Новокаин Раствор, 10 шт, 5 мл, 0.5 %

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Выводится преимущественно почками в виде метаболитов, в неизмененном виде выводится не более 2%."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"- Инфильтрационная анестезия;"}},{"type":"paragraph","data":{"text":"- вагосимпатическая шейная, паранефральная, циркулярная и паравертебральная блокады."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Гиперчувствительность (в т.ч. к пара-аминобензойной кислоте и другим местным анестетикам);"}},{"type":"paragraph","data":{"text":"- детский возраст до 12 лет;"}},{"type":"paragraph","data":{"text":"- выраженные фиброзные изменения в тканях (для анестезии методом ползучего инфильтрата)."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- Экстренные операции, сопровождающиеся острой кровопотерей;"}},{"type":"paragraph","data":{"text":"- состояния, сопровождающиеся снижением печеночного кровотока (например, при хронической сердечной недостаточности, заболеваниях печени);"}},{"type":"paragraph","data":{"text":"- прогрессирование сердечно-сосудистой недостаточности (обычно вследствие развития блокад сердца и шока);"}},{"type":"paragraph","data":{"text":"- воспалительные заболевания кожи или инфицирование места инъекций;"}},{"type":"paragraph","data":{"text":"- дефицит псевдохолинэстеразы;"}},{"type":"paragraph","data":{"text":"- почечная недостаточность;"}},{"type":"paragraph","data":{"text":"- детский возраст (от 12 до 18 лет) и у пожилых пациентов (старше 65 лет);"}},{"type":"paragraph","data":{"text":"- ослабленные больные;"}},{"type":"paragraph","data":{"text":"- беременность и период родов."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"При беременности и в период грудного вскармливания следует применять только после консультации с врачом, в тех случаях, когда предполагаемая польза для матери превышает потенциальный риск для плода или младенца."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Для инфильтрационной анестезии используют растворы 2,5 мг/мл, 5 мг/мл; для анестезии по методу Вишневского (тугая ползучая инфильтрация) - растворы 1,25 мг/мл, 2,5 мг/мл. Для уменьшения всасывания и удлинения действия при местной анестезии дополнительно вводят 0,1% раствор эпинефрина гидрохлорида - по 1 капле на 2-5-10 мл раствора прокаина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри паранефральной блокаде (по А.В. Вишневскому)\u003c/i\u003e в околопочечную клетчатку вводят 50-80 мл раствора 5 мг/мл или 100-150 мл раствора 2,5 мг/мл."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри вагосимпатической блокаде\u003c/i\u003e вводят 30-100 мл раствора 2,5 мг/мл."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля циркулярной или паравертебральной блокады\u003c/i\u003e внутрикожно вводят раствор 2,5 мг/мл или 5 мг/мл."}},{"type":"paragraph","data":{"text":"Высшие дозы \u003ci\u003eдля инфильтрационной анестезии для взрослых\u003c/i\u003e: первая разовая доза в начале операции - не более 500 мл раствора 2,5 мг/мл или 150 мл раствора 5 мг/мл. Максимальная доза для применения у детей старше 12 лет - 15 мг/кг."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Головная боль, головокружение, тошнота, рвота, паралич дыхательных мышц, непроизвольное мочеиспускание, непроизвольная дефекация, сонливость, слабость, повышение или снижение артериального давления, коллапс, периферическая вазодилатация, брадикардия, аритмия, боль в грудной клетке, тризм, тремор, нарушения зрения и слуха, нистагм, стойкая анестезия, гипотермия, метгемоглобинемия, аллергические реакции (вплоть до анафилактического шока)."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы:\u003c/i\u003e бледность кожных покровов и слизистых оболочек, головокружение, тошнота, рвота, \"холодный\" пот, учащение дыхания, тахикардия, снижение артериального давления вплоть до коллапса, апноэ, метгемоглобинемия. Действие на центральную нервную систем (ЦНС) проявляется чувством страха, галлюцинациями, судорогами, двигательным возбуждением."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e поддержание адекватной легочной вентиляции, дезинтоксикационная и симптоматическая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Усиливает угнетающее действие на ЦНС средств для общей анестезии, снотворных и седативных препаратов, наркотических анальгетиков и транквилизаторов."}},{"type":"paragraph","data":{"text":"Антикоагулянты (ардепарин натрия, далтепарин натрия, данапароид натрия, эноксапарин натрия, гепарин, варфарин) повышают риск развития кровотечений."}},{"type":"paragraph","data":{"text":"При обработке места инъекции местного анестетика дезинфицирующими растворами, содержащими тяжелые металлы, повышается риск развития местной реакции в виде болезненности и отека."}},{"type":"paragraph","data":{"text":"Использование с ингибиторами моноаминоксидазы (МАО) (фуразолидон, прокарбазин, селегилин) повышает риск развития гипотонии."}},{"type":"paragraph","data":{"text":"Усиливают и удлиняют действие миорелаксантов."}},{"type":"paragraph","data":{"text":"При назначении прокаина совместно с наркотическими анальгетиками отмечается аддитивный эффект, что используется при проведении спинальной и эпидуральной анестезии, при этом усиливается угнетение дыхания."}},{"type":"paragraph","data":{"text":"Вазоконстрикторы (эпинефрин, метоксамин, фенилэфрин) удлиняют местноанестезирующее действие."}},{"type":"paragraph","data":{"text":"Прокаин снижает антимиастеническое действие лекарственных средств, особенно при использовании его в высоких дозах, что требует дополнительной коррекции лечении миастении."}},{"type":"paragraph","data":{"text":"Ингибиторы холинэстеразы (антимиастенические лекарственные средства, циклофосфамид, тиотепа) снижают метаболизм прокаина."}},{"type":"paragraph","data":{"text":"Метаболит прокаина (парааминобензойная кислота) является антагонистом сульфаниламидов."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Пациентам требуется контролировать функции сердечно-сосудистой, дыхательной и центральной нервной систем. Необходимо отменить ингибиторы МАО за 10 дней до введения местного анестетика."}},{"type":"paragraph","data":{"text":"Перед применением необходимо проведение проб на индивидуальную чувствительность к препарату. Необходимо учитывать, что при проведении местной анестезии при использовании одной и той же общей дозы, токсичность новокаина тем выше, чем более концентрированный раствор используется."}},{"type":"paragraph","data":{"text":"Не всасывается со слизистых оболочек; не обеспечивает поверхностной анестезии при накожном применении."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения необходимо воздерживаться от вождения автотранспорта и занятий 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, 5 мг/мл."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света месте при температуре не выше 25°С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"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 \"Московское производственное химико-фармацевтическое объединение им. Н.А. Семашко\" (ОАО \"Мосхимфармпрепараты\" им.Н.А.Семашко\"), 115172, г. Москва, ул. Большие Каменщики, д. 9, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"Мосхимфармпрепараты\" им.Н.А.Семашко\""}}]}],"source":null},"description_toggle":false,"short_description":"Местноанестезирующее средство с умеренной анестезирующей активностью и большой широтой терапевтического действия. Являясь слабым основанием, блокирует Nа+-каналы, препятствует генерации импульсов в окончаниях чувствительных нервов и проведению импульсов по нервным волокнам. Изменяет потенциал действия в мембранах нервных клеток без выраженного влияния на потенциал покоя. Подавляет проведение не только болевых, но и импульсов др. модальности. При всасывании и непосредственном сосудистом введении в ток крови снижает возбудимость периферических холинергических систем, уменьшает образование и высвобождение ацетилхолина из преганглионарных окончаний (обладает некоторым ганглиоблокирующим действием), устраняет спазм гладкой мускулатуры, уменьшает возбудимость миокарда и моторных зон коры головного мозга. При внутривенном введении оказывает анальгезирующее, гипотензивное и антиаритмическое действие (увеличивает эффективный рефрактерный период, снижает возбудимость, автоматизм и проводимость), в больших дозах может нарушать нервно-мышечную проводимость. Устраняет нисходящие тормозные влияния ретикулярной формации ствола мозга. Угнетает полисинаптические рефлексы. В больших дозах может вызывать; судороги. Обладает короткой анестезирующей активностью (продолжительность инфильтрационной анестезии составляет 0,5-1 ч). Подвергается полной системной абсорбции. Степень абсорбции зависит от места и пути введения (особенно от васкуляризации и скорости кровотока в области введения) и итоговой дозы (количества и концентрации). Быстро гидролизуется эстеразами плазмы и печени с образованием 2 основных фармакологически активных метаболитов: диэтиламиноэтанола (обладает умеренным сосудорасширяющим действием) и парааминобензойной кислоты (является конкурентным антагонистом сульфаниламидных химиотерапевтических препаратов и может ослабить их противомикробное действие). Период полувыведения 30-50 секунд, в неонатальном периоде - 54-114 секунд. Выводится преимущественно почками в виде метаболитов, в неизмененном виде выводится не более 2%.","substance":[{"id":849,"title":"Прокаин","title_latin":"Procainum","slug":"prokain_849"}],"branding":null,"valid_for_quick_buy":false,"is_available_to_delivery":false,"comments":null,"image_alt":"Новокаин - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/188692/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/188692/share_default/"}},"diseases":[],"other_packages":[{"id":97045,"title":"Новокаин","subtitle":{"full":"Раствор, ампулы, 10 шт, 5 мл, 0,5 %, для инъекций","short":"Раствор, 10 шт, 5 мл, 0,5 %","package":"10 шт, 5 мл, 0,5 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