Novocaine of 0,25%

General characteristics. Structure:

Active ingredient: 2,5 g of Procainum of a hydrochloride (novocaine).

Excipients: acid solution of hydrochloric 0,1 M - to рН 3,8 - 4,5, water for injections.

Pharmacological properties:

Pharmacodynamics. Novocaine is local anesthetic. Novocaine has the moderate anesthetizing activity and big width of therapeutic action. Blocks natrium channels and thus interferes with generation of impulses in the terminations of sensory nerves and to carrying out impulses on nerve fibrils. Suppresses carrying out not only painful, but also impulses of other modality.

At resorptive action has the oppressing effect on the central nervous system, weakens a spasm of smooth muscles, possesses ganglioblokiruyushchy action, in high doses can break neuromuscular conductivity. Novocaine has hypotensive and antiarrhythmic effect (reduces excitability and automatism, worsens conductivity). In comparison with lidocaine and bupivacaine, novocaine has less expressed anesthetic effect, has rather small toxicity and bigger therapeutic width.

Pharmacokinetics. In an organism drug is hydrolyzed by esterases of a blood plasma and fabrics with formation of two main metabolites: diethylaminoethanol and para-aminobenzoic acid (is an antagonist of sulfanamide chemotherapeutic drugs). Metabolites are allocated with kidneys.

Indications to use:

For local anesthesia (infiltration, conduction, epidural) at various surgical interventions; for carrying out novocainic blockade - perinephric and vagosympathetic; for carrying out circulator and juxtaspinal blockade at eczema, neurodermatitis, a sciatica; for stopping of pain at a peptic ulcer of a stomach, duodenum, hemorrhoids, etc.; for removal of spasms of peripheral vessels and improvement of microcirculation at freezing injuries (in the doreaktivny period); for potentiation of action of fixed assets of the general anesthesia.

Route of administration and doses:

For an infiltration anesthesia the following highest doses are established: the first single dose at the beginning of operation no more than 500 ml of 0,25% of solution or 150 ml of 0,5% of solution, further at each o'clock to 1000 ml of 0,25% of solution or 400 ml of 0,5% of solution. At local anesthesia for reduction of absorption and increase in duration of action add 0,1% to solution of novocaine Adrenalinum hydrochloricum solution at the rate of 1 drop on 2 - 5 - 10 ml of solution of novocaine.

At perinephric blockade by A. V. Vishnevsky's method enter into pararenal cellulose on 50 - 80 ml 0,5% of solution or 100 - 150 ml of 0,25% of solution of novocaine.

For carrying out circulator and juxtaspinal blockade at eczema, neurodermatitis, a sciatica enter 0,25 - 0,5% novocaine solution. At frostbites a varteriya of the affected extremity enter mix of the following structure: 10 ml of 0,25% of solution of novocaine, 10 ml of 2,4% of solution of an Euphyllinum, 1 ml of 1% of solution of niacin.

The highest single doses at intramuscular introduction: 0,1 g (20 ml 0,5%rastvor); at intravenous administration - 0,05g (20 ml of 0,25% of solution). For removal of spasms and improvement of microcirculation, the mix consisting of  10 ml of 0,25% of solution of novocaine, 2 ml of 2% of solution of a papaverine, 2 ml of 1% of acid solution of nicotinic and 10000 PIECES of heparin is used. It is entered vnutriarterialno slowly.

Features of use:

Hypersensitivity cases to novocaine were observed. For identification it is carried out by skin tests (swelled also reddening around the place of a prick). Sometimes at this test the general reaction is possible.    It is necessary to consider that when carrying out local anesthesia at use of the same general dose toxicity of novocaine of subjects is higher, than the applied solution is more concentrated. Novocaine slowly gets through the unimpaired mucous membranes therefore it is a little effective for surface anesthesia.

Side effects:

It is a little toxic. Dizziness, weakness, hypotonia, allergic skin reactions are in certain cases possible. Toxicity of novocaine increases in process of increase in concentration.

From cardiovascular system: arterial hypotension, collapse.

From the central nervous system: weakness, dizziness.

Allergic reactions: a small tortoiseshell, development of an acute anaphylaxis is possible.

Interaction with other medicines:

Novocaine strengthens the oppressing action on TsNS of anesthetics, hypnotic drugs, sedative drugs, narcotic analgetics and anxiolytics. The metabolite of PABK novocaine inhibits effect of streptocides. Atropini sulfas strengthens anesthetic effect of novocaine. Novocaine weakens diuretic effect of diuretics. At a combination to salicylates, sulfanamide drugs both bacteriostatic action, and anesthetic effect decreases.

Contraindications:

Children up to 12 years. Hypersensitivity to drug, a myasthenia, hypotension, treatment by streptocides, purulent process in an injection site.

With care to apply at a serious illness of heart, liver, kidneys.

Overdose:

At overdose coma develops, spasms are possible. First aid at overdose - maintenance of lung ventilation, disintoxication and symptomatic therapy.

Storage conditions:

List B. In the dry, protected from light place at a temperature not above 25 °C. To store in the place, unavailable to children. Period of validity 2 years.

Issue conditions:

According to the recipe

Packaging:

0,25% solution for injections on 100 ml, 250 ml and 500 ml in polymeric containers.