Лидокаин Раствор, 10 шт, 2 мл, 2 %, для инъекций

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Подкисление мочи способствует увеличению выведения лидокаина."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"- местная инфильтрационная анестезия;- проводниковая анестезия (в том числе ретробульбарная, парабульбарная);- спинальная анестезия;- эпидуральная анестезия."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- повышенная чувствительность к любому из компонентов препарата;- гиперчувствительность к другим амидным местноанестезирующим лекарственным средствам в анамнезе;- инфицирование места предполагаемой инъекции;- синдром слабости синусового узла;- атриовентрикулярная блокады II-III степени (кроме случаев, когда установлен искусственный водитель ритма);- синоаурикулярная блокада;- синдром Вольфа-Паркинсона-Уайта (синдром WPW);- кардиогенный шок;- нарушения внутрижелудочковой проводимости;- закрытоугольная глаукома (при ретробульбарном введении);- беременность, грудное вскармливание (проникает через плацентарный барьер, выделяется с грудным молоком).Также необходимо учитывать общие противопоказания к проведению того или иного вида анестезии."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Хроническая сердечная недостаточность II-III функционального класса по классификации Нью-Йоркской кардиологической ассоциации (NYHA), тяжелая печеночная недостаточность, тяжелая почечная недостаточность, гиповолемия, атриовентрикулярная блокада I степени, синусовая брадикардия, артериальная гипотензия, тяжелая миастения, наличие в анамнезе эпилептиформных судорог (в том числе вызванных лидокаином), детский возраст до 12 лет (вследствие замедленного метаболизма возможно накопление препарата), тяжелобольные, ослабленные больные, пожилой возраст (старше 65 лет), местная анестезия богатых кровеносными сосудами областей. Для спинальной (субарахноидальной) и эпидуральной анестезии -заболевания центральной нервной системы (ЦНС) (в том числе инфекции, опухоли), наличие примеси крови в спинномозговой жидкости, парастезии, психоз, деформация позвоночника, периферическая нейропатия, аортальный стеноз, терапия антиагрегантами (включая ацетилсалициловую кислоту)."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Данные о безопасности лидокаина при его применении у беременных женщин отсутствуют. Во время беременности и грудного вскармливания препарат противопоказан. При необходимости назначения препарата в период лактации следует прекратить грудное вскармливание."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Количество раствора и общая доза лидокаина зависит от вида анестезии, характера и продолжительности оперативного вмешательства."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСпособ разведения 20 мг/мл (2 %) раствора лидокаина до получения раствора необходимой концентрации:\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Для приготовления 10 мг/мл (1 %) раствора лидокаина необходимо взять 1 часть 20 мг/мл раствора лидокаина и 1 часть воды для инъекций, т.е. смешать 2 мл 20 мг/мл раствора лидокаина с 2 мл воды для инъекций (для ампулы объемом 2 мл), либо смешать 5 мл 20 мг/мл раствора лидокаина с 5 мл воды для инъекций (для ампулы объемом 5 мл)."}},{"type":"paragraph","data":{"text":"Для приготовления 5 мг/мл (0,5 %) раствора лидокаина необходимо взять 1 часть 20 мг/мл раствора лидокаина и 3 части воды для инъекций, т.е. смешать 2 мл 20 мг/мл раствора лидокаина с 6 мл воды для инъекций (для ампулы объемом 2 мл), либо смешать 5 мл 20 мг/мл раствора лидокаина с 15 мл воды для инъекций (для ампулы 5 мл)."}},{"type":"paragraph","data":{"text":"Для приготовления 2,5 мг/мл (0,25 %) раствора лидокаина необходимо взять 1 часть 20 мг/мл раствора лидокаина и 7 частей воды для инъекций, т. е. смешать 2 мл 20 мг/мл раствора лидокаина с 14 мл воды для инъекций (для ампулы объемом 2 мл), либо смешать 5 мл 20 мг/мл раствора лидокаина с 35 мл воды для инъекций (для ампулы 5 мл)."}},{"type":"paragraph","data":{"text":"Для приготовления 1,25 мг/мл (0,125 %) раствора лидокаина необходимо взять 1 часть 20 мг/мл раствора лидокаина и 15 частей воды для инъекций, т. е. смешать 2 мл 20 мг/мл раствора лидокаина с 30 мл воды для инъекций (для ампулы объемом 2 мл), либо смешать 5 мл 20 мг/мл раствора лидокаина с 75 мл воды для инъекций (для ампулы объемом 5 мл)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля инфилътрационной анестезии\u003c/i\u003e (внутрикожно, подкожно) используются 0,125 %, 0,25 %, 0,5 % растворы; для достижения инфильтрационной анестезии используется до 60 мл (5-300 мг) 0,5 % раствора или до 30 мл 1% раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля проводниковой анестезии\u003c/i\u003e (анестезия периферических нервов, в т. ч. при блокаде нервных сплетений) применяют 1 и 2 % растворы; максимальная общая доза - до 400 мг (40 мл 1 % раствора или 20 мл 2 % раствора). Для блокады нервных сплетений 10-20 мл 1 % раствора или 5-10 мл 2 % раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля проводниковой анестезии периферических нервов\u003c/i\u003e: плечевого - 15-20 мл (225-300 мг) 1,5 % раствора; в стоматологической практике - 1-5 мл (20-100 мг) 2 % раствора; блокада межреберных нервов - 3 мл (30 мг) 1 % раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля парацервикалъной анестезии:\u003c/i\u003e 10 мл (100 мг) 1 % раствора в каждую сторону, при необходимости возможно повторное введение не менее чем через 1,5 часа."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля паравертебралъной анестезии\u003c/i\u003e: от 3 до 5 мл (30-50 мг) 1 % раствора. \u003ci\u003eРетробульбарная анестезия -\u003c/i\u003e 3,0-4,0 (60-80 мг) 2 % раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПарабульбарная анестезия\u003c/i\u003e - 1,0-2,0 (20-40 мг) 2 % раствора. \u003ci\u003eВагосимпатическая блокада:\u003c/i\u003e шейного отдела (звездчатого узла) - 5 мл (50 мг) 1 % раствора, поясничного - 5-10 мл (50-100 мг) 1 % раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСпиналъная анестезия\u003c/i\u003e - 3,0-4,0 мл (60-80 мг) 2 % раствора."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЭпидуралъная анестезия -\u003c/i\u003e для получения аналгезии используется 25-30 мл (250-300 мг) 1 % раствора; для получения анестезии 15-20 мл (225-300 мг) 1,5 % раствора или 10-15 мл (200-300 мг) 2 % раствора; для торакальной эпидуральной анестезии - 20-30 мл (200-300 мг) 1 % раствора. Не рекомендуется использовать непрерывное введение анестетика с помощью катетера; введение максимальной дозы не должно повторяться чаще, чем через 90 мин."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри использовании каудалъной анестезии:\u003c/i\u003e в хирургической практике - 15-20 мл (225-300 мг) 1,5% раствора. Не рекомендуется использовать непрерывное введение анестетика с помощью катетера; введение максимальной дозы не должно повторяться чаще, чем через 90 мин. Рекомендуемые дозы для детей при нервно-мышечной блокаде до 4,5 мг/мл 0,25-1,0 % раствора."}},{"type":"paragraph","data":{"text":"Максимальная доза для детей - 4,5 мг/кг, но не более 100 мг; максимальная доза для взрослых - не более 4,5 мг/кг или 300 мг. Эти дозы должны быть повторены в течение 24 часов."}},{"type":"paragraph","data":{"text":"Эффект лидокаина может быть удлинен добавлением 0,1 % раствора эпинефрина (0,1 мл на 20 мл лидокаина). В этом случае при региональной анестезии доза лидокаина может быть увеличена до 600 мг."}},{"type":"paragraph","data":{"text":"Порядок работы с полимерной ампулой:"}},{"type":"paragraph","data":{"text":"1.Взять ампулу и встряхнуть её, удерживая за горлышко."}},{"type":"paragraph","data":{"text":"2.Сдавить ампулу рукой, при этом не должно происходить выделение препарата, и вращающими движениями повернуть и отделить клапан."}},{"type":"paragraph","data":{"text":"3.Через образовавшееся отверстие немедленно соединить шприц с ампулой."}},{"type":"paragraph","data":{"text":"4. Перевернуть ампулу и медленно набрать в шприц ее содержимое."}},{"type":"paragraph","data":{"text":"5. Надеть иглу на шприц."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота развития побочных эффектов приведена в соответствии с классификацией Всемирной организации здравоохранения: очень часто - не менее 10%; часто - не менее 1% и менее 10%; не часто - не менее 0,1% и менее 1%; редко - не менее 0,01% и менее 0,1%; очень редко - менее 0,01%, включая единичные случаи.\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны центральной нервной системы и органов чувств: часто - \u003c/i\u003eголовокружение, головная боль, слабость,\u003ci\u003e нечасто -\u003c/i\u003e двигательное беспокойство,\u003ci\u003e редко -\u003c/i\u003e нистагм, потеря сознания, сонливость, зрительные и слуховые нарушения, тремор, тризм, судороги (риск их развития повышается на фоне гиперкапнии и ацидоза),\u003ci\u003e очень редко\u003c/i\u003e - паралич дыхательных мышц, остановка дыхания, блок моторный и чувствительный, респираторный паралич (чаще развивается при субарахноидальной анестезии)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы: часто -\u003c/i\u003e повышение или снижение артериального давления,\u003ci\u003e редко\u003c/i\u003e - брадикардия, аритмия, тахикардия - при введении с вазоконстриктором,\u003ci\u003e очень редко - \u003c/i\u003eпериферическая вазодилатация, коллапс, боль в грудной клетке."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны органов желудочно-кишечного тракта: часто -\u003c/i\u003e тошнота, рвота, непроизвольная дефекация."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны крови: нечасто\u003c/i\u003e - метгемоглобинемия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eМестные реакции: часто -\u003c/i\u003e при спинальной анестезии - боль в спине, при эпидуральной анестезии - случайное попадание в субарахноидальное пространство."}},{"type":"paragraph","data":{"text":"\u003ci\u003eАллергические реакции: часто -\u003c/i\u003e кожная сыпь, крапивница (на коже и слизистых оболочках), зуд кожи,\u003ci\u003e очень редко\u003c/i\u003e - ангионевротический отек, анафилактический шок."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие: нечасто -\u003c/i\u003e стойкая анестезия,\u003ci\u003e очень редко\u003c/i\u003e - угнетение дыхания, вплоть до остановки, гипотермия."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: начальные признаки интоксикации - головокружение, тошнота, рвота, эйфория, сонливость, головная боль, парестезии, дезориентация, нарушение зрения; затем - судороги мимической мускулатуры лица с переходом в тонико-клонические судороги скелетной мускулатуры, психомоторное возбуждение, астения, апноэ, брадикардия, снижение артериального давления, коллапс, метгемоглобинемия; при применении в родах, у новорожденного - брадикардия, угнетение дыхательного центра, апноэ. Лечение: при появлении первых признаков интоксикации введение прекращают, пациента переводят в горизонтальное положение и проводят оксигенацию. При судорогах вводят внутривенно 10 мг диазепама, при брадикардии - м-холиноблокаторы (атропин), вазоконстрикторы (норэпинефрин, фенилэфрин). При необходимости показано проведение интубации, искусственной вентиляции легких, реанимационных мероприятий. Диализ неэффективен."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Вазоконстрикторы (эпинефрин, метоксамин, фенилэфрин) удлиняют местноанестезирующее действие. Циметидин снижает печеночный клиренс лидокаина (снижение метаболизма вследствие ингибирования микросомального окисления) и повышает риск развития токсических эффектов. Снижает эффект антимиастенических лекарственных средств. При обработке места инъекции местного анестетика дезинфицирующими растворами, содержащими тяжелые металлы, повышается риск развития местной реакции в виде болезненности и отека. При использовании местноанестезирующих лекарственных средств для спинальной и эпидуральной анестезии с гуанадрелем, гуанетидином, мекамиламином, триметофана камзилатом повышается риск выраженной гипотензии и брадикардии. Бета-андреноблокаторы замедляют метаболизм лидокаина, увеличивая его токсичность (снижение величины печеночного кровотока). Сердечные гликозиды ослабляют кардиотонический эффект. Усиливает и удлиняет эффект миорелаксирующих лекарственных средств. При одновременном назначении лидокаина и снотворных и седативных лекарственных средств возможно усиление их угнетающего действия на центральную нервную систему. При совместном применении с наркотическими анальгетиками развивается аддитивный эффект, что используется при проведении эпидуральной анестезии, однако усиливается угнетение дыхания. Использование с ингибиторами моноаминооксидазы (фуразолидон, прокарбазин, селегилин) повышает риск снижения артериального давления. Антикоагулянты (в т.ч. ардепарин натрия, далтепарин натрия, данапароид натрия, эноксапарин натрия, гепарин натрия, варфарин и другие) увеличивают риск развития кровотечений.Не снижает противомикробную активность сульфаниламидов (при метаболизме не происходит образования ПАБК (парааминобензойная кислота))."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Недопустимо применение лидокаина, раствора для инъекций (2 %), в качестве антиаритмического средства. Особую осторожность следует проявлять при проведении местной анестезии богатых кровеносными сосудами органов; следует избегать внутрисосудистой инъекции во время введения. При введении в васкуляризированные ткани рекомендуется проводить аспирационную пробу. Необходимо отменить ингибиторы моноаминоксидазы (МАО) не менее чем за 10 дней до планирования субарахноидальной анестезии с помощью лидокаина. При быстром внутривенном введении может произойти резкое снижениеартериального давления и развиться коллапс. В этих случаях применяютфенилэфрин, эфедрин и другие сосудосуживающие средства."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при вождении автотранспорта и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для инъекций 2 %"}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте, при температуре не выше 25°С. Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. Не использовать по истечении срока годности, указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Борисовский завод медицинских препаратов\" (ОАО \"БЗМП\"), 222120, Минская область, г. Борисов, ул. Чапаева, д. 64/27, Республика Беларусь, Республика Беларусь"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"БЗМП\""}}]}],"source":null},"description_toggle":false,"short_description":"Обладает местноанестезирующим действием, блокирует потенциалзависимые натриевые каналы, что препятствует генерации импульсов в окончаниях чувствительных нервов и проведению импульсов по нервным волокнам. Подавляет проведение не только болевых импульсов, но и импульсов другой модальности.Анестезирующее действие лидокаина в 2-6 раз сильнее, чем прокаина (действует быстрее и дольше - до 75 мин, а после добавления эпинефрина -более 2 ч). При местном применении расширяет сосуды, не оказывает местнораздражающего действия на ткани. При парентеральном введении степень абсорбции зависит от места введения и дозы. В концентрации 20 мг/мл внутривенно не применяется. 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