Ultrakain d-s injection solution ampoules 2ml N10
Condition: New product
998 Items
Rating:
Be the first to write a review!
More info
Active ingredients
Artikain + Epinephrine
Release form
Solution
Composition
1 ml contains articaine hydrochloride 40 mg. Auxiliary substances: sodium chloride - 2.1 mg, water d / and up to 1 ml.
Pharmacological effect
Combined local anesthetic drug, which includes articaine (amide-type local anesthetic) and epinephrine (a vasoconstrictor), which is added to the drug to prolong the duration of anesthesia. The amide structure of articaine is similar to that of other local anesthetic agents, but its molecule contains one additional ester group, which in the human body is rapidly hydrolyzed by esterases. Artikain blocks the sodium channels of the neuron membrane, which leads to a decrease in the conduction of impulses along the nerve fiber, thereby providing a local anesthetic effect. Local anesthetics cause a reversible loss of sensitivity due to the cessation or reduction of the conductivity of sensory nerve impulses directly at the injection site and around it. They have a membrane stabilizing effect by reducing the permeability of the membranes of nerve cells to sodium ions. The drug has a fast (latency period - from 1 to 3 min) and a strong anesthetic effect and has good tissue tolerance. The duration of anesthesia is at least 45 minutes. The duration of anesthesia drug Ultracain D-C forte is at least 75 minutes. With the rapid destruction of articaine to its inactive metabolite (articainic acid) is associated very low systemic toxicity of the drug, allowing for repeated injections of the drug. Due to the very low content in the preparation of epinephrine, the effect of the latter on the cardiovascular system is expressed slightly: there is almost no increase in blood pressure and an increase in heart rate
Pharmacokinetics
Absorption After submucosal administration of 2 ml of Tmax of articaine in the blood plasma is 10-15 minutes, and the average plasma value of Cmax of articaine is approximately 400 μg / l, Tmax of articaic acid is 45 minutes, and the average value of Cmax of articic acid is 2000 μg / l Comparative pharmacokinetic data were obtained in children.The differences between the plasma concentrations of articaine and articaic acid reflect the rapid hydrolysis of articaine in tissues and blood, so that the articaine injected enters the systemic circulation mainly as an inactive metabolite. Distribution After submucosal administration, the concentration of articaine in the blood in the area of the dental alveoli is thousands of times higher than the concentration of articaine in the systemic circulation. An inverse relationship between the time after injection and the concentration of articain in the alveoli of the tooth. The binding of articaine with plasma proteins is 95%. Metabolism All amide-type local anesthetics are metabolized in liver microsomes. In addition, articain in tissues and blood is still inactivated by nonspecific plasma esterases by hydrolysis in the carboxyl group. Since hydrolysis occurs very quickly and begins immediately after administration, about 90% of articaine is inactivated by this method. The resulting major metabolite of articaine, articaic acid, does not have local anesthetic activity and does not have systemic toxicity. Withdrawal After submucosal administration, elimination of articaine occurs exponentially with T1 / 2 for approximately 25 minutes. Artikain is excreted mainly by the kidneys in the form of articainic acid (64.2 ± 14.4%), articainic glucuronide (13.4 ± 5%) and unchanged articaine (1.45 ± 0.77%). After injection of the drug into the oral mucosa, the total clearance of articaine is 235 ± 27 l / h.
Indications
Infiltration and conduction anesthesia during dental operations: - uncomplicated removal of one or more teeth; - treatment of carious cavities of the tooth; - turning of teeth before prosthetics
Contraindications
Severe sinus dysfunction or severe conduction disorders (such as severe bradycardia, AV-block II-III degree); - acute decompensated heart failure; - severe hypotension; - anemia (including B12-deficiency anemia); - methemoglobinemia; - hypoxia; - children's age up to 4 years (no clinical experience); - hypersensitivity to articaine or to other local anesthetic agents of amide type, except for cases when allergy to hypersensitivity to these drugs The articaine was excluded with the help of appropriate studies conducted in compliance with all the necessary rules and requirements. The drug should be used with caution in case of cholinesterase deficiency (used only when absolutely necessary,because prolonged and excessively strong effect of the drug is possible).
Precautionary measures
In order to avoid intravascular administration, an aspiration test should always be carried out. To prevent infections (including viral hepatitis) from entering, it is necessary to ensure that new sterile syringes and needles are always used when taking the solution from the ampoules. Open cartridges cannot be used again for other patients. Do not use a damaged cartridge for injection. In patients with diseases of the cardiovascular system (chronic heart failure, coronary vascular disease, angina pectoris, cardiac rhythm disturbances, history of myocardial infarction, arterial hypertension), cerebrovascular disorders, a history of stroke, chronic bronchitis, heart failure, I, I, I, I have the use of a template, I, I, I, I, I have to use I, I have to use the settings, I have already set up my contact details, I have already I, I, I, I have not been able to use it), I have the use of items, I, I, I, etc., I have the use of the items, I have to use the items, I have to use the items, I have to use the items, I have to use the items, I have already set up a heartbeat, I have heart failure, heart disease, heart failure, heart failure, heart failure, heart disease, heart disease, heart disease, heart disease, arterial hypertension). and also in the presence of expressed concern, it is advisable to use the drug Ultracain D-C containing a smaller amount of epinephrine, or the drug Ultracain D that does not contain epinephrine. Eating is possible only after the termination of the local anesthesia (restoration of sensitivity). The impact on the ability to drive vehicles and control mechanisms Local anesthesia drug Ultrakain DS, as shown by tests, does not cause any noticeable deviation from the usual ability to drive and participate in traffic. However, the decision about when the patient after dental surgery will be able to return to driving vehicles and engage in potentially hazardous activities requiring increased concentration and psychomotor speed must be taken by the doctor.
Use during pregnancy and lactation
Artikain penetrates the placental barrier. Due to insufficient clinical data, a decision on the appointment of a drug by a dentist can be made only if the potential benefits of its use justify the potential risk to the fetus. During lactation there is no need to interrupt breastfeeding, because no clinically significant concentrations of articaine are detected in breast milk, however, with a view to precaution, breastfeeding should be interrupted for 4 hours after the last dose of articaine
Dosage and administration
For adults, the maximum dose is 4-6 mg / kg body weight.The total dose is not more than 400 mg. In case of infiltration anesthesia in the absence of inflammation, usually, 1.7 ml of Ultracaine D solution is administered per tooth or two adjacent teeth. When conducting anesthesia of the inferior alveolar nerve, approximately 1-1.7 ml of the preparation solution is required. conduct an aspiration test in order to avoid inadvertent intravascular administration of the drug. Injection pressure during the administration of the drug should be adjusted depending on tissue sensitivity. The introduction of the drug in the inflamed areas of the mucous membrane is not recommended
Side effects
On the part of the central nervous system: dose-dependent reactions - a stupor, sometimes progressing to loss of consciousness, respiratory disorders, sometimes progressing to stop breathing, muscle tremor, muscle twitching, sometimes progressing to generalized seizures; possible - dizziness, paresthesia, hypesthesia, transient visual disorders (blurred vision, blindness, double vision) arising during or after a short time after injection of local anesthetic in the head area. Sometimes with a violation of the correct injection technique when administering a local anesthetic in a dental the practice may damage the nerve, in particular, in such cases, damage to the facial nerve may occur, which can lead to the development of facial nerve paralysis. Oron digestive system: nausea, rvota.So the cardiovascular system: reduction in blood pressure, bradycardia, cardiac insufficiency, shok.Allergicheskie reactions: possible - skin hyperemia, conjunctivitis, rhinitis and angioedema. Angioedema can be manifested by swelling of the upper and / or lower lips, cheeks, swelling of the vocal cords with a feeling of a lump in the throat and difficulty in swallowing, urticaria, difficulty breathing. Any of these manifestations can progress to anaphylactic shock. Local reactions: swelling or inflammation of the mucous membrane at the injection site
Overdose
Symptoms: the first manifestations of toxic action - dizziness, motor agitation or stupor; possible bradycardia, a sharp decrease in blood pressure, respiratory disorders, muscle twitching, generalized convulsions,severe circulatory disorders, shock. Treatment: at the first manifestations of symptoms of toxic action during the administration of the drug, it should stop its introduction and transfer the patient to a horizontal position with elevated lower limbs. It is necessary to ensure the permeability of the respiratory tract and monitor hemodynamic parameters (heart rate and blood pressure). It is always recommended, even if the symptoms of intoxication seem mild, to put a catheter in / in order, if necessary, to be able to immediately / in the introduction of necessary drugs. When breathing is impaired, depending on their severity, oxygen supply is recommended, and in the event of indications for artificial respiration - endotracheal intubation and mechanical ventilation. The introduction of central-acting analeptics is contraindicated. Muscle twitching and generalized convulsions may be revel in / in the introduction of barbiturates or short-acting. It is recommended to administer these drugs slowly, under constant medical supervision (risk of hemodynamic disorders and respiratory depression) and with simultaneous supply of oxygen and monitoring of hemodynamic indicators. severe circulatory disorders and shock, regardless of their cause, the drug should be stopped and the patient should be transferred to a horizontal position with raised lower limbs. It is necessary to provide oxygen, in / in the introduction of electrolyte solutions, GCS (250-1000 mg of methylprednisolone), if necessary, plasma substitutes, including Albumin. With the development of collapse and strengthening of bradycardia, slow intravenous administration of epinephrine solution (0.0025-0.1 mg) is shown under the control of heart rhythm and blood pressure. If necessary, the introduction of doses greater than 0.1 mg, epinephrine should be administered infusion, adjusting the rate of administration under the control of heart rate and blood pressure.
Interaction with other drugs
Use with MAO inhibitors increases the risk of reducing blood pressure; it is necessary to cancel MAO inhibitors 10 days before the introduction of the anesthetic. Local anesthetics increase the effect of drugs that depress the central nervous system.Opioid analgesics increase the effects of local anesthetics and increase the risk of respiratory depression. When injecting Ultracain D is used in patients receiving heparin or acetylsalicylic acid, bleeding at the injection site may occur. skeletal muscle with drugs for the treatment of myasthenia, therefore, its use, especially in high doses, requires additional correction tion treatment miastenii.Ultrakain D slows down metabolism mestnoanesteziruyuschih sredstv.Mestnoanesteziruyuschee medicinal effect articaine enhance and prolong the vasoconstrictive drugs
special instructions
In order to avoid intravascular injection, an aspiration test should always be carried out. To prevent infections (including viral hepatitis) from being infected, it is necessary to ensure that new sterile syringes and needles are always used when taking the solution from the ampoules. Open cartridges cannot be used again for other patients. A damaged cartridge should not be used for injections. Patients need to monitor the state of the cardiovascular system, respiratory system, central nervous system. Food can only be taken after termination of local anesthesia (sensitivity recovery). Effect on ability to drive vehicles and control mechanisms When the patient after dental intervention will be able to return to driving vehicles and engage in potentially hazardous activities requiring increased concentration attention and quickness of psychomotor reactions should be a doctor.