Anesthetics, detoxification

Naloxone is used for rapid opioid detoxification in conjunction with anesthetic agents for conscious sedation. 

Systemic absorption of topical anesthetics can result in high blood levels by any of the following mechanisms (1) too large a dosage of the local anesthetic (2) unusually rapid absorption of the drug, as in patients with marked conjunctival hyperemia (3) unusually slow drug detoxification and (4) slow elimination of the drug. 

Over the years, hundreds of new local anesthetics have been synthesized and tested. For one reason or another, most have not come into general use. The search for the perfect local anesthetic is still under way. All the drugs found to be active have certain structural features in common. At one end of the molecule is an aromatic ring. At the other is a secondary or tertiary amine. These two essential features are separated by a central chain of atoms usually one to four units long. The aromatic part is usually an ester of an aromatic acid. The ester group is important to the bodily detoxification of these compounds. The first step in deactivating them is a hydrolysis of this ester linkage, a process that occurs in the bloodstream. 

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