mepivacaine (Carbocaine)
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Introduction
Tradename: Carbocaine. (mepivacaine hydrochloride)
Indications
- local anesthetic used in blocks for anesthesia & analgesia
- used locally for anesthetic purposes
- NOT used for spinal anesthesia
Contraindications
Caution:
Dosage
- depends upon indication
- cumulative doses usually do not exceed 400 mg
Injection: 1% (30 mL, 50 mL), 1.5%, 2% (20 mL, 50 mL), 3%.
Pharmacokinetics
- less vasodilation, more rapid onset & longer duration than lidocaine
- onset of action: 7-15 minutes following epidural or local injection
- duration of action: 2.5-5 hours, similar for epidural or local injection
- metabolized by the liver & lungs by N-demethylation, hydroxylation & glucuronidation
- metabolites excreted in the urine & feces
- some is exhaled as CO2
elimination via liver
elimination via kidney
Adverse effects
- uncommon (< 1%)
- bradycardia, myocardial depression, bradycardia, hypotension, cardiovascular collapse, edema, anxiety, restlessness, disorientation, confusion, tremors, shivering, chills, seizures*, drowsiness, unconsciousness, urticaria, nausea/vomiting, transient stinging or burning at site of injection, blurred vision, tinnitus, respiratory arrest, anaphylatoid reactions
* seizures leading to cardiac arrest may occur with intravascular injection
Mechanism of action
- amide-type anesthetic similar to lidocaine or bupivicaine
More general terms
Additional terms
Component of
References
- ↑ The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
- ↑ Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
- ↑ Kaiser Permanente Northern California Regional Drug Formulary, 1998