Lidocort Disease Interactions

Topical lidocaine is not recommended to be used in teething infants and young children, as its ingestion is dangerous and potentially fatal. Ingestion of the drug has shown to result in seizures, severe brain injury, and heart problems in children.

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Lidocaine is absorbed through intact skin and mucosal membranes following topical administration. Prolonged exposure, large doses, frequent applications and/or use on compromised skin or mucosa can produce systemic effects. At high plasma levels, lidocaine can cause hypotension, bradycardia, and cardiovascular collapse. Therapy with lidocaine topical should be administered cautiously in patients with shock, sinus bradyarrhythmia, or severe heart block. The recommended dosage should not be exceeded. Children and debilitated, elderly, or acutely ill patients should be given reduced dosages commensurate with their age, weight, and physical condition.

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Lidocaine topical is absorbed through intact skin and mucosal membranes. Prolonged exposure, large doses, and/or application to compromised skin or mucosa can result in elevated plasma concentrations of lidocaine. Lidocaine is rapidly and extensively metabolized by the liver. Less than 10% is eliminated unchanged in the urine. Several inactive and two active forms (MEGX and GX) have been identified. MEGX and GX exhibit antiarrhythmic and convulsant properties. The pharmacokinetic disposition of lidocaine is altered by changes in hepatic function, including hepatic blood flow. Therapy with lidocaine topical should be administered cautiously and dosing modified for patients with compromised hepatic function.

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Lidocaine topical is absorbed through intact skin and mucosal membranes. Prolonged exposure, large doses, and/or application to compromised skin or mucosa can result in elevated plasma concentrations of lidocaine. Lidocaine is primarily eliminated by the kidney. Less than 10% is eliminated unchanged in the urine. Two active metabolites (MEGX and GX) have been identified that exhibit antiarrhythmic and convulsant properties. Serum concentrations of lidocaine and the active metabolites are increased and the half-life prolonged in patients with renal impairment. Therapy with lidocaine topical should be administered cautiously and dosing modified for repeated doses in patients with compromised renal function.

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Lidocaine topical is absorbed through intact skin and mucosal membranes. Prolonged exposure, large doses, and/or application to compromised skin or mucosa can result in elevated plasma concentrations of lidocaine. Seizures can occur as a result of accumulation of active metabolites. Therapy with lidocaine topical should be administered cautiously to patients with or predisposed to seizure disorders.

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Corticosteroids can raise blood glucose level by antagonizing the action and suppressing the secretion of insulin, which results in inhibition of peripheral glucose uptake and increased gluconeogenesis. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with diabetes mellitus, glucose intolerance, or a predisposition to hyperglycemia. Systemic absorption of topical corticosteroids may occur depending on the vehicle and concentration of the preparation, the size of the application area, the integrity of the skin, and the duration of administration. Use of occlusive dressings over the applied areas may also increase percutaneous absorption. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults.

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Topical corticosteroids, especially the potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol), are generally not recommended for use in the treatment of diaper rash. Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are usually at the greatest risk for systemic toxicity such as adrenal suppression, Cushing's syndrome and intracranial hypertension because of their larger skin surface to body mass ratios. If topical corticosteroids are necessary to treat diaper rash, medium- to low-potency agents should preferably be used, and parents should be advised not to put tight-fitting diapers or plastic pants over the rash, since occlusion of treated area may increase percutaneous drug absorption.

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The use of topical corticosteroids may precipitate or aggravate conditions of hyperadrenocorticism. Systemic absorption of these agents can produce reversible hypothalamic-pituitary-adrenal axis suppression. Systemic absorption, depends on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Patients with an altered skin barrier or liver failure are also at increased risk. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. The development of symptoms such as menstrual irregularities, acneiform lesions, cataracts and cushingoid features during topical corticosteroid therapy may indicate excessive use.

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Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Clinically significant local as well as systemic immunosuppressant and anti-inflammatory effects may occur, which can cause or exacerbate an infection. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios. Therapy with topical corticosteroids should be administered cautiously in patients with latent or active infections, particularly if a potent agent is used on a large area for prolonged periods or if occlusive dressings are used. Effective antimicrobial therapy or other appropriate treatment should be instituted to treat the infection. If possible, the use of highly potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) should be avoided in children and limited to small areas for 2 weeks in adults. Occlusive dressings should not be used in patients with skin infection.

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Prolonged use of corticosteroids may cause posterior subcapsular cataracts and elevated intraocular pressure, the latter of which may lead to glaucoma and/or damage to the optic nerves. Therapy with topical corticosteroids rarely produces these effects but should be administered cautiously nonetheless in patients with a history of cataracts, glaucoma, or increased intraocular pressure, especially when potent agents (e.g., augmented betamethasone, clobetasol, diflorasone, and halobetasol) are used in the periorbital area. Topical corticosteroids may be systemically absorbed, depending on the vehicle and concentration of the preparation, the size of the application area, the duration of administration, and whether or not occlusive dressings are used. Given equivalent doses, small children are generally at the greatest risk because of their larger skin surface to body mass ratios.

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