The effect of age on pharmacokinetics of the local anesthetic drug articaine.
ABSTRACT With increasing age, there are physiologic changes that could affect pharmacokinetics of drugs. More elderly patients are undergoing routine dental procedures for which local anesthesia could be required. The goal of the present study was to evaluate the effect of age on pharmacokinetics of the local anesthetic agent articaine.
The submucosal infiltration anesthesia from two different dosages of 4% articaine without epinephrine was compared in healthy elderly and young volunteers. High performance liquid chromatography has been used to determine concentrations of articaine in serum. Basic pharmacokinetic parameters were calculated according to standard procedures using a two-exponent equation.
The clearance and volume of distribution (Vdss) of articaine after infiltration anesthesia were significantly lower in elderly volunteers compared with young volunteers. The area under the serum concentration-time curve and maximum drug concentration (Cmax) values did not differ significantly with age; however, both parameters tended to be higher in elderly volunteers. No changes in terminal half-life and time to reach maximum serum concentration (t(max)) were observed. The Cmax and tmax values of the metabolite articainic acid were similar in young and elderly volunteers. CONCLUSIONS The results show that the metabolism of articaine is age-independent in healthy male volunteers. The smaller Vdss in the elderly results in a trend to higher serum levels after a given dose of articaine. No change of dosage of articaine in elderly patients should be necessary.
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ABSTRACT: The paper addresses two control problems of discrete-time switching systems subject to modal nonlinearities satisfying sector conditions, actuator saturations and additive L2-bounded disturbances. Such switching systems consist of a finite family of discrete-time processes that are supervised by logical decision-making algorithms. Conditions based on LMIs are provided for synthesizing the control gains and for obtaining regions of absolute λ-contractivity as large as possible or for obtaining a L2-gain as small as possible. A numerical example illustrates the proposed approaches.Nonlinear Analysis Hybrid Systems 05/2011; 5(2):289-300. · 1.79 Impact Factor
Article: Articaine use in children: A review.[Show abstract] [Hide abstract]
ABSTRACT: Lidocaine has been considered the gold standard for local analgesia agents in dentistry for years. Articaine is now widely used but there has been a reluctance to use it in children. Compared with lidocaine, articaine is 1.5 times as potent and only 0.6 times as toxic and has been shown to be superior in achieving successful anaesthesia following infiltration. The use of inferior alveolar nerve blocks (IANB) can be almost eliminated in children by using articaine due to its ability to effectively anaesthetise teeth up to the first permanent molar region. In addition, diffusion of the anaesthetic agent onto the palatal surface may also eliminate the discomfort of palatal infiltration. Soft tissue analgesia may be prolonged, but the risk of other adverse reactions is similar to other local anaesthetic agents. The use of articaine achieves successful pain control while reducing the volume administered and is advocated as a safe and effective alternative to lidocaine for use in children.European Archives of Paediatric Dentistry. Official Journal of the European Academy of Paediatric Dentistry. 12/2012; 13(6):293-6.