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Lidocaine (Lidocaine) instructions for use, price, description, composition
The active substance (INN) Lidocaine (Lidocaine)
Application: Ventricular premature beats and tachyarrhythmias, including for acute myocardial infarction in the postoperative period, ventricular fibrillation; local anesthesia: the surface, infiltration, conduction, epidural, spinal, intraligamentarnaya with surgical interventions, painful manipulations, endoscopic and instrumental studies.
Contraindications: Hypersensitivity, history of epileptiform seizures in the lidocaine, WPW-syndrome, cardiogenic shock, sinus, heart block (AV, intraventricular, sinoatrial), severe liver disease, myasthenia gravis.
Restrictions to use: Pregnancy, breast-feeding.
Application of pregnancy and breastfeeding: During pregnancy and lactation is possible if the expected effect of therapy outweighs the potential risk to the fetus and child.
Side effects: Since the nervous system and sensory organs: central nervous system depression or excitement, nervousness, euphoria, flashing "flies" before the eyes, photophobia, drowsiness, headache, dizziness, tinnitus, diplopia, disturbance of consciousness, depression or respiratory arrest, muscle twitching, tremor, disorientation, convulsions.
With the cardiovascular system and blood (hematopoiesis, hemostasis): sinus bradycardia, conduction disturbances of the heart, the transverse heart block, hypotension, collapse.
From the digestive tract: nausea, vomiting.
Other: sensation of heat, cold or numb extremities, malignant hyperthermia, immune system suppression, allergic reactions (rash, generalized exfoliative dermatitis, anaphylaxis); transient burning sensation in the area of the aerosol.
Interactions: Beta-blockers increase the risk of bradycardia and hypotension. Norepinephrine and beta-blockers, by reducing hepatic blood flow, decrease (increased toxicity), and glucagon izadrin - increase the clearance of lidocaine. Cimetidine increases the plasma concentration (displaces from its association with proteins and slows inactivation in the liver). Barbiturates, causing induction of microsomal enzymes, stimulate the degradation of lidocaine and reduce its activity. Anticonvulsants (hydantoin derivatives) accelerate the biotransformation in the liver (decreased concentration in the blood), at / in the introduction may increase cardiodepressive action of lidocaine. Antiarrhythmics (amiodarone, verapamil, quinidine, Aymalin) potentiate kardiodepressiyu. Combination with novokainamid may cause CNS excitement and hallucinations. Strengthens the inhibitory effect of anesthesia (geksobarbital, thiopental sodium), hypnotics and sedatives on the respiratory center and weakens the influence of cardiac digitoksina, enhances muscle relaxation caused by drugs kurarepodobnoe (possible paralysis of respiratory muscles). MAO inhibitors prolong local anesthesia.
Overdose: Symptoms: psychomotor agitation, dizziness, weakness, decreased blood pressure, tremors, tonic-clonic convulsions, coma, collapse, possible AV blockade, CNS depression, respiratory arrest.
Treatment: discontinuation, pulmonary ventilation, oxygen therapy, anticonvulsants, vasoconstrictors (norepinephrine, mezaton), at a bradycardia - anticholinergics (atropine). Possible to carry out intubation, mechanical ventilation, resuscitation. Dialysis is ineffective.
Dosage and administration: Arrhythmias: in / bolus (within 3-4 min) 50-100 mg / kg body weight) at a rate of 25-50 mg / min, then infusion at a rate of 1-4 mg / min. V / m at the rate of 4.3 mg / kg body weight, if necessary, again in 60-90 minutes. The maximum dose for adults with I / and / m administration - up to 300-400 mg for 1 h. The maximum daily dose - 2000 mg. Children entering the bolus of 1 mg / kg at a rate of 25-50 mg / min, 5 min possible re-introduction of (total dose should not exceed 3 mg / kg). Then infuziruyut at 30 mg / kg / min. The maximum daily dose for children - 4 mg / kg.
For surface anesthesia - 2-10% solution (200 mg - 2 mL).
In adults, for infiltration anesthesia is used 0,5% solution for the wire - 1-2% solution. Maximum total dose - 300-400 mg.
Children under 2 years are designated for surface anesthesia, pre inflicting on a cotton swab, 1-2 aerosol dose (4,8-9,6 mg).
In ophthalmology - 2 drops of 2.4% solution in the conjunctival sac for 30-60 min before surgery.
Precautions: Use caution when liver and kidney diseases, hypovolemia, severe heart failure, in violation of the contractility of genetic susceptibility to malignant hyperthermia. In children, the elderly and debilitated patients require dosage adjustment in accordance with the age and physical status. When injected into vascularized tissue is recommended aspiration test.
Special instructions: For extension of the anesthetic can add a drop of 0.1% solution of adrenaline in 5-10 ml of lidocaine (the maximum permissible dose is increased to 500 mg).
