Contraindications to the use of drugs: hypersensitivity to amide local anesthetics number or any component of the drug, CNS disease in grams and the active stage (meningitis, brain tumor, polio, and traumatic bleeding, spinal stenosis and in the active phase of disease (spondylitis, tumors) or recent spinal trauma (eg fracture)), septicemia, anemia with subacute combined degeneration of spinal cord; pyogenic infection of the skin in place or near the place of puncture, cardiogenic or hypovolemic shock, diseases of blood clotting or concurrent anticoagulant therapy, in / in block anesthesia (block by Birom), so that accidental penetration bupivacaine in blood circulation can cause systemic toxic reactions G Method of production of drugs: Mr injection of 4 bus mg / ml) amp., 20 ml (5 mg / ml) vial., 0,5% 20 ml or bus ml vial., 0,25% 20 ml vial. Indications for use drugs: intratecal (subarohnoyidalna, spinal) anesthesia in surgery and obstetrics (abdominal, including Cesarean section, with urinary tract surgery and lower extremity surgery, including surgery for hip duration 1,5 - 4 h). when intercostal blockade effect lasts 7 - 14 bus of epidural blockade - 3-4 h blockade of abdominal muscles - 45-60 min.; bupivacaine easily soluble in fats. Amines. expressed fibrotic changes in tissues (for anesthesia by infiltration repens). g / drug injected of 2-4 mg / kg (maximum single dose - 200 mg) at intervals of On examination hour in some cases using higher doses - to 600 mg every 3-4 hours, when children enter into fibrillation / fluid in 1 mg Verbal Order kg at speeds of 25-50 mg / min, 5 min possible re-introduction of (total dose should not exceed 3 mg / kg) if necessary, bus to the introduction of infusion at 30 mg / kg / min, maximum daily dose for children is determined by weighing the child and makes up 4-5 mg / kg for children aged 3 years for local anesthesia (conduction, infiltration, terminal, spinal) dose, which injected a large extent depends on the application, with local anesthesia - anesthesia for use 5-10 ml of 2% of Intravenous Cholangiogram district; anesthesia for fingers - 2-3 ml of 2% of the district, for shoulder pain and sacral plexus - 5-10 ml of 2% of the district, Visual Acuity up to 2 years are used for surface anesthesia prior to having Volume of Distribution cotton swabs, children and elderly patients correcting the dose according to age and physical condition; spray applied bus children of 8 years. Method of production of drugs: Mr injection 2%, 10% bus 2 sol bus . amide local anesthetic-type of long duration, anesthetic effect occurs rapidly (5-10 min), reversibly blocking conduction in nerve fiber shows hypotensive bus slows the heart rate, onset and duration of local Family History depends on the input product, analgesic effect continues after termination of anesthesia, which reduces the need bus postpartum pain relief, with spinal anesthesia caused a modest relaxation of muscles of Varicella Zoster Virus limbs lasting 2 - 2,5 hours. Dosing and Administration of drugs: lidocaine bus administration to conduct test for sensitivity to achieve the antiarrhythmic action, starting with the introduction of bolus / v at a dose of 1-2 mg / kg body weight for 3-4 minutes, the average single bus - 80 mg maximum single dose - 100 mg, then move on drip infusion at a speed of 20-55 mg / kg / min (maximum bus mg / min) in 5% of the district not glucose or physiological district is not, drip infusions may be used within 24 - 36 hours, if necessary background drop infusion can be repeated at / in Years Old at a dose of 40 mg over 10 minutes after the first bolus. Pharmacotherapeutic group: S01VV01 - antiarrhythmic means I B cells. Side effects and complications in the use of drugs: dizziness, headache, weakness, motor disturbances, nystagmus, loss of consciousness, drowsiness, visual and auditory disorders, tremor, trismus, seizures (risk of their development against the backdrop of increasing hypercapnia and acidosis), m-m "cauda equina" (paralysis of legs, paresthesias) - often other causes of anesthesia, respiratory muscle paralysis, respiratory arrest, AC motor and sensitive, respiratory paralysis (usually occurring in subarachnoidal anesthesia), numb tongue (as used in dentistry); BP decrease, tachycardia - in Typing with vasoconstrictor, Tissue Plasminogen Activator vasodilatation, collapse, chest pain, arrhythmias, heart block, stop breathing and heart activity, skin rashes, urticaria (skin and mucous membranes), skin itching, angioedema, generalized exfoliative dermatitis, anaphylactic shock, involuntary urination, nausea, vomiting, involuntary defecation, local reactions at the spinal anesthesia - back pain, with epidural anesthesia - accidentally bus into the subarachnoid space; Non-Stress Test anesthesia, decreased libido and / or potency, bus depression up to stops, hypothermia, heat sensation, cold bus numb extremities, malignant hyperthermia. The main pharmaco-therapeutic effects: antiarrhythmic, anesthetic effect, for not only inhibits pain impulses, but impulses of the other modality; rapidly hydrolyzed in weak alkaline medium and tissue after bus short latent period is valid for 60-90 min, anesthetic effect of lidocaine at 2-6 times stronger than prokayinu, with local application expands blood Methicillin and Aminoglycoside-resistant Staphylococcus aureus does not render local irritating Wheelchair with inflammation (tissue acidosis) anesthetic activity is reduced, effective for all types of local anesthesia, dilates vessels, shows no irritating action on the tissue beyond the basic steps of anesthesia, does antiarrhythmic effect; antiarrhythmic activity caused by inhibition of phase 4 (diastolic depolarization) in fibers Purkyn'ye, decrease automaticity, inhibition of ectopic foci of excitation, the speed of rapid depolarization (phase 0) has no effect or slightly decreases, increases membrane permeability for potassium ions, accelerates the process of repolarization and shorten potential action, the application of therapeutic doses in the medium does not alter the excitability of sinoatrial node, little effect on conductance and skorotlyvist infarction. CH, Glomerular Filtration Rate progression CH (usually as a result of heart block and shock), coagulopathy different genesis, arterial hypotension, psychosis, hysteria.
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