scholarly journals Lidocaine: A Local Anesthetic, Its Adverse Effects and Management

Medicina ◽  
2021 ◽  
Vol 57 (8) ◽  
pp. 782
Author(s):  
Entaz Bahar ◽  
Hyonok Yoon
Keyword(s):  
Adverse Effects ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Adverse Reactions ◽  
Rapid Diagnosis ◽  
Diagnosis And Treatment ◽  
Allergic Reactions ◽  
Life Threatening

The most widely used medications in dentistry are local anesthetics (LA), especially lidocaine, and the number of recorded adverse allergic responses, particularly of hazardous responses, is quite low. However, allergic reactions can range from moderate to life-threatening, requiring rapid diagnosis and treatment. This article serves as a review to provide information on LA, their adverse reactions, causes, and management.

Local Anesthetics for Neuraxial and Regional Techniques

2018 ◽  
Author(s):  
Michael J Schontz ◽  
Krystina Geiger
Keyword(s):  
Pain Relief ◽  
Adverse Effects ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Lipid Emulsion ◽  
Systemic Toxicity ◽  
Duration Of Action ◽  
Liposomal Bupivacaine ◽  
Provide Pain Relief ◽  
Local Anesthetic Systemic Toxicity

Local anesthetics are used with neuraxial and regional techniques to provide pain relief, most commonly postoperatively. Each agent is a sodium-channel blocker, although each agent differs in onset of action, potency, duration of action, and safety profile. Chemical structure and lipophilicity are the main determinants of these characteristics. The agents may be used alone or in combination with an additive which alters the local anesthetic’s properties . Clinically, local anesthetics provide pain relief in a multimodal approach. This reduces opiate consumption, opiate-related adverse effects, and length of stay. Additional benefits when using neuraxial techniques include decreases in mortality, venous thromboembolism, myocardial infarction, pneumonia, respiratory depression, and duration of ileus. Although there are many adverse effects, the most serious include neurologic and cardiovascular. Seizures and cardiac arrest may result from local anesthetic systemic toxicity when systemic levels are elevated or the patient is predisposed. Dose adjustment, removal, or reversal of the agent may be clinically indicated. Lipid emulsion therapy is a reversal agent which acts as a sequestering vehicle for the local anesthetic. Liposomal bupivacaine, the newest formulation of local anesthetic, may provide an increased duration of action compared with standard formulations, although more evidence is needed. This review contains 5 figures, 5 tables, and 59 references. Keywords: amide, ester, epidural, local anesthetic, local anesthetic systemic toxicity, lipid emulsion therapy, liposomal bupivacaine, peripheral nerve block

Adverse reactions to medication

2019 ◽  
pp. 103-114
Author(s):  
Tomasz Bajorek ◽  
Jonathan Hafferty
Keyword(s):  
Adverse Effect ◽  
Adverse Effects ◽  
Adverse Reactions ◽  
Bleeding Risk ◽  
Inpatient Setting ◽  
Extrapyramidal Side Effects ◽  
Inpatient Psychiatry ◽  
Drug Induced ◽  
Threatening Condition ◽  
Life Threatening

Adverse reactions to medication represent a major issue in inpatient psychiatry. This chapter systematically explores the most relevant, concerning, and problematic adverse effects routinely encountered in an inpatient setting. It describes the typical presentation, pathophysiology, incidence, and practical management of these problems. Extrapyramidal side effects including acute dystonia, drug-induced parkinsonism, akathisia, and tardive dyskinesia are considered before the chapter explores the rare but potentially life-threatening condition of neuroleptic malignant syndrome. Other adverse effects common to antipsychotics that are described include hyperprolactinaemia and psychotropic-induced arrhythmias including QTc prolongation. Sexual dysfunction is an under-recognized and undertreated adverse effect common to several classes of psychotropic medication and is also considered. Focusing on antidepressants, the chapter reviews the frequently encountered issue of hyponatraemia as well as serotonin syndrome and selective serotonin reuptake inhibitor-induced bleeding risk. Finally, the chapter addresses perinatal considerations for psychotropic drugs.

scholarly journals Tetracycline Allergy

Pharmacy ◽  
2019 ◽  
Vol 7 (3) ◽  
pp. 104 ◽  
Author(s):  
Leslie A. Hamilton ◽  
Anthony J. Guarascio
Keyword(s):  
Adverse Reaction ◽  
Adverse Reactions ◽  
Allergic Reactions ◽  
Hypersensitivity Reactions ◽  
Serious Adverse Events ◽  
Tetracycline Antibiotics ◽  
Reaction Type ◽  
Pubmed Search ◽  
Life Threatening ◽  
Selection Of

Despite the widespread use of tetracycline antibiotics since the late 1940s, tetracycline hypersensitivity reactions have rarely been described in the literature. A comprehensive PubMed search was performed, including allergic and serious adverse reactions attributed to the tetracyclines class of antibiotics. Of the evaluated tetracycline analogs, minocycline was attributed to the greatest overall number and severity of serious adverse events reported in the literature, with notable reactions primarily reported as respiratory and dermatologic in nature. Reactions to tetracycline have also been well described in the literature, and although dermatologic reactions are typically less severe in comparison with minocycline and doxycycline, various reports of anaphylactic reactions exist. Although doxycycline has been noted to have had the fewest reports of severe allergic reactions, rare descriptions of life-threatening reactions are still reported in the literature. Allergic reactions regarding tetracyclines are rare; however, adverse reaction type, severity, and frequency among different tetracycline analogs is somewhat variable. A consideration of hypersensitivity and adverse reaction incidence should be performed prior to the selection of individual tetracycline entities.

scholarly journals Local Anesthetics: Review of Pharmacological Considerations

2012 ◽  
Vol 59 (2) ◽  
pp. 90-102 ◽  
Author(s):  
Daniel E Becker ◽  
Kenneth L Reed
Keyword(s):  
Adverse Effects ◽  
Continuing Education ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Dental Practice ◽  
Efficacy And Safety ◽  
History Of ◽  
Technical Considerations

Local anesthetics have an impressive history of efficacy and safety in medical and dental practice. Their use is so routine, and adverse effects are so infrequent, that providers may understandably overlook many of their pharmacotherapeutic principles. The purpose of this continuing education article is to provide a review and update of essential pharmacology for the various local anesthetic formulations in current use. Technical considerations will be addressed in a subsequent article.

scholarly journals Immediate local anesthetic reactions and diagnostic test results in pediatric patients

2021 ◽  
Vol 49 (3) ◽  
pp. 108-114
Author(s):  
Ahmet Selmanoglu ◽  
Hakan Guvenir ◽  
İlknur Kulhas Celik ◽  
Betul Karaatmaca ◽  
Muge Toyran ◽  
...  
Keyword(s):  
Local Anesthetic ◽  
Local Anesthetics ◽  
Pediatric Patients ◽  
Diagnostic Testing ◽  
Challenge Test ◽  
Skin Tests ◽  
Test Results ◽  
Life Threatening ◽  
History Of ◽  
Ige Mediated

Background/objectives: Adverse reactions to local anesthetics are relatively common, but proven IgE-mediated allergy is extremely rare. We aimed to determine the frequency of local anesthetic allergy in pediatric patients.Patients and methods: The medical records of 73 patients who presented to our clinic with a history of suspected allergic reaction to local anesthetics and underwent diagnostic testing between 2012 and 2020 were retrospectively analyzed. Diagnoses were based on case histories, skin tests, and subcutaneous challenge tests.Results: A total of 75 test series were carried out on the 73 patients (43 boys; median [IQR] age 9.25 [7.26–14.25] years, range 3–17.8 years). The most commonly tested drugs were lido-caine (n = 38; 50.6%) and prilocaine (n = 15; 20%). Local anesthetic allergy was confirmed in one (1.3%) of the 73 patients by positive subcutaneous challenge test with mepivacaine. Conclusion: There are limited data in the current literature regarding local anesthetic allergies and diagnosis test results in pediatric patients. Proven local anesthetic allergy is less common than expected by society and physicians, and therefore diagnostic tests are needed for patients with no contra-indications such as severe or life-threatening reactions.

scholarly journals A Single Drop in the Eye – Effects on the Whole Body?

2017 ◽  
Vol 11 (1) ◽  
pp. 305-314 ◽  
Author(s):  
Anu Vaajanen ◽  
Heikki Vapaatalo
Keyword(s):  
Adverse Effects ◽  
Whole Body ◽  
Systemic Absorption ◽  
Eye Drops ◽  
Allergic Reactions ◽  
Single Drop ◽  
Active Components ◽  
Life Threatening ◽  
Systemic Side Effects ◽  
Kinetics Of

Introduction: Although the local adverse effects of ophthalmic drugs, including allergic reactions, are well recognized, less is known about the systemic side- effects of eye drops, especially during pregnancy, breast-feeding and early childhood. Ophthalmologists should also be aware of unusual, in some cases even life-threatening, effects of commonly used eye drops. Conclusion: This brief review outlines the routes of systemic absorption and the kinetics of active components present in eye drops, and identifies the clinically relevant systemic adverse effects.

Adverse Effects of Treatment with Porcine Factor VIII

1991 ◽  
Vol 65 (03) ◽  
pp. 245-247 ◽  
Author(s):  
A Gringeri ◽  
E Santagostino ◽  
F Tradati ◽  
P LF Giangrande ◽  
P M Mannucci
Keyword(s):  
Platelet Count ◽  
Adverse Effects ◽  
Factor Viii ◽  
Adverse Reactions ◽  
High Titer ◽  
Home Treatment ◽  
Allergic Reactions ◽  
Median Percentage ◽  
Baseline Platelet Count ◽  
Anaphylactoid Reactions

SummaryIn the last 10 years 63 courses (283 infusions) of porcine FVIII were given to 25 hemophiliacs with high titer alloantibodies and to 5 patients with autoantibodies to factor VIII. Although the product was in general clinically efficacious, adverse effects of treatment were more frequent and severe than previously reported. After 63 courses there was a median percentage fall in baseline platelet count of 54% (range 8-86%); for 10 courses (16%), thrombocytopenia was severe or moderately severe (<100 × 109/1), with nadirs of platelet count ranging from 10 to 99 × 109/1 (median 67). Allergic reactions were seen in 15 of 30 patients (50%), in 20 of 63 courses (32%), more frequently but not exclusively after the first infusion. Relatively mild symptoms (fever, Hushing, urticaria, shivering) occurred in 15 courses; 5 courses, however, were accompanied by more severe anaphylactoid reactions, 2 of which required resuscitation therapy. Allergic reactions were observed both in patients pretreated with steroids or anti-histamines (in 7 of 18 courses, 39%) and in nonpretreated patients (in 13 of 45 courses, 29%). In conclusion, adverse reactions are frequent after porcine FVIII (in 30 of 63 courses, 47%), and can occur also with infusions subsequent to the first. Hence, the recently proposed use of porcine FVIII as home treatment should be implemented with caution.

scholarly journals Toxic and Adverse Effects of Chemotherapy with 5-Fluoropyrimidine Drugs. Could Dihydropyrimidine Dehydrogenase Enzyme Screening Serve as a Prerequisite to Successful Chemotherapy?

2020 ◽  
Vol 13 (2) ◽  
pp. 87-99
Author(s):  
Velko T. Minchev
Keyword(s):  
Adverse Effects ◽  
Adverse Reactions ◽  
Dihydropyrimidine Dehydrogenase ◽  
Clinical Expertise ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Enzyme Screening ◽  
Dehydrogenase Enzyme ◽  
Life Threatening ◽  
Pros And Cons ◽  
Methodological Approaches

Summary The article presents a detailed survey of recent publications in the literature concerning clinical expertise, existing guidelines, and differing opinions on Fluoropyrimidine chemotherapy-related toxicity and the implication of Dihydropyrimidine dehydrogenase (DPD) screening aiming to prevent severe 5-Fluorouracil-induced adverse drug reactions. The first section provides information on the mechanism of action, clinical application, pharmacokinetics and pharmacodynamics, and toxicity and adverse reactions of 5-Fluorouracil, Capecitabine, Floxuridine, and Flucytosine. The second section summarizes DPD phenol- and genotype data and provides reasons for determining a DPD life-threatening complete or partial enzyme deficiency. The pros and cons of the methodological approaches for DPD screening are analysed, and recommendations are made to introduce them into clinical practice. The third section includes a brief economic analysis of expenses for DPD screening of patients scheduled for 5-Fluorouracil chemotherapy. The costs are compared to those related to the treatment of patients suffering from 5-Fluorouracil-induced toxicity and unwanted adverse effects.

scholarly journals A Misleading Apical Periodontitis Like Symptoms Post COVID-19 Vaccine

2021 ◽  
Author(s):  
Mohammed Alzahrani
Keyword(s):  
Immune System ◽  
Side Effects ◽  
Adverse Effects ◽  
Adverse Reactions ◽  
Treatment Plan ◽  
Apical Periodontitis ◽  
Diagnosis And Treatment ◽  
Tentative Diagnosis

Abstract BackgroundAdverse effects of vaccines are common, yet the reaction to vaccines widely varies between people. Companies provide an adverse effects list of their products. Adverse reactions might indicate the effectiveness of vaccines and that the immune system is responding. Case presentationIn this study, we present unusual side effects of the Pfizer/BioN-Tech vaccine. The patient had severe continuous pain related to the lower left first molar after the second dose of the Pfizer/BioN-Tech vaccine. The symptoms are typically resembling symptomatic apical periodontitis cases.ConclusionPfizer/BioN-Tech vaccine might lead to symptoms that mimic symptomatic apical periodontitis. The patient who develops such symptoms shortly after the covid -19 vaccine without an apparent cause should be assured and kept under observation for one to two weeks. A tentative diagnosis and treatment plan should be considered in the follow-up visit.

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