Polidocanol

When ATH:
C05BB02

Pharmacological action.
Venoskleroziruyuschee, mestnoanesteziruyuschee.

Application.

Sclerotherapy varices, telangiectasia and hemorrhoids; obliteration or parietal sclerosis of varicose veins of the esophagus and stomach in liver cirrhosis and portal hypertension nepechenochnyh forms, Instrumental endoscopic hemostasis in gastroduodenal ulcer bleeding, bleeding from esophageal varices and gastric.

Contraindications.

Hypersensitivity, state of shock, atherosclerotic lesion arteries with stenosis grade III-IV, chronic arterial insufficiency, acute form of thrombophlebitis of superficial veins, strict bed rest.

Restrictions apply.

Swelling of limbs, severe obesity, thrombosis of superficial and deep veins, diabetic microangiopathy, Heart Disease, decompensated heart failure, arterial hypertension, fevers, bronchial asthma, pregnancy, advanced age, infectious and inflammatory processes at the site of the alleged administration.

Side effects.

Allergic reactions, local skin necrosis (d=2мм) to form ulcerations (when administered intradermally in a concentration greater than 0,5%), hyperpigmentation of the skin over the sclerotic veins, thrombophlebitis of superficial and deep veins, nodular fibrosis tissue fragments sclerosed veins. When sklerozirovanii hemorrhoids — pain in the anus, in prostate, post-injection bleeding from the injection site. When sklerozirovanii esophageal varices and gastric-dysphagia, fever, dizziness, difficulty breathing, chest discomfort, nausea, visual impairment, metallic taste in mouth, nekrozy, ulceration, bleeding, perforation, esophageal stenosis, pleurisy, mediastinit.

Cooperation.

Enhances arrhythmogenic activity anesthetic agents.

Overdose.

Symptoms: When paravazal′nyh injections — development of necrosis.

Treatment: the introduction of 0.5-2 ml 1% novokaina solution or 5-20 ml izotoniceski solution of sodium chloride in combination with hyaluronidase.

Dosing and Administration.

B /, paravazalno (submucosal, subepithelial) dose 2 mg / kg body weight per day (no more). Hardening of the subcutaneous veins when varicose veins is strictly retikulârnom intravazal′no, very thin needles, an injection is performed at a tangent to the venous wall, enter 0.1-0.3 ml 0,5% solution (depending on the diameter of the vein). Hardening of Telangiectasia is 0.1-0.2 ml 0,5% solution, central vein is 0.1-0.2 ml 1% solution, small varicose vein Extensions-0.1-0.3 ml 1% solution, varicose veins average is 0.5-1 ml 3% solution. Varicose veins oesophagus and stomach — endoscopic paravazal′noe introduction 0.5-1% solution via needle injector. Treatment begins with an introduction to probe Black-Mora and later 1-3 days is entered polidokanol in doses of 1-1, 5 ml at several points, from the cardia to the proximal part of the. The minimum one-off doses — 2-3 ml, the maximum is 10-12 ml. Treatment consists of 3-7 treatments with an interval of 3-4 days. Hemorrhoids: syringe with two eyes and a long needle with a limiter at the sharp edges using the exam into a lumen of haemorrhoid closer to its stem is entered 1.5-2 ml 3% solution; in men node, located on the 11 no, Enter no more than 0,5 ml.

Precautions.

Before treatment should be carried out standard inspection (Doppler ultrasound of lower limb veins, "Marching sample") and warn the patient about the possibility of hyperpigmentation during the sclerotic veins of the extremities (self disappears within 6-24 months). With careful use of sclerosing veins in the ankle and ankle (recommend small doses of the minimum concentration of the solution). Hemorrhoids simultaneous administration may not be more, than 2 haemorrhoid (the introduction of more severe pain triggers); repeat procedure is carried out not earlier, than 12-14 days after decrease inflammation.

Cautions.

In the case of a false / administration and, threatening gangrene limb, must leave the needle into the artery, Enter 5-10 ml 2% lidocaine or novocaine, heparin dose 5000 ED, ischemic limb wool wrap, impose ice, drop down, establish/in infuziu reopoligliukina with heparin dose 400 ED 1 kg body weight.