Lidokain (When ATH D04AB01)

When ATH:
D04AB01

Characteristic.

White or almost white crystalline powder, poorly soluble in water. Used as the hydrochloride salt, easily soluble in water.

Pharmacological action.
Mestnoanesteziruyuschee, antiarrhythmic.

Application.

Ventricular arrhythmias and tachyarrhythmias, incl. in acute myocardial infarction, postoperatively, ventricular fibrillation; all kinds of local anesthesia, incl. superficial, infiltration, wires, Epidural, Spinal, intraligamentarnaya during surgery, painful manipulation, endoscopic and instrumental investigations; in the form of plates is a pain syndrome in vertebral lesions, myositis, postgerpeticheskaya neuralgia.

Contraindications.

Hypersensitivity, a history of seizures, epileptiform lidocaine, WPW-syndrome, cardiogenic shock, sick sinus, heart block (OF, intraventricular, sinoatrial), severe liver disease, myasthenia.

Restrictions apply.

States, accompanied by a decrease in hepatic blood flow (such as congestive heart failure, liver diseases), progression of cardiovascular disease (usually as a result of heart block and shock), debilitated patient, advanced age (senior 65 years), violation of the integrity of the skin (in place of the overlay plate), pregnancy, lactation.

Pregnancy and breast-feeding.

During pregnancy and lactation is possible, if the effect of therapy outweighs the potential risk to the fetus and child.

Category actions result in FDA - B. (The study of reproduction in animals revealed no risk of adverse effects on the fetus, and adequate and well-controlled studies in pregnant women have not done.)

Side effects.

From the nervous system and sensory organs: CNS depression or agitation, nervousness, euphoria, flashing "flies" before the eyes, photophobia, drowsiness, headache, dizziness, noise in ears, diplopia, disturbance of consciousness, depression or respiratory arrest, vellication, tremor, disorientation, convulsions (It increases the risk of development against the backdrop of hypercapnia and acidosis).

Cardio-vascular system and blood (hematopoiesis, hemostasis): sinusovaya bradycardia, cardiac conduction disturbances, transverse heart block, decrease or increase in blood pressure, collapse.

From the digestive tract: nausea, vomiting.

Allergic reactions: generalized exfoliative dermatitis, anaphylactic shock, angioedema, contact dermatitis (redness at the site of application, skin rash, hives, itch), transient burning sensation in an aerosol or in an area of ​​application of the plate.

Other: feeling the heat, cold or numbness in the extremities, malignant hyperthermia, suppression of the immune system.

Cooperation.

Beta-blockers increase the likelihood of bradycardia and hypotension. Norepinephrine and beta-blockers, reducing hepatic blood flow, lower (increases toxicity), izadrin and glucagon increase lidocaine clearance. Cimetidine increases the concentration in plasma (It displaces from its association with proteins and slows inactivation in the liver). Barbiturates, causing induction of microsomal enzymes, promote degradation of lidocaine and reduce its activity. Anticonvulsants (hydantoin derivatives) accelerate hepatic biotransformation (decreases blood concentration), at / in the introduction may increase the action of lidocaine cardiodepressive. Antiaritmiki (Amiodarone, verapamil, quinidine, aimalin) potentiate kardiodepressiyu. Combination with novokainamidom can excite the central nervous system and hallucinations. Dampening effect of anesthesia (geksoʙarʙital, thiopental sodium), hypnotics and sedatives on the respiratory center, weakens the effect of cardiotonic digitoksina, enhances muscle relaxation, kurarepodobnymi caused by drugs (possible paralysis of the respiratory muscles). MAO inhibitors prolong local anesthesia.

Overdose.

Symptoms: psychomotor agitation, dizziness, generalized weakness, decrease in blood pressure, tremor, tonic-clonic seizures, coma, collapse, possible AV block, CNS depression, respiratory arrest.

Treatment: discontinuation, pulmonary ventilation, or oxygen therapy, anticonvulsants, vasoconstrictors (noradrenaline, mezaton), When bradycardia-holinolitiki (atropyn). Perhaps intubation, IVL, resuscitation. Dialysis nyeeffyektivyen.

Dosing and Administration.

The mode set individually, depending on the evidence, clinical situation and the dosage form. Arrhythmias: w / jet (for 3-4 minutes) 50-100 mg at a speed of 25-50 mg/min, then drip with a speed of 1-4 mg/min. In/m 4,3 mg / kg body weight, if necessary, again after 60-90 minutes. The maximum dose for adults in/in and/m introduction-to 300-400 mg for 1 no. The maximum daily dose - 2000 mg. Children enter Jet 1 mg/kg at a speed of 25-50 mg/min, through 5 min possible re-introduction (the total dose should not exceed 3 mg / kg). Infuziruut then at speeds 30 ug / kg / min. The maximum daily dose for children is 4 mg / kg.

For surface anaesthesia-2-10% solution (no more 200 mg - 2 ml).

In adults, for infiltration anesthesia used 0,5% solution, for wire-1-2% solution. The maximum total dose is 300-400 mg.

In ophthalmology is by 1-2 drops 2-3 times at intervals of 30-60 with.

Locally (aerosol, gel, spray, plates). Children up 2 years indicated for surface anesthesia, pre inflicting on a cotton swab, 1-2 Aerosol dose (4,8-9.6 Mg).

The plate must be attached to the skin, to cover the painful surface. After applying the plate to avoid hand contact with the eyes, you must immediately wash your hands. The plate may be on the skin for 12 no. The plate was then removed and do 12-hour break. At the same time you can stick to three plates.

Precautions.

Caution must be exercised in the liver and kidney diseases, gipovolemii, severe heart failure with motility disorders, genetic susceptibility to malignant hyperthermia. Children, debilitated patients, elderly patients require dose adjustment in accordance with the age and physical status. When injected into the vascularized tissue is recommended aspirate.

When applied topically used with caution during infection or injury in the place of application.

If the period of application of the plate there a burning sensation or redness of the skin, it must be removed and not be used until redness disappears. Used plates should not be accessible to children or pets. Immediately after the application of the plate should be destroyed.

Cautions.

For extension of the anesthetic may be added 1 drops 0,1% solution of adrenalin on the 5-10 ml lidocaine (The maximum tolerated dose increases to 500 mg).

Cooperation