LIDOCAINE -AN OLD DRUG FOR NEW INDICATION
Abstract
Lidocaine, a known local anaesthetic agent has been demonstrated to possess significant efficacy in managing asthma due to its anti inflammatory and direct spasmolytic actions. Various clinical studies have been conducted to assess the role of Lidocaine in asthma management with convincing results showing reduction in steroid dose or discontinuation of steroid therapy associated with improvement in quality of life, marking this old drug as a novel efficacious, fast and safe addition in armamentarium of anti asthma drugs. Inhaled Lidocaine when given alone causes biphasic effect on bronchi with initial bronchoconstriction followed by bronchodilatation. Treatment with combination inhalers, containing Lidocaine and a long-acting β2- agonist seems the safer and more reliable alternative to minimise adverse effects of initial reflex bronchoconstriction caused by inhaled Lidocaine. This review elucidates the available evidence on efficacy and safety of inhaled Lidocaine after analyzing various clinical studies. Searches of pubmed, Cochrane database, Medscape, Google and clinicaltrial.org were made for terms like Lidocaine and bronchial asthma.
Keywords:
Lidocaine, bronchial asthma, bronchial hyper responsivenessDOI
https://doi.org/10.25004/IJPSDR.2013.050301References
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2. Neri M, Spanevello A. Chronic bronchial asthma from challenge to treatment: epidemiology and social impact. Thorax 2000; 55(Suppl 2):S57-S58.
3. Barnes PJ. Pathophysiology of asthma. Br J Clin Pharmacol 1996;42:3-10
4. Siqueira RA, Costa JCS, Cordeiro RSB, Serra MF,e Silva PMR, Martins MA. Local anaesthetic medication for the treatment of asthma. Mem Inst Oswaldo Cruz, Rio de Janeiro 2005; 100:161-65.
5. Barnes PJ. New drugs for asthma. Nat Rev Drug Discov 2004; 3: 831-44.
6. Ukena D, Fishman L, Niebling WB. Bronchial Asthma: Diagnosis and Long-Term Treatment in Adults. Dtsch Arztebl Int 2008; 105(21): 385-94.
7. Schimmer BP, Parker KL. Goodman and Gilmann's: The Pharmacological Basis of Therapeutics, Ed 12, New York, 2011, pp.1103-28.
8. Trochtenberg S. Nebulized lidocaine in the treatment of refractory cough. Chest 1994 May; 105(5):1592-3.
9. Sanders RV, Kirkpatrick MB. Prolonged suppression of cough after inhalation of lidocaine in a patient with sarcoid. JAMA 1984; 252(17):2456-7.
10. Ashburn TT, Thor KB .Drug Repositioning: Identifying and Developing New Uses for Existing Drugs. Nature Reviews2004; 3:673-83.
11. Burburan SM, Xisto DG, Rocco PRM. Anaesthetic management in asthma. Minerva Anestesiol 2007; 73:357-65.
12. Groeben H, Silvanus MT, Beste M, Peters J. Both intravenous and inhaled lidocaine attenuate reflex bronchoconstriction but at different plasma concentrations. Am J Respir Crit Care Med 1999; 159:530-35.
13. Zucker M. Nebulized Lidocaine: An Option for Severe Asthma. Respiratory Reviews.com. 2002; 7:4.
14. Bankers-Fulbright JL, Kephart GM, Loegering DA, Bradford AL, Okada S, Kita H, et al. Sulfonylureas inhibit cytokine-induced eosinophil survival and activation. J Immunol1998; 160:5546-53.
15. Kai T, Nishimura J, Kobayashi S, Takahashi S, Yoshitake J, McAlpine LG, et al. Lidocaine-induced bronchoconstriction in asthmatic patients. Relation to histamine airway responsiveness and effect of preservative. Chest 1989; 96:1012-15.
16. Okumura F, Denborough MA. Effects of anaesthetics on guinea pig tracheal smooth muscle. Br J Anaesth 1980; 52:199- 204.
17. Downes H, Loehning RW. Local anesthetic contracture and relaxation of airway smooth muscle. Anesthesiology 1977; 47:430-6.
18. Shirk MB, Donahue KR, Shirvani J. Unlabeled Uses of Nebulized Medications. Am J Health Syst Pharm 2006; 63(18):1704-16.
19. McAlpine LG, Thomson NC. Lidocaine-induced bronchoconstriction in asthmatic patients. Relation to histamine airway responsiveness and effect of preservative. Chest 1989; 96:1012-15.
20. Fish JE, Peterman VI. Effects of inhaled lidocaine on airway function in asthmatic subjects. Respiration 1979; 37:201-7.
21. Groeben H, Silvanus MT, Beste M, Peters J. Combined lidocaine and salbutamol inhalation for airway anesthesia markedly protects against reflex bronchoconstriction. Chest 2000; 118:509-15.
22. Bulut Y, Hirshman CA, Brown RH. Prevention of lidocaine aerosol-induced bronchoconstriction with intravenous lidocaine. Anesthesiology 1996; 85: 853-9.
23. Harrison TW, Tattersfield AE. Effect of single doses of inhaled lignocaine on FEV1 and bronchial reactivity in asthma. Respir Med 1998; 92:1359-63.
24. Decco ML, Neeno TA, Hunt LW, O’Connell EJ, Yunginger JW,Sachs MI. Nebulized lidocaine in the treatment of severe asthma in children: a pilot study. Ann Allergy Asthma Immunol1999; 82:29-32.
25. Hunt LW, Swedlund HA, Gleich GJ. Effect of nebulized lidocaine on severe glucocorticoid-dependent asthma. Mayo Clin Proc 1996; 71:361-8.
26. Hunt LW, Frigas E, Butterfield JH, Kita H, Blomgren J, Dunnette SL, et al. Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study.J Allergy Clin Immunol 2004; 113:853-9.
27. de Paz AS, Rodriguez MM, Fernandez PB, Santaolalla MM, Herrera MI, Perez PA. Treatment with nebulized lidocaine in steroid-dependent asthma]. Allergol Immunopathol 2005; 33(4):231-4.
28. Chong CF, Chen CC, PMa H, Wu YC, Chen YC, Wang TL. Comparison of lidocaine and bronchodilator inhalation treatments for cough suppression in patients with chronic obstructive pulmonary disease. Emerg Med J 2005; 22:429–32.
29. Abuan T, Yeager M, Montgomery AB. Inhaled Lidocaine for the Treatment of Asthma: Lack of Efficacy in Two Double-Blind, Randomized, Placebo-Controlled Clinical Studies Journal of Aerosol Medicine and Pulmonary Drug Delivery 2010, 23(6): 381-8.
30. Zu-ming Lv, Li Chen, Jie Tang. Nebulized lidocaine inhalation in the treatment of patients with acute asthma. World J Emerg Med 2011; 2(1):30-2.
31. Adamzik M, Groeben H, Farahani R, Lehmann N, Peters J. Intravenous Lidocaine After Tracheal Intubation Mitigates Bronchoconstriction in Patients with Asthma. Anesth Analg 2007; 104:168-72.
2. Neri M, Spanevello A. Chronic bronchial asthma from challenge to treatment: epidemiology and social impact. Thorax 2000; 55(Suppl 2):S57-S58.
3. Barnes PJ. Pathophysiology of asthma. Br J Clin Pharmacol 1996;42:3-10
4. Siqueira RA, Costa JCS, Cordeiro RSB, Serra MF,e Silva PMR, Martins MA. Local anaesthetic medication for the treatment of asthma. Mem Inst Oswaldo Cruz, Rio de Janeiro 2005; 100:161-65.
5. Barnes PJ. New drugs for asthma. Nat Rev Drug Discov 2004; 3: 831-44.
6. Ukena D, Fishman L, Niebling WB. Bronchial Asthma: Diagnosis and Long-Term Treatment in Adults. Dtsch Arztebl Int 2008; 105(21): 385-94.
7. Schimmer BP, Parker KL. Goodman and Gilmann's: The Pharmacological Basis of Therapeutics, Ed 12, New York, 2011, pp.1103-28.
8. Trochtenberg S. Nebulized lidocaine in the treatment of refractory cough. Chest 1994 May; 105(5):1592-3.
9. Sanders RV, Kirkpatrick MB. Prolonged suppression of cough after inhalation of lidocaine in a patient with sarcoid. JAMA 1984; 252(17):2456-7.
10. Ashburn TT, Thor KB .Drug Repositioning: Identifying and Developing New Uses for Existing Drugs. Nature Reviews2004; 3:673-83.
11. Burburan SM, Xisto DG, Rocco PRM. Anaesthetic management in asthma. Minerva Anestesiol 2007; 73:357-65.
12. Groeben H, Silvanus MT, Beste M, Peters J. Both intravenous and inhaled lidocaine attenuate reflex bronchoconstriction but at different plasma concentrations. Am J Respir Crit Care Med 1999; 159:530-35.
13. Zucker M. Nebulized Lidocaine: An Option for Severe Asthma. Respiratory Reviews.com. 2002; 7:4.
14. Bankers-Fulbright JL, Kephart GM, Loegering DA, Bradford AL, Okada S, Kita H, et al. Sulfonylureas inhibit cytokine-induced eosinophil survival and activation. J Immunol1998; 160:5546-53.
15. Kai T, Nishimura J, Kobayashi S, Takahashi S, Yoshitake J, McAlpine LG, et al. Lidocaine-induced bronchoconstriction in asthmatic patients. Relation to histamine airway responsiveness and effect of preservative. Chest 1989; 96:1012-15.
16. Okumura F, Denborough MA. Effects of anaesthetics on guinea pig tracheal smooth muscle. Br J Anaesth 1980; 52:199- 204.
17. Downes H, Loehning RW. Local anesthetic contracture and relaxation of airway smooth muscle. Anesthesiology 1977; 47:430-6.
18. Shirk MB, Donahue KR, Shirvani J. Unlabeled Uses of Nebulized Medications. Am J Health Syst Pharm 2006; 63(18):1704-16.
19. McAlpine LG, Thomson NC. Lidocaine-induced bronchoconstriction in asthmatic patients. Relation to histamine airway responsiveness and effect of preservative. Chest 1989; 96:1012-15.
20. Fish JE, Peterman VI. Effects of inhaled lidocaine on airway function in asthmatic subjects. Respiration 1979; 37:201-7.
21. Groeben H, Silvanus MT, Beste M, Peters J. Combined lidocaine and salbutamol inhalation for airway anesthesia markedly protects against reflex bronchoconstriction. Chest 2000; 118:509-15.
22. Bulut Y, Hirshman CA, Brown RH. Prevention of lidocaine aerosol-induced bronchoconstriction with intravenous lidocaine. Anesthesiology 1996; 85: 853-9.
23. Harrison TW, Tattersfield AE. Effect of single doses of inhaled lignocaine on FEV1 and bronchial reactivity in asthma. Respir Med 1998; 92:1359-63.
24. Decco ML, Neeno TA, Hunt LW, O’Connell EJ, Yunginger JW,Sachs MI. Nebulized lidocaine in the treatment of severe asthma in children: a pilot study. Ann Allergy Asthma Immunol1999; 82:29-32.
25. Hunt LW, Swedlund HA, Gleich GJ. Effect of nebulized lidocaine on severe glucocorticoid-dependent asthma. Mayo Clin Proc 1996; 71:361-8.
26. Hunt LW, Frigas E, Butterfield JH, Kita H, Blomgren J, Dunnette SL, et al. Treatment of asthma with nebulized lidocaine: a randomized, placebo-controlled study.J Allergy Clin Immunol 2004; 113:853-9.
27. de Paz AS, Rodriguez MM, Fernandez PB, Santaolalla MM, Herrera MI, Perez PA. Treatment with nebulized lidocaine in steroid-dependent asthma]. Allergol Immunopathol 2005; 33(4):231-4.
28. Chong CF, Chen CC, PMa H, Wu YC, Chen YC, Wang TL. Comparison of lidocaine and bronchodilator inhalation treatments for cough suppression in patients with chronic obstructive pulmonary disease. Emerg Med J 2005; 22:429–32.
29. Abuan T, Yeager M, Montgomery AB. Inhaled Lidocaine for the Treatment of Asthma: Lack of Efficacy in Two Double-Blind, Randomized, Placebo-Controlled Clinical Studies Journal of Aerosol Medicine and Pulmonary Drug Delivery 2010, 23(6): 381-8.
30. Zu-ming Lv, Li Chen, Jie Tang. Nebulized lidocaine inhalation in the treatment of patients with acute asthma. World J Emerg Med 2011; 2(1):30-2.
31. Adamzik M, Groeben H, Farahani R, Lehmann N, Peters J. Intravenous Lidocaine After Tracheal Intubation Mitigates Bronchoconstriction in Patients with Asthma. Anesth Analg 2007; 104:168-72.
Published
01-07-2013
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“LIDOCAINE -AN OLD DRUG FOR NEW INDICATION”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 5, no. 3, July 2013, pp. 84-87, https://doi.org/10.25004/IJPSDR.2013.050301.
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How to Cite
“LIDOCAINE -AN OLD DRUG FOR NEW INDICATION”. International Journal of Pharmaceutical Sciences and Drug Research, vol. 5, no. 3, July 2013, pp. 84-87, https://doi.org/10.25004/IJPSDR.2013.050301.
