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Xylocaine or Procaine and Lidocaine (p. 159-160):
Other: Marcaine, moncaine, nesacaine, nupercaine, duranest, sylocaine, carocaine, oracaine, unacaine, citanest, and novocaine. All are related to cocaine, and are synthetic version of the coca bush alkaloids.
Toxicity (scale of 1-6; 1=almost non-toxic, 6=super toxic): 5
Form: colorless liquids or thick gels, the drugs are given by injection or used topically. As a general, it can be given intravenously.
Effects and Symptoms: These drugs are rapidly distributed in the body and numbness occurs locally.
At first giddiness develops, then feelings of oppression, followed by severe collapse of the body organs, coma, convulsions, and respiratory arrest. After injection or large surface application, circulatory collapse comes about by direct depression of blood vessel tone or by effect on the central nervous system. Dizziness, cyanosis, fall of blood pressure, muscular tremors, convulsions, coma, irregular and weak breathing, bronchial spasm, and cardiac standstill are other symptoms. Rapid intravenous injection causes cardiac arrest.
Hypersensitivity (allergic reaction brought on by repeated exposure) occurs with repeated topical applications; reactions include itching, redness, edema, blistering. A person allergic to the drug can go into anaphylactic shock.
Reaction Time: Immediate. Efforts to remove the drug after thirty minutes are useless. After survival of one hour, the victim usually recovers.
Antidotes and Treatments: The injected drug is stopped and absorption from the injection site limited by tourniquet and ice pack. Airway is maintained and artificial respiration given with oxygen until convulsions and central nervous system depression are controlled.
1. Procaine is considered the most dangerous of all the derivatives and has caused numerous fatalities. As with cocaine, states of shock with a possible fatal outcome can occur with very small doses of procaine. Procaine and other similar drugs also enhance the effects of muscle relaxants.