Drugs seldom exert their beneficial effects without also causing adverse drug reactions (ADRs). In addition to overdose, ADRs may be caused by therapeutic doses of drugs because of drug-drug, drug-food, drug-herbal, and drug-disease interaction-related to pharmacokinetic or pharmacodynamic processes. Drugs or their metabolites may also be inherently toxic and produce cytotoxic reactions. Other LA-related ADRs may be immune mediated or are idiosyncratic.14,18-25,27-29
ADRs associated with the administration to lidocaine, mepivacaine, prilocaine, articaine, and bupivacaine, in general, are similar and may be consider together.14,18-25 However, some LAs with unique toxicities will be highlighted. For example, prilocaine is more likely to induce methemoglobinemia in susceptible patients;23 prilocaine and articaine are more likely to produce paresthesia following mandibular nerve blocks;49-51 and bupivacaine is the most cardiotoxic.14,18-25
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