Page 17 - PBA Medicine list - edition 5_SW_Neat

By Aaron Wilson and Emerald Hoang

Generic Name: Mepivacaine

Brand names: Scandonest

Side effects/precautions:

Infection; gingivitis; pain; oedema; headache; paresthesia; hyperaesthesia; CNS (lightheadedness,
euphoria, tinnitus, tremor, convulsion, confusion), CV effects (hypotension, CV collapse, bradycardia);
allergic reaction eg cutaneous lesion, urticaria, oedema, anaphylaxis.

Rapid admin; monitor CV, respiratory vital signs postinj; hepatic (esp severe), renal, CV impairment;
diabetes; thyrotoxicosis; familial malignant hyperthermia; repeated, high dose; epilepsy; bradycardia;
digitalis intoxication; severe shock; heart block; Stoke-Adams, WPW syndrome; postpone eating,
drinking hot liquids until normal function returns; areas with compromised blood supply; peripheral,
hypertensive vascular disease; IHD; asthma; acute illness; debility; elderly; pregnancy; lactation (not
recommended); children < 3 yrs (do not use) Scandonest 2% Special: also other conditions that may
be aggravated by adrenaline (epinephrine).

Interactions:
Hypoglycaemics; antiarrhythmics (eg procainamide, mexiletine, disopyramide); suxamethonium;
cardiac glycosides eg digoxin; adrenergic neuron blockers eg guanethidine; quinidine; cimetidine;
amiodarone; phenytoin, other antiepileptics incl phenobarbital, primidone, carbamazepine;
halogenated compounds eg chloroform, halothane, cyclopropane, trichlorethylene; structurally
related local anaethetics; β-blockers eg timolol, propranolol, metoprolol Scandonest 2% Special: also
phenothiazines, butyrophenones, vasopressors, ergot-type oxytocics, thyroid hormones

Reasons for interactions:

The administration of local anaesthetic solutions containing adrenaline to patients receiving
monoamine oxidase inhibitors, tricyclic antidepressants or phenothiazines may produce severe
prolonged hypotension or hypertension. Phenothiazines and butyrophenones may reduce or reverse
the pressor effect of adrenaline, Concurrent use of these agents should generally be avoided. In
situations when concurrent therapy is necessary, careful patient monitoring is essential. Concurrent
administration of vasopressor drugs and ergot-type oxytocic drugs may cause severe, persistent
hypertension or cerebrovascular accidents.

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