Lidocaine, bupivacaine, ropivacaine, mepivacaine, chloroprocaine
Amide local anesthetic / class IB antiarrhythmic
Blocks voltage-gated Na⁺ channels in nerves (LA) and cardiac myocytes (antiarrhythmic).
Amide local anesthetic, long-acting
Voltage-gated Na⁺ channel blocker. Higher protein binding and lipid solubility than lidocaine → longer duration but greater cardiotoxicity.
Amide local anesthetic, long-acting
S-enantiomer of propivacaine. Less lipid-soluble than bupivacaine → less cardiotoxicity but slightly less potency.
Ester local anesthetic (long-acting)
Blocks voltage-gated Na⁺ channels. Long-acting ester, metabolized by plasma cholinesterase. High potency + toxicity.
Ester local anesthetic (short-acting)
Na⁺-channel blocker. Extremely rapid plasma-cholinesterase metabolism (half-life seconds) → lowest systemic toxicity of the LAs, ideal for OB epidural top-up.
Ester local anesthetic (short-acting)
Na⁺-channel blocker; prototype ester LA. Plasma-cholinesterase metabolized to PABA.
Amide local anesthetic (intermediate-acting)
Na⁺-channel blocker. Metabolized to o-toluidine → oxidizes hemoglobin → methemoglobinemia at high doses.
Amide local anesthetic (long-acting)
The S(−)-enantiomer of bupivacaine → similar block with LESS cardiotoxicity + CNS toxicity than racemic bupivacaine.
Amide local anesthetic (with an ester side-group)
Amide LA that uniquely also has a thiophene ester group → partial plasma-esterase metabolism → shorter systemic half-life. Excellent bone/tissue penetration in dentistry.
Ester local anesthetic (topical only)
Na⁺-channel blocker; poorly water-soluble → topical use only. Classic cause of methemoglobinemia.
Ester local anesthetic + sympathomimetic (topical)
Na⁺-channel block (LA) PLUS blockade of norepinephrine reuptake → vasoconstriction. The only LA that is intrinsically vasoconstrictive.
Amide local anesthetic (most potent/toxic) — topical; also a lab reagent
Na⁺-channel blocker; most potent and most toxic LA. Clinically used topically, but best known for the dibucaine-number test of pseudocholinesterase.
Eutectic mixture of local anesthetics (topical)
Eutectic (lower combined melting point) lidocaine/prilocaine emulsion penetrates intact skin for dermal anesthesia.
Combination topical ester local anesthetic spray
Benzocaine/tetracaine/butamben ester blend for rapid topical mucosal anesthesia.
Extended-release liposomal amide local anesthetic
Bupivacaine encapsulated in multivesicular liposomes → slow release over ~72 h for prolonged postoperative analgesia.
Extended-release bupivacaine + meloxicam wound instillation
Bupivacaine (LA) + low-dose meloxicam (NSAID lowers local pH to enhance bupivacaine release/uptake) applied into the surgical site for up to ~72 h analgesia.
Amide local anesthetic (intermediate-acting)
Na⁺-channel blocker. Intermediate duration; less intrinsic vasodilation than lidocaine → slightly longer duration without epinephrine.