Lidocaine injection 2% 2ml N10
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Active ingredients
Lidocaine
Release form
Solution
Composition
Active ingredient: Lidocaine. Concentration of active ingredient (%): 2%
Pharmacological effect
Class IB antiarrhythmic agent, local anesthetic, acetanilide derivative. Possesses membrane stabilizing activity. Causes the blockade of sodium channels of the excitable membranes of neurons and cardiomyocyte membranes. Reduces the duration of the action potential and effective refractory period in Purkinje fibers, suppresses their automatism. At the same time lidocaine suppresses the electrical activity of depolarized, arrhythmogenic areas, but minimally affects the electrical activity of normal tissues. When used in moderate therapeutic doses, it practically does not alter myocardial contractility and does not slow down AV conductivity. When used as an antiarrhythmic agent with a / in the introduction of the beginning of the action after 45-90 seconds, duration - 10-20 minutes; with intramuscular injection, the onset of action after 5-15 minutes, duration - 60-90 minutes. Causes all types of local anesthesia: terminal, infiltration, conduction.
Pharmacokinetics
After i / m administration, absorption is almost complete. The distribution is fast, Vd is about 1 l / kg (in patients with lower heart failure). Binding to proteins depends on the concentration of the active substance in the plasma and is 60-80%. Metabolized mainly in the liver with the formation of active metabolites, which can contribute to the manifestation of therapeutic and toxic effects, especially after infusion for 24 hours or more. T1 / 2 tends to be biphasic with a distribution phase of 7-9 minutes. In general, T1 / 2 depends on the dose, is 1-2 hours and can increase up to 3 hours or more during long-term intravenous infusions (more than 24 hours). Excreted by the kidneys as metabolites, 10% unchanged.
Indications
A solution of lidocaine hydrochloride 2% is used for local anesthesia in ophthalmic, dental, surgical and otolaryngological practice. In addition, a 2% solution of lidocaine can be used to block peripheral nerves and nerve plexuses in patients with pain syndrome. Lidocaine hydrochloride solution 10% is used for application anesthesia mucous membranes in various fields of medicine (including gynecology, dentistry, gastroenterology, pulmonology, ENT-practice) during the diagnostic procedure and surgical interventions. A 10% solution of lidocaine hydrochloride is also used as an antiarrhythmic agent.
Contraindications
A solution of lidocaine hydrochloride is not used for the treatment of patients with individual intolerance to the components of the drug, as well as other amide local anesthetic drugs (including a history of seizures developed in response to the introduction of lidocaine hydrochloride). , heart failure II and III degree, sick sinus syndrome, Wolf-Parkinson-White syndrome and Adams-Stokes syndrome. Not recommended for the value of lidocaine in patients with severe bradycardia, arterial hypotension (systolic blood pressure values less than 90 mm Hg), cardiogenic shock and complete transverse heart block. Do not use lidocaine hydrochloride solution in myasthenia, porphyria, hypovolemia, as well as severe impaired liver function kidneys. Pregnant and lactating women, as well as children under 12 years old, do not recommend the administration of Lidocaine hydrochloride. Patients suffering from glaucoma do not inject a solution of lidocaine hydrochloride. bulbarno.It is recommended to be careful when prescribing lidocaine hydrochloride solution to patients with heart failure, incomplete atrioventricular block, epilepsy, arrhythmia (in history). Only after a careful study of the risk / benefit ratio, lidocaine is used for heart surgery, and the members of the hereditary community will be prescribed to the members of the hereditary community. to hyperthermia and elderly patients. It is not necessary to drive a car and perform work that requires increased attention during the period of application of the lidok solution Aina hydrochloride.
Precautionary measures
Do not exceed recommended doses.
Use during pregnancy and lactation
In pregnancy and lactation, use only for health reasons. Lidocaine is excreted in breast milk. In obstetric practice, use paracervical with caution in cases of intrauterine fetal impairment, placental insufficiency, prematurity, postmaturity, preeclampsia.
Dosage and administration
Before using the drug Lidocaine hydrochloride should be a skin test to identify possible hypersensitivity to the active component (in patients with hypersensitivity during the skin test marked development of edema and hyperemia at the injection site).When intramuscular injection of the solution before starting the introduction of the drug into the muscle, you should slightly delay the syringe plunger to avoid accidental intravascular injection of lidocaine. Lidocaine hydrochloride solution 2%: The drug is intended for intramuscular, subcutaneous administration, as well as for conduction anesthesia, instillation into the conjunctival sac and mucosal treatment shells. The route of administration and dosages of lidocaine hydrochloride are determined by the attending physician individually. For local anesthesia, as a rule, subcutaneous, intramuscular or local (for mucous membranes) administration of lidocaine solution is prescribed. For conduction anesthesia, as a rule, administration of 100-200mg of lidocaine hydrochloride is prescribed. For anesthesia fingers, ear and nose, as a rule, prescribe 40-60mg lidocaine hydrochloride. The maximum recommended daily dose of lidocaine for adults (with conduction anesthesia) is 200mg. In order to increase the therapeutic effect of lidocaine, it is allowed to administer the drug in combination with epinephrine (1: 50000-1: 100000) in the absence of contraindications to the use of epinephrine in patients. In ophthalmic practice, 2 drops of lidocaine hydrochloride solution are usually prescribed in the conjunctival sac up to 3 times with an interval of 30-60 seconds. As a rule, 4-6 drops in one eye is enough for sufficient anesthesia during diagnostic procedures and surgical interventions. For terminal anesthesia, mucous membranes lubricate 2-20 ml of lidocaine hydrochloride solution. The duration of terminal anesthesia is 15-30 minutes. The maximum daily dose of Lidocaine hydrochloride solution for terminal anesthesia is 20ml. Children with any type of peripheral anesthesia should not exceed 3mg / kg body weight.Lidocaine hydrochloride solution 10%: The preparation is intended for intramuscular administration as well as for application anesthesia. The route of administration and doses of lidocaine hydrochloride are determined by the attending physician individually. For application anesthesia, the maximum recommended volume of a 10% lidocaine solution is 2 ml. If a longer anesthesia is needed, a solution of lidocaine is used combined with 0.1% hydrochloride adrenaline solution (1 drop of epinephrine solution per 5-10 ml of lidocaine solution). To relieve an arrhythmia attack, the drug is administered intramuscularly at a dose of 200-400 mg.If necessary, repeat the administration after 3 hours. In case of arrhythmias, it is also possible to administer 1% or 2% lidocaine hydrochloride solution intravenously in a dose of 50-100 mg, after which they switch to intramuscular administration of 10% lidocaine hydrochloride solution according to the standard regimen. 2% and 10% lidocaine hydrochloride is recommended to monitor the ECG. Do not use solutions containing heavy metals for disinfection of the injection site. When using a high dose of the drug, before injection of lidocaine, we recommend The appointment of barbiturates.
Side effects
Undesirable effects when using lidocaine solution are rarely observed, but the development of such side effects cannot be ruled out: From the sense organs, the central and peripheral nervous system: weakness, fatigue, headache, nystagmus, euphoria, drowsiness, photophobia, diplopia, hearing loss, nocturnal nightmares, numbness of lips and tongue. In addition, the development of tremor of the extremities, seizures, paresthesias, motor block, respiratory muscle paralysis and sensitivity disorders is possible. On the side of the heart and blood vessels: cardiac arrhythmias, decreased blood pressure, cardiac lateral blockage, cardiac conduction disorders, chest pain, peripheral vasodilation. In addition, mainly when using high doses of lidocaine, the development of collapse, heart block and cardiac arrest is possible. On the respiratory system: dyspnea, apnea, shortness of breath. Allergic reactions: pruritus, allergic rhinitis or conjunctivitis, exfoliative dermatitis, angioedema, urticaria , anaphylactic shock. Others: vomiting, nausea, soreness at the injection site, decrease in body temperature, feeling of heat and numbness of extremities, chills.
Overdose
Information about cases of overdose are absent.
Interaction with other drugs
With simultaneous use with barbiturates (including with phenobarbital), it is possible to increase the metabolism of lidocaine in the liver, decrease the concentration in the blood plasma and, consequently, decrease its therapeutic efficacy. When used simultaneously with beta-adrenergic blockers (including propranolol, nadolol) may increase the effects of lidocaine (includingtoxic), apparently due to the slowing down of its metabolism in the liver. When used simultaneously with MAO inhibitors, the local anesthetic effect of lidocaine may be enhanced. If used simultaneously with drugs that cause a neuromuscular blockade (including suxamethonium chloride), it may be enhanced effects of drugs that cause the blockade of neuromuscular transmission. When used simultaneously with sleeping and sedatives, it is possible to increase the inhibitory effect on the central nervous system; with aymalin, quinidine - may increase cardiodepressive action; with amiodarone - cases of convulsions and SSSU are described. If used concurrently with hexenal, sodium thiopental (in / in), respiratory depression is possible. When used simultaneously with meksiletin, the toxicity of lidocaine increases; with midazolam - a moderate decrease in plasma lidocaine concentration; with morphine - enhancing the analgesic effect of morphine. When used simultaneously with prenylamine, there is a risk of developing ventricular arrhythmias such as pirouette. There are described cases of excitement, hallucinations, while using procainamide. It is believed that under the influence of rifampicin, a decrease in plasma lidocaine concentration is possible. With simultaneous intravenous infusion of lidocaine and phenytoy and possibly increased side-effects of central origin; A case of sinoatrial blockade due to the additive cardiodepressive action of lidocaine and phenytoin is described. In patients receiving phenytoin as an anticonvulsant, the plasma lidocaine concentration may decrease due to the induction of microsomal liver enzymes under the influence of phenytoin. its concentration in the blood plasma increases, there is a risk of increased side effects of lidocaine.
special instructions
With caution should be used in conditions involving a decrease in hepatic blood flow (including in chronic heart failure, liver disease),progressive cardiovascular insufficiency (usually due to the development of heart block and shock), in severe and debilitated patients, in elderly patients (over 65 years); for epidural anesthesia - for neurological diseases, septicemia, inability to perform puncture due to spinal deformity; for subarachnoid anesthesia - with back pain, brain infections, benign and malignant brain tumors, with coagulopathies various origins, migraine, subarachnoid hemorrhage, hypertension, hypotension, paresthesia, psychosis, hysteria, in uncooperative patients, the inability of the puncture of - due to spinal deformity. It is necessary to carefully inject lidocaine solutions into tissues with abundant vascularization (for example, in the neck area during thyroid surgery). se), in such cases, lidocaine applied in smaller dozah.Pri simultaneous use of beta-blockers, cimetidine required dose reduction lidocaine; with polymyxin B - respiratory function should be monitored. During treatment with MAO inhibitors, lidocaine should not be used parenterally. Injection solutions, which include epinephrine and norepinephrine, are not intended for intravenous administration. Lidocaine should not be added to transfused blood. Effect on the ability driving vehicles and controlling machinery. After lidocaine is used, it is not recommended to engage in activities that require high concentration of attention and quick psychomotor reactions.