Prilocaine
Mechanism :
Prilocaine is a local anesthetic. Local anesthetics block the generation and the conduction of nerve impulses by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential.
Indication :
Contraindications :
Prilocaine is contraindicated in patients with a known hypersensitivity to it or to any local anesthetic agent of the amide type or to other components of prilocaine solutions. Avoid in anemia, methemoglobinemia and in inflamed/infected areas.
Dosing :
<10 years:
40 mg or 1 ml (4% solution); maximum dose of 600 mg (8 mg/kg) within 2 hours to not be exceeded.
>10 years:
40-80 mg or 1-2 ml (4% solution) with
epinephrine; maximum dose of 600 mg (8 mg/kg) within 2 hours to not be exceeded.
Adverse Effect :
Hypersensitivity reactions may be provoked. Systemic adverse effects are likely to occur following accidental IV administration or following excessive dosage. Cutaneous lesions, urticaria, oedema and anaphylaxis may occur.
Interaction :
Monoamine Oxidase Inhibitors or Tricyclic Antidepressants: May produce severe, prolonged hypertension.
Vasopressor drugs and of Ergot-Type Oxytocic drugs: Cause severe, persistent hypertension or cerebrovascular accidents.
Phenothiazines and Butyrophenones: May reduce or reverse the pressor effect of epinephrine.
Hepatic Dose :
Dose adjustment guidelines are not available, dose adjustment may be required as drug undergoes extensive hepatic metabolization, use with caution in hepatic impairment and administer low dose. Effect of drug can be prolonged due to systemic accumulation.