73-78-9 Usage
General
Lidocaine hydrochloride was synthesized by L?fgren and Lundquist in 1943, and
was clinically introduced in 1948. It remains one of the most widely used local
anaesthetics. It can be administered parenterally for a peripheral nerve block
(PNB), intravenously, or applied topically at strengths of 2–4%. The addition of
epinephrine 1:200 000 to 1:100 000 slows the vascular absorption of lidocaine and
prolongs its effects.
Physical and chemical properties
Lidocaine hydrochloride is white and odorless crystal with bitter and numb taste. It is easily soluble in water, ethanol and organic solvents, but insoluble in ether. Aqueous solution in the case of acid and alkali do not break down, repeated autoclave rarely go bad.
Local anesthetic and antiarrhythmic drugs
Lidocaine hydrochloride is a local anesthetic and antiarrhythmic drug. It is clinically used for infiltration anesthesia, epidural anesthesia, surface anesthesia (including in the thoracoscopy or abdominal surgery for mucosal anesthesia) and nerve conduction block. The drug can also be used for acute myocardial infarction after ventricular premature beats and ventricular tachycardia, and for digitalis poisoning, cardiac surgery and ventricular arrhythmias caused by cardiac catheterization. But it is usually ineffective for supraventricular arrhythmias.
Lidocaine hydrochloride is an amide local anesthetic. After blood absorption or intravenous administration, the drug has obvious excitement and inhibition of biphasic effects for the central nervous system, and no excitement of the pioneer. With the dose increased, the role or toxicity increased, there is an anti-convulsive effect with sub-poisoning plasma concentration; Blood concentration of more than 5μg ? ml-1 can occur convulsions. Lidocaine hydrochloride in low doses can promote outflow of K+ in cardiomyocytes, reduce myocardial autonomy, and has antiarrhythmic effects. In the treatment dose, lidocaine hydrochloride has no significant effect for the electrical activity of cardiomyocytes, atrioventricular conduction and myocardial contraction. Increased plasma concentration may cause slowing of heart conduction, atrioventricular block, inhibition of myocardial contractility and decreased cardiac output.
Application
Lidocaine hydrochloride is characterized by strong penetration, strong dispersion, rapidly onset. The anesthetic performance is twice that of procaine and the toxicity is1. There is an anesthetic effect after 5 minutes treatments, and anesthesia can last 1 to 1.5 hours, 50% longer than procaine. The drug is effective on the heart of the disease or arrhythmia caused by cardiac glycoside, but on the supraventricular tachycardia is poor. This product is fast and oral ineffective, with short duration, and often used as intravenous administration.
Metabolism
Lidocaine is metabolized by the liver with only a small amount (3%) found
unchanged in urine. The three main mechanisms of metabolism are shown below:
N-de-ethylation > monoethylglycinexylidide (MEGX) > glycinexylidide
Hydrolysis of glycinexylidide
5-hydroxylation of lidocaine’s benzene ring
Lidocaine possesses convulsant activity. Hepatic disease or reduced hepatic blood
flow (as in congestive cardiac failure) will lower metabolic capacity.
Indications
The drug can be used for infiltration anesthesia, epidural anesthesia, surface anesthesia and nerve conduction block
The drug can be used for acute myocardial infarction after ventricular premature beats and ventricular tachycardia, and for digitalis poisoning, cardiac surgery and ventricular arrhythmias caused by cardiac catheterization. But it is usually ineffective for supraventricular arrhythmias.
Usage and dosage
Surface anesthesia with solution of 2% to 5%.Infiltration anesthesia with solution of 0.25% to 0.5%, conduction anesthesia with 2%, each injection point, horse, cattle 8 to 12 ml, sheep 3 to 4 ml. Epidural anesthesia with 2% solution, horse, cow, 8 to 12 ml, dog, cat, 0.22 ml per kilogram of body weight. Subcutaneous injection with 2% solution, pig, sheep, 80 ml, horse, cow, 400 ml, dog,25 ml, cat, 8.5 ml.
Treatment of arrhythmia, intravenous injection: Per kg of dog’s body weight of the initial dose is 2 to 4 mg, followed by 25 to 75 micrograms per minute intravenous infusion; Cat initial dose of 250 to 500 micrograms, followed by intravenous infusion of 20 micrograms per minute.
Adverse effect
The incidence of adverse effect with lidocaine hydrochloride was about 6.3%. Most adverse effects are dose dependent. Adverse effects are drowsiness, dizziness, nausea, vomiting, burnout, euphoria, insanity, muscle convulsions, syncope, blurred vision, confusion and difficulty breathing. Large doses lead to severe sinus bradycardia, cardiac arrest, severe atrioventricular block and weakened myocardial contractility, reduced blood pressure and so on. Excess concentrations of lidocaine hydrochloride in the blood cause some problems. For example, atrial conduction slows, atrioventricular blocks (A-V-B), and inhibits myocardial contractility and cardiac output decreases. There are little allergic effects, such as erythema rash, angioneurotic edema and so on.
Additional information
Lidocaine is contraindicated in patients with known hypersensitivity to local
anaesthetics of the amide type and in patients with porphyria. Reactions due to
overdose with lidocaine (high plasma levels) are systemic and involve the central
nervous and cardiovascular systems. Effects include medullary depression, tonic and
clonic convulsions, and cardiovascular collapse
Solutions in multidose vials may contain hydrobenzoate derivatives and have been
associated with allergic reactions in some patients. As with all of the amide local
anaesthetics protein binding is reduced in the neonate (50% versus 64% in the
adult), which necessitates reduced doses if adverse reactions are to be avoided.
Medicine interactions
Cimetidine and β-blockers can inhibit metabolism of lidocaine through liver, so that the blood concentration increases and adverse reactions occur in the heart and nervous system. We should adjust the dose of lidocaine hydrochloride.
Barbiturates can promote the metabolism of lidocaine hydrochloride, and the two drugs can cause bradycardia and sinus arrest.
Combined with procainamide, the drug can produce excessive delirium and hallucinations, but does not affect the product plasma concentration.
Isoprenaline Isoprinosine could increase the total clearance of lidocaine hydrochloride through increased liver blood flow; norepinephrine could reduce the total clearance of lidocaine hydrochlor through reduced liver blood flow.
The drug is contraindicated with phenobarbital, thiopental sodium, sodium nitroprusside, mannitol, amphotericin B, ampicillin, and sulfadiazine.
Precautions
Patients Allergic to other local anesthetics may be allergic to lidocaine hydrochloride.
The following circumstances with caution: Pregnancy, neonatal especially in premature infants, liver blood flow reduction, liver and kidney dysfunction, congestive heart failure, severe myocardial damage, low blood volume, shock and other patients.
Strictly grasp the concentration and total medication, excessive can cause convulsions and cardiac arrest; the body metabolism is slower than procaine, and there is accumulation, causing poisoning and convulsions.
Medication of the elderly should be adjusted the dose according to the needs and tolerability, and over the age of 70 should be halved.
Prevent straying into the blood vessels when anaesthetizing, prevent local anesthetic poisoning.
?We should pay attention to monitoring blood pressure, electrocardiogram, and with rescue equipment when arrhythmia Treatment; drug administration should be immediately discontinued in some circumstances. For example, ECG P-R interval prolongs or QRS wave widens, other arrhythmia or the original arrhythmia deteriorates.
References
https://www.drugbank.ca/drugs/DB00281
https://en.wikipedia.org/wiki/Lidocaine
Chemical Properties
White to Off-White Solid
Uses
Apply to affected site 5 to 10 minutes before procedure. Duration of
anesthesia is relatively short (<1 hour).
Definition
ChEBI: The anhydrous form of the hydrochloride salt of lidocaine.
Biological Functions
Lidocaine hydrochloride (Xylocaine) is the most commonly
used local anesthetic. It is well tolerated, and in
addition to its use in infiltration and regional nerve
blocks, it is commonly used for spinal and topical anesthesia
and as an antiarrhythmic agent.
Lidocaine has a more rapidly occurring, more intense,
and more prolonged duration of action than does procaine.
General Description
Lidocaine hydrochloride,2-(diethylamino)-2 ,6 -acetoxylidide monohydrochloride(Xylocaine), was conceived as a derivative of gramine(3-dimethylaminomethylindole) and introduced as a localanesthetic. It is now being used intravenously as a standardparenteral agent for suppression of arrhythmias associatedwith acute myocardial infarction and cardiac surgery.It isthe drug of choice for the parenteral treatment of prematureventricular contractions.
Mechanism of action
Lidocaine can block Na+ and K+ ?ion channels and regulate intracellular and extracellular calcium ?concentrations through other ligand-gated ion channels. Lidocaine was ?the first sodium channel blocker to be identified. Its main mechanism of ?action is blocking voltage-gated Na+ channels (VGSC/NaVs).
Clinical Use
Lidocaine hydrochloride is a class IB antiarrhythmicagent with a different effect on the electrophysiologicalproperties of myocardial cells from that of procainamideand quinidine. It binds with equal affinity to the active (A)and inactive (I) Na+ ion channels. It depresses diastolic depolarizationand automaticity in the Purkinje fiber networkand increases the functional refractory period relative toaction potential duration, as do procainamide and quinidine.It differs from the latter two drugs, however, in that it doesnot decrease, and may even enhance, conduction velocity and increase membrane responsiveness to stimulation.There are fewer data available on the subcellular mechanismsresponsible for the antiarrhythmic actions of lidocainethan on the more established drug quinidine. It has been proposedthat lidocaine has little effect on membrane cation exchangeof the atria. Sodium ion entrance into ventricularcells during excitation is not influenced by lidocaine becauseit does not alter conduction velocity in this area.Lidocaine hydrochloride does depress Na+ influx duringdiastole, as do all other antiarrhythmic drugs, to diminishautomaticity in myocardial tissue. It also alters membraneresponsiveness in Purkinje fibers, allowing increased conductionvelocity and ample membrane potential at the timeof excitation.
Safety Profile
Poison by ingestion,
intraperitoneal, intravenous, subcutaneous,
intramuscular, and intratracheal routes.
Human systemic effects: somnolence,
respiratory depression, low blood pressure,
cardiomyopathy includmg infarction, pulse
rate increase. An experimental teratogen.
Other experimental reproductive effects. A
skin and eye irritant. An anesthetic. When
heated to decomposition it emits very toxic
fumes of NOx and HCl.
storage
Store in a tightly closed container at room temperature away from light
and moisture. Do not store in the bathroom. Do not freeze. Keep all medications away from children and pets.
Check Digit Verification of cas no
The CAS Registry Mumber 73-78-9 includes 5 digits separated into 3 groups by hyphens. The first part of the number,starting from the left, has 2 digits, 7 and 3 respectively; the second part has 2 digits, 7 and 8 respectively.
Calculate Digit Verification of CAS Registry Number 73-78:
(4*7)+(3*3)+(2*7)+(1*8)=59
59 % 10 = 9
So 73-78-9 is a valid CAS Registry Number.
InChI:InChI=1/C14H22N2O.ClH/c1-5-16(6-2)10-13(17)15-14-11(3)8-7-9-12(14)4;/h7-9H,5-6,10H2,1-4H3,(H,15,17);1H
73-78-9Relevant articles and documents
The molecular structure and vibrational, 1H and 13C NMR spectra of lidocaine hydrochloride monohydrate
Badawi, Hassan M.,F?rner, Wolfgang,Ali, Shaikh A.
, p. 92 - 100 (2016)
The structure, vibrational and NMR spectra of the local anesthetic drug lidocaine hydrochloride monohydrate salt were investigated by B3LYP/6-311G calculations. The lidocaine·HCl·H2O salt is predicted to have the gauche structure as the predominant form at ambient temperature with NCCN and CNCC torsional angles of 110° and -123° as compared to 10° and -64°, respectively in the base lidocaine. The repulsive interaction between the two N-H bonds destabilized the gauche structure of lidocaine·HCl·H2O salt. The analysis of the observed vibrational spectra is consistent with the presence of the lidocaine salt in only one gauche conformation at room temperature. The 1H and 13C NMR spectra of lidocaine·HCl·H2O were interpreted by experimental and DFT calculated chemical shifts of the lidocaine salt. The RMSD between experimental and theoretical 1H and 13C chemical shifts for lidocaine·HCl·H2O is 2.32 and 8.21 ppm, respectively.
Method for preparing lidocaine hydrochloride
-
, (2016/11/28)
The invention provides a method for preparing lidocaine hydrochloride, and belongs to the technical field of anesthetic synthesis. The method comprises the following steps: by taking 2,6-xylenol as a raw material, Pd/C as a main catalyst and 2,6-dimethylcyclohexanone as a promoter, performing liquid phase amination with ammonia water at high temperature, thereby obtaining a midbody 2,6-dimethylaniline; enabling sodium methylate, 2,6-dimethylaniline and N,N-lignocaine methyl acetate as raw materials to react at 90-95 DEGC, distilling while reaction is performed to remove methanol till no methanol can be evaporated out, continuously reacting for 30 minutes, cooling to the room temperature, adding dichloroethane, washing with water, and leaving to stand to layer, thereby obtaining an organic layer, namely, a lidocaine based dichloroethane solution; further adding hydrochloric acid into the lidocaine based dichloroethane solution, adjusting the pH value to be 3.5-4 by using hydrogen chloride, adding activated carbon to reflux for 20-40 minutes, filtering, concentrating the filtrate, cooling, crystallizing, and dying, thereby obtaining lidocaine hydrochloride. The lidocaine hydrochloride prepared by using the method is simple in synthesis process and high in product purity, that is, the purity can be greater than 99%, and the total yield is greater than 84%.
