Артикаин-Бинергия Раствор, 10 шт, 2 мл, 20 мг / мл

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Артикаин выводится почками, главным образом, в виде артикаиновой кислоты."}},{"type":"paragraph","data":{"text":"После внутримышечного введения максимальная концентрация артикаина в крови достигается через 20-40 минут, период полувыведения составляет 39,8 ± 3,1 минут."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"paragraph","data":{"text":"Артикаин-Бинергия применяется для местной и регионарной блокады нервных окончаний."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"- Повышенная чувствительность к артикаину, другим местноанестезирующим средствам амидного типа или к любому из вспомогательных компонентов препарата;"}},{"type":"paragraph","data":{"text":"- тяжелые нарушения функции синусового узла или тяжелые нарушения проводимости (такие, как выраженная брадикардия, атриовентрикулярная блокада 2-й или 3-й степени);"}},{"type":"paragraph","data":{"text":"- острая декомпенсированная сердечная недостаточность (острое нарушение функционального состояния сердца);"}},{"type":"paragraph","data":{"text":"- тяжелая артериальная гипотензия, шок."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- У пациентов с недостаточностью холинэстеразы (применение возможно только в случае крайней необходимости, так как возможно пролонгирование и выраженное усиление действия препарата);"}},{"type":"paragraph","data":{"text":"- у пациентов со стенокардией, атеросклерозом;"}},{"type":"paragraph","data":{"text":"- у пациентов с нарушениями свертываемости крови;"}},{"type":"paragraph","data":{"text":"- у пациентов с тяжелыми нарушениями функции печени / почек;"}},{"type":"paragraph","data":{"text":"- у пациентов с эпилепсией в анамнезе."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eБеременность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Опыт применения артикаина беременными женщинами отсутствует, за исключением его применения во время родов. В ходе экспериментальных исследований на животных каких-либо признаков прямого или косвенного негативного влияния артикаина на беременность, развитие эмбриона/плода, роды или постнатальное развитие не обнаружено."}},{"type":"paragraph","data":{"text":"Артикаин проникает через плацентарный барьер в меньшей степени по сравнению с другими местными анестетиками."}},{"type":"paragraph","data":{"text":"Концентрация артикаина в плазме крови у новорожденных (после введения препарата матери) составляет приблизительно 30 % от концентрации артикаина в плазме крови матери."}},{"type":"paragraph","data":{"text":"Ввиду недостаточности клинических данных, решение о применении препарата врачом может быть принято только в том случае, если потенциальная польза от его применения для матери оправдывает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"При использовании родовспомогательной анестезии негативного влияния артикаина на новорожденных не отмечено."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПериод грудного вскармливания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При краткосрочном применении препарата в период грудного вскармливания, как правило, не требуется прерывать кормление грудью, так как в грудном молоке не обнаруживается клинически значимых концентраций артикаина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФертильность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В исследованиях на животных с применением артикаина 40 мг/мл + эпинефрина 0,01 мг/мл не отмечено влияния на фертильность. При применении в терапевтических дозах негативное действие препарата на фертильность человека отсутствует."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Артикаин-Бинергия, в зависимости от выбранного вида анестезии, применяется для инфильтрационной, проводниковой, эпидуральной и внутривенной регионарной анестезии."}},{"type":"paragraph","data":{"text":"Следует вводить минимальную дозу, с помощью которой достигается желаемая достаточная анестезия."}},{"type":"paragraph","data":{"text":"Дозу устанавливают индивидуально в соответствии с особенностями каждого конкретного случая."}},{"type":"paragraph","data":{"text":"Для детей и пациентов пожилого возраста необходим подбор дозы."}},{"type":"paragraph","data":{"text":"Рекомендуемая максимальная доза для взрослых: 5-6 мг/кг массы тела (не более 400 мг). Ниже представлены ориентировочные дозы, которые необходимо корректировать в зависимости от глубины анестезии и состояния пациента."}},{"type":"paragraph","data":{"text":"Во избежание случайной интраваскулярной инъекции, перед введением препарата и в ходе введения основной дозы, всегда следует проводить аспирационную пробу. Давление инъекции должно соответствовать чувствительности тканей."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Частота развития побочных эффектов представлена в соответствии с классификацией, рекомендованной Всемирной Организацией Здравоохранения: очень часто (≥1/10); часто (≥1/100, <1/10); нечасто (≥1/1000, <1/100); редко (≥1/10000, <1/1000); очень редко (<1/10000), включая отдельные сообщения; частота неизвестна (по имеющимся данным определить частоту встречаемости не представляется возможным)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто"}},{"type":"paragraph","data":{"text":"Парестезия, гипестезия."}},{"type":"paragraph","data":{"text":"Нечасто"}},{"type":"paragraph","data":{"text":"Головокружение."}},{"type":"paragraph","data":{"text":"Частота неизвестна"}},{"type":"paragraph","data":{"text":"Дозозависимые реакции со стороны центральной нервной системы (особенно при введении слишком большой дозы или при случайной интраваскулярной инъекции): чувство тревоги, нервозность, ступор, помрачение сознания, иногда прогрессирующее до потери сознания, кома, дыхательные расстройства, иногда прогрессирующие до остановки дыхания, мышечный тремор, мышечные подергивания, иногда прогрессирующие до генерализованных судорог."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны органа зрения\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна"}},{"type":"paragraph","data":{"text":"Зрительные расстройства (нечеткость зрительного восприятия, мидриаз, слепота, двоение в глазах), возникающие во время или через короткое время после инъекции препарата в области головы. Как правило, эти симптомы являются преходящими."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Часто"}},{"type":"paragraph","data":{"text":"Тошнота, рвота."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны сердечно-сосудистой системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна"}},{"type":"paragraph","data":{"text":"Снижение артериального давления, брадикардия, сердечная недостаточность и шок (при определённых обстоятельствах с угрозой для жизни)."}},{"type":"paragraph","data":{"text":"В процессе родовспомогательной анестезии, в частности при парацервикальной блокаде, может появиться брадикардия у плода. Рекомендуется тщательно контролировать сердечную деятельность плода."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Частота неизвестна"}},{"type":"paragraph","data":{"text":"Могут развиваться аллергические или аллергоподобные реакции. В месте инъекции они могут проявляться в виде отечности/припухлости и/или воспаления. Проявлениями, не связанными с местом введения, могут быть гиперемия кожных покровов, зуд, конъюнктивит, ринит и ангионевротический отек. Ангионевротический отек может проявляться отеком верхней и/или нижней губы, и/или щек, отеком голосовых связок с ощущением \"комка в горле\" и затруднением глотания, крапивницей и затруднением дыхания вплоть до анафилактического шока."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы передозировки\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны центральной нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eВозбуждение центральной нервной системы: \u003c/i\u003eчувство тревоги, страха, спутанность сознания, гиперпноэ, тахикардия, увеличение артериального давления с покраснением лица, тошнота, рвота, тремор, подергивания, тонико-клонические судороги."}},{"type":"paragraph","data":{"text":"\u003ci\u003eУгнетение центральной нервной системы:\u003c/i\u003e головокружение, нарушение слуха, потеря способности говорить, ступор, бессознательное состояние, атония, паралич сосудодвигательных нервов (слабость, бледность), одышка, смерть от асфиксии из-за паралича дыхательных мышц."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eУгнетение сердечно-сосудистой системы: \u003c/i\u003eбрадикардия, аритмия, мерцание желудочков, падение артериального давления, цианоз, остановка сердца."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЭкстренная помощь и противодействующие средства\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При появлении первых признаков побочного действия или интоксикации, таких как головокружение, двигательное возбуждение, помрачение сознания или ступор во время введения препарата, следует прекратить его введение и перевести пациента в горизонтальное положение с приподнятыми нижними конечностями. Необходимо обеспечить проходимость дыхательных путей и мониторировать показатели гемодинамики (число сердечных сокращений и артериальное давление)."}},{"type":"paragraph","data":{"text":"Рекомендуется освободить доступ к венам (даже при симптомах, которые не кажутся серьезными), для того, чтобы в случае необходимости иметь возможность немедленно провести внутривенное введение необходимых лекарственных средств."}},{"type":"paragraph","data":{"text":"При нарушениях дыхания, в зависимости от их тяжести, рекомендуется подача кислорода, в случае необходимости - сделать искусственное дыхание, а при определенных обстоятельствах - провести эндотрахеальную интубацию и искусственную вентиляцию легких под контролем."}},{"type":"paragraph","data":{"text":"Мышечные подергивания и генерализованные судороги могут быть купированы внутривенным введением быстродействующего спазмолитического средства (например, суксаметония хлорид, диазепам). Также рекомендуется проведение искусственной вентиляции лёгких (подача кислорода)."}},{"type":"paragraph","data":{"text":"Резкое снижение артериального давления, тахикардия или брадикардия могут устраняться при простом переведении пациента в горизонтальное положение с приподнятыми нижними конечностями."}},{"type":"paragraph","data":{"text":"При тяжелых нарушениях кровообращения и шоке любого происхождения введение препарата должно быть прекращено. Необходимо перевести пациента в горизонтальное положение с приподнятыми нижними конечностями и освободить дыхательные пути (инсуффляция кислорода). Должно проводиться внутривенное введение сбалансированных растворов электролитов, глюкокортикостероидов (250-1000 мг преднизолона или эквивалентное количество производного, например, метилпреднизолона), заместительная инфузионная терапия (при необходимости дополнительно плазмозаменители, например, альбумин человека)."}},{"type":"paragraph","data":{"text":"При развитии циркуляторного коллапса и усилении брадикардии внутривенно немедленно вводится эпинефрин (адреналин). После разведения 1 мл 0,1 % раствора эпинефрина (1:1000) до 10 мл, используя полученный 0,01 % раствор эпинефрина (1:10000), проводят медленное введение сначала 0,25 - 1 мл (0,025-0,1 мг эпинефрина), контролируя пульс и артериальное давления (осторожно: возможны нарушения сердечного ритма!). Не превышать разовую внутривенную дозу 1 мл (0,1 мг эпинефрина). При необходимости введения доз, превышающих разовую внутривенную дозу эпинефрина 0,1 мг, эпинефрин следует вводить с инфузионным раствором, отрегулировав капельную скорость введения в соответствии с частотой пульса и артериальным давлением."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Сочетания различных местных анестетиков вызывают появление дополнительных воздействий на сердечно - сосудистую систему и центральную нервную систему."}},{"type":"paragraph","data":{"text":"С антикоагулянтами и другими препаратами, уменьшающими свертываемость крови При проведении инъекций препарата Артикаин-Бинергия пациентам, получающим, например, гепарин или ацетилсалициловую кислоту, возможно развитие серьезных кровотечений при непреднамеренной перфорации сосуда, так как у таких пациентов выше склонность к кровотечениям."}},{"type":"paragraph","data":{"text":"Препарат Артикаин-Бинергия несовместим с щелочными растворами."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Регионарная и местная анестезия должна проводиться опытными специалистами в соответствующим образом оборудованном помещении при доступности готового к немедленному использованию оборудования и препаратов, необходимых для проведения мониторинга сердечной деятельности и реанимационных мероприятий. Персонал, выполняющий анестезию, должен быть квалифицированным и обучен технике выполнения анестезии, должен быть знаком с диагностикой и лечением системных токсических реакций, нежелательных явлений и реакций и других осложнений."}},{"type":"paragraph","data":{"text":"Только при наличии строгих показаний препарат Артикаин-Бинергия можно применять у пациентов с дефицитом холинэстеразы, так как возможно пролонгирование и, при определённых обстоятельствах, усиление его действия."}},{"type":"paragraph","data":{"text":"Нельзя вводить препарат Артикаин-Бинергия в воспалённые (инфицированные) участки ткани (усиление поглощения артикаина при уменьшении эффективности)."}},{"type":"paragraph","data":{"text":"Для того, чтобы избежать риска развития побочных реакций, необходимо соблюдать следующие условия:"}},{"type":"paragraph","data":{"text":"- у пациентов группы риска и при применении более высоких доз (более 25% максимальной однократной дозы) следует освободить доступ к венам, чтобы при необходимости иметь возможность немедленно сделать внутривенную инъекцию;"}},{"type":"paragraph","data":{"text":"- применять минимальные эффективные дозы препарата;"}},{"type":"paragraph","data":{"text":"- до введения препарата провести двухэтапную аспирационную пробу в двух плоскостях (во избежание случайной интраваскулярной инъекции);"}},{"type":"paragraph","data":{"text":"- регулярно контролировать жизненные показатели (контроль сердечно - сосудистой системы и сознания)."}},{"type":"paragraph","data":{"text":"Для применения в офтальмологии и при нейроаксиальной анестезии забор препарата можно осуществлять только из вновь открытых ампул и флаконов (препарат не содержит консервантов)."}},{"type":"paragraph","data":{"text":"Для предотвращения инфицирования (в том числе, вирусным гепатитом) необходимо следить за тем, чтобы при заборе препарата из ампул и флаконов всегда использовались новые стерильные шприцы и иглы."}},{"type":"paragraph","data":{"text":"Открытые ампулы и флаконы нельзя использовать повторно для других пациентов!"}},{"type":"paragraph","data":{"text":"В 1 мл препарата Артикаин-Бинергия раствор для инъекций 10 мг/мл содержится 0,12 ммоль (2,75 мг) натрия."}},{"type":"paragraph","data":{"text":"В 1 мл препарата Артикаин-Бинергия раствор для инъекций 20 мг/мл содержится 0,09 ммоль (2,04 мг) натрия."}},{"type":"paragraph","data":{"text":"Эти данные следует учитывать при применении препарата Артикаин-Бинергия у пациентов, контролирующих потребление натрия (диета с малым содержанием поваренной соли)."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Решение о том, когда пациент сможет вернуться к управлению транспортными средствами и занятиям другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций, должен принимать врач."}},{"type":"paragraph","data":{"text":"Невроз ожидания и послеоперационный стресс могут привести к изменению способности к управлению транспортными средствами или другими видами деятельности, несмотря на то, что местная анестезия артикаином по результатам соответствующих тестов не показала определяемых отклонений от обычной способности управлять транспортными средствами."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для инъекций 10 мг/мл или 20 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":"5 лет."}},{"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":"Федеральное казенное предприятие \"Армавирская биологическая фабрика\" (ФКП \"Армавирская биофабрика\"), 352212, Краснодарский край, Новокубанский район, п. Прогресс, ул. Мечникова, д. 11, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ЗАО \"Бинергия\""}}]}],"source":null},"description_toggle":false,"short_description":"Артикаин является местноанестезирующим средством амидного типа. Артикаин оказывает местноанестезирующее действие за счет блокады потенциалзависимых натриевых каналов в клеточной мембране нейронов, что приводит к обратимому угнетению проводимости импульсов по нервному волокну и обратимой потере чувствительности. Артикаин обладает очень небольшим анестезирующим эффектом для поверхностной анестезии. При всех способах введения артикаин оказывает быстрое (латентный период -от 1 до 11 минут) и сильное анестезирующее действие и имеет хорошую тканевую переносимость. Продолжительность анестезии без добавления сосудосуживающего средства (например, эпинефрина), составляет от 60 до 225 минут. Препарат Артикаин-Бинергия не содержит эпинефрин и применяется, когда добавление эпинефрина к местноанестезирующему средству необязательно или применение эпинефрина противопоказано. Связывание артикаина с белками плазмы крови составляет приблизительно 95 %. Артикаин быстро и практически сразу после введения метаболизируется (путем гидролиза) неспецифическими плазменными эстеразами в тканях и крови (90 %); остальные 10 % дозы артикаина метаболизируется микросомальными ферментами печени. Артикаин выводится почками, главным образом, в виде артикаиновой кислоты. После внутримышечного введения максимальная концентрация артикаина в крови достигается через 20-40 минут, период полувыведения составляет 39,8 ± 3,1 минут.","substance":[{"id":1681,"title":"Артикаин","title_latin":"Articainum","slug":"artikain_1681"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Артикаин-Бинергия - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/203174/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/203174/share_default/"}},"diseases":[],"other_packages":[{"id":283246,"title":"Артикаин-Бинергия","subtitle":{"full":"Раствор, 10 шт, 1.7 мл, 20 мг / мл","short":"Раствор, 10 шт, 1.7 мл, 20 мг / мл","package":"10 шт, 1.7 мл, 20 мг / мл"},"prescription":true,"catalog_section_id":72,"manufacturer":{"id":2226,"title":"Армавирская Биофабрика 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