A case is reported of an infant who experienced seizures while being treated with a topical lidocaine 2% solution (Xylocaine® 2% Viscous) for teething. The pharmacology of lidocaine is reviewed to alert physicians to the potential dangers of topical mucosal application of these preparations.
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References
1.
Anonymous.Lidocaine monograph. Physicians' Desk Reference. 36th ed. Oradell, NJ: Medical Economics Co, 1982:613-4.
2.
Fruncillo RJ , Gibbons W., Bowman SMCNS toxicity after ingestion of topical lidocaine . N Engl J Med1982;306: 426-7.
3.
Sakai RI, Lattin JELidocaine ingestion. Am J Dis Child1980; 134:323.
4.
Cohen MR, Levinsky WJTopical anesthesia and swallowing. JAMA1976 ;236:562.
5.
Adriani J., Zepernick R.Clinical effectiveness of drugs used for topical anesthesia. JAMA1964; 188:711-6.
6.
Boyes RN, Scott DB, Jebson PJ, et al. Pharmacokinetics of lidocaine in man. Clin Pharmacol Ther1971;12:105-16.
7.
Benowitz N., Forsyth RP, Melmon KL, et al. Lidocaine disposition kinetics in monkey and man. 1. Prediction by a perfusion model. Clin Pharmacol Ther1974;16:87-98.
8.
Keenaghan JB , Boyes RNThe tissue distribution metabolism and excretion of lidocaine in rats, guinea pigs, dogs and man. J Pharmacol Exp Ther1972; 180:454-63.
9.
Strong JM, Mayfield DE, Atkinson AJ, et al. Pharmacological activity, metabolism and pharmacokinetics of glycinexylidide. Clin Pharm Ther1975;17:184-94.
10.
Seldon R., Sasahara AACentral nervous system toxicity induced by lidocaine. JAMA1967;202:908.
11.
Covino BGLocal anesthesia: part I. N Engl J Med1972 ;286:975-1035.
12.
Ritchie JM, Greene NMLocal anesthetics. In: Goodman LS, Gilman A, eds. The pharmacological basis of therapeutics. 6th ed. New York : Macmillan, 1980:300-320.
