Azher a auda BDS CABS
Local anesthetic cartridgeCARTRIDGES AND VIALS
Contais primarily ;1- L A drugs
2- vasoconstrictor drug
3- preservative for vasoconstrictor
4- ringers sol.
5- distilled water
6- general preservative
L A drugs
• Either topical or local injection• - causes loss of sensation or pain
• Listed drugs by %
• Mesurred by ml or mg
Ideal L A
Properties of ideal L A;
1- potency and reliability
2- reversibility of action
3- lack of irritation
4- rapidity of onset
5- duration of effect
6- sterility
7- adequate shelf life
8- penetration of mucous membrane
Ideal L A
9- FREE from allergic reactions10-it should be stable in sol. And readly undergo biotransformation in the body
Classification of l a
On the basis of occurance in nature;1- naturally occurring e.g. cocaine
2- synthetic compound e. g. procaine , lidocaine
On the basis of duration of action;
1- short acting as articaine, lidocaine
2- long acting as bupivacaine, bucricaine
On the basis of chemical structure;
1- ester
2- amide
Ester type
• Procaine
• Chloroprocaine
• Propoxycaine
• Butacaine
• Cocaine
• benzocaine
Amide types
LidocainePrilocaine
Articaine
Bupivcaine
Dibucaine
etidocaine
distribution
Absorbed into the blood vessel, distributed to the bodyBlood level of L A is influenced by;
1- rate of absorbtion by cardiovascular system
2- rate of distribution of L A from blood vessel to tissue
3- elimination of the drug throught the excretory pathways
metabolism
1- ester
Hydrolized in plasma by enzyme pseudocholinesterase
2- amide
Hydrolized in liver and excrete in the urine
excretion
Kidney is the primary organ for all L A metabliteslignocaine
The most commonly used L AMetabolized in liver
Effective dental conce. 2%
Available in dental cartridge of 2% lidocaine with epinephrine
1: 80,000
Factors effecting L A action
1-PH value2-lipid solubility
3-protein binding
4-vasodilator activity
Selection of L A
The agents are selected on the basis of the needs of each Pt.
Factors consider for the selection of particular agent;
1 – duration of action
2 – need for control of post operative pain
3 – physical and mental status of the Pt.
4 – concomitant medications