Pharm 101: Prilocaine

Class

Local anaesthetic

Pharmacodynamics

• Amide local anaesthetic
• See Pharm 101: Bupivacaine for information regarding mechanism of action of amide local anaesthetics

Pharmacokinetics

• Distribution half-life 5 minutes
• Elimination half-life 1.5 hours
• Volume od distribution 261L
• Clearance 2.84L/min
  • Highest clearance of amino-amide anaesthetics, reducing risk of systemic toxicity

Clinical uses

• IV for peripheral nerve block e.g. bier’s block

Adverse effects

• CNS toxicity:
  • Sedation
  • Visual and auditory hallucinations
  • Tongue/mouth numbness, metallic taste
  • Seizure
  • Respiratory depression
• Cardiac toxicity (high volume blocks):
  • Arrhythmias
  • Cardiovascular collapse
  • Hypotension and arrest
• Local toxicity: trauma, neurotoxicity
• Methaemoglobinaemia

Further reading

• Buttner R. Pharm 101: Lignocaine. LITFL
• Baker M. SCGH ED: Bier’s Block. Charlie’s ED

References

• Katzung BG. Basic and Clinical Pharmacology. 14e. 2018: 460-472