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Lidocaine hydrochloride is metabolized rapidly by the liver, and metabolites and unchanged drug are excreted by the kidneys. Biotransformation includes oxidative N-dealkylation, ring hydroxylation, cleavage of the amide linkage, and conjugation. N-dealkylation, a major pathway of biotransformation, yields the metabolites monoethylglycinexylidide and glycinexylidide. The pharmacological/toxicological actions of these metabolites are similar to, but less potent than, those of Lidocaine hydrochloride. Approximately 90% of Lidocaine hydrochloride administered is excreted in the form of various metabolites, and less than 10% is excreted unchanged. The primary metabolite in urine is a conjugate of 4-hydroxy-2,6-dimethylaniline.
1. Lidocaine, xylocaine, or lignocaine is a common local anesthetic and class-1b antiarrhythmic drug. Lidocaine is used topically to relieve itching, burning, and pain from skin inflammations, injected as a dental anesthetic, or as a local anesthetic for minor surgery.
2.It is on the World Health Organization's List of Essential Medicines, a list of the most important medications needed in a basic healthcare system.
3. Lidocaine is the most important class-1b antiarrhythmic drug; it is used intravenously for the treatment of ventricular arrhythmias if amiodarone is not available or contraindicated.
4. Lidocaine should be given for this indication after defibrillation, CPR, and vasopressors have been initiated. A routine prophylactic administration is no longer recommended for acute cardiac infarction; the overall benefit of this measure is not convincing.
