Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Antiarrhythmic agent (See CH 14)
Medium

Short-duration procedures, epidural, spinal anesthesia

Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Long

Cardiovascular collapse

Longer-duration procedures

Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Sympathomimetic effects; Blocks NE reuptake → vasoconstriction
Medium

Convulsions, cardiac arrhythmias, hypertension, stroke

CNS stimulation

Procedures requiring high surface activity and vasoconstriction

Used to ↓ bleeding in ENT

Blockade of voltage-gated sodium channels, increases threshold until ability to generate action potential is lost; effect is greater in rapidly firing channels

In spinal anesthesia, inhibit transmission via substance P, NMDA, and AMPA receptors

CNS excitation

Sleepiness, light-headedness, visual and auditory disturbances, nystagmus,  convulsions with high concentrations

Weak bases

Less effective in infected (acidic) tissues

Often administered with epinephrine to ↓ blood flow and ↑ duration of action

Long

Spinal, epidural anesthesia