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Articaine, also known as Septocaine, is a local anesthetic that was approved for use in the United States in 2000. It offers unique properties and benefits in dentistry. Unlike other amino amide-type local anesthetics, articaine contains a thiophene ring and a carbomethoxy group, making it more lipophilic and easier to cross lipid membranes. This article explores the potency, application, manufacturing process, and pharmacological effects of articaine.
Articaine has gained popularity in dentistry due to its quick onset and short duration of action. It provides approximately 60 to 75 minutes of pulpal anesthesia and 3 to 6 hours of soft tissue anesthesia. Its structure and lipophilic nature allow for better diffusion through tissues, making it an effective choice for dental procedures.
Compared to lidocaine, articaine has approximately 1.5 times the local anesthetic potency. Despite having similar pKa and plasma protein binding properties, articaine's duration of action is much shorter. It is metabolized primarily by plasma cholinesterases, resulting in a shorter duration of action compared to lidocaine. Articaine is considered a safer drug for regional anesthesia and is the preferred choice for dental procedures.
The manufacturing process of articaine involves the synthesis of 3-α-chloropropionylamino-2-carbomethoxy-4-methylthiophene. This compound is dissolved in toluene, and n-propylamine is added. After several steps, the hydrochloride of 3-n-propylamino-α-propionylamino-2-carbomethoxy-4-methylthiophene is obtained. The manufacturing process ensures the purity and quality of articaine for dental use.
Articaine's unique structure allows for better lipid solubility and enhanced ability to cross lipid membranes. It is rapidly hydrolyzed by plasma esterases and liver enzymes. The majority of articaine metabolism occurs in the blood, reducing the risk of systemic toxicity. Its major metabolite, articainic acid, is inactive as a local anesthetic. This rapid metabolism and lack of active metabolites make articaine a safer option for readministration during dental visits if additional anesthesia is required.
Articaine's excretion primarily occurs through the kidneys, with only a small percentage being excreted unchanged. Unlike ester anesthetic agents, articaine does not have a higher risk of allergy due to its ester linkage. It shares the same allergy profile as other amide agents. However, high doses of articaine administered intravenously may cause methemoglobinemia, although no such cases have been reported at the recommended dental dose.
