procaine (Novocain, Spinocaine, Planocaine)

Tradename: Novocain. (procaine hydrochloride) Indications: 1) spinal anesthesia 2) epidural & peripheral nerve block Contraindications: 1) cerebrospinal disease 2) heart block 3) hypotension 4) hypertension 5) bowel pathology 6) GI hemorrhage Caution: 1) cardiac disease 2) hyperthyroidism Dosage: 1%, 2%, 10% (2 mL) Pharmacokinetics: 1) onset of action: within 2-5 minutes 2) duration of action: 30-90 minuts 3) rapidly hydrolyzed by plasma enzymes to para-amino- benzoic acid & diethylaminoethanol (80% conjugated prior to elimination) 4) excreted in the urine as metabolites & some unchanged Adverse effects: 1) not common (1-10%) - burning sensation at site of injection, pain, tissue irritation 2) uncommon (< 1%) - aseptic meningitis resulting in paralysis, CNS stimulation followed by CNS depression, skin discoloration, nausea/vomiting, miosis, tinnitus, chills, anaphylactoid reaction Laboratory: 1) specimen: a) plasma (heparin) b) add 2 drops of 50% sodium arsenite (or 1 mg of echothiopate) per mL of blood 2) methods: color, GLC

General

ester local anesthetic

Properties

MISC-INFO: elimination route PLASMA LIVER KIDNEY 1/2life 6.7-8.7 MIN therapeutic-range <11 UG/ML toxic-range >21 UG/ML protein-binding 73-92% elimination by hemodialysis - hemoperfusion - peritoneal dialysis -