Pharmacogenetic and PK/PD study after infiltrative application of lidocaine associated or not with epinephrine in saliva samples by LC MS/MS

Published: 25 March 2024| Version 1 | DOI: 10.17632/b4r9srvshr.1
Gabriela de Moraes Oliveira, Thiago Dionisio, Douglas Pedrolongo, Adriana Calvo, Carlos F. Santos


The individualization of drug prescription has increasingly become the focus of current research in pharmacology so that the adverse effects of drugs are minimized whenever possible. Some studies in the current literature show the relationship that cytochrome P450 polymorphisms, more specifically CYP3A4 and CYP1A2, exert on the metabolism of lidocaine into its main metabolite, monoethyl-glycinexylidide (MEGX). Lidocaine is the most used local anesthetic in dentistry worldwide, being one of the oldest sodium channel blockers on the market and considered the safest amide local anesthetic. Even so, it can cause some side effects on the cardiovascular system and the central nervous system, especially when accidental administration occurs directly into a blood vessel, and the association with vasoconstrictors, especially epinephrine, is a strategy to minimize these effects. In this research, clinical data will be collected from the largest possible number of volunteers in the first 18 months of the project, who will attend two different dental appointments, according to the protocol, for scaling and crown-radicular polishing, sulcular infiltrative injection in the region of maxillary molars of a cartridge of lidocaine associated or not with 1:100,000 epinephrine. For the pharmacokinetic (PK) study, saliva samples will be collected. For the pharmacodynamic parameters (PD), variations in blood pressure, oximetry, and heart rate will be evaluated during the procedure, in addition to the beginning and duration of local anesthesia in soft tissues. Altogether, data will be analyzed for CYP3A4 and CYP1A2 polymorphisms and their relationship with individual patient responses.



Universidade de Sao Paulo Faculdade de Odontologia de Bauru, Universidade de Sao Paulo


Mass Spectrometry, Pharmacodynamics, Pharmacokinetics, Pharmacogenetics, Local Anesthesia by Infiltration


Fundação de Amparo à Pesquisa do Estado de São Paulo