The effect of lidocaine when used as a local anesthetic or by intravenous injection

2021 ◽  
Vol 1 (4) ◽  
pp. 234-237
Author(s):  
Hamza Khalifa , ,, , Ibrahim ◽  
Abdulfatah Saed ◽  
Naser Ramdan R. Amaizah ◽  
Aejeeliyah Yousuf ◽  
Malak Abdalh Akim Esdera
Keyword(s):  
Myocardial Infarction ◽  
Local Anesthetic ◽  
Ventricular Arrhythmias ◽  
Rapid Onset ◽  
The Other ◽  
Important Class ◽  
Onset Of Action ◽  
Digitalis Poisoning ◽  
Duration Of Efficacy ◽  
Efficacy Profile

The efficacy profile of lidocaine as a local anesthetic is characterized by a rapid onset of action and an intermediate duration of efficacy. Therefore, lidocaine is suitable for infiltration, block, and surface anesthesia. Longer-acting substances such as bupivacaine are sometimes given preference for spinal and peridural anesthesias, however, lidocaine, on the other hand, has the advantage of a rapid onset of action. Adrenaline supplements could delay the resorption and the duration of efficacy could be doubled. Lidocaine is the most important class 1B antiarrhythmic drug: it is used intravenously for the treatment of ventricular arrhythmias (for acute myocardial infarction, digitalis poisoning, cardioversion, or cardiac catheterization). However, a routine prophylactic administration is no longer recommended for acute cardiac infarction. The overall benefit of this measure is not convincing. Lidocaine has also been efficient in refractory cases of status epilepticus.

scholarly journals Onset of Bronchodilation and Finger Tremor Induced by Salmeterol and Salbutamol in Asthmatic Patients

1998 ◽  
Vol 5 (3) ◽  
pp. 191-194 ◽  
Author(s):  
Jan Lötvall ◽  
Helen Lunde ◽  
Nils Svedmyr
Keyword(s):  
Lung Function ◽  
Rapid Onset ◽  
Forced Expiratory Volume ◽  
The Other ◽  
Beta Agonist ◽  
Onset Of Action ◽  
Asthmatic Patients ◽  
Other Hand ◽  
Finger Tremor ◽  
Linear Accelerometer

Salmeterol is a beta-agonist with bronchodilator properties that last for at least 12 h after inhalation. However, the onset of action of salmeterol immediately after inhalation has not been sufficiently investigated. In the present study, the onset of action and tremor-inducing effect of two doses of inhaled salmeterol (50 and 100 µg) were compared with inhaled salbutamol (200 and 400 µg) and placebo. Lung function was measured using forced expiratory volume in 1 s (FEV), and tremor was measured using a linear accelerometer. With salbutamol there was rapid bronchodilation, both doses producing more than 15% improvement in mean FEV1 within 2 mins of inhalation. With salmeterol, on the other hand, significant bronchodilation was delayed until 7 mins versus placebo, and the full bronchodilation effect was not achieved until 60 mins after inhalation. There was a much more rapid onset of tremor with salbutamol (400 µg) than salmeterol. There was a much slower onset of bronchodilation with salmeterol than salbutamol. Therefore, salmeterol cannot be recommended to relieve acute symptoms.

COMPARATIVE BLOOD PRESSURE AND ELECTROCARDIOGRAPHIC CHANGES INDUCED BY PROSCILLARIDIN AND OUABAIN

1966 ◽  
Vol 44 (6) ◽  
pp. 887-892 ◽  
Author(s):  
K. I. Melville ◽  
H. E. Shister ◽  
B. Klingner
Keyword(s):  
Blood Pressure ◽  
Ventricular Fibrillation ◽  
Ventricular Arrhythmias ◽  
Pressor Response ◽  
The Other ◽  
Onset Of Action ◽  
Qualitative And Quantitative ◽  
Arterial Blood ◽  
Electrocardiographic Changes ◽  
Quantitative Changes

Femoral arterial blood pressure and electrocardiograms (ECG, lead II) were recorded concurrently in artificially respired cats anesthetized with pentobarbital, and responses to the new squill glycoside, proscillaridin (Talusin), and to ouabain were compared. All drugs were injected intravenously, in groups of five cats for each dose level. Following single injections, it was observed that doses of 150 μg of proscillaridin/kg produced only slight increases in blood pressure and slight bradycardia, but no change in the ECG pattern. In contrast, similar doses of ouabain or doses of 500 μg of proscillaridin/kg produced bradycardia, ventricular arrhythmias, and fibrillation in all experiments. Whereas striking pressor effects were noted with ouabain those due to proscillaridin were slight. With continuous infusions, proscillaridin and ouabain in doses of 5 μg/kg per minute led to similar qualitative and quantitative changes (bradycardia, arrhythmias, and ventricular fibrillation), but these developed more slowly with proscillaridin. Infusions of proscillaridin in doses of 2.5 μg/kg per minute also produced similar but still more delayed changes. Doses of 15 μg/kg per minute of proscillaridin, on the other hand, produced all the effects more rapidly than 5 μg/kg per minute of ouabain, but the pressor response was again less pronounced. It is concluded that (a) proscillaridin exerts characteristic digitalis-like effects; (b) when single intravenous doses are compared, proscillaridin is approximately one-third as toxic to the heart as ouabain; (c) when continuous intravenous infusions are compared, proscillaridin shows variable onset of action depending on dosage and is approximately one-half as toxic as ouabain; and (d) in all experiments proscillaridin exerts less marked pressor effects than ouabain. The drug is being further studied.

Pharmacokinetic peculiarities of drugs used in the form of rapidly dispersible tablets (oral delivery system)

2020 ◽  
pp. 7-24
Author(s):  
Zhanna Kozlova ◽  
Ivan Krasnyuk ◽  
Yuliya Lebedeva ◽  
Ekaterina Odintsova
Keyword(s):  
Oral Mucosa ◽  
Oral Delivery ◽  
Chemical Properties ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Systemic Delivery ◽  
Onset Of Action ◽  
Mucosal Drug Delivery ◽  
Physical And Chemical ◽  
Pass Metabolism

Oral mucosal drug delivery is an alternative method of systemic delivery with several advantages over both injectable and enteral methods. Drugs that are absorbed through the oral mucosa directly enter the systemic circulation, passing through the gastrointestinal tract and first-pass metabolism in the liver due to oral mucosa being highly vascularised. This results in rapid onset of action for some drugs because of a more comfortable and convenient way of delivery than the intravenous one. But not all drugs can be administered through the oral mucosa due to characteristics of the oral mucosa and physical and chemical properties of the drug.

RESEARCH THE VALUE OF THE COMBINATION OF T WAVE ALTERNANS AND NT-PROBNT IN PREDICTING SUDDEN CARDIAC DEATH

2012 ◽  
pp. 74-83
Author(s):  
Anh Tien Hoang ◽  
Nhat Quang Nguyen
Keyword(s):  
Myocardial Infarction ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Ventricular Arrhythmias ◽  
Healthy Person ◽  
Treadmill Test ◽  
T Wave ◽  
T Wave Alternans

Background: Decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-to-bedside foundation makes TWA, NT-ProBNP a very plausible index of susceptibility to ventricular arrythmia, and motivates the need to define optimal combination of TWA and NT-ProBNP in predicting ventricular arrythmia in myocardial infarction patients. We research this study with 2 targets: 1. To evaluate the role of TWA in predicting sudden cardiac death in myocardial infarction patients. 2. To evaluate the role of NT-ProBNP in predicting sudden cardiac death in myocardial infarction patients 3. Evaluate the role of the combined NT-ProBNP and TWA in predicting sudden cardiac death in myocardial infarction patients. Methods: Prospective study with follow up the mortality in 2 years: 71 chronic myocardial infarction patients admitted to hospital from 5/2009 to 5/20011 and 50 healthy person was done treadmill test to caculate TWA; ECG, echocardiography, NT-ProBNP. Results: Cut-off point of NT-ProBNP in predicting sudden cardiac death is 3168 pg/ml; AUC = 0,86 (95% CI: 0,72 - 0,91); Cut-off point of TWA in predicting sudden cardiac death is 107 µV; AUC = 0,81 (95% CI: 0,69 - 0,87); NT-ProBNP can predict sudden cardiac death with OR= 7,26 (p<0,01); TWA can predict sudden cardiac death with OR= 8,45 (p<0,01). The combined NT-ProBNP and TWA in predicting ventricular arrythmia in heart failure patients: OR= 17,91 (p<0,001). Conclusions: The combined NT-ProBNP and TWA have the best predict value of sudden cardiac death in myocardial infarction patients, compare to NT-ProBNP or TWA alone

A Review on Enteric Coated Pellets Composed of Core Pellets Prepared by Extrusion-Spheronization

2019 ◽  
Vol 13 (2) ◽  
pp. 83-90 ◽  
Author(s):  
Hetal Patel ◽  
Mukesh Gohel
Keyword(s):  
Dosage Form ◽  
Extended Release ◽  
Rapid Onset ◽  
Enteric Coating ◽  
Onset Of Action ◽  
The Core ◽  
Current State ◽  
Enteric Coated ◽  
Extrusion Spheronization ◽  
Acid Labile

Enteric coated dosage form bypasses the stomach and releases the drug into the small intestine. Advantages of enteric coated pellets in comparison with enteric coated tablets are a) Pellets provide rapid onset of action and faster drug release due to the smaller size than tablets and b) Pellets exhibit less residence time of acid-labile drugs in the stomach compared to tablets. Dosage form coat can be damaged by longer resistance time in the stomach. The present review summarizes the current state of enteric coated pellets where core pellets are prepared by extrusion-spheronization technique and the enteric coating is applied in a fluidized bed processor. Two approaches are involved in the preparation of core pellets. In the first approach, a mixture of drug and excipient(s)/co-processed excipient is passed through extruders to prepare core pellets. In the second approach, excipient core pellets are prepared by extrusion technique and the drug is layered onto it before the enteric coating. The excipients present in the core pellets decide immediate or extended release of drug in the intestine. The coprocessed excipient pellets provide less batch variability and provide a platform for layering of many drugs before enteric coating. Some patents included enteric coating pellets [CN105456223 (A), CN105596310 (A), CN105616371 (A), CN105663095 (A), CN101611766B, CN106511862 (A), CN106668018 (A), CN106727381 (A), CN106924222 (A), TW200624127 (A), US 2017/0165248A1, US 2017/0224720A1] are discussed.

scholarly journals Nasal Delivery of Acute Medications for Migraine: The Upper Versus Lower Nasal Space

2021 ◽  
Vol 10 (11) ◽  
pp. 2468
Author(s):  
Vincent Martin ◽  
John Hoekman ◽  
Sheena K. Aurora ◽  
Stephen B. Shrewsbury
Keyword(s):  
Acute Treatment ◽  
Drug Efficacy ◽  
Hepatic Metabolism ◽  
Rapid Onset ◽  
Systemic Circulation ◽  
Nasal Delivery ◽  
Attractive Alternative ◽  
Gi Tract ◽  
Onset Of Action ◽  
First Pass

The acute treatment of migraine requires effective drugs that are well tolerated and provide rapid and consistent pain relief. Oral tablets are the most commonly used acute treatment for migraine; however, their effectiveness is limited by the rate of gastrointestinal (GI) tract absorption and first-pass hepatic metabolism, and they may not be ideal for patients experiencing GI motility issues. Nasal delivery is an attractive alternative route as it may circumvent GI tract absorption, avoid first-pass metabolism in the liver, and potentially reduce the frequency of GI adverse events. The large surface area and high vascularity within the nose may permit rapid absorption of therapeutics into the systemic circulation, allowing for rapid onset of action. However, the site of drug deposition (upper versus lower nasal cavity) may influence drug pharmacokinetics. Most approved nasal migraine therapies target the lower nasal space where the epithelium is less permeable, and they may be quickly cleared away due to increased ciliary function or dripping from the nose or swallowing, resulting in variable absorption and limited bioavailability. Together with its abundant vascularization, relative mucosal thickness stability, and low clearance rates, the upper nasal space harnesses the benefits of nasal delivery to potentially maximize drug efficacy.

Sustained ventricular arrhythmias and mortality among patients with acute myocardial infarction: Results from the GUSTO-III trial

2003 ◽  
Vol 145 (3) ◽  
pp. 515-521 ◽  
Author(s):  
Sana M. Al-Khatib ◽  
Amanda L. Stebbins ◽  
Robert M. Califf ◽  
Kerry L. Lee ◽  
Christopher B. Granger ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Ventricular Arrhythmias
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