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Lidocaine Patch

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701. Analysis of Response of Subjects With Atopic Dermatitis or Psoriasis to Oral Vitamin D3

, and is characterized by scaling skin and inflammation (pain, swelling, heat, and redness). Most psoriasis cause patches of thick, red skin with silvery scales. These patches can itch or feel sore. This sub-study will provide additional information on psoriatic responses to oral vitamin D. (Originally listed separately as ADVN-CATH-03-01). Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 82 participants Allocation: Randomized Intervention Model (...) channel blockers, or beta-blockers Currently taking magnesium-containing antacids, mineral oil, cholestyramine (Questran), colestipol(Colestid), orlistat (xenical), the fat substitute Olestra, cod liver oil, fish oil, or omega 3 fatty acids Currently taking oral antifungals such as ketoconazole History of serious or life-threatening anaphylactic reaction to tape or adhesives Lidocaine allergy History of or active hyperparathyroidism, sarcoid, tuberculosis or lymphoma. Exclusion Criteria (Sub-Study

2008 Clinical Trials

702. Autologous Transplantation of Melanocytes for Treatment of Vitiligo Skin

Details Study Description Go to Brief Summary: The purpose of this study is to investigate the efficacy and safety of autologous transplantation of melanocytes in patients with vitiligo. Condition or disease Intervention/treatment Phase Vitiligo Biological: Melanocyte transplantation Phase 3 Detailed Description: Vitiligo is a pigmentation disorder in which white patches of skin appear on different parts of the body. Histologically it is characterized by absence of melanocytes along the epidermal (...) to epidermis. A shaved biopsy specimen (about 1 cm2) is taken from the patient`s normally pigmented area under local anesthesia (lidocaine hydrochloride 20 mg/ml). The specimens are incubated in 0.25% trypsin solution for 15 minutes at 37°C 0.02% EDTA solution for 10 minutes. Then epidermal sheets are gently manipulated with forceps to dissociate the epidermal cells and to yield a cell suspension, followed by treatment with 0.5% trypsin/versene solution at 37C for 3-5 minutes. Well-dispersed cell

2008 Clinical Trials

703. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. Full Text available with Trip Pro

that there is evidence to support the use of the following orally administered therapies: tricyclic antidepressants, "strong" opioids, gabapentin, tramadol, and pregabalin. Topical therapies associated with efficacy were lidocaine 5% patch and capsaicin. Finally, a single study of spinal intrathecal administration of lidocaine and methyl prednisolone demonstrated efficacy, although this has yet to be replicated. Data suggest that the following therapies are not associated with efficacy in PHN: certain NMDA receptor (...) . However, many of the trials that demonstrated a lack of efficacy represented comparatively low numbers of patient episodes or were single-dose studies, so it may be appropriate to regard such interventions as "not yet adequately tested" rather than demonstrating "no evidence of efficacy." Topical aspirin/diethyl ether has not been adequately tested.The evidence base supports the oral use of tricyclic antidepressants, certain opioids, and gabapentinoids in PHN. Topical therapy with lidocaine patches

2005 PLoS medicine

704. Use of bulleyaconitine a as an adjuvant for prolonged cutaneous analgesia in the rat. Full Text available with Trip Pro

Use of bulleyaconitine a as an adjuvant for prolonged cutaneous analgesia in the rat. Bulleyaconitine A (BLA) is an analgesic and antiinflammatory drug isolated from Aconitum plants. BLA has several potential targets, including voltage-gated Na+ channels. We tested whether BLA elicited long-lasting cutaneous analgesia, when co-injected with lidocaine and epinephrine, as a model for prolonged infiltration anesthesia.The local anesthetic properties of BLA were assessed by the patch-clamp (...) . However, when stimulated at 2 Hz for 1000 pulses, their peak Na+ currents were >90% reduced by BLA. This use-dependent inhibition was not significantly reversed after 15-min washing. Complete nociceptive blockade after injection of lidocaine (0.5%)/epinephrine (1:200,000) lasted for approximately 1 h in rats; full recovery occurred after approximately 6 h. Co-injection of 0.125 mM BLA with lidocaine/epinephrine increased the duration of complete nociceptive blockade to 24 h. Full recovery occurred

2008 Anesthesia and Analgesia

705. Adjuvant agents in cancer pain. (Abstract)

essential. Coanalgesics have been well integrated into cancer pain management strategies and are often used as first-line options for treatment of certain disease processes such as neuropathic pain. These medicines, including antidepressant and anticonvulsant agents, are recommended by evidence-based guidelines, whereas others, such as lidocaine patch 5%, are supported by randomized, controlled, clinical trial data. In addition to understanding which agents are recommended for neuropathic pain

2008 Clinical Journal of Pain

706. Brain dynamics for perception of tactile allodynia (touch-induced pain) in postherpetic neuralgia. Full Text available with Trip Pro

, 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. Pain 2007;128:88-100]), delineate regions that specifically code the magnitude of perceived allodynia, and show the transformation of allodynia-related information in the brain as a time-evolving network. Eleven PHN patients were studied for DMA and its modulation with Lidoderm therapy (patches of 5% lidocaine applied to the PHN affected

2008 Pain

707. Management of herpes zoster and postherpetic neuralgia. (Abstract)

of some complications. The addition of corticosteroids to antiviral medication may further alleviate short-term zoster pain, but is associated with an increased risk of serious adverse effects, especially among older adults. If a patient does develop postherpetic neuralgia, gabapentin, pregabalin, opioids, tricyclic antidepressants, lidocaine patch 5%, and capsaicin may all be considered as palliative treatments. For individuals with treatment-refractory postherpetic neuralgia, nonpharmacologic

2007 Journal of American Academy of Dermatology

708. Delayed-type hypersensitivity (type IV) reactions in dental anesthesia. (Abstract)

hours with evaluation up to 72 hours was performed. Three patients presented with a history of localized edema after dental anesthesia. All had negative lidocaine and mepivacaine testing as well as negative lidocaine challenge on evaluation at 1 hour. The first patient, who had previously reacted to EMLA, reacted to both lidocaine and mepivacaine patch testing and challenge, with delayed swelling at 24 and 48 hours after challenge. This patient subsequently tolerated the ester anesthetic (...) chloroprocaine. Two other patients had strong histories of contact dermatitis. Patch testing and challenge with lidocaine was negative, but strong reactions were found to benzocaine on patch testing. Patients undergoing local anesthetic testing should be screened historically for features and risk factors associated with type IV reactions. This should be considered in patients who react to multiple amide anesthetics, who have delayed swelling, or who have a history of severe contact dermatitis. We confirm

2007 Allergy and Asthma Proceedings

709. Effects of ifenprodil on voltage-gated tetrodotoxin-resistant Na+ channels in rat sensory neurons. (Abstract)

, recordings of whole-cell membrane currents being made using patch-clamp technique.Both drugs blocked tetrodotoxin-resistant Na+ currents dose dependently, their half-maximal inhibitory concentrations being 145+/-12.1 micromol (ketamine) and 2.6+/-0.95 micromol (ifenprodil). Ifenprodil shifted the inactivation curve for tetrodotoxin-resistant Na+ channels in the hyperpolarizing direction and shifted the activation curve in the depolarizing direction. Use-dependent blockade of tetrodotoxin-resistant Na (...) + channels was more marked with ifenprodil than with ketamine. When paired with lidocaine, these drugs produced similar additive inhibitions of tetrodotoxin-resistant Na+ channel activity.The observed suppressive effects on tetrodotoxin-resistant Na+ channel activity may, at least in part, underlie the antinociceptive effects of these N-methyl-D-aspartate receptor antagonists.

2007 European Journal of Anaesthesiology

710. Effects of alpha2-adrenoceptor agonists on tetrodotoxin-resistant Na+ channels in rat dorsal root ganglion neurons. (Abstract)

the effects of alpha2-adrenoceptor agonists on tetrodotoxin-resistant Na+ currents.Using the whole-cell patch-clamp technique, we recorded tetrodotoxin-resistant Na+ currents from rat dorsal root ganglion neurons.Both clonidine and dexmedetomidine reduced the peak amplitude of the tetrodotoxin-resistant Na+ current concentration- and use-dependently. The concentration required for a half-maximal effect was significantly lower for dexmedetomidine (58.0 +/- 10.2 micromol) than for clonidine (257.2 +/- 30.9 (...) micromol) at holding potential -70 mV. The current inhibitions induced by these agonists were not prevented by 1 micromol yohimbine, an alpha2-adrenoceptor antagonist. Both clonidine and dexmedetomidine shifted the inactivation curve for the tetrodotoxin-resistant Na+ current in the hyperpolarizing direction. The combinations clonidine with lidocaine and dexmedetomidine with lidocaine produced an additive blockade-type interaction on the tetrodotoxin-resistant Na+ current.The results suggest

2007 European Journal of Anaesthesiology

711. Magnesium sulfate diminishes the effects of amide local anesthetics in rat sciatic-nerve block. Full Text available with Trip Pro

block model. Further, the mechanism of possible synergy between LAs and MgSO(4) was investigated in whole-cell mode patch-clamp experiments.Sciatic nerves were exposed to 2%/73.9 mM lidocaine, 0.25%/7.7 mM bupivacaine, and 0.5%/15.4 mM ropivacaine, with or without addition of 1.25%, 2.5%, or 5% MgSO(4)/50.7 mM, and nerve block characteristics were assessed. To elucidate the LA-MgSO(4) interaction, voltage-dependent inactivation curves were determined in cultured rat GH(3) cells that expressed (...) neuronal Na(+) channels.Unexpectedly, the addition of MgSO(4) overall significantly shortened the duration of block by lidocaine, bupivacaine, and ropivacaine. The steady-state inactivation of Na(+) channels in the presence of 300 muM lidocaine was almost unchanged by the addition of 10 mM MgSO(4), indicating that MgSO(4) does not affect the potency of lidocaine toward the inactivated Na(+) channel.MgSO(4) coadministered with amide-type LAs shortened the duration of sciatic-nerve block in rats

2007 Regional Anesthesia and Pain Medicine

712. Atrium-selective sodium channel block as a strategy for suppression of atrial fibrillation: differences in sodium channel inactivation between atria and ventricles and the role of ranolazine. Full Text available with Trip Pro

Atrium-selective sodium channel block as a strategy for suppression of atrial fibrillation: differences in sodium channel inactivation between atria and ventricles and the role of ranolazine. The development of selective atrial antiarrhythmic agents is a current strategy for suppression of atrial fibrillation (AF).Whole-cell patch clamp techniques were used to evaluate inactivation of peak sodium channel current (I(Na)) in myocytes isolated from canine atria and ventricles (...) . The electrophysiological effects of therapeutic concentrations of ranolazine (1 to 10 micromol/L) and lidocaine (2.1 to 21 micromol/L) were evaluated in canine isolated coronary-perfused atrial and ventricular preparations. Half-inactivation voltage of I(Na) was approximately 15 mV more negative in atrial versus ventricular cells under control conditions; this difference increased after exposure to ranolazine. Ranolazine produced a marked use-dependent depression of sodium channel parameters, including the maximum

2007 Circulation

713. The pain quality assessment scale: assessment of pain quality in carpal tunnel syndrome. (Abstract)

for assessing neuropathic pain and also would be used to assess pain qualities associated with non-neuropathic pain. To evaluate the responsivity of the PQAS items to pain treatment, secondary analyses were conducted on data from a trial that compared the efficacy of lidocaine patch 5% versus a single steroid injection in 40 patients with carpal tunnel syndrome. Statistically significant (P < .0025) decreases in 10 of the 20 PQAS pain descriptor ratings occurred with both treatments, and 8 ratings showed

2006 The journal of pain : official journal of the American Pain Society Controlled trial quality: uncertain

714. A pH-sensitive potassium conductance (TASK) and its function in the murine gastrointestinal tract Full Text available with Trip Pro

muscles. TASK-2, cloned from murine intestinal muscles, resulted in a pH-sensitive, time-dependent, non-inactivating K+ conductance with slow activation kinetics. A similar conductance was found in native intestinal myocytes using whole-cell patch-clamp conditions. The pH-sensitive current was blocked by local anaesthetics. Lidocaine, bupivacaine and acidic pH depolarized circular muscle cells in intact muscles and decreased amplitude and frequency of slow waves. The effects of lidocaine were (...) not blocked by tetraethylammonium chloride, 4-aminopyridine, glibenclamide, apamin or MK-499. However, depolarization by acidic pH was abolished by pre-treatment with lidocaine, suggesting that lidocaine-sensitive K+ channels were responsible for pH-sensitive changes in membrane potential. The kinetics of activation, sensitivity to pH, and pharmacology of the conductance in intestinal myocytes and the expression of TASK-1 and TASK-2 in these cells suggest that the pH-sensitive background conductance

2005 The Journal of physiology

715. Cu2+(1,10 phenanthroline)3 is an open-channel blocker of the human skeletal muscle sodium channel Full Text available with Trip Pro

Cu2+(1,10 phenanthroline)3 is an open-channel blocker of the human skeletal muscle sodium channel The formation of disulfide bridges is a classical approach used to study the mobility, proximity and distances of residues in a variety of proteins, including ligand- and voltage-gated ion channels. We performed patch-clamp studies to investigate the interaction of a pair of cysteines introduced into the human skeletal muscle voltage-gated Na+ channel (hNa(v)1.4) using the oxidation catalyst, Cu2 (...) was capable of blocking Na+ channels in the absence of Cu2+ ions. Our results indicate a use- and voltage-dependent binding and unbinding of CuPhen, reminiscent of the lidocaine quaternary derivative QX-314 and the neurotoxin batrachotoxin. Care should be taken when using CuPhen as an oxidizing reagent in cross-linking experiments, since it may directly affect channel activity. Our results identify CuPhen (and phenantroline) as a novel use-dependent inhibitor of Na+ channels, a mechanism that is shared

2006 British journal of pharmacology

716. Lichen Sclerosus

patches (porcelain-white papules and plaques). These may progress to crinkled white patches (like cigarette paper). Active lesions may have areas of ecchymosis, hyperkeratosis or bullae. Women Symptoms: Itch - can be severe and disturb sleep, as it is usually worse at night. This is usually the first symptom. Pain can occur if there are fissures or erosions, leading to dyspareunia. Perianal lesions are common (about 30%) and may cause constipation. May be asymptomatic and found incidentally. Signs (...) , glans penis and coronal sulcus. Symptoms: Soreness, haemorrhagic blisters. Itching is not usually a common symptom in men. Dyspareunia, painful erections due to phimosis. If there is meatal scarring, poor urinary stream or dysuria. Signs: White patches on the glans or prepuce. Haemorrhagic vesicles or purpura. Rarely, blisters or ulcers. If scarring has occurred - phimosis, wasting of the prepuce, meatal narrowing/thickening. Perianal involvement rarely (if ever) occurs. May be asymptomatic. Other

2008 Mentor

717. Lumbar Puncture

. Sterilise the area with iodine-based antiseptic unless the patient is allergic. If you are using a fenestrated sterile adhesive drape, the sterile field can be isolated at this point. Anaesthetise the skin with 1% lidocaine. Use a small-gauge needle to minimise pain. Let a minute pass, then infiltrate lidocaine into the interspinous area; in bigger patients use a longer, larger-gauge needle if required. ALWAYS aspirate before injecting lidocaine, to avoid intravascular injection. After one minute (...) is essentially clinical, based on the history of an LP, the postural nature and the associated symptoms. [ ] Prevention of PLPH It may be prevented by using a thin LP needle (22G) with an atraumatic tip. Epidural saline or morphine, and prophylactic blood patch have been studied; however, there is not consensus on the best preventative practice. [ ] There is no evidence that caffeine reduces the incidence of PLPH. [ ] Treatment of PLPH With pain relief and oral fluids. A Cochrane review has shown caffeine

2008 Mentor

718. Living with Disability and Pain

in addition to non-pharmacological treatments. Topical NSAIDs should be considered in the treatment of patients with chronic pain from musculoskeletal conditions, particularly for patients who cannot tolerate oral NSAIDs. Topical capsaicin patches should be considered in the treatment of patients with peripheral neuropathic pain when first-line pharmacological therapies have been ineffective or not tolerated. (This is from SIGN guidance for chronic pain - NICE guideline on neuropathic pain advises (...) this is only used under specialist advice, although it gives capsaicin cream as an option [ ] .) Topical lidocaine should be considered for the treatment of patients with postherpetic neuralgia if first-line pharmacological therapies have been ineffective. Topical rubefacients should be considered for the treatment of pain in patients with musculoskeletal conditions if other pharmacological therapies have been ineffective. Opioids Over recent years there has been a significant increase in prescribing

2008 Mentor

719. Infection control and instrument sterility for GP minor surgery

but should not be used with cryotherapy. Lidocaine 1% is the most commonly used local anaesthetic and it can be used for these procedures. It is most conveniently administered using a dental syringe with a fine dental needle and cartridges made for the syringe. A lidocaine/adrenaline (epinephrine) mixture is often used. This prolongs the duration of action and increases the total dose that can be used; however, its greatest asset is that it induces vasoconstriction and so reduces bleeding. It must (...) not be used on fingers, toes or the penis. If analgesia is required on a mucous membrane it is possible to apply lidocaine directly via a piece of gauze and this numbs the surface so that injection is less painful. It does not cross the horny barrier of keratinised epithelium in the skin and so is of no use to numb skin. For topical use, a 2% or 4% solution is acceptable but otherwise a maximum of 1% is recommended. Remember that after injection of local anaesthetic it is necessary to allow a few minutes

2008 Mentor

720. Herpes Simplex Oral

: Aphthous ulcers - are not unilateral and are more likely to be on non-keratinised mucosa. . . Lip cancer. Primary oral chancre of . Signs of possible oral cancer include: Ulceration of the oral mucosa persisting for more than three weeks. Oral swellings persisting for more than three weeks. All red or red and white patches of the oral mucosa. The level of suspicion is further increased if the person is a heavy smoker, heavy alcohol drinker, aged over 45 years or male. The National Institute for Health (...) and Care Excellence (NICE) guidance on referral for suspected cancer recommends urgent referral [ ] : By a doctor for unexplained ulceration in the oral cavity lasting for more than three weeks. By a dentist for: A lump on the lip or in the oral cavity consistent with oral cancer; or A red or red and white patch in the oral cavity consistent with erythroplakia or erythroleukoplakia. Investigations Tests are not usually necessary in immunocompetent people, as history and examination will usually confirm

2008 Mentor

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