Why does articaine have a much shorter elimination half-life than the other amide local anesthetics used in dentistry?

  • Correct answer

    Its ester side group allows hydrolysis by plasma cholinesterase

  • It is excreted unchanged by the kidneys

  • It is almost entirely bound to plasma proteins

  • It is metabolized mainly in the lungs

This question is one of 15 in AFK practice: Pharmacology, local anesthesia and emergencies. Test yourself on all of them.

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Explanations

  • Although classed as an amide, articaine carries an ester group, so most of it is inactivated in the blood by plasma cholinesterase rather than relying only on hepatic metabolism. Renal excretion of unchanged drug accounts for only a small fraction.

    Source: Malamed, Handbook of Local Anesthesia — oneguy

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