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Posted: 12/16/2005 5:57:32 PM EDT
If I drank a shot-glass full of novacaine would my body go numb, or would I just die? No, I'm not actually considering it, just curious after a trip to the dentist.
Link Posted: 12/16/2005 5:58:31 PM EDT
I'm pretty sure you would die. =)

I'm only in 1st year med school, I'll have to ask about that.
Link Posted: 12/16/2005 5:58:32 PM EDT
you'd probably puke most of it up and chew your tongue off
Link Posted: 12/16/2005 5:59:20 PM EDT
Send me your guns and then try it!
Link Posted: 12/16/2005 6:00:15 PM EDT
I would die. Then again I'm allergic to the stuff.
Link Posted: 12/16/2005 6:01:06 PM EDT

Originally Posted By geezhound:
If I drank a shot-glass full of novacaine would my body go numb, or would I just die? No, I'm not actually considering it, just curious after a trip to the dentist.



If it is injectable novacaine it is not made to be ingested only injected, so I would think that it would make you sick or worse!
Link Posted: 12/16/2005 6:04:23 PM EDT

Originally Posted By geezhound:
If I drank a shot-glass full of novacaine would my body go numb, or would I just die? No, I'm not actually considering it, just curious after a trip to the dentist.



No, your body would not go numb. If you take a lethal overdose of novacaine you would have seizures then cardiac arrest. You have to be careful not to inject a vein directly with the drug when used as a local anesthetic. In diluted IV form it is used as an anti-arrhythmic.
Link Posted: 12/16/2005 6:05:18 PM EDT

Originally Posted By Macumazahn:
I'm pretty sure you would die. =)

I'm only in 1st year med school, I'll have to ask about that.



There is much suffering in your future.
Link Posted: 12/16/2005 6:09:55 PM EDT
Your throat will go numb and you will choke on your own spit and die a miserable death. Maybe.
Link Posted: 12/16/2005 6:16:08 PM EDT
Unlikely to kill you. Maybe, if you were allergic to amide type anesthetics.

A dose to affect the CNS is 6 mcg/ml, given average of 5 liters of blood in the typical adult, 30,000 mikes, or 30 grams would need to be introduced to the bloodstream. A lethal dose is even higher than that. So considering that lidocaine is usually 1 or 2% concentration (10 or 20 mg/ml) you would need to drink a shitload, also, systemic absorption from oral injestion is never as high as intravenous administration.

Might give you a nice bellyache though.
Link Posted: 12/16/2005 10:20:33 PM EDT

Originally Posted By fish223:
Unlikely to kill you. Maybe, if you were allergic to amide type anesthetics.

A dose to affect the CNS is 6 mcg/ml, given average of 5 liters of blood in the typical adult, 30,000 mikes, or 30 grams would need to be introduced to the bloodstream. A lethal dose is even higher than that. So considering that lidocaine is usually 1 or 2% concentration (10 or 20 mg/ml) you would need to drink a shitload, also, systemic absorption from oral injestion is never as high as intravenous administration.

Might give you a nice bellyache though.





Dude, Not tryin' to be a dick, but will it kill me or not? 4 oz novacaine down the gullet, or not?>
Link Posted: 12/16/2005 10:35:15 PM EDT
[Last Edit: 12/16/2005 10:35:52 PM EDT by wolffie]
As one who injects a lot of people with it, I'd have to say no, it won't kill you unless you have an allergy to it. Our rule of thumb injectable limit on 2% Xylocaine with 1:100,000 epi is about 10 carpules for someone without heart problems. That's 18ml. It has a relatively high first pass effect and you are unlikely to be affected by it. You won't go numb, but it may make you sick.
Link Posted: 12/16/2005 10:37:28 PM EDT
try it and post pics
Link Posted: 12/17/2005 8:05:49 AM EDT

Originally Posted By geezhound:

Originally Posted By fish223:
Unlikely to kill you. Maybe, if you were allergic to amide type anesthetics.

A dose to affect the CNS is 6 mcg/ml, given average of 5 liters of blood in the typical adult, 30,000 mikes, or 30 grams would need to be introduced to the bloodstream. A lethal dose is even higher than that. So considering that lidocaine is usually 1 or 2% concentration (10 or 20 mg/ml) you would need to drink a shitload, also, systemic absorption from oral injestion is never as high as intravenous administration.

Might give you a nice bellyache though.





Dude, Not tryin' to be a dick, but will it kill me or not? 4 oz novacaine down the gullet, or not?>



Drinking 4 oz. is unlikely to kill you, but I still wouldn't recommend it. If you injected 4 oz, call the morgue first, and reserve a slab, especially if it is intravenous, probably intramuscular or subcutaneous too.

Sorry to be confusing in my post above, I was kinda thinking out loud.

There is a huge difference between taking most drugs orally, versus injecting them. As a general rule, most drugs can be taken in much higher doses by mouth than injecting.

Link Posted: 12/17/2005 8:09:25 AM EDT

Originally Posted By fish223:

Originally Posted By geezhound:

Originally Posted By fish223:
Unlikely to kill you. Maybe, if you were allergic to amide type anesthetics.

A dose to affect the CNS is 6 mcg/ml, given average of 5 liters of blood in the typical adult, 30,000 mikes, or 30 grams would need to be introduced to the bloodstream. A lethal dose is even higher than that. So considering that lidocaine is usually 1 or 2% concentration (10 or 20 mg/ml) you would need to drink a shitload, also, systemic absorption from oral injestion is never as high as intravenous administration.

Might give you a nice bellyache though.



Dude, Not tryin' to be a dick, but will it kill me or not? 4 oz novacaine down the gullet, or not?>



Drinking 4 oz. is unlikely to kill you, but I still wouldn't recommend it. If you injected 4 oz, call the morgue first, and reserve a slab, especially if it is intravenous, probably intramuscular or subcutaneous too.

Sorry to be confusing in my post above, I was kinda thinking out loud.

There is a huge difference between taking most drugs orally, versus injecting them. As a general rule, most drugs can be taken in much higher doses by mouth than injecting.




I disagree.

Novacaine will instantly be absorbed by the mucosal surfaces in the oral cavity and thee blood levels will increase significantly and quickly. I think C-4 has it correctly.
Link Posted: 12/17/2005 8:16:29 AM EDT
Interesting post.


Fish223 and C-4, what are your occupations?
Link Posted: 12/17/2005 8:20:02 AM EDT

Originally Posted By geezhound:

Originally Posted By fish223:
Unlikely to kill you. Maybe, if you were allergic to amide type anesthetics.

A dose to affect the CNS is 6 mcg/ml, given average of 5 liters of blood in the typical adult, 30,000 mikes, or 30 grams would need to be introduced to the bloodstream. A lethal dose is even higher than that. So considering that lidocaine is usually 1 or 2% concentration (10 or 20 mg/ml) you would need to drink a shitload, also, systemic absorption from oral injestion is never as high as intravenous administration.

Might give you a nice bellyache though.





Dude, Not tryin' to be a dick, but will it kill me or not? 4 oz novacaine down the gullet, or not?>




When did a shot glass become 4 ounces ?
Link Posted: 12/17/2005 8:27:33 AM EDT

Originally Posted By ARDOC:
Novacaine will instantly be absorbed by the mucosal surfaces in the oral cavity and thee blood levels will increase significantly and quickly. I think C-4 has it correctly.



Transmucosal absorption of lidocaine is actually slow, and shallow. Hence the difficulty with mucosal anesthesia with topical application of viscous lidocaine, or even 20% benzocaine.

Lidocaine is available at 1% and 2%, so 4 ounces of 2% would contain (120 ml times 20 mg/ml) 2400 mg of pure lidocaine. Assuming perfect, immediate absorption, the plama level of a normal adult would get to 2mg/ml. the oral LD 50 of lido is 459 (346-773) mg/kg, which is 32,130 mg for a 70 kg adult

Conclusion is you are less than 1 tenth lethal dose with 4 ounces.

Link Posted: 12/17/2005 8:28:09 AM EDT

Originally Posted By tyman:
Interesting post.


Fish223 and C-4, what are your occupations?



see sig line
Link Posted: 12/17/2005 9:09:55 AM EDT

Originally Posted By fish223:

Originally Posted By tyman:
Interesting post.


Fish223 and C-4, what are your occupations?



see sig line



Nice.
Link Posted: 12/17/2005 10:27:15 AM EDT

Originally Posted By fish223:

Originally Posted By ARDOC:
Novacaine will instantly be absorbed by the mucosal surfaces in the oral cavity and thee blood levels will increase significantly and quickly. I think C-4 has it correctly.



Transmucosal absorption of lidocaine is actually slow, and shallow. Hence the difficulty with mucosal anesthesia with topical application of viscous lidocaine, or even 20% benzocaine.

Lidocaine is available at 1% and 2%, so 4 ounces of 2% would contain (120 ml times 20 mg/ml) 2400 mg of pure lidocaine. Assuming perfect, immediate absorption, the plama level of a normal adult would get to 2mg/ml. the oral LD 50 of lido is 459 (346-773) mg/kg, which is 32,130 mg for a 70 kg adult

Conclusion is you are less than 1 tenth lethal dose with 4 ounces.




That is for rats (although I see that you got your numbers from the PDR as well). The LD50 for humans is most often unavailable because it's difficult to get volunteers. Often, the LD50 dose can be ten times smaller in humans than in rats or mice.

According to the PDR, the maximum recommended total subcutaneous dosage of lidocaine with epinephrine is 3.5mg/lb not to exceed 500mg. For lidocaine without epi it's 2mg/lb not to exceed 300mg.

Without epi, that translates into 15ml (cc's) of a 2% soln.

Now back to the original question: If I drank a shot-glass full of novacaine would my body go numb, or would I just die?

A shot glass contains one fluid ounce which is about 28ml. The maximum recommended dose is for lidocaine given by needle injection, not orally. Lidocaine is rapidly metabolized by the liver. You are drinking a dose that if given by injection could kill two people. But since most (some of it will be absorbed in the oral mucosa, esophagus, stomach lining, etc.) of the lidocaine has to pass through the liver before reaching the heart and brain, you are hoping that over half of the drug gets detoxified.

Now you'd have to ask a pharmacist exactly how much of the lidocaine actually gets metabolized on its first pass through the liver, but if it isn't over 50%, then you are seriously putting your life at risk.

Now if you drank 4 oz, you would likely die.

Listen to fish223 and me. Don't do it.
Link Posted: 12/17/2005 10:34:45 AM EDT
First of all he said procaine and not lidocaine. Second, I disagree with the shallow absorption. From your mouth all the way to the stomach you going to start absorbing the med. Second even if not in sufficient quantities in you bloodstream, it may make your gag reflex not work and you may choke to death.

Second, it tastes like shit.

Third, I have seen a women get a direct infusion of lidocaine and the cardiovascular effects made you shit. And we are not talking about the patient. After her heart was back in rthyhm we had to bag her for a loonnng time.
Link Posted: 12/17/2005 10:39:58 AM EDT
Why ask? Planning on swallowing a shaved gerbil?
Link Posted: 12/17/2005 10:53:05 AM EDT

Originally Posted By ARDOC:
First of all he said procaine and not lidocaine. Second, I disagree with the shallow absorption. From your mouth all the way to the stomach you going to start absorbing the med. Second even if not in sufficient quantities in you bloodstream, it may make your gag reflex not work and you may choke to death.

Second, it tastes like shit.

Third, I have seen a women get a direct infusion of lidocaine and the cardiovascular effects made you shit. And we are not talking about the patient. After her heart was back in rthyhm we had to bag her for a loonnng time.



Sorry, I had a brain fart. Novocaine = procaine which is 3 times less toxic than lidocaine.

I wonder if there is a recreational use for desensitizing someones gag reflex. Hmmm . . . .
Link Posted: 12/17/2005 11:00:48 AM EDT

Originally Posted By Gravity_Tester:
Send me your guns and then try it!



Beat me to it!
Link Posted: 12/17/2005 11:00:56 AM EDT

Originally Posted By C-4:

Originally Posted By ARDOC:
First of all he said procaine and not lidocaine. Second, I disagree with the shallow absorption. From your mouth all the way to the stomach you going to start absorbing the med. Second even if not in sufficient quantities in you bloodstream, it may make your gag reflex not work and you may choke to death.

Second, it tastes like shit.

Third, I have seen a women get a direct infusion of lidocaine and the cardiovascular effects made you shit. And we are not talking about the patient. After her heart was back in rthyhm we had to bag her for a loonnng time.



Sorry, I had a brain fart. Novocaine = procaine which is 3 times less toxic than lidocaine.



I wonder if there is a recreational use for desensitizing someones gag reflex. Hmmm . . . .



C-4 I didnt mean to correct you. Not at all. But I think in this case it may make a difference.

We had a hooker come in and she couldnt feel her mouth. She thought something was wrong. It turned out the guy is a ICU nurse. He got some lidocaine gel and put it on his dick because he didnt want come too fast. So we have this hooker with a numb mouth. The jokes were flying in the ER that night.
Link Posted: 12/17/2005 11:18:48 AM EDT
[Last Edit: 12/17/2005 11:21:28 AM EDT by AFARR]
A “GI Cocktail with Lidocaine” consists of:

A. Maalox Plus 30cc P.O.

B. Elixir Donnatal 10cc P.O.

C. Viscous Lidocaine 5cc P.O.


About 100cc in 4 ozs.

When we do digital/foot/ankle injections it is normally <20cc 1% Lidocaine (Xylocaine) plain (without Epi). That is injected into the soft tissue, avoiding the blood vessels.

Per the ER Doc--someone gets a metallic taste in their mouth from the lidocaine, grab the Valium because they are going to have a siezure. I would go with ARDoc--that much will be absorbed and would exceed a toxic dose.

PS--Novacaine is not used much anymore (it is an Ester, as was pointed out before--they cause more allergic reactions than the Amides--Lidocaine, Marcaine, Carbocaine).

AFARR

Edited to add: Your dentist probably used Carbocaine (per a classmated of mine that was a dental assistant before going back to school). Probably only used <3cc of the stuff to numb you up. Stock bottles of injectable Lidocaine normally come in 10cc or 20cc bottles).
Link Posted: 12/17/2005 4:45:19 PM EDT
[Last Edit: 12/17/2005 4:46:46 PM EDT by fish223]
I discussed lido because when he said he went to the dentist and got novocaine, I knew he really meant lidocaine. Dentists haven't used actual novocaine in years, decades even.

In any event, ARDOC is right, it tastes like shit, and I don't think anyone would voluntarily drink it.

Also, C-4 is correct in pointing out the LD 50 is studied in rats, and humans can be much more sensitive. So there probably isn't the saftey margin that I mentioned, but still, injesting 4 oz is probably not gonna kill a healthy 70kg adult.

Wolffie pointed out that dentists stay under 18ml 2% injected, but that is not intravenous, and also, most dentists use lido with epi for vasoconstriction, and as such, the epi component has its own set of issues.

Lastly, geezhound, although we all arrived at similar conclusions for various different reasons, we all agree that it is not a good idea. So unless you were planning on maybe getting a Darwin Award in the 2005 presentations, lets keep this academic, and not try it out.

Fish
Link Posted: 12/17/2005 9:37:40 PM EDT
Not to bring this up again, but if I remember right Lido has a 70% first pass effect. Carbocaine (Mepivicaine) has a much shorter duration of action, and is generally more expensive than Xylocaine (Lido). Depending on the procedure, I'd guess that he had Lido. The limit for Mepivicaine is 4 carpules for your average 70Kg patient.

I'm still in school, so my pt. base is pretty small, but the last time I used Carbocaine was to avoid drug interactions with a cocaine user.

Moot point, it's still not a good idea.

Macumazahn: If I can offer one piece of advice:

Oh, Oh, Oh, To Touch And Feel A Vigin Girls Vagina And Hiney
Some Say Money Matter Most, But Brother Says Big Breasts Matter More

Just curious if anyone else recognizes that?
Link Posted: 12/17/2005 10:39:09 PM EDT
Cranial nerves
Link Posted: 12/17/2005 11:53:59 PM EDT
Here's another way of asking it (by someone who knows nothing about it);

Would it croak the dude if it was actual Novocaine, and was straight rather than all the % per ml and stuff you guys were saying?
(Totally discounting whether it's in common use or he could actually get it. Not mixed with anything or diluted, but just plain ol' Novocaine).
Link Posted: 12/18/2005 6:40:01 AM EDT

Would it croak the dude if it was actual Novocaine, and was straight rather than all the % per ml and stuff you guys were saying


That's a bit like asking if your car will run on crude oil if you go to the gas station and get some to try....

He would have to go to the manufacturer to get it--I'd guess that is is a crystaline solid usually provided in suspension, but I don't have a PDR handy to check. That would be like eating a shotglass of salt.
Link Posted: 12/18/2005 8:38:37 AM EDT

Originally Posted By wolffie:

Oh, Oh, Oh, To Touch And Feel A Vigin Girls Vagina And Hiney
Some Say Money Matter Most, But Brother Says Big Breasts Matter More

Just curious if anyone else recognizes that?



Wolffie, check the books.

Its Oh, OH, OH, to touch and feel virgin girls vagina and hiney (you added an extra "A" after feel.)

olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal

and the other one is
some say marry money but my mother says big boobs matter most

if you do it your way you get some sensory and motor mixed up

and don't forget, "as she lay flat, oscars penis slipped in"

let me know if you can't figure it out.

Link Posted: 12/18/2005 8:59:54 AM EDT
Fish223 - check the books as well:
Facial nerve is sensory & motor - change "mother" to "brother"

I learned the other one a bit differently, but branches of ECA.
Link Posted: 12/18/2005 10:05:57 AM EDT
Its the max dose that will kill ya, not the number of oz's, need to know the concentration selected first. Max dose for Novacain in a 70kg pt is 800mg. With that said, there is a fair safety margin. Ingesting it would most likely break down the protiens and render most of it ineffective. Its pKA 8.9 and stomach acid is a LOT lower than that, so even if it survived, it would move very slowly accross the gut mucosa.

Plastic surgeons routinly laugh at me when I tell them the max dose of Lidocain is 500mg, as they inject upwards of a thousand, with epi of course, but still!

Esters are still used, I use them for spinals all the time, they work great for hypobaric spinals.

Wally

Link Posted: 12/18/2005 12:00:05 PM EDT
Wally,

The way I learned it is that the max dose of Lidocaine is based on intravascular injection. Injecting into the soft tissue leaches into the vascular system a bit more slowly (allows it to clear). Epi increases the max dose bay about 1.5x (slower vascular absorbtion)..

AFARR
Link Posted: 12/18/2005 12:02:43 PM EDT
[Last Edit: 12/18/2005 12:09:14 PM EDT by odontia32m]
First of all Novacaine is no longer used because of allergic reactions with the preservatives in it.

If you are talking about lidocaine, the answer is nothing if you are not allergic to it whick I would doubt. I give 30 ccs (1 ounce)of it all the time to people with stomach/troat pain. Numb mouth, throat and gut, posssible elevated heart rate but I doubt it with oral solution.. It will stay numb about 30-40 minutes.

ETA carbocaine is only used in cardiac patients. Carbocaines hal life if fat too short as it has only neocobefrin as a vasoconstictor. There are 2 types of local anesthesias, amides and esters.

Drink away.

Bob RN, 1st sx asst, Former Dental Hygienist
Link Posted: 12/18/2005 6:13:20 PM EDT
[Last Edit: 12/18/2005 6:15:22 PM EDT by wolffie]

Originally Posted By fish223:

Originally Posted By wolffie:

Oh, Oh, Oh, To Touch And Feel A Vigin Girls Vagina And Hiney
Some Say Money Matter Most, But Brother Says Big Breasts Matter More

Just curious if anyone else recognizes that?



Wolffie, check the books.

Its Oh, OH, OH, to touch and feel virgin girls vagina and hiney (you added an extra "A" after feel.)

olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, hypoglossal

and the other one is
some say marry money but my mother says big boobs matter most

if you do it your way you get some sensory and motor mixed up

and don't forget, "as she lay flat, oscars penis slipped in"

let me know if you can't figure it out.




My Bad. I guess I got sloppy and it's been a while. After a while they started to click and I haven't relied on it since my gross final. But, I'm glad you straightened it out, because I've got the NDBE Part I tomorrow. I've been putting it off.

I don't know the other one.
Link Posted: 12/18/2005 7:56:42 PM EDT
Closest I could find is the branches of the External Carotid:

Sally Superior Thyroid
Ann Ascending Pharyngeal
Likes Lingual
Flirting Facial
On Occipital
Philidelphia's Posterior auricular
Main Maxillary
Street Superficial temporal
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