVICE: Avoid concomitant use.MajorAtracurium (Besylate)Cimetidine (HCl)Cimitidine increases lignocaine toxicity.Edrophonium (Cl)EnfluraneFosphenytoinHalothaneNadololOxprenolol (HCl)PentazocinePropafenone (HCl)Propranolol (HCl)Propranolol reduces clearance of lignocaine.Rocuronium (Br)Suxamethonium (Cl)Suxamethonium (Cl)Timolol (Maleate)Tocainide (HCl) These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.
Interfrence
Risks
Drug should not be given to Cardiac / Hypertensive Patients, patients suffering from Liver Malfunction, and Neonates.If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.
Storage
Inj, Soln, Gel Store Between 15°C-30°C. Do not Freeze. Protect from Sunlight.
Warnings
Lignocaine should be used with caution in patients receiving anti-coagulant therapy, with genetic predisposition of malignant hyperthermia, hypovolemia, shock and all types of heart block, congestive heart failure, bradycardia, respiratory depression or impaired liver or renal function. The injection of lignocaine should not be administered in areas of inflammation or infection. It should be avoided if plasma cholinesterase concentration is low.
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