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mepivacaine (Carbocaine)
Tradename: Carbocaine. (mepivacaine hydrochloride)
Indications:
1) local anesthetic used in blocks for anesthesia & analgesia
2) used locally for anesthetic purposes
3) NOT used for spinal anesthesia
Contraindications: AV nodal block
Caution:
1) cardiac disease
2) renal disease
3) hyperthyroidism
Dosage:
1) depends upon indication
2) cumulative doses usually do not exceed 400 mg
Injection: 1% (30 mL, 50 mL), 1.5%, 2% (20 mL, 50 mL), 3%.
Pharmacokinetics:
1) less vasodilation, more rapid onset & longer duration than lidocaine
2) onset of action: 7-15 minutes following epidural or local injection
3) duration of action: 2.5-5 hours, similar for epidural or local injection
2) metabolized by the liver & lungs by N-demethylation, hydroxylation & glucuronidation
3) metabolites excreted in the urine & feces
4) some is exhaled as CO2
Adverse effects:
- uncommon (< 1%)
- bradycardia, myocardial depression, bradycardia, hypotension, cardiovascular collapse, edema, anxiety, restlessness, disorientation, confusion, tremors, shivering, chills, seizures*, drowsiness, unconsciousness, urticaria, nausea/vomiting, transient stinging or burning at site of injection, blurred vision, tinnitus, respiratory arrest, anaphylatoid reactions
* seizures leading to cardiac arrest may occur with intravascular injection
Mechanism of action:
1) amide-type anesthetic similar to lidocaine or bupivicaine
Related
bupivacaine (Marcaine, Sensorcaine, Exparel)
lidocaine (Xylocaine)
General
amide
amine
local anesthetic
Properties
MISC-INFO: elimination route LIVER
KIDNEY
therapeutic-range 0.2-5 UG/ML
toxic-range >8 8G/ML
Database Correlations
PUBCHEM correlations
References
- The Pharmacological Basis of Therapeutics, 9th ed.
Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
Component-of
levonordefrin/mepivacaine