Prilocaine Side Effects
Dentsply Pharmaceutical sells the injectable local prilocaine under the brand name Citanest Plain Dental. As the trademark implies, dentists administer prilocaine to paralyze nerves in the moth and gums before extracting teeth or performing other minor dental surgeries. Prilocaine generally produces few side effects beyond minor swelling around the injection site and lingering numbness, but the anesthetic can become deadly when administered in excessive doses or inappropriately injected into a blood vessel.
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Central Nervous System Side Effects
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When patients have a high sensitivity to prilocaine, when large doses of prilocaine get administered or when prilocaine gets injected directly into a blood vessel instead of gum tissue, patients can experience central nervous system (CNS) problems. As listed in prilocaine's prescribing information, these CNS side effects can include dizziness, nervousness, blurred vision, drowsiness, tremors, convulsions and respiratory arrest.
Cardiovascular Side Effects
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Injections of prilocaine can slow patients' hearts and lower their arterial pressure to the point that too little oxygenated blood reaches the brain. Symptoms of this condition---known as cerebral hypoxia---include sweating, moving in and out of consciousness and mental confusion.
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Allergic Reaction
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Anyone who has had an allergic reaction to lidocaine (e.g., Anestacon from Polymedica), mepivacaine (e.g., Polocaine from Dentsply) or benzocaine (e.g., Anbesol from Wyeth Consumer Healthcare) will also be allergic to prilocaine. Allergies occur rarely, according to the prescribing information prilocaine, but the symptoms of such a reaction include hives, throat swelling and skin lesions. People have died because of prilocaine allergies.
Overdose
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Severe CNS and/or cardiovascular side effects indicate that a patient has received an overdose of prilocaine. Doctors may need to administer medications to control convulsions or increase the heart rate and arterial pressure. Patients may also need to have supplemental oxygen.
Warnings
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Doctors who administer prilocaine must have emergency equipment on hand to resuscitate patients who have severe adverse reactions to the anesthetic. Patients with severe liver or kidney impairment should not receive prilocaine injections, nor should patients with a red blood cell disorder known as methemoglobinemia. People with methemoglobinemia cannot eliminate old or damaged iron- and oxygen-carrying blood cells.
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References
Resources
- Photo Credit Fairfex County Health Department
