Magic mouthwash

Revision as of 11:36, 25 July 2015 by Neil.m.young (talk | contribs)

Background

In infants, do NOT use oral lidocaine due to risk of lidocaine toxicity and FDA black box warning[2][3]

Warnings

  • DO NOT EXCEED dosing limits especially for lidocaine.
  • DO NOT use under 2 years old
  • Never give a family an amount that can be toxic if unintetionally swallowed in its entirety

Lidocaine

1 cc Viscous 2% lidocaine = 20 mg lidocaine

Max dose = 5mg/kg

For a 10 kg child = 50 mg lidocaine = 2.5 cc

Diphenhydramamine

Diphenhydramamine 6.25mg/5cc or 12.5mg/5cc

Max dose = 5mg/kg/day

For a 10 kg child = 50 mg benadryl =20 cc of 12.5mg/5cc

Makeup

Equal parts:

  1. Viscous lido 2%
  2. Diphenhydramamine
  3. Maalox

Treatment

0.5-1cc before feeds

See Also

References

  1. Hopper S. et al. Topical lidocaine to improve oral intake in children with painful infectious mouth ulcers: a blinded, randomized, placebo-controlled trial. Ann Emerg Med. 2014 Mar;63(3):292-9
  2. FDA recommends not using lidocaine to treat teething pain. http://www.fda.gov/Drugs/DrugSafety/ucm402240.htm
  3. Curtis LA, Dolan TS, Seibert HE. Are one or two dangerous? Lidocaine and topical anesthetic exposures in children. J Emerg Med 2009;37:32-39