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Classification of Local Anesthetics

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  • Local anesthetics are categorized based on their chemical structure.

  • Each class shares a common mechanism of action, primarily involving the inhibition of nerve impulse transmission.

  • Below is the classification along with the mechanism of action for each class:

1) Benzoic Acid Derivatives

  • Mechanism of Action: Block sodium channels by binding to the intracellular portion of the channel, preventing depolarization and nerve impulse conduction.

  • Examples: Cocaine, Hexylcaine, Meprylcaine, Cyclomethycaine, Piperocaine

2) Amino Benzoic Acid Derivatives

  • Mechanism of Action: Inhibit sodium ion influx by binding to sodium channels, thereby blocking nerve impulse transmission.

  • Examples: Benzocaine, Butamben, Procaine, Butacaine, Propoxycaine, Tetracaine, Benoxinate

3) Lidocaine/Anilide Derivatives

  • Mechanism of Action: Stabilize neuronal membranes by blocking voltage-gated sodium channels, which inhibits the initiation and conduction of nerve impulses.

  • Examples: Lignocaine (Lidocaine), Mepivacaine, Prilocaine, Etidocaine

4) Miscellaneous

  • Mechanism of Action: Primarily block sodium channels to prevent the propagation of nerve impulses, with varying affinities and durations of action.

  • Examples: Phenacaine, Diperodon, Dibucaine

Here is a shortened version of the table:

Classification

Examples

Mechanism

Uses

Side Effects

Benzoic Acid Derivatives

Cocaine, Hexylcaine, Meprylcaine, Cyclomethycaine, Piperocaine

Block Na⁺ channels

Topical anesthesia, minor surgeries

Nervousness, tachycardia, hypertension, addiction risk

Amino Benzoic Acid Derivatives

Benzocaine, Butamben, Procaine, Butacaine, Propoxycaine, Tetracaine, Benoxinate

Block Na⁺ channels

Surface anesthesia, minor procedures

Methemoglobinemia, allergic reactions, systemic toxicity

Lidocaine/Anilide Derivatives

Lidocaine, Mepivacaine, Prilocaine, Etidocaine

Block Na⁺ channels

Dental work, surgeries, arrhythmias

CNS toxicity, cardiovascular issues, allergies

Miscellaneous

Phenacaine, Diperodon, Dibucaine

Block Na⁺ channels

Various anesthesia uses

Varies: CNS/cardio toxicity, allergies


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