Record Information |
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Version | 2.0 |
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Creation Date | 2009-07-21 20:26:32 UTC |
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Update Date | 2014-12-24 20:25:51 UTC |
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Accession Number | T3D2742 |
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Identification |
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Common Name | Bupivacaine |
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Class | Small Molecule |
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Description | Bupivacaine is only found in individuals that have used or taken this drug. It is a widely used local anesthetic agent. Bupivacaine blocks the generation and the conduction of nerve impulses, presumably by increasing the threshold for electrical excitation in the nerve, by slowing the propagation of the nerve impulse, and by reducing the rate of rise of the action potential. Bupivacaine binds to the intracellular portion of sodium channels and blocks sodium influx into nerve cells, which prevents depolarization. In general, the progression of anesthesia is related to the diameter, myelination and conduction velocity of affected nerve fibers. Clinically, the order of loss of nerve function is as follows: (1) pain, (2) temperature, (3) touch, (4) proprioception, and (5) skeletal muscle tone. The analgesic effects of Bupivicaine are thought to potentially be due to its binding to the prostaglandin E2 receptors, subtype EP1 (PGE2EP1), which inhibits the production of prostaglandins, thereby reducing fever, inflammation, and hyperalgesia. |
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Compound Type | - Amide
- Amine
- Anesthetic, Local
- Drug
- Metabolite
- Organic Compound
- Synthetic Compound
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Chemical Structure | |
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Synonyms | Synonym | (+-)-Bupivacaine | (RS)-bupivacaine | 1-Butyl-2',6'-pipecoloxylidide | 1-Butyl-N-(2,6-dimethylphenyl)-2-piperidinecarboxamide | Bloqueina | Bupivacaina | Bupivacaine HCL | Bupivacaine HCL KIT | Bupivacainum | Bupivan | Carbostesin | CBupivacaine | dl-1-Butyl-2',6'-pipecoloxylidide | DL-Bupivacaine | DUR-843 | EXPAREL | LAC-43 | Marcain | Marcaina | Marcaine | Racemic bupivacaine | Sensorcaine | Sensorcaine-MPF | Vivacaine |
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Chemical Formula | C18H28N2O |
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Average Molecular Mass | 288.428 g/mol |
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Monoisotopic Mass | 288.220 g/mol |
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CAS Registry Number | 2180-92-9 |
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IUPAC Name | 1-butyl-N-(2,6-dimethylphenyl)piperidine-2-carboxamide |
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Traditional Name | bupivacaine |
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SMILES | CCCCN1CCCCC1C(O)=NC1=C(C)C=CC=C1C |
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InChI Identifier | InChI=1/C18H28N2O/c1-4-5-12-20-13-7-6-11-16(20)18(21)19-17-14(2)9-8-10-15(17)3/h8-10,16H,4-7,11-13H2,1-3H3,(H,19,21) |
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InChI Key | InChIKey=LEBVLXFERQHONN-UHFFFAOYNA-N |
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Chemical Taxonomy |
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Description | belongs to the class of organic compounds known as alpha amino acid amides. These are amide derivatives of alpha amino acids. |
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Kingdom | Organic compounds |
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Super Class | Organic acids and derivatives |
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Class | Carboxylic acids and derivatives |
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Sub Class | Amino acids, peptides, and analogues |
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Direct Parent | Alpha amino acid amides |
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Alternative Parents | |
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Substituents | - Alpha-amino acid amide
- 2-piperidinecarboxamide
- Piperidinecarboxamide
- Anilide
- M-xylene
- Xylene
- N-arylamide
- Monocyclic benzene moiety
- Benzenoid
- Piperidine
- Carboxamide group
- Tertiary aliphatic amine
- Tertiary amine
- Secondary carboxylic acid amide
- Azacycle
- Organoheterocyclic compound
- Organic nitrogen compound
- Hydrocarbon derivative
- Organic oxide
- Organooxygen compound
- Organonitrogen compound
- Organopnictogen compound
- Carbonyl group
- Organic oxygen compound
- Amine
- Aromatic heteromonocyclic compound
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Molecular Framework | Aromatic heteromonocyclic compounds |
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External Descriptors | |
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Biological Properties |
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Status | Detected and Not Quantified |
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Origin | Exogenous |
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Cellular Locations | - Caveolae
- Cytosol
- Endoplasmic reticulum
- Extracellular
- Membrane
- Mitochondrion
- Nerve Fiber
- Plasma Membrane
- Sarcoplasm
- Sarcoplasmic Reticulum
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Biofluid Locations | Not Available |
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Tissue Locations | Not Available |
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Pathways | Name | SMPDB Link | KEGG Link |
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Apoptosis | Not Available | map04210 | Fatty acid Metabolism | SMP00051 | map00071 | Antiarrhythmic Drugs | Not Available | Not Available | Bupivacaine Pathway | Not Available | Not Available |
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Applications | |
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Biological Roles | |
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Chemical Roles | |
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Physical Properties |
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State | Solid |
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Appearance | White powder. |
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Experimental Properties | Property | Value |
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Melting Point | 107-108°C | Boiling Point | Not Available | Solubility | 2400 mg/L (at 25°C) | LogP | 3.41 |
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Predicted Properties | |
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Spectra |
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Spectra | Spectrum Type | Description | Splash Key | Deposition Date | View |
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Predicted GC-MS | Predicted GC-MS Spectrum - GC-MS (Non-derivatized) - 70eV, Positive | splash10-006t-6920000000-20e4e8d5c09a52a31c75 | 2017-09-01 | View Spectrum | Predicted GC-MS | Predicted GC-MS Spectrum - GC-MS (Non-derivatized) - 70eV, Positive | Not Available | 2021-10-12 | View Spectrum | Predicted GC-MS | Predicted GC-MS Spectrum - GC-MS (Non-derivatized) - 70eV, Positive | Not Available | 2021-10-12 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-000i-0290000000-c1dbebb634be5e7e1140 | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-0006-0910000000-ae34de204bcb9a9deb23 | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-0006-0900000000-7ea7001506aae0c271a0 | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-0006-2900000000-ef819c5e235d6d524d8c | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-0006-7900000000-22d7491053c05d773e93 | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - LC-ESI-QFT , positive | splash10-001l-9400000000-71357b8186126c5933ce | 2017-09-14 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 90V, Positive | splash10-001l-9400000000-f152216f702642a2a96b | 2021-09-20 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 15V, Positive | splash10-000i-0290000000-473772a88887df5462f7 | 2021-09-20 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 45V, Positive | splash10-0006-0900000000-73c58abee6a70ae243ed | 2021-09-20 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 30V, Positive | splash10-0006-0910000000-2d35aaa0fbbc69b60c7d | 2021-09-20 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 60V, Positive | splash10-0006-2900000000-c1144b59f68c25239771 | 2021-09-20 | View Spectrum | LC-MS/MS | LC-MS/MS Spectrum - 75V, Positive | splash10-0006-7900000000-a4b8408dc9df27267589 | 2021-09-20 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 10V, Positive | splash10-0079-0970000000-e665f05dc8da9fafd8f0 | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 20V, Positive | splash10-00dl-2900000000-6396ddc6fc9d5e9b6c64 | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 40V, Positive | splash10-0ac0-9200000000-befeaee90e72918d68b3 | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 10V, Negative | splash10-000i-0290000000-e01610a30f93d9c5ec2a | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 20V, Negative | splash10-00ri-0970000000-e26949f880557c6da815 | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 40V, Negative | splash10-00xr-3900000000-56dfe5d9cd7f629f17e3 | 2016-08-03 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 10V, Negative | splash10-000i-0090000000-e83ab5b70775090159b7 | 2021-09-25 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 20V, Negative | splash10-000i-0690000000-6ff0193988455d286726 | 2021-09-25 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 40V, Negative | splash10-00xr-1920000000-87f1897c4a60793791d5 | 2021-09-25 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 10V, Positive | splash10-000i-0190000000-23ffc562239624515183 | 2021-09-25 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 20V, Positive | splash10-000g-3920000000-6aaf7d8f5f0149cec33e | 2021-09-25 | View Spectrum | Predicted LC-MS/MS | Predicted LC-MS/MS Spectrum - 40V, Positive | splash10-0007-8900000000-e62af4b8065c6c1caf01 | 2021-09-25 | View Spectrum |
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Toxicity Profile |
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Route of Exposure | Epidural, Intraspinal, Infiltration.
The rate of systemic absorption of local anesthetics is dependent upon the total dose and concentration of drug administered, the route of administration, the vascularity of the administration site, and the presence or absence of epinephrine in the anesthetic solution. |
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Mechanism of Toxicity | Bupivacaine is a cholinesterase or acetylcholinesterase (AChE) inhibitor. A cholinesterase inhibitor (or 'anticholinesterase') suppresses the action of acetylcholinesterase. Because of its essential function, chemicals that interfere with the action of acetylcholinesterase are potent neurotoxins, causing excessive salivation and eye-watering in low doses, followed by muscle spasms and ultimately death. Nerve gases and many substances used in insecticides have been shown to act by binding a serine in the active site of acetylcholine esterase, inhibiting the enzyme completely. Acetylcholine esterase breaks down the neurotransmitter acetylcholine, which is released at nerve and muscle junctions, in order to allow the muscle or organ to relax. The result of acetylcholine esterase inhibition is that acetylcholine builds up and continues to act so that any nerve impulses are continually transmitted and muscle contractions do not stop. Among the most common acetylcholinesterase inhibitors are phosphorus-based compounds, which are designed to bind to the active site of the enzyme. The structural requirements are a phosphorus atom bearing two lipophilic groups, a leaving group (such as a halide or thiocyanate), and a terminal oxygen. |
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Metabolism | Amide-type local anesthetics such as bupivacaine are metabolized primarily in the liver via conjugation with glucuronic acid. The major metabolite of bupivacaine is 2,6-pipecoloxylidine, which is mainly catalyzed via cytochrome P450 3A4.
Route of Elimination: Only 6% of bupivacaine is excreted unchanged in the urine.
Half Life: 2.7 hours in adults and 8.1 hours in neonates |
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Toxicity Values | The mean seizure dosage of bupivacaine in rhesus monkeys was found to be 4.4 mg/kg with mean arterial plasma concentration of 4.5 mcg/mL.
LD50: 6 to 8 mg/kg (intravenous, mice)
LD50: 38 to 54 mg/kg (subcutaneous, mice) |
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Lethal Dose | Not Available |
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Carcinogenicity (IARC Classification) | No indication of carcinogenicity to humans (not listed by IARC). |
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Uses/Sources | For the production of local or regional anesthesia or analgesia for surgery, for oral surgery procedures, for diagnostic and therapeutic procedures, and for obstetrical procedures. |
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Minimum Risk Level | Not Available |
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Health Effects | Acute exposure to cholinesterase inhibitors can cause a cholinergic crisis characterized by severe nausea/vomiting, salivation, sweating, bradycardia, hypotension, collapse, and convulsions. Increasing muscle weakness is a possibility and may result in death if respiratory muscles are involved. Accumulation of ACh at motor nerves causes overstimulation of nicotinic expression at the neuromuscular junction. When this occurs symptoms such as muscle weakness, fatigue, muscle cramps, fasciculation, and paralysis can be seen. When there is an accumulation of ACh at autonomic ganglia this causes overstimulation of nicotinic expression in the sympathetic system. Symptoms associated with this are hypertension, and hypoglycemia. Overstimulation of nicotinic acetylcholine receptors in the central nervous system, due to accumulation of ACh, results in anxiety, headache, convulsions, ataxia, depression of respiration and circulation, tremor, general weakness, and potentially coma. When there is expression of muscarinic overstimulation due to excess acetylcholine at muscarinic acetylcholine receptors symptoms of visual disturbances, tightness in chest, wheezing due to bronchoconstriction, increased bronchial secretions, increased salivation, lacrimation, sweating, peristalsis, and urination can occur. Certain reproductive effects in fertility, growth, and development for males and females have been linked specifically to organophosphate pesticide exposure. Most of the research on reproductive effects has been conducted on farmers working with pesticides and insecticdes in rural areas. In females menstrual cycle disturbances, longer pregnancies, spontaneous abortions, stillbirths, and some developmental effects in offspring have been linked to organophosphate pesticide exposure. Prenatal exposure has been linked to impaired fetal growth and development. Neurotoxic effects have also been linked to poisoning with OP pesticides causing four neurotoxic effects in humans: cholinergic syndrome, intermediate syndrome, organophosphate-induced delayed polyneuropathy (OPIDP), and chronic organophosphate-induced neuropsychiatric disorder (COPIND). These syndromes result after acute and chronic exposure to OP pesticides. |
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Symptoms | Recent clinical data from patients experiencing local anesthetic induced convulsions demonstrated rapid development of hypoxia, hypercarbia, and acidosis with bupivacaine within a minute of the onset of convulsions. These observations suggest that oxygen consumption and carbon dioxide production are greatly increased during local anesthetic convulsions and emphasize the importance of immediate and effective ventilation with oxygen which may avoid cardiac arrest. |
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Treatment | If the compound has been ingested, rapid gastric lavage should be performed using 5% sodium bicarbonate. For skin contact, the skin should be washed with soap and water. If the compound has entered the eyes, they should be washed with large quantities of isotonic saline or water. In serious cases, atropine and/or pralidoxime should be administered. Anti-cholinergic drugs work to counteract the effects of excess acetylcholine and reactivate AChE. Atropine can be used as an antidote in conjunction with pralidoxime or other pyridinium oximes (such as trimedoxime or obidoxime), though the use of '-oximes' has been found to be of no benefit, or possibly harmful, in at least two meta-analyses. Atropine is a muscarinic antagonist, and thus blocks the action of acetylcholine peripherally. |
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Normal Concentrations |
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| Not Available |
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Abnormal Concentrations |
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| Not Available |
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External Links |
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DrugBank ID | DB00297 |
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HMDB ID | HMDB14442 |
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PubChem Compound ID | 2474 |
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ChEMBL ID | CHEMBL1098 |
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ChemSpider ID | 2380 |
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KEGG ID | C07529 |
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UniProt ID | Not Available |
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OMIM ID | |
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ChEBI ID | 3215 |
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BioCyc ID | Not Available |
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CTD ID | Not Available |
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Stitch ID | Bupivacaine |
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PDB ID | Not Available |
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ACToR ID | Not Available |
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Wikipedia Link | Bupivacaine |
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References |
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Synthesis Reference | Thuresson, B. and Egner, B.P.H.; U.S. Patent 2,792,399; May 14, 1957; assigned to AB Bofors, Sweden.
Thuresson, B. and Pettersson, B.G.; US. Patent 2,955.1 11; October 4,1960; assigned to AB
Bofors, Sweden. |
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MSDS | Link |
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General References | - Picard J, Meek T: Lipid emulsion to treat overdose of local anaesthetic: the gift of the glob. Anaesthesia. 2006 Feb;61(2):107-9. [16430560 ]
- Rosenblatt MA, Abel M, Fischer GW, Itzkovich CJ, Eisenkraft JB: Successful use of a 20% lipid emulsion to resuscitate a patient after a presumed bupivacaine-related cardiac arrest. Anesthesiology. 2006 Jul;105(1):217-8. [16810015 ]
- Drugs.com [Link]
- eMedicine (2008). Local Anesthetics. [Link]
- RxList: The Internet Drug Index (2009). [Link]
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Gene Regulation |
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Up-Regulated Genes | Gene | Gene Symbol | Gene ID | Interaction | Chromosome | Details |
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Down-Regulated Genes | Not Available |
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