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Procaine (Ester-Type) / Lidocaine (Amide-Type) --> Therapeutic Use

--> Different drugs can be used for surface, infiltration, nerve block, epidural, and spinal anesthesia
--> Lidocaine is also used to treat cardiac arrhythmia

Procaine / Lidocaine --> MOA

--> Blocks Na+ channels in neurons to prevent the entry of Na+ ions that cause the depolarization phase of the action potential

Adverse Effects of Esters (Ex. Procaine)

1) Allergic Reactions (Especially on second administration)
2) Shorter duration of action

Adverse Effects of Amides (Ex. Lidocaine)

1) Allergic Reactions (Less than Esters)
2) Low concentrations entering the circulation produce DROWSINESS, DISORIENTATION, AND EXCESSIVE TALKATIVENESS, but the patient should only be monitored for toxicity IF it occurs
3) High concentrations entering the circulation produce RESTLESSNESS, TREMORS, AND SEIZURES
4) Extremely high concentrations entering the circulation produce RESPIRATORY FAILURE, CARDIOVASCULAR COLLAPSE, AND DEATH due to the depression of the cardiovascular and respiratory centers of the brain.

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