Local anesthetic cartridges and vials

Azher a auda BDS CABS

Local anesthetic cartridge

CARTRIDGES 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 reactions
10-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

Lidocaine
Prilocaine
Articaine
Bupivcaine
Dibucaine
etidocaine

distribution

Absorbed into the blood vessel, distributed to the body
Blood 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 metablites

lignocaine

The most commonly used L A
Metabolized 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 value
2-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