Typical clinico-pharmacological article
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Combined drug, the effect of which is due to its constituent components; has a local anesthetic effect. Epinephrine, causing the narrowing of the vessels at the injection site, makes it difficult to absorb and prolongs the effect.
The time of the onset of the effect is 0.5-3 minutes, the duration of the action is 45 minutes.
INDICATIONS
- infiltration and conductive anesthesia (including in dentistry - tooth extirpation, cavity filling, tooth grinding for crowns).
DOSING MODE
Infiltration anesthesia : tonsillectomy (for each amygdala) - 5-10 ml; correction of fractures - 5-20 ml; seam of the perineum - 5-15 ml.
Conducting anesthesia : anesthesia according to Oberst - 2-4 ml, retrobulbar - 1-2 ml, intercostal - 2-4 ml (for each segment), paravertebral - 5-10 ml, epidural (epidural) - 10-30 ml, sacral - 10-30 ml, blockade of the trigeminal nerve - 1-5 ml, blockade of the stellate node - 5-10 ml, blockade of the brachial plexus - 10-30 ml (supraclavicular or axillary access), blockade of the external genital organs - 7-10 ml (for each side), paracervical blockade - 6-10 ml (on each side).
With uncomplicated removal of the teeth of the upper jaw in the non-inflammatory stage is administered under the mucous membrane in the region of the transitional fold - vestibular depot 1.7 ml per tooth, if necessary - an additional 1-1.7 ml; palatal incision or suture - palatal depot 0.1 ml.
With the removal of premolars of the lower jaw (5-5) in an uncomplicated stage, infiltration anesthesia gives the effect of conductive analgesia.
When the cavities are prepared and the teeth are sharpened for the crowns , with the exception of the molars of the lower jaw, a vestibular injection of 0.5-1.7 ml per tooth. The maximum dose is 7 mg / kg.
SIDE EFFECT
From the side of the central nervous system (depends on the magnitude of the applied dose): headache, impaired consciousness (until losing it); breathing disorders (up to apnea); tremor, twitching of muscles, convulsions.
From the digestive system: nausea, vomiting, diarrhea.
From the senses: rarely - transient visual impairment (up to blindness), diplopia.
From the cardiovascular system: lowering blood pressure, tachycardia, bradycardia, arrhythmia.
Allergic reactions: hyperemia and itching of the skin, conjunctivitis, rhinitis, angioedema, various degrees of severity (including edema of the upper and / or lower lip and / or cheeks, glottis with difficulty swallowing, hives, difficulty breathing), anaphylactic shock.
Local reactions: edema or inflammation at the injection site, the appearance of ischemic zones at the injection site (until the development of tissue necrosis - with a random intravascular injection); nerve damage (up to the development of paralysis) - occurs only when the technique of injection is disturbed.
CONTRAINDICATIONS
hypersensitivity;
- B 12 -deficient anemia;
- Methemoglobinemia;
paroxysmal ventricular tachycardia;
atrial tachyarrhythmia;
- an angle-closure glaucoma;
- hypoxia;
- intolerance of sulfo groups (especially in bronchial asthma).
With caution: cholinesterase deficiency, renal failure, bronchial asthma, diabetes mellitus, hyperthyroidism, arterial hypertension, children's age (up to 4 years - efficacy and safety not determined).
When conducting a paracerebral blockade: pre-eclampsia, bleeding in the last trimester, amnionitis.
PREGNANCY AND LACTATION
It has no harmful effect on the fetus (with the possible exception of bradycardia) in any application and dosage technique.
APPLICATION FOR FUNCTIONS OF THE LIVER
With caution: kidney failure.
APPLICATION FOR CHILDREN
With caution: children's age (up to 4 years - effectiveness and safety are not defined).
SPECIAL INSTRUCTIONS
Do not enter in / in! To avoid intravascular injection, an aspiration test should be performed. The injection pressure should correspond to the sensitivity of the tissue.
Do not inject into an inflamed area.
Food intake is possible only after restoration of sensitivity.
To prevent infection (including viral hepatitis), it is always necessary to use new sterile syringes and needles every time a solution is taken from vials or ampoules.Open cartridges can not be used again for other patients (hepatitis risk). Do not use a damaged cartridge.
On the label of the reusable bottle, it is necessary to note the time of the first intake of the solution. Opened vials should be stored according to the instructions and used within 2 days.
Impact on the ability to drive vehicles and manage mechanisms
The possibility of allowing the patient to drive vehicles or to engage in activities that require a high mental and motor reaction is determined by the doctor.
OVERDOSE
Symptoms: dizziness, motor agitation, loss of consciousness, lowering blood pressure, tachycardia, bradycardia.
Treatment: at the appearance of the first signs of an overdose during the injection, it is necessary to stop the drug administration, give the patient a horizontal position, provide free airway patency, monitor heart rate and blood pressure.
With dyspnoea, apnea - oxygen, endotracheal intubation, IVL (central analeptics are contraindicated); with convulsions - in / in slowly barbiturates of short action with simultaneous supply of oxygen and control of hemodynamics; with severe circulatory disturbances and shock - IV infusion of solutions of electrolytes and plasma substitutes, GCS, albumin; with vascular collapse and increasing bradycardia - in / in slowly epinephrine 0.1 mg, then in / in the drip under the control of heart rate and blood pressure; with severe tachycardia and tachyarrhythmia - intravenous beta-blockers (selective); with increasing blood pressure - peripheral vasodilators.Oxygenotherapy and blood circulation monitoring are necessary in all cases.
DRUG INTERACTION
Tricyclic antidepressants, MAO inhibitors increase hypertensive action.
The local anesthetic effect of articaine is enhanced and lengthened by vasoconstrictors.
Non-selective beta-blockers increase the risk of hypertensive crisis and severe bradycardia.
