Quote from angelina28
What I need is trade name classification, Use, Dose/Route, and side Effects and any contraindications and nursing considerations.. The drug is Prilocaine... If you could help me I would be so indebt to you.. Tammy
Prilocaine: Trade name Citanest.
Classification Local Anesthetic.
Adult dosing: Dental infiltration 40-80 mg (1-2 ml) of 4% soln. NMT 600 mg (8 mg/kg) within 2 hr.
Pediatric dosing: Dental infiltration 40 mg of (1 ml) 4% soln. NMT 8 mg / kg within 2 hr.
Contraindications: Hypersensitivity to prilocaine, amide-type local anesthetics, sulfites, parabens. Methemoglobinemia.
Cautions: Administration of >600 mg to adults causes non-acute 15% methemoglobinemia via formulation of o-toluidine metabolite. Use preservative-free preparations for spinal or epidural anesthesia. DO NOT use solutions with epinephrine in distal areas of body (e.g. digit, nose, ear, etc). In pts with history of malignant hyperthermia use with caution. Addition of vasoconstrictor, epinephrine, will promote local hemostasis, decrease systemic absorption, and increase duration of action.
Indications: Infiltrative or nerve block anesthesia for dental procedures.
Mechanism of action: Local anesthetics prevent generation / conduction of nerve impulses by reducing sodium permeability and increasing action potential threshold.
Adverse drug reactions: CNS and Cardiovascular Effect: anxiety, apprehension, restlessness, nervousness, disorientation, confusion, dizzinesss, blurred vision, tremors, twitching, shivering, seisures; CNS depression manifested by drowsiness, unconsciousness, respiratory arrest, nausea, vomiting, chills, miosis, tinnitus; myocardial depression, bradycardia, cardiac arrhythmias, hypotension, cardiovascular collapse, cardiac arrest; anxiety, palpitation, dizziness, headache, restlessness, tremors, tachycardia, anginal pain, hypertension (epinephreine-containing solutions).
Sensitivity reactions: edema, status asthmaticus, anaphylactoid reactions (sometimes fatal).
Kinetics/Dynamics: Pregnancy category C. Lactation: not known if excreted in human breast milk. Duration: the greater the degree of vasodilation produced by the local anesthetic, the faster the rate of absorption and shorter the duration of action (bupivacaine has a long duration of action).
Protein bound: highly
Metabolites: ester- and amide-type local anesthetics
Excretion: urine (principally)
Overdose management: supportive tx; anticonvulsant Rx if indicated
Quoted from PEPID RN, a PDA program available at http://www.pepid.com
and HIGHLY recommended by NurseWeasel.