Lidocaine hydrochloride
Producer: JSC Himfarm Republic of Kazakhstan
Code of automatic telephone exchange: N01BB02
Release form: Liquid dosage forms. Solution for injections.
General characteristics. Structure:
Active agent - lidocaine a hydrochloride (in terms of 100% substance) 35 mg.
Excipients: sodium hydroxide, water for injections.
Pharmacological properties:
Pharmacokinetics. After intramuscular introduction absorption almost full. Communication with proteins of plasma - 50-80%. It is distributed quickly, at first comes to well krovosnabzhayemy fabrics (heart, lungs, a brain, a liver, a spleen), and then to fatty and muscular fabrics. It is actively metabolized in a liver. The poluvyvydeniye period – 1-3ch. Metabolites eliminirutsya with urine.
Pharmacodynamics. Derivative acetanilide. Possesses mestnoanesteziruyushchy action, causes blockade of natrium channels of excitable membranes of neurons and membranes of cardiomyocytes. It is applied at all types of local anesthesia: terminal, infiltration, conduction. In comparison with novocaine he acts quicker, stronger and more for a long time.
Indications to use:
- anesthesia of peripheral nerves
- blockade of neuroplexes
- for greasing of mucous membranes: (at an intubation of a trachea, a bronkhoezofagoskopiya, removal of polyps, punctures of a Highmore's bosom)
- as solvent for tsefalosporinovy antibiotics.
Route of administration and doses:
For anesthesia of peripheral nerves, including at blockade of neuroplexes: the maximum general dose to 400 mg (40 ml of 1% of solution).
For blockade of neuroplexes: 10-20 ml of 1% lidocaine solution.
For epidural anesthesia: 1% solution (no more than 300 mg).
For greasing of mucous membranes of 1% lidocaine solution (at an intubation of a trachea, a bronkhoezofagoskopiya, removal of polyps, punctures of a Highmore's bosom).
As solvent for tsefalosporinovy antibiotics: for an intramuscular injection, no more than 1 g of an antibiotic (Tsef III) dissolve in 3,5ml 1% of solution of lidocaine and enter deeply into a gluteus. Solution the containing lidocaine and a tsefalosporinovy antibiotic (Tsef III) cannot be entered intravenously.
Features of use:
With care it is necessary to appoint at local anesthesia of bodies rich with blood vessels.
At pregnancy and in the period of a lactation use of lidocaine is possible only according to vital indications.
Use of drug influences ability to manage the vehicle or potentially dangerous mechanisms.
Side effects:
Seldom:
- skin rash
- itch
- Quincke's disease
- acute anaphylaxis.
Are possible:
- headache
- dizziness
- sleep disorder
- concern.
At use of high doses are possible:
- bradycardia
- conductivity delay
- arterial hypotension.
Local reactions:
- at epidural anesthesia – accidental hit in a subarachnoid space.
Interaction with other medicines:
Chlorpromazinum, Cimetidinum, propranolol, bupivacaine, quinidine, Disopyramidum, amitriptyline, Imipraminum, нортриптилин increase concentration of lidocaine in blood serum. At a combination to Amiodaronum decrease of clearance of lidocaine and strengthening of toxic effects (arrhythmia, convulsive attacks and a coma). Beta adrenoblockers (system and eye) slow down metabolism of lidocaine in a liver and increase risk of emergence of toxic effects. The combination with antiarrhytmic means (quinidine, procaineamide, Disopyramidum) leads to lengthening of an interval of Q-t on the electrocardiogram and is rare to emergence of ventricular fibrillation. Phenytoinum strengthens cardiodepressive effect of lidocaine. At a combination with prokainamidom-side effects from the central nervous system (a delirium, hallucinations) are possible, with analgetics - sedation summation. Strengthens action of blockers of neuromuscular synapses. Alcohol strengthens the oppressing effect of lidocaine on the center of breath.
Contraindications:
- methemoglobinemia, heavy bleedings
- cardiac standstill, shock
- infectious defeat in the place of estimated anesthesia
- sepsis without purulent metastasises
- weakness of a sinus node at patients of advanced age
- atrioventricular block of II and III degrees
- hypersensitivity to lidocaine.
With care:
- renal failure
- cardiovascular insufficiency.
When using 1% of solution of lidocaine as solvent intravenous administration is contraindicated.
Overdose:
Symptoms: first symptoms of intoxication dizziness, nausea, vomiting, euphoria; then - spasms of mimic muscles of the person with transition to toniko-clonic spasms of skeletal muscles, psychomotor excitement, the general weakness, an apnoea, bradycardia, a lowering of arterial pressure, a collapse, a methemoglobinemia.
Treatment: the patient has to be in horizontal position; appoint inhalation of oxygen and enter 10 mg of diazepam. In cases of display of spasms of skeletal muscles, the last are stopped by slow intravenous administration of 1% of solution of hexobarbital or thiopental of sodium. At bradycardia - M-cholinolytics (atropine), vasoconstrictors (Norepinephrinum, Phenylephrinum). Dialysis is inefficient.
Storage conditions:
To store in the dry, protected from light place, at a temperature not above 30 °C. To store in the place, unavailable to children!
Issue conditions:
According to the recipe
Packaging:
1% solution for injections in ampoules on 3,5 ml in a blister strip packaging of 5 pieces, in a cardboard pack 1 ampoule of lidocaine of a hydrochloride together with 1 bottle of a tsefalosporinovy antibiotic (Tsef III – a tseftriaksona of sodium) powder for injections.
