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Local Anesthetics: Common Agents and Their Applications01:23

Local Anesthetics: Common Agents and Their Applications

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Local anesthetics (LAs) are commonly used for various applications in medical and dental procedures. Some of the common agents used are cocaine, lidocaine, and bupivacaine.
Cocaine is an ester of benzoic acid and methylecgogine. It is used to anesthetize and vasoconstrict locally. Currently, it is used primarily for topical applications. It is beneficial for surgeries on the upper respiratory tract, providing anesthesia and shrinking the mucosa. Cocaine in the form of cocaine hydrochloride is...
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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia01:30

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
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Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

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Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
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Topical Analgesics.

Steven Stanos1

  • 1Swedish Pain Services, 600 Broadway, Suite #530, Seattle, WA 98112, USA.

Physical Medicine and Rehabilitation Clinics of North America
|April 14, 2020
PubMed
Summary
This summary is machine-generated.

Topical analgesics offer localized pain relief with fewer systemic side effects. This review updates on formulations, drug delivery advancements, and guidelines for conditions like osteoarthritis and neuropathic pain.

Keywords:
Neuropathic pain guidelinesNonsteroidal anti-inflammatory drugsOsteoarthritis guidelinesTopical NSAIDsTopical analgesics

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Area of Science:

  • Pharmacology
  • Pain Management
  • Drug Delivery Systems

Background:

  • Topical analgesics are gaining clinical importance due to enhanced formulations and local delivery.
  • They manage acute and chronic pain, including musculoskeletal, neuropathic, and trauma-related muscle pain.
  • Improved drug delivery minimizes systemic adverse effects.

Purpose of the Study:

  • To review updated formulations for acute and chronic pain topical analgesics.
  • To discuss advancements in drug delivery systems for topical medications.
  • To provide an update on recent treatment guidelines for osteoarthritis and neuropathic pain.

Main Methods:

  • Literature review of recent studies on topical analgesic formulations.
  • Analysis of advancements in drug delivery technologies for topical applications.
  • Synthesis of current treatment guidelines for topical pain management.

Main Results:

  • Formulation improvements enhance efficacy and patient compliance.
  • Novel drug delivery systems increase local drug concentration and reduce systemic exposure.
  • Updated guidelines emphasize topical treatments for specific pain conditions.

Conclusions:

  • Topical analgesics represent a safe and effective option for localized pain management.
  • Advancements in formulation and delivery are expanding their therapeutic applications.
  • Evidence supports their use in osteoarthritis and neuropathic pain management according to recent guidelines.