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afya
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Lidocaine 1% (10mg/ml) without adrenaline for insertion of SDI 1-2 mlas to insert, 0.5-1 ml to remove - ''below'' distal end of implant max dose - 4mg/kg - 280mg overall % solution is g solute in 100 mls solvent % unionization (lipid solubility) effects speed of onset of action chemical structure (ester or amide) effects protein binding so duration of action (amide more bound longer acting) is removed by slow uptake into systemic circulation CI not in hypovolaemia, complete heart block, known hypersensitivity Precautions membrane stabilizing drug which can cause arrythmymias - beware in renal / hepatic impairment / cardiac conduction impaired, avoid intravascular admin (be sure to aspirate), have resus facility available Interactions BB, cimetidine, NA - synergystic Diazepam - inc risk fits liver inducers dec efficacy SE urticaria - anaphyllaxis if systemic - blurred vision, tinnitis, circumoral and tongue numbness, then twitching, fits, coma, death note - giving diazepam concurrently raises threshold for fits so looses sign of gross overdose but if fits give 10mg rectally Mx reaction stop giving drug phone 999 do ABC give Diazepam if fits
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