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Mritunjay Kumar, Rajiv Chawla, Manish Goyal
Topical anesthetics are being widely used in numerous medical and surgical sub-specialties such as anesthesia, ophthalmology, otorhinolaryngology, dentistry, urology, and aesthetic surgery. They cause superficial loss of pain sensation after direct application. Their delivery and effectiveness can be enhanced by using free bases; by increasing the drug concentration, lowering the melting point; by using physical and chemical permeation enhancers and lipid delivery vesicles. Various topical anesthetic agents available for use are eutectic mixture of local anesthetics, ELA-max, lidocaine, epinephrine, tetracaine, bupivanor, 4% tetracaine, benzocaine, proparacaine, Betacaine-LA, topicaine, lidoderm, S-caine patch™ and local anesthetic peel...
October 2015: Journal of Anaesthesiology, Clinical Pharmacology
Phani Krishna Kondamudi, Phani Prasanth Tirumalasetty, Rajkumar Malayandi, Srinivas Mutalik, Raviraj Pillai
The present study aims to develop the correlation between in vitro and in vivo skin permeation of lidocaine in its transdermal patch. In order to minimize the run-to-run variability during in vitro skin permeation studies, release normalized cumulative percent (%Ct n) was calculated. A suitable polynomial mathematical model was used to establish a correlation between time and %Ct n. Percent in vivo absorbed was calculated by using numerical deconvolution (NDC) and non-compartmental analysis (NCA) methods. Pharmacokinetic (PK) parameters such as AUC last and C max were predicted with the established in vitro-in vivo correlation (IVIVC) models...
June 2016: AAPS PharmSciTech
Cheul-Hong Kim, Ji-Uk Yoon, Hyeon-Jung Lee, Sang-Wook Shin, Ji-Young Yoon, Gyeong-Jo Byeon
PURPOSE: Venipuncture- or injection-related pain is still major problem during anesthetic induction in children. This study was designed to determine the availability of a 5% lidocaine patch used prophylactically for venipuncture- or injection-related pain during the induction of anesthesia. METHODS: In a randomized, double-blind study, 72 pediatric patients were allocated to one of two groups: pretreatment with a 5% lidocaine patch (Lidoderm(®), Endo Pharmaceuticals, Chadds Ford, PA, USA) (group A) or pretreatment with a placebo patch (group B)...
August 2012: Journal of Anesthesia
Aaron S Kesselheim, Jessica A Myers, Daniel H Solomon, Wolfgang C Winkelmayer, Raisa Levin, Jerry Avorn
INTRODUCTION: The Orphan Drug Act encourages drug development for rare conditions. However, some orphan drugs become top sellers for unclear reasons. We sought to evaluate the extent and cost of approved and unapproved uses of orphan drugs with the highest unit sales. METHODS: We assessed prescription patterns for four top-selling orphan drugs: lidocaine patch (Lidoderm) approved for post-herpetic neuralgia, modafinil (Provigil) approved for narcolepsy, cinacalcet (Sensipar) approved for hypercalcemia of parathyroid carcinoma, and imatinib (Gleevec) approved for chronic myelogenous leukemia and gastrointestinal stromal tumor...
2012: PloS One
Nima Shemirani, Darryl Tang, David R Friedland
OBJECTIVES: To describe a case of systemic lidocaine toxicity from the simultaneous use of transdermal patches and a heating pad. METHODS: Case report and discussion. RESULTS: The focus of this case report are the interesting neuro-otologic signs of central lidocaine toxicity that occurred after a patient fell asleep on a heating pad with his Lidoderm patches in place. Hearing improvement, tinnitus reduction, and severe dizziness and ataxia were present for approximately 48 hours before spontaneous resolution...
January 2010: Clinical Journal of Pain
Honorio T Benzon, Kiran Chekka, Amit Darnule, Brian Chung, Oscar Wille, Khalid Malik
OBJECTIVE: A patient with postherpetic neuralgia (PHN) did not respond to medications, either singly or in combination, or to intrathecal methylprednisolone but responded to intrathecal alcohol. This evidenced-based case management article evaluates and grades the evidence for the prevention and treatment of PHN. METHODS: A search of published English-language studies on the prevention and treatment of PHN was made. RESULTS: Randomized clinical studies showed the efficacy of antiviral agents in the prevention of PHN and the use of anticonvulsants, antidepressants, opioids, and Lidoderm patch in the treatment of PHN (level A evidence)...
September 2009: Regional Anesthesia and Pain Medicine
Alan A Saber, Mohamed H Elgamal, Arun J Rao, Edward A Itawi, Ruvie L Martinez
INTRODUCTION: Reduced postoperative pain is one of the many factors that have driven the growing emphasis on the role of laparoscopic surgery for surgical management. Several studies have documented the advantages of the laparoscopic repair of ventral hernias compared to the open ventral herniorraphy. However, the laparoscopic approach may be associated with more postoperative pain initially. In this preliminary study, we present data from our early experience with the use of a lidocaine patch for pain control in the immediate postoperative period following laparoscopic ventral hernia repair (LVH)...
February 2009: International Journal of Surgery
P Y Geha, M N Baliki, X Wang, R N Harden, J A Paice, A V Apkarian
Postherpetic neuralgia (PHN) is a debilitating chronic pain condition often accompanied by a sensation of pain when the affected region is touched (tactile allodynia). Here we identify brain regions involved in stimulus-induced touch-evoked pain (dynamical mechanical allodynia, DMA), compare brain activity between DMA and spontaneous pain (described earlier for the same patients in [Geha PY, Baliki MN, Chialvo DR, Harden RN, Paice JA, Apkarian AV. Brain activity for spontaneous pain of postherpetic neuralgia and its modulation by lidocaine patch therapy...
September 15, 2008: Pain
Mehul J Desai, Radhika Siriki, Dajie Wang
INTRODUCTION: Dercum's disease is a rare disorder characterized by multiple painful subcutaneous lipomas on the trunk and extremities. It most commonly occurs in obese, postmenopausal women. The pain associated with this condition is postulated to arise from enlarging lipomas producing pressure on peripheral nerves, thereby initiating pain and sometimes paresthesias. Treatment has been challenging due to the rarity of this condition. CASE: A patient with Dercum's disease successfully treated with transdermal lidocaine 5% patches...
November 2008: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
A Karmarkar, I Lieberman
We report a case of a patient developing complex regional pain syndrome of the upper limb after a laceration injury with glass. The pain in his hand was resistant to all conventional modes of treatment. The pain reduced dramatically after a diagnostic lidocaine infusion and the reduction in pain lasted for 3 days. Following this the patient responded well to lidoderm 5% patches and achieved 80% pain relief with an improved range of movement in his hand.
February 2007: British Journal of Anaesthesia
P Y Geha, M N Baliki, D R Chialvo, R N Harden, J A Paice, A V Apkarian
Postherpetic neuralgia (PHN) is a debilitating chronic pain condition, yet there is a lack of knowledge regarding underlying brain activity. Here we identify brain regions involved in spontaneous pain of PHN (n=11) and determine its modulation with Lidoderm therapy (patches of 5% lidocaine applied to the PHN affected body part). Continuous ratings of fluctuations of spontaneous pain during fMRI were contrasted to ratings of fluctuations of a bar observed during scanning, at three sessions: (1) pre-treatment baseline, (2) after 6h of Lidoderm treatment, and (3) after 2 weeks of Lidoderm use...
March 2007: Pain
Lydia Estanislao, Kay Carter, Justin McArthur, Richard Olney, David Simpson
OBJECTIVE: To investigate the analgesic efficacy and safety of 5% lidocaine gel in painful HIV-associated distal sensory polyneuropathy (DSP). BACKGROUND: Painful DSP, the most common neurologic complication in HIV infection, is difficult to treat. Lidocaine 5% gel was effective in alleviating neuropathic pain in an open-label study of HIV DSP. METHODS: In a double-blind, placebo-controlled, crossover, multi-center study, 64 subjects were randomized to receive 5% lidocaine or vehicle gel for 2 weeks (phase A)...
December 15, 2004: Journal of Acquired Immune Deficiency Syndromes: JAIDS
Pamela S Davies, Bradley S Galer
Postherpetic neuralgia (PHN) is a chronic pain syndrome that disproportionately affects the elderly; its incidence is anticipated to increase as the population ages. PHN presents as pain (continuous burning or intense paroxysmal), most often with tactile allodynia, which may be severe and disabling, resulting in poor quality of life and depression. Traditional treatments have included tricyclic antidepressants, anticonvulsants and opioids; however, adverse systemic effects associated with these agents have led to the development of a newer and potentially safer agent, the topical lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic...
2004: Drugs
Robert Hines, Diane Keaney, Michael H Moskowitz, Steven Prakken
OBJECTIVE: To describe the use of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic, in treatment of patients with chronic low back pain. DESIGN: This retrospective case series examines four patients with pain secondary to spinal degeneration and complications from failed back surgery syndrome, who were prescribed the lidocaine patch as an add-on to their analgesic regimen. SETTING: Bay Area Pain Medical Associates, Mill Valley, California...
December 2002: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Nathaniel P Katz, Arnold R Gammaitoni, Matthew W Davis, Robert H Dworkin
OBJECTIVE: To assess the effectiveness of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic, in reducing pain intensity/interference with quality of life (QOL) among patients with postherpetic neuralgia (PHN). DESIGN: Open-label, nonrandomized, effectiveness study; up to three patches applied to area of greatest pain for 12 hours per day for 28 days. SETTING: Forty-two centers consisting of large institutional primary care programs and academic centers, including pain centers, neurologists, and pain specialists affiliated with a university...
December 2002: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Arnold R Gammaitoni, Nancy A Alvarez, Bradley S Galer
The safety, tolerability, and efficacy of the lidocaine patch 5% (Lidoderm), a targeted peripheral analgesic with an FDA-approved indication for the treatment of postherpetic neuralgia, has been well established. Recent case reports and studies have suggested potential efficacy in other neuropathic and nonneuropathic pain conditions. Several pharmacokinetic studies have demonstrated minimal systemic absorption with 12-, 18-, and 24-hour/day dosing. Mean maximum plasma concentrations have shown the lidocaine patch to possess a minimal risk for systemic toxicities or drug-drug interactions...
February 2003: Journal of Clinical Pharmacology
A Devers, B S Galer
OBJECTIVE: Our goal was to perform a pilot study to assess the effectiveness and tolerability of a topical lidocaine patch (Lidoderm) for the treatment of peripheral neuropathic pain conditions other than postherpetic neuralgia. DESIGN: This was an open-label prospective study. PATIENTS: Sixteen patients with refractory peripheral neuropathic pain conditions who had reported intolerable side effects or inadequate pain relief with antidepressant, anticonvulsant, antiarrhythmic, and opioid medications participated in this study...
September 2000: Clinical Journal of Pain
C E Argoff
Despite the availability of different pharmacologic agents for the treatment of various chronic neuropathic pain syndromes, complete symptom reduction and/or complete functional restoration is rarely achieved. New, safe, and effective treatments for chronic neuropathic pain, therefore, must be developed. One such agent, the lidocaine patch (Lidoderm, Endo Pharmaceuticals, Inc., Chadds Ford, PA), has been approved recently by the US Food and Drug Administration for the treatment of postherpetic neuralgia. Like other local anesthetics, the lidocaine patch results in sodium channel blockade, dampening, both peripheral nociceptor sensitization and, ultimately, central nervous system hyperexcitability...
June 2000: Clinical Journal of Pain
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