Lidocaine

Lub npe dav: Lidocaine hydrochloride
Dosage form: txhaj tshuaj
Chav kawm tshuaj: Pab pawg I antiarrhythmics , Local txhaj tshuaj loog



Ntawm nplooj ntawv no
Nthuav

Rau Infiltration thiab Nerve Block



Rx xwb

Lidocaine piav qhia

Lidocaine HCl Txhaj, USP yog ib qho tshuaj tsis muaj menyuam, tsis yog pyrogenic, cov tshuaj aqueous uas muaj cov tshuaj loog hauv zos thiab raug tswj hwm los ntawm kev txhaj tshuaj. Saib QHOV TSEEB rau kev siv tshwj xeeb.



Lidocaine HCl Txhaj Tshuaj, USP tov muaj Lidocaine HCl, uas yog chemically xaiv raws li acetamide, 2-(diethylamino)-N-(2,6-dimethylphenyl)-, monohydrochloride thiab muaj cov molecular wt. 270.8 ib. Lidocaine HCl (C14H22NobO • HCl) muaj cov qauv hauv qab no:


Lidocaine HCl Txhaj Tshuaj, USP tshuaj yog siv rau ib koob tshuaj, thiab yogMethylPcov arabenFree (Preservative-Free).

Lidocaine HCl Txhaj Tshuaj, USP yog cov tshuaj tsis muaj tshuaj lom, tsis muaj pyrogenic, isotonic tshuaj muaj sodium chloride. Cov pH ntawm cov tshuaj no yog kho rau kwv yees li 6.5 (5.0 txog 7.0) nrog sodium hydroxide thiab / lossis hydrochloric acid.



Lidocaine - Clinical Pharmacology

Mechanism ntawm Action

Lidocaine HCl stabilizes lub paj hlwb los ntawm inhibiting ionic fluxes xav tau rau kev pib thiab kev ua ntawm impulses yog li cuam tshuam cov tshuaj loog hauv zos.

Hemodynamics

Cov ntshav ntau dhau tuaj yeem ua rau muaj kev hloov pauv hauv cov zis, tag nrho peripheral tsis kam, thiab txhais tau tias cov hlab ntshav siab. Nrog rau hauv nruab nrab neural blockade cov kev hloov pauv no tuaj yeem cuam tshuam los ntawm kev thaiv cov autonomic fibers, ib qho kev cuam tshuam ncaj qha ntawm cov tshuaj loog hauv zos rau ntau yam ntawm cov hlab plawv. Cov nyhuv net feem ntau yog ib qho me me hypotension thaum cov koob tshuaj pom zoo tsis tshaj.

Pharmacokinetics thiab Metabolism

Cov ntaub ntawv muab los ntawm ntau yam formulations, concentrations thiab kev siv qhia tau hais tias Lidocaine HCl yog absorbed tag nrho tom qab parenteral kev tswj hwm, nws tus nqi ntawm kev nqus nyob ntawm seb, piv txwv li, raws li ntau yam xws li qhov chaw ntawm kev tswj hwm thiab qhov muaj lossis tsis muaj vasoconstrictor tus neeg sawv cev. Tsuas yog rau kev tswj hwm intravascular, cov ntshav siab tshaj plaws tau txais tom qab intercostal hlab ntsha thaiv thiab qis tshaj tom qab kev tswj hwm subcutaneous.

Lub plasma khi ntawm Lidocaine HCl yog nyob ntawm cov tshuaj concentration, thiab cov feem cuam tshuam nrog kev nce siab. Ntawm qhov siab ntawm 1 mus rau 4 mcg ntawm lub hauv paus dawb ib mL 60 mus rau 80 feem pua ​​​​ntawm Lidocaine HCl yog cov protein khi. Kev khi kuj tseem nyob ntawm qhov plasma concentration ntawm alpha-1-acid glycoprotein.

Lidocaine HCl hla cov ntshav-hlwb hlwb thiab placental teeb meem, suav tias yog passive diffusion.

Lidocaine HCl yog metabolized sai heev los ntawm lub siab, thiab cov metabolites thiab cov tshuaj tsis hloov pauv tau tawm los ntawm ob lub raum. Biotransformation suav nrog oxidative N-dealkylation, nplhaib hydroxylation, cleavage ntawm amide linkage, thiab conjugation. N-dealkylation, txoj hauv kev tseem ceeb ntawm biotransformation, yields cov metabolites monoethylglycinexylidide thiab glycinexylidide. Cov tshuaj pharmacological / toxicological kev ua ntawm cov metabolites no zoo ib yam li, tab sis muaj zog tsawg dua li ntawm Lidocaine HCl. Kwv yees li ntawm 90% ntawm Lidocaine HCl tswj hwm yog tawm hauv daim ntawv ntawm ntau yam metabolites, thiab tsawg dua 10% raug tshem tawm tsis hloov pauv. Lub hauv paus metabolite hauv cov zis yog conjugate ntawm 4-hydroxy-2,6-dimethylaniline.

Kev tshem tawm ib nrab-lub neej ntawm Lidocaine HCl tom qab txhaj tshuaj bolus feem ntau yog 1.5 mus rau 2 teev. Vim tias qhov ceev ceev ntawm Lidocaine HCl yog metabolized, txhua yam mob uas cuam tshuam rau daim siab ua haujlwm yuav hloov Lidocaine HCl kinetics. Ib nrab-lub neej tuaj yeem ntev ob zaug lossis ntau dua hauv cov neeg mob uas muaj lub siab ua haujlwm tsis zoo. Lub raum tsis ua haujlwm tsis cuam tshuam rau Lidocaine HCl kinetics tab sis tuaj yeem ua rau muaj cov metabolites ntau ntxiv.

Cov yam ntxwv xws li acidosis thiab kev siv CNS stimulants thiab depressants cuam tshuam rau CNS qib ntawm Lidocaine HCl yuav tsum tau ua kom muaj kev cuam tshuam loj heev. Lub hom phiaj tsis zoo tshwm sim ua kom pom tseeb nrog nce qib venous ntshav siab tshaj 6 mcg dawb puag ib mL. Hauv cov ntshav rhesus liab cov ntshav ntawm 18 txog 21 mcg / mL tau pom tias yog qhov pib rau kev ua kom muaj zog.

Cov lus qhia thiab kev siv rau Lidocaine

Lidocaine HCl Txhaj, USP yog qhia rau kev tsim cov tshuaj loog hauv zos lossis hauv cheeb tsam los ntawm cov txheej txheem infiltration xws li percutaneous txhaj thiab intravenous regional tshuaj loog los ntawm peripheral hlab ntsha thaiv cov tswv yim xws li brachial plexus thiab intercostal thiab los ntawm central neural cov tswv yim xws li lumbar thiab caudal epidural blocks, thaum. Cov txheej txheem lees paub rau cov txheej txheem no raws li tau piav qhia hauv cov phau ntawv qhia raug pom zoo.

Contraindications

Lidocaine HCl yog contraindicated nyob rau hauv cov neeg mob uas paub txog keeb kwm ntawm hypersensitivity rau lub zos tshuaj loog ntawm amide hom.

Ceeb toom

Lidocaine HCl txhaj tshuaj, USP rau kev nkag mus thiab lub paj hlwb yuav tsum tau ua haujlwm tsuas yog los ntawm cov kws kho mob uas ua tau zoo nyob rau hauv kev kuaj mob thiab kev tswj xyuas cov tshuaj tiv thaiv kab mob uas cuam tshuam rau kev ua xua thiab lwm yam kev kho mob.Tam sim noMuaj OXYGEN, lwm yam RESUSCITATIVE DRUGS, CARDIOPULMONARY EQUIPMENT THIAB COV PHOOJ YWG YUAV TSUM TAU TXAIS KEV PAB CUAM TXOJ CAI TSHIAB THIAB KEV KAWM NTAWV (saib TXOJ CAI TSHIAB thiab COV KEV CEEV FAJ ). NTAUB NTAWV HAUJ LWM HAUJ LWM NTAWM DAIM NTAWV THOV KEV PAB CUAM NTAWM TXOJ CAI NTAWM TXOJ HAUJ LWM HAUJ LWM HAUJ LWM THIAB / lossis hloov rhiab heev tuaj yeem ua rau muaj kev loj hlob ntawm ACIDOSIS, CARDIAC ARREST THIAB, TAB SIS, TUAG.

Methemoglobinemia

Cov xwm txheej ntawm methemoglobinemia tau tshaj tawm hauv kev koom nrog kev siv tshuaj loog hauv zos. Txawm hais tias tag nrho cov neeg mob muaj kev pheej hmoo rau methemoglobinemia, cov neeg mob uas muaj cov piam thaj-6-phosphate dehydrogenase tsis txaus, congenital lossis idiopathic methemoglobinemia, mob plawv lossis pulmonary cuam tshuam, cov menyuam mos hnub nyoog qis dua 6 lub hlis, thiab cov neeg ua haujlwm sib xyaw ua ke ntawm oxidizing cov neeg ua haujlwm lossis lawv cov metabolites muaj kev cuam tshuam ntau dua. soj ntsuam manifestations ntawm tus mob. Yog tias cov tshuaj loog hauv zos yuav tsum tau siv rau cov neeg mob no, kev soj ntsuam ze rau cov tsos mob thiab cov tsos mob ntawm methemoglobinemia raug pom zoo.

Cov tsos mob ntawm methemoglobinemia tuaj yeem tshwm sim tam sim ntawd lossis tuaj yeem ncua sijhawm qee teev tom qab kis tau, thiab muaj cov tsos mob ntawm daim tawv nqaij cyanotic thiab / lossis xim txawv txav ntawm cov ntshav. Methemoglobin qib yuav nce ntxiv; Yog li ntawd, yuav tsum tau kho tam sim ntawd kom tsis txhob muaj teeb meem loj hauv nruab nrab ntawm lub paj hlwb thiab cov kab mob plawv, nrog rau qaug dab peg, coma, arrhythmias, thiab tuag. Txiav Lidocaine HCl Txhaj Tshuaj, USP thiab lwm yam oxidizing tus neeg sawv cev. Nyob ntawm qhov mob hnyav ntawm cov tsos mob thiab cov tsos mob, cov neeg mob tuaj yeem teb rau kev txhawb nqa kev kho mob, piv txwv li, kev kho cov pa oxygen, hydration. Kev nthuav qhia kho mob hnyav dua tuaj yeem xav tau kev kho mob nrog methylene xiav, pauv hloov pauv, lossis hyperbaric oxygen.

Intra-articular infusions ntawm cov tshuaj loog hauv zos tom qab arthroscopic thiab lwm cov txheej txheem phais yog ib qho kev siv tsis tau pom zoo, thiab muaj cov ntaub ntawv tshaj tawm tom qab kev lag luam ntawm chondrolysis hauv cov neeg mob tau txais cov tshuaj no. Feem ntau ntawm cov xwm txheej ntawm chondrolysis tau koom nrog lub xub pwg nyom; Cov neeg mob ntawm gleno-humeral chondrolysis tau piav qhia hauv cov neeg mob hauv menyuam yaus thiab cov neeg laus tom qab intra-articular infusions ntawm cov tshuaj loog hauv zos rau lub sijhawm 48 txog 72 teev. Muaj cov ntaub ntawv tsis txaus los txiav txim siab seb lub sij hawm luv luv ntawm cov infusion tsis cuam tshuam nrog cov kev tshawb pom no. Lub sijhawm pib ntawm cov tsos mob, xws li mob pob qij txha, txhav thiab poob ntawm kev txav tuaj yeem hloov pauv, tab sis tuaj yeem pib ntxov li 2 lub hlis tom qab kev phais. Tam sim no, tsis muaj kev kho mob zoo rau chondrolysis; Cov neeg mob uas tau ntsib chondrolysis tau xav tau kev kuaj mob ntxiv thiab kho cov txheej txheem thiab qee qhov yuav tsum tau arthroplasty lossis lub xub pwg hloov.

Txhawm rau zam kev txhaj tshuaj intravascular, aspiration yuav tsum tau ua ua ntej txhaj tshuaj loog hauv zos. Lub koob yuav tsum tau muab rov qab mus kom txog thaum tsis muaj ntshav rov qab los ntawm kev xav tau. Nco ntsoov, txawm li cas los xij, tias qhov tsis muaj ntshav hauv cov koob txhaj tshuaj tsis tau lees tias kev txhaj tshuaj intravascular tau zam.

Cov tshuaj loog hauv zos uas muaj cov tshuaj tua kab mob (piv txwv li, methylparaben) yuav tsum tsis txhob siv rau cov tshuaj loog epidural lossis txha caj qaum vim tias kev nyab xeeb ntawm cov neeg ua haujlwm no tsis tau tsim los hais txog kev txhaj tshuaj intrathecal, tsis txhob txwm los yog raug mob.

Cov tshuaj anaphylactic tuaj yeem tshwm sim tom qab kev tswj hwm ntawm Lidocaine hydrochloride (saib TXOJ CAI TSHIAB ).

Nyob rau hauv cov ntaub ntawv ntawm cov tshuaj tiv thaiv hnyav, txiav kev siv cov tshuaj.

Cov kev ceev faj

General

Kev nyab xeeb thiab kev ua tau zoo ntawm Lidocaine HCl nyob ntawm seb muaj pes tsawg leeg, cov txheej txheem raug, kev ceev faj txaus, thiab kev npaj rau xwm txheej ceev. Cov phau ntawv txheej txheem yuav tsum tau sab laj rau cov txheej txheem tshwj xeeb thiab kev ceev faj rau ntau yam txheej txheem tshuaj loog hauv cheeb tsam.

Cov cuab yeej siv hluav taws xob, cov pa oxygen, thiab lwm yam tshuaj resuscitative yuav tsum muaj rau kev siv tam sim ntawd (saib CEEB TOOM thiab TXOJ CAI TSHIAB ). Cov koob tshuaj qis tshaj plaws uas ua rau muaj kev siv tshuaj loog zoo yuav tsum tau siv kom tsis txhob muaj cov ntshav plasma siab thiab muaj kev cuam tshuam loj heev. Cov koob txhaj tshuaj yuav tsum tau ua ua ntej thiab thaum lub sijhawm txhaj tshuaj ntxiv thaum siv cov txheej txheem catheter hauv tsev. Thaum lub sij hawm tswj hwm ntawm epidural tshuaj loog, nws raug nquahu kom txhaj tshuaj rau thawj zaug thiab tus neeg mob yuav tsum tau saib xyuas rau lub hauv paus paj hlwb toxicity thiab plawv toxicity, nrog rau cov cim qhia ntawm kev tswj tsis tau intrathecal, ua ntej ua. Thaum cov kev kho mob tau tso cai, kev txiav txim siab yuav tsum tau muab rau kev siv cov tshuaj loog hauv zos uas muaj cov tshuaj epinephrine rau qhov kev sim tshuaj vim tias cov kev hloov pauv hloov pauv tau sib xws nrog epinephrine kuj tseem tuaj yeem ua qhov ceeb toom ntawm kev txhaj tshuaj intravascular tsis xav tau. Kev txhaj tshuaj intravascular tseem ua tau txawm tias qhov kev xav rau ntshav tsis zoo. Kev noj tshuaj ntau dua ntawm Lidocaine HCl tuaj yeem ua rau cov ntshav nce ntxiv nrog rau txhua qhov rov ua dua vim tias qeeb ntawm cov tshuaj los yog nws cov metabolites. Kev kam rau siab rau cov ntshav siab txawv raws li tus neeg mob. Debilitated, cov neeg mob laus, cov neeg mob hnyav, thiab cov menyuam yaus yuav tsum tau txo cov koob tshuaj kom zoo raws li lawv lub hnub nyoog thiab lub cev mob. Lidocaine HCl yuav tsum tau siv nrog ceev faj hauv cov neeg mob uas muaj kev poob siab lossis lub plawv nres.

Lumbar thiab caudal epidural tshuaj loog yuav tsum tau siv nrog ceev faj heev nyob rau hauv cov neeg uas muaj cov nram qab no tej yam kev mob: kab mob uas twb muaj lawm neurological, spinal deformities, septicemia, thiab kub siab heev.

Cov tshuaj loog hauv zos uas muaj vasoconstrictor yuav tsum tau siv ceev faj thiab ua tib zoo txiav cov khoom hauv cov cheeb tsam ntawm lub cev los ntawm cov hlab ntsha kawg lossis muaj lwm yam kev cuam tshuam cov ntshav. Cov neeg mob uas muaj kab mob peripheral vascular thiab cov neeg mob hypertensive vascular kab mob tuaj yeem pom cov lus teb vasoconstrictor exaggerated. Ischemic raug mob los yog necrosis yuav tshwm sim. Kev npaj uas muaj vasoconstrictor yuav tsum tau siv nrog ceev faj hauv cov neeg mob thaum lub sijhawm lossis ua raws li kev tswj hwm ntawm cov tshuaj loog uas muaj zog, vim tias mob plawv arrhythmias tuaj yeem tshwm sim hauv cov xwm txheej zoo li no.

Ua tib zoo saib xyuas thiab ua tib zoo saib xyuas cov hlab plawv thiab ua pa (qhov txaus ntawm qhov cua) cov cim tseem ceeb thiab tus neeg mob lub xeev ntawm kev nco qab yuav tsum ua tiav tom qab txhua qhov tshuaj loog hauv zos. Nws yuav tsum tau khaws cia rau hauv lub siab thaum lub sij hawm xws li tsis xis nyob, ntxhov siab vim, tinnitus, kiv taub hau, qhov muag tsis pom kev, tremors, kev nyuaj siab los yog tsaug zog pw tsaug zog tej zaum yuav yog ib tug ceeb toom qhia ntxov ntxov ntawm lub paj hlwb toxicity.

Txij li thaum amide-hom tshuaj loog hauv zos yog metabolized los ntawm daim siab, Lidocaine HCl Txhaj, USP yuav tsum tau siv nrog ceev faj rau cov neeg mob uas muaj kab mob siab. Cov neeg mob uas muaj kab mob siab hnyav, vim lawv tsis muaj peev xwm ua kom metabolize cov tshuaj loog hauv zos ib txwm muaj, muaj kev pheej hmoo ntau dua ntawm kev tsim cov ntshav plasma ntau dua. Lidocaine HCl Txhaj Tshuaj, USP kuj yuav tsum tau siv nrog ceev faj rau cov neeg mob uas muaj lub plawv tsis ua haujlwm vim lawv yuav tsis muaj peev xwm them rov qab rau cov kev hloov pauv uas cuam tshuam nrog kev ncua ntev ntawm A-V conduction uas tsim los ntawm cov tshuaj no.

Ntau cov tshuaj uas siv thaum lub sij hawm ua tshuaj loog yog suav hais tias yog cov muaj peev xwm ua rau cov neeg ua haujlwm rau tsev neeg malignant hyperthermia. Txij li nws tsis paub meej tias amide-hom tshuaj loog hauv zos tuaj yeem ua rau cov tshuaj tiv thaiv no thiab vim tias qhov kev xav tau ntawm kev siv tshuaj loog ntxiv tsis tuaj yeem kwv yees ua ntej, nws tau pom zoo tias cov txheej txheem rau kev tswj hwm ntawm malignant hyperthermia yuav tsum muaj. Thaum ntxov tsis tau piav qhia ntawm tachycardia, tachypnea, labile ntshav siab thiab metabolic acidosis tuaj yeem ua ntej qhov kub siab. Cov txiaj ntsig tau zoo yog nyob ntawm kev kuaj mob ntxov, kev txiav txim siab sai ntawm tus neeg raug liam ua rau tus neeg sawv cev thiab lub chaw kho mob, suav nrog kev kho cov pa oxygen, qhia txog kev txhawb nqa thiab dantrolene (sib tham nrog dantrolene sodium intravenous pob ntxig ua ntej siv).

Cov txheej txheem tourniquet kom raug, raws li tau piav qhia hauv cov ntawv tshaj tawm thiab cov phau ntawv qhia, yog qhov tseem ceeb hauv kev ua haujlwm ntawm cov tshuaj loog hauv cheeb tsam. Cov tshuaj uas muaj epinephrine lossis lwm yam vasoconstrictors yuav tsum tsis txhob siv rau cov txheej txheem no.

phiv da dej ntsev

Lidocaine HCl yuav tsum tau siv nrog ceev faj rau cov neeg uas paub txog tshuaj rhiab heev. Cov neeg mob ua xua rau para-aminobenzoic acid derivatives (procaine, tetracaine, benzocaine, thiab lwm yam) tsis tau pom tias muaj kev cuam tshuam rau Lidocaine HCl.

Siv nyob rau hauv lub taub hau thiab caj dab cheeb tsam

Cov koob tshuaj me me ntawm cov tshuaj loog hauv zos txhaj rau hauv lub taub hau thiab caj dab, suav nrog retrobulbar, kho hniav thiab stellate ganglion blocks, tuaj yeem ua rau muaj kev phiv tshuaj zoo ib yam li cov kab mob toxicity pom nrog tsis txhob txwm ua intravascular txhaj tshuaj ntau dua. Tsis meej pem, convulsions, ua pa nyuaj siab thiab / los yog ua pa ntes, thiab mob plawv stimulation los yog kev nyuaj siab tau raug tshaj tawm. Cov tshuaj tiv thaiv no tuaj yeem yog vim kev txhaj tshuaj intra-arterial ntawm cov tshuaj loog hauv zos nrog retrograde ntws mus rau cerebral ncig. Cov neeg mob uas tau txais cov blocks no yuav tsum tau saib xyuas lawv txoj kev ncig thiab kev ua pa thiab yuav tsum tau saib xyuas tas li. Cov cuab yeej resuscitative thiab cov neeg ua haujlwm kho cov tshuaj tiv thaiv tsis zoo yuav tsum muaj tam sim ntawd. Cov lus pom zoo noj yuav tsum tsis pub tshaj (saib KEV PAB CUAM THIAB KEV PAB CUAM ).

Cov ntaub ntawv rau cov neeg mob

Thaum tsim nyog, cov neeg mob yuav tsum tau ceeb toom ua ntej tias lawv yuav ntsib kev tsis hnov ​​​​lus ib ntus thiab lub cev muaj zog, feem ntau nyob rau hauv ib nrab ntawm lub cev, tom qab kev tswj hwm ntawm epidural tshuaj loog.

Qhia rau cov neeg mob tias kev siv tshuaj loog hauv zos tuaj yeem ua rau methemoglobinemia, ib qho mob hnyav uas yuav tsum tau kho tam sim. Qhia rau cov neeg mob lossis cov neeg saib xyuas kom nrhiav kev kho mob tam sim yog tias lawv lossis ib tus neeg hauv lawv txoj kev saib xyuas tau ntsib cov tsos mob lossis cov tsos mob hauv qab no: daj ntseg, grey, lossis xim xiav ntawm daim tawv nqaij (cyanosis); mob taub hau; ceev lub plawv dhia; ua tsis taus pa; lightheadedness; los yog qaug zog.

Clinically tseem ceeb tshuaj cuam tshuam

Kev tswj hwm ib txhij ntawm cov tshuaj vasopressor (rau kev kho mob ntawm hypotension cuam tshuam nrog obstetric blocks) thiab ergot-type oxytocic tshuaj yuav ua rau mob hnyav, mob ntshav siab lossis mob hlab ntsha tawg.

Kev Sib Tham Tshuaj/Lab Sib Tham

Kev txhaj tshuaj intramuscular ntawm Lidocaine HCl tuaj yeem ua rau nce qib creatine phosphokinase. Yog li, kev siv qhov kev txiav txim siab enzyme no, tsis muaj kev sib cais isoenzyme, raws li kev kuaj mob rau qhov muaj tus mob myocardial infarction yuav raug cuam tshuam los ntawm kev txhaj tshuaj intramuscular ntawm Lidocaine HCl.

Cov neeg mob uas tau txais tshuaj loog hauv zos muaj kev pheej hmoo siab ntawm kev tsim cov tshuaj methemoglobinemia thaum sib koom ua ke nrog cov tshuaj hauv qab no, uas tuaj yeem suav nrog lwm cov tshuaj loog hauv zos:

Piv txwv ntawm Cov Tshuaj Koom Tes Nrog Methemoglobinemia:

Chav kawm

Piv txwv

Nitrates / Nitrites

nitric oxide, nitroglycerin, nitroprusside, nitrous oxide

Cov tshuaj loog hauv zos

Articaine, benzocaine, bupivacaine, Lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, tetracaine

Cov tshuaj antineoplastic

Cyclophosphamide, flutamide, hydoxyurea, ifosfamide, rasburicase

Tshuaj tua kab mob

dapsone, nitrofurantoin, para-aminosalicylic acid, sulfonamides

Antimalarials

chloroquine, primaquine

Anticonvulsants

Phenobarbital, phenytoin, sodium valproate

Lwm yam tshuaj

acetaminophen, metoclopramide, quinine, sulfasalazine

Carcinogenesis, Mutagenesis, Impairment of Fertility

Kev tshawb fawb ntawm Lidocaine HCl nyob rau hauv cov tsiaj los ntsuas cov carcinogenic thiab mutagenic peev xwm los yog cov nyhuv ntawm fertility tsis tau ua.

Kev xeeb tub

Cov teebmeem teratogenic: Kev xeeb tub qeb B.

Kev tshawb fawb txog kev yug me nyuam tau ua nyob rau hauv nas ntawm koob tshuaj txog li 6.6 npaug ntawm tib neeg koob tshuaj thiab tau qhia tias tsis muaj pov thawj ntawm kev puas tsuaj rau tus menyuam hauv plab los ntawm Lidocaine HCl. Txawm li cas los xij, tsis muaj kev tshawb fawb txaus thiab tswj tau zoo hauv cov poj niam cev xeeb tub. Kev tshawb nrhiav tsiaj yug tsiaj tsis yog ib txwm kwv yees ntawm tib neeg cov lus teb. Kev txiav txim siab dav dav yuav tsum tau muab rau qhov tseeb no ua ntej muab Lidocaine HCl rau cov poj niam uas muaj peev xwm xeeb tub, tshwj xeeb tshaj yog thaum cev xeeb tub thaum ntxov tshaj plaws organogenesis tshwm sim.

Kev Ua Haujlwm thiab Kev Xa Khoom

Cov tshuaj loog hauv zos sai hla cov placenta thiab thaum siv rau epidural, paracervical, pudendal lossis caudal block tshuaj loog, tuaj yeem ua rau muaj kev sib txawv ntawm cov niam txiv, menyuam hauv plab thiab cov menyuam mos toxicity (saib CLINICAL PHARMACOLOGY , Pharmacokinetics thiab Metabolism ). Lub peev xwm rau toxicity nyob ntawm tus txheej txheem ua, hom thiab tus nqi ntawm cov tshuaj siv, thiab cov txheej txheem ntawm kev tswj hwm tshuaj. Kev tsis zoo tshwm sim nyob rau hauv lub sij hawm tsis pub dhau, fetus thiab neonate cuam tshuam nrog kev hloov pauv ntawm lub hauv paus paj hlwb, peripheral vascular suab thiab lub plawv ua haujlwm.

Cov niam txiv hypotension tau tshwm sim los ntawm cov tshuaj loog hauv cheeb tsam. Cov tshuaj loog hauv zos ua rau vasodilation los ntawm kev thaiv cov hlab ntsha sympathetic. Nce tus neeg mob ob txhais ceg thiab tso nws ntawm nws sab laug yuav pab tiv thaiv kom tsis txhob muaj ntshav siab.

Lub plawv dhia hauv plab kuj yuav tsum tau saib xyuas tas li, thiab kev saib xyuas tus menyuam hauv plab yog qhov pom zoo.

Epidural, spinal, paracervical, lossis pudendal tshuaj loog tuaj yeem hloov pauv lub zog ntawm kev yug menyuam los ntawm kev hloov pauv hauv uterine contractility lossis kev siv zog ntawm niam txiv. Hauv ib txoj kev tshawb fawb, paracervical block anesthesia tau cuam tshuam nrog kev txo qis hauv lub sijhawm nruab nrab ntawm thawj theem kev ua haujlwm thiab kev txhawb nqa ntawm ncauj tsev menyuam. Txawm li cas los xij, tus txha caj qaum thiab epidural tshuaj loog kuj tau tshaj tawm kom ncua lub sijhawm thib ob ntawm kev ua haujlwm los ntawm kev tshem tawm tus neeg mob lub siab xav kom dais lossis cuam tshuam nrog lub cev muaj zog. Kev siv cov tshuaj loog obstetrical tuaj yeem ua rau muaj kev xav tau kev pabcuam forceps.

Kev siv qee cov khoom siv tshuaj loog hauv zos thaum lub sijhawm ua haujlwm thiab kev yug menyuam tuaj yeem ua raws li cov leeg nqaij muaj zog thiab lub suab nrov rau thawj hnub lossis ob ntawm lub neej. Lub sij hawm ntev tseem ceeb ntawm cov kev soj ntsuam no tsis paub. Fetal bradycardia tuaj yeem tshwm sim hauv 20 mus rau 30 feem pua ​​​​ntawm cov neeg mob uas tau txais cov paj hlwb paracervical thaiv cov tshuaj loog nrog cov tshuaj loog hauv zos amide thiab tej zaum yuav cuam tshuam nrog fetal acidosis. Lub plawv dhia ntawm fetal yuav tsum tau saib xyuas thaum lub sij hawm tshuaj loog paracervical. Tus kws kho mob yuav tsum ntsuas qhov muaj txiaj ntsig zoo tiv thaiv kev pheej hmoo thaum xav txog qhov thaiv kab mob paracervical thaum ntxov ntxov, kev xeeb tub ntawm cev xeeb tub, thiab kev nyuaj siab ntawm fetal. Ua tib zoo ua raws li kev pom zoo noj yog qhov tseem ceeb tshaj plaws hauv obstetrical paracervical block. Kev ua tsis tiav txaus tshuaj loog nrog cov koob tshuaj pom zoo yuav tsum ua kom muaj kev xav tsis thoob ntawm kev txhaj tshuaj intravascular lossis fetal intracranial. Cov teeb meem sib xws nrog qhov tsis xav tau ntawm tus menyuam hauv plab intracranial txhaj tshuaj tshuaj loog hauv zos tau raug tshaj tawm tom qab npaj paracervical lossis pudendal block lossis ob qho tib si. Cov menyuam mos uas muaj feem cuam tshuam nrog qhov tsis tau piav qhia txog kev nyuaj siab thaum yug los, uas cuam tshuam nrog cov qib tshuaj loog hauv zos siab, thiab feem ntau tshwm sim qaug dab peg li ntawm rau teev. Kev siv cov kev txhawb nqa tam sim ua ke nrog kev tso zis tso zis ntawm cov tshuaj loog hauv zos tau siv ua tiav los tswj qhov teeb meem no.

Cov ntaub ntawv ceeb toom ntawm leej niam convulsions thiab lub plawv dhia tom qab siv qee cov tshuaj loog hauv zos rau paracervical block thaum cev xeeb tub thaum ntxov (raws li tshuaj loog rau kev rho menyuam tawm) qhia tias kev nqus dej hauv cov xwm txheej no yuav nrawm. Cov koob tshuaj ntau tshaj plaws ntawm txhua cov tshuaj yuav tsum tsis pub tshaj. Kev txhaj tshuaj yuav tsum tau ua kom maj mam thiab nrog kev ua siab ntev. Cia lub sijhawm 5 feeb ntawm ob sab.

Niam laus

Nws tsis paub tias cov tshuaj no puas tawm hauv tib neeg cov kua mis. Vim tias ntau cov tshuaj tau tawm hauv tib neeg cov kua mis, yuav tsum tau ceev faj thaum siv Lidocaine HCl rau tus poj niam laus.

Kev siv menyuam yaus

Cov koob tshuaj hauv cov menyuam yaus yuav tsum raug txo kom tsawg, ua raws li lub hnub nyoog, lub cev qhov hnyav thiab lub cev (saib KEV PAB CUAM THIAB KEV PAB CUAM ).

Kev Phem Tsis Zoo

Txheej txheem

Cov kev tsis zoo tom qab kev tswj hwm ntawm Lidocaine HCl yog qhov zoo sib xws rau cov neeg pom nrog lwm cov tshuaj loog hauv zos. Cov kev tsis zoo no yog, feem ntau, cov koob tshuaj muaj feem xyuam thiab tuaj yeem tshwm sim los ntawm cov ntshav plasma ntau dhau los ntawm kev siv ntau dhau, nqus sai lossis tsis pom zoo rau kev txhaj tshuaj intravascular, lossis tuaj yeem tshwm sim los ntawm kev kub siab, idiosyncrasy lossis txo qis kev kam rau ntawm tus neeg mob. Cov kev tsis zoo tshwm sim feem ntau yog qhov tshwm sim hauv qhov xwm txheej. Cov hom hauv qab no yog cov uas feem ntau tshaj tawm:

Central Nervous System

CNS manifestations yog excitatory thiab/los yog kev nyuaj siab thiab tej zaum yuav tshwm sim los ntawm lightheadedness, nervousness, apprehension, euphoria, tsis meej pem, kiv taub hau, tsaug zog, tinnitus, qhov muag tsis pom los yog ob lub qhov muag, xeev siab thiab ntuav, hnov ​​kub, txias los yog loog loog, tshee, tshee, tshee, convulsions, tsis nco qab, ua pa nyuaj siab thiab ntes. Cov excitatory manifestations tej zaum yuav luv luv los yog tej zaum yuav tsis tshwm sim nyob rau hauv tag nrho cov, nyob rau hauv cov ntaub ntawv uas thawj manifestation ntawm toxicity tej zaum yuav tsaug zog merging rau hauv unconsciousness thiab ua pa nres.

sulfamethoxazole-tmp ds ntsiav tshuaj

Kev qaug zog tom qab kev tswj hwm ntawm Lidocaine HCl feem ntau yog ib qho kev qhia ntxov ntawm cov ntshav siab ntawm cov tshuaj thiab tej zaum yuav tshwm sim raws li qhov tshwm sim ntawm kev nqus sai.

Cardiovascular System

Cov tsos mob ntawm cov hlab plawv feem ntau yog kev nyuaj siab thiab yog tus cwj pwm los ntawm bradycardia, hypotension, thiab plawv plawv, uas yuav ua rau mob plawv.

Ua xua

Kev ua xua tshwm sim los ntawm cov kab mob ntawm daim tawv nqaij, urticaria, edema lossis anaphylactoid cov tshuaj tiv thaiv. Kev ua xua tuaj yeem tshwm sim los ntawm rhiab heev rau cov tshuaj loog hauv zos. Kev tsis haum tshuaj, suav nrog cov tshuaj tiv thaiv anaphylactic, tuaj yeem tshwm sim los ntawm kev nkag siab zoo rau Lidocaine, tab sis tsis tshua muaj. Yog tias muaj kev tsis haum tshuaj tshwm sim, lawv yuav tsum tau tswj hwm los ntawm cov lus pom zoo. Kev kuaj pom ntawm rhiab heev los ntawm kev kuaj tawv nqaij yog qhov tsis txaus ntseeg.

Tsis muaj kev tshaj tawm txog kev sib txawv ntawm Lidocaine hydrochloride thiab procainamide lossis nruab nrab ntawm Lidocaine hydrochloride thiab quinidine.

Neurological

Qhov tshwm sim ntawm qhov tsis zoo tshwm sim cuam tshuam nrog kev siv tshuaj loog hauv zos tuaj yeem cuam tshuam nrog tag nrho cov koob tshuaj loog hauv zos uas tau tswj hwm thiab tseem nyob ntawm cov tshuaj siv tshwj xeeb, txoj hauv kev ntawm kev tswj hwm thiab lub cev ntawm tus neeg mob. Hauv kev tshuaj xyuas yav tom ntej ntawm 10,440 tus neeg mob uas tau txais Lidocaine HCl rau kev siv tshuaj loog ntawm tus txha caj qaum, qhov tshwm sim ntawm cov kev phiv tshwm sim tau tshaj tawm txog li 3 feem pua ​​​​txhua qhov mob taub hau, hypotension thiab mob nraub qaum; 2 feem pua ​​rau tshee; thiab tsawg dua 1 feem pua ​​​​txhua tus rau cov tsos mob ntawm cov hlab ntsha peripheral, xeev siab, ua pa tsis txaus thiab tsis pom kev. Ntau qhov kev soj ntsuam no yuav cuam tshuam nrog cov txheej txheem tshuaj loog hauv zos, nrog lossis tsis muaj kev koom tes los ntawm kev siv tshuaj loog hauv zos.

Hauv kev xyaum ntawm caudal lossis lumbar epidural block, qee zaus tsis txhob txwm nkag mus rau ntawm qhov chaw subarachnoid los ntawm catheter yuav tshwm sim. Cov teebmeem tshwm sim tom qab tuaj yeem nyob ntawm qee qhov ntawm cov tshuaj uas tau tswj hwm subdurally. Cov no tuaj yeem suav nrog tus txha caj qaum ntawm qhov sib txawv (nrog rau tag nrho cov leeg txha caj qaum), hypotension theem nrab mus rau tus txha caj qaum, poob ntawm lub zais zis thiab lub plab zom mov, thiab poob ntawm perineal rhiab heev thiab kev ua haujlwm ntawm kev sib deev. Lub cev muaj zog tsis tu ncua, kev hnov ​​​​qab thiab / lossis autonomic (sphincter tswj) qhov tsis txaus ntawm qee qhov qis qis qis nrog kev rov qab qeeb (ntau lub hlis) lossis rov ua tsis tiav tau raug tshaj tawm nyob rau hauv qee zaus thaum caudal lossis lumbar epidural block tau sim. Mob nraub qaum thiab mob taub hau kuj tau raug sau tseg tom qab siv cov txheej txheem tshuaj loog.

Muaj tau tshaj tawm cov xwm txheej ntawm kev raug mob mus tas li rau cov leeg pob txha uas xav tau kev kho phais tom qab kev tswj hwm retrobulbar.

Hematology
Methemoglobinemia.

Kev noj ntau dhau

Cov xwm txheej kub ntxhov los ntawm cov tshuaj loog hauv zos feem ntau muaj feem cuam tshuam rau cov ntshav plasma siab thaum lub sij hawm kho kev siv tshuaj loog hauv zos lossis rau kev txhaj tshuaj subarachnoid uas tsis xav tau ntawm cov tshuaj loog hauv zos (saib TXOJ CAI TSHIAB, CEEB TOOM, thiab COV KEV CEEV FAJ ).

Kev tswj hwm qhov xwm txheej hauv zos tshuaj loog

Thawj qhov kev txiav txim siab yog kev tiv thaiv, ua tiav zoo tshaj plaws los ntawm kev ceev faj thiab kev saib xyuas tas li ntawm cov kab mob plawv thiab ua pa tseem ceeb thiab tus neeg mob lub xeev ntawm kev nco qab tom qab txhua qhov tshuaj loog hauv zos. Thaum thawj qhov kev hloov pauv, cov pa oxygen yuav tsum tau tswj hwm.

Thawj kauj ruam hauv kev tswj hwm ntawm convulsions, nrog rau kev ua tsis taus pa lossis kev ua tsis taus pa vim qhov tsis xav tau subarachnoid txhaj tshuaj tshuaj, muaj kev saib xyuas tam sim rau kev saib xyuas ntawm txoj hlab pa patent thiab pab lossis tswj kev ua pa nrog oxygen thiab lub cev xa khoom muaj peev xwm tso cai tam sim ntawd. Qhov zoo ntawm txoj hlab cua siab los ntawm daim npog qhov ncauj. Tam sim ntawd tom qab lub koom haum ntawm cov kev ntsuas qhov cua, qhov txaus ntawm cov kev ncig yuav tsum tau soj ntsuam, nco ntsoov tias cov tshuaj siv los kho cov mob convulsions qee zaum ua rau cov hlab ntsha tsis zoo thaum siv tshuaj intravenously. Yuav tsum tau qaug zog txawm tias muaj kev txhawb nqa ua pa txaus, thiab yog tias qhov xwm txheej ntawm kev tso cai, kev nce me me ntawm kev ua yeeb yam luv luv (xws li thiopental lossis thiamylal) lossis benzodiazepine (xws li diazepam) yuav raug muab tso rau hauv txoj hlab ntshav. Tus kws kho mob yuav tsum paub, ua ntej siv cov tshuaj loog hauv zos, nrog rau cov tshuaj tiv thaiv kab mob. Kev txhawb nqa kev kho mob ntawm kev ntxhov siab tuaj yeem xav tau kev tswj hwm cov kua dej hauv cov hlab ntsha thiab, thaum tsim nyog, vasopressor raws li qhia los ntawm qhov chaw kho mob (xws li ephedrine).

Yog tias tsis kho tam sim ntawd, ob qho tib si convulsions thiab kev nyuaj siab plawv tuaj yeem ua rau hypoxia, acidosis, bradycardia, arrhythmias thiab plawv nres. Kev ua tsis taus pa los yog apnea vim tsis txhob txwm txhaj tshuaj subarachnoid ntawm cov tshuaj loog hauv zos tuaj yeem tsim cov cim zoo li no thiab tseem tuaj yeem ua rau lub plawv nres yog tias tsis muaj lub tshuab ua pa. Yog tias lub plawv nres yuav tsum tshwm sim, tus qauv cardiopulmonary resuscitative ntsuas yuav tsum tau tsim.

Endotracheal intubation, kev siv tshuaj thiab cov tswv yim paub txog tus kws kho mob, tej zaum yuav qhia tau tias, tom qab thawj zaug kev tswj hwm cov pa oxygen los ntawm daim npog ntsej muag, yog tias muaj teeb meem tshwm sim hauv kev saib xyuas ntawm txoj hlab pa patent lossis yog tias lub tshuab ua pa ntev ntev (pab lossis tswj tau) tau qhia.

Dialysis yog qhov tsis txaus ntseeg hauv kev kho mob ntawm kev noj ntau dhau nrog Lidocaine HCl.

Qhov ncauj LDtsib caugLidocaine HCl nyob rau hauv cov poj niam uas tsis yoo mov yog 459 (346 txog 773) mg / kg (raws li ntsev) thiab 214 (159 txog 324) mg / kg (raws li ntsev) hauv cov nas yoo mov.

Lidocaine Dosage thiab Administration

Table 1 (Cov Lus Pom Zoo) qhia txog cov ntim tau pom zoo thiab qhov ntau ntawm Lidocaine HCl Txhaj Tshuaj, USP rau ntau hom kev siv tshuaj loog. Cov koob tshuaj uas tau qhia hauv cov lus no yog rau cov neeg laus noj qab haus huv thiab xa mus rau kev siv cov tshuaj tsis muaj epinephrine. Thaum yuav tsum muaj cov ntim loj dua, tsuas yog cov kev daws teeb meem uas muaj epinephrine yuav tsum tau siv tshwj tsis yog hauv cov xwm txheej uas cov tshuaj vasopressor yuav raug contraindicated.

Muaj cov ntawv ceeb toom tsis zoo ntawm chondrolysis nyob rau hauv cov neeg mob tau txais intra-articular infusions ntawm cov tshuaj loog hauv zos tom qab arthroscopic thiab lwm yam kev phais. Lidocaine HCl Txhaj, USP tsis pom zoo rau kev siv no (saib CEEB TOOM thiab KEV PAB CUAM THIAB KEV PAB CUAM ).

Cov koob tshuaj uas pom zoo no tsuas yog qhia rau tus nqi ntawm cov tshuaj loog uas xav tau rau feem ntau cov txheej txheem niaj hnub. Qhov tseeb ntim thiab cov concentrations uas yuav tsum tau siv yog nyob ntawm ntau yam xws li hom thiab qhov ntev ntawm txoj kev phais, qhov tob ntawm cov tshuaj loog thiab qib ntawm cov leeg yuav tsum tau so, lub sijhawm ntawm kev siv tshuaj loog xav tau, thiab lub cev ntawm tus neeg mob. Nyob rau hauv txhua rooj plaub, qhov tsawg tshaj plaws concentration thiab tsawg tshaj plaws koob tshuaj uas yuav tsim tau cov kev xav tau yuav tsum tau muab. Kev noj tshuaj yuav tsum raug txo rau cov menyuam yaus thiab cov neeg laus thiab cov neeg mob uas tsis muaj zog thiab cov neeg mob plawv thiab / lossis kab mob siab.

Advair diskus 250 50 nqe

Qhov pib ntawm kev siv tshuaj loog, lub sijhawm ntawm kev siv tshuaj loog thiab qib ntawm cov leeg nqaij so yog proportional rau lub ntim thiab concentration (piv txwv li, tag nrho cov koob tshuaj) ntawm cov tshuaj loog hauv zos siv. Yog li, qhov nce hauv ntim thiab concentration ntawm Lidocaine HCl Txhaj Tshuaj, USP yuav txo qhov pib ntawm kev siv tshuaj loog, ncua lub sijhawm ntawm kev siv tshuaj loog, muab ntau dua ntawm cov leeg nqaij so thiab ua kom cov segmental kis ntawm tshuaj loog. Txawm li cas los xij, nce qhov ntim thiab qhov siab ntawm Lidocaine HCl Txhaj Tshuaj, USP tuaj yeem ua rau muaj kev poob qis dua hauv cov ntshav siab thaum siv tshuaj loog epidural. Txawm hais tias qhov tshwm sim ntawm cov kev mob tshwm sim nrog Lidocaine HCl yog qhov tsawg heev, kev ceev faj yuav tsum tau siv thaum siv cov ntim loj thiab qhov ntau, vim tias qhov tshwm sim ntawm cov kev mob tshwm sim yog ncaj qha proportional rau tag nrho cov koob tshuaj loog hauv zos tshuaj loog.

Epidural tshuaj loog

Rau kev siv tshuaj loog epidural, tsuas yog cov hauv qab no ntau npaum li cas Lidocaine HCl Txhaj, USP raug pom zoo:

1% tsis muaj epinephrine 5 ml iav ampoule

Txawm hais tias qhov kev daws teeb meem no yog npaj tshwj xeeb rau kev siv tshuaj loog epidural, nws kuj tseem siv tau rau kev nkag mus thiab cov hlab ntsha peripheral, yog tias nws ua haujlwm ua ib koob tshuaj ib zaug. Cov tshuaj no tsis muaj cov kab mob bacteriostatic.

Hauv kev siv tshuaj loog epidural, qhov ntau npaum li cas sib txawv nrog cov dermatomes yuav tsum tau tshuaj loog (feem ntau 2 mus rau 3 mL ntawm qhov qhia tau hais tias concentration ib dermatome).

Caudal thiab Lumbar Epidural Block

Raws li kev ceev faj tiv thaiv qhov tsis zoo tshwm sim qee zaum pom tom qab tsis txhob txwm nkag mus ntawm qhov chaw subarachnoid, kev sim tshuaj xws li 2 mus rau 3 mL ntawm 1.5% Lidocaine HCl yuav tsum tau noj tsawg kawg 5 feeb ua ntej txhaj tshuaj tag nrho cov ntim uas xav tau rau lub lumbar lossis caudal. epidural thaiv. Cov koob tshuaj yuav tsum tau rov ua dua yog tias tus neeg mob tau txav mus rau hauv ib qho uas yuav tau hloov lub catheter. Tus neeg mob sedated tuaj yeem pom tsuas yog tus mem tes nce ntawm 20 lossis ntau dua ib feeb rau 15 lossis ntau dua vib nas this. Cov neeg mob ntawm beta blockers yuav tsis pom qhov hloov pauv hauv lub plawv dhia, tab sis kev ntsuas ntshav siab tuaj yeem kuaj pom qhov nce siab hauv systolic ntshav siab. Lub sij hawm tsim nyog yuav tsum tau tso cai rau qhov pib ntawm tshuaj loog tom qab kev tswj hwm ntawm txhua qhov kev sim tshuaj. Kev txhaj tshuaj sai ntawm qhov ntim loj ntawm Lidocaine HCl Txhaj, USP los ntawm lub catheter yuav tsum raug zam, thiab, thaum ua tau, cov koob tshuaj feem ntau yuav tsum tau muab.

Nyob rau hauv cov kev tshwm sim ntawm lub paub txhaj tshuaj ntawm ib tug loj ntim ntawm cov tshuaj loog nyob rau hauv lub cheeb tsam subarachnoid qhov chaw, tom qab tsim nyog resuscitation thiab yog hais tias lub catheter nyob rau hauv qhov chaw, xav txog kev sim rov qab cov tshuaj los ntawm ntws ib tug npaum li cas ntawm cerebrospinal kua (xws li 10 mL. ) los ntawm lub epidural catheter.

MAXIMUM NYIAJ NYIAJ NYIAJ DUA

Cov neeg laus

Qhov siab tshaj plaws ib tus neeg koob tshuaj yuav tsum tsis txhob ntau tshaj 4.5 mg / kg (2 mg / lb) ntawm lub cev hnyav, thiab feem ntau nws raug pom zoo tias qhov siab tshaj plaws koob tshuaj tsis pub tshaj 300 mg. Rau kev siv tshuaj loog tsis tu ncua los yog caudal tshuaj loog, qhov siab tshaj plaws uas tau pom zoo yuav tsum tsis txhob muab coj los siv rau lub sijhawm tsawg dua 90 feeb. Thaum nruam lumbar los yog caudal epidural tshuaj loog yog siv rau cov txheej txheem tsis-obstetrical, ntau cov tshuaj yuav raug muab yog tias xav tau los tsim cov tshuaj loog txaus.

Qhov siab tshaj plaws pom zoo koob tshuaj ib 90 feeb ntawm Lidocaine hydrochloride rau paracervical block nyob rau hauv obstetrical cov neeg mob thiab tsis-obstetrical cov neeg mob yog 200 mg tag nrho. Ib nrab ntawm tag nrho cov koob tshuaj feem ntau yog muab rau txhua sab. Txhaj maj mam, tsib feeb ntawm sab (saib kev sib tham ntawm paracervical thaiv hauv COV KEV CEEV FAJ ).

Rau kev tso tshuaj loog hauv cheeb tsam, koob tshuaj yuav tsum tsis pub tshaj 4 mg / kg rau cov neeg laus.

Me nyuam

Nws yog ib qho nyuaj rau kev pom zoo kom ntau npaum li cas ntawm cov tshuaj rau cov menyuam yaus, vim qhov no txawv raws li lub hnub nyoog thiab qhov hnyav. Rau cov menyuam yaus hnub nyoog qis dua 3 xyoos uas muaj lub cev tsis muaj zog thiab kev loj hlob ntawm lub cev, qhov siab tshaj plaws yog txiav txim siab los ntawm tus menyuam lub hnub nyoog thiab qhov hnyav. Piv txwv li, hauv tus menyuam hnub nyoog 5 xyoos uas hnyav 50 lbs koob tshuaj Lidocaine HCl yuav tsum tsis pub tshaj 75 txog 100 mg (1.5 txog 2 mg / lb). Kev siv cov kev daws teeb meem ntau dua (piv txwv li, 0.25 txog 0.5%) thiab tag nrho cov koob tshuaj tsis pub tshaj 3 mg / kg (1.4 mg / lb) raug pom zoo rau induction intravenous regional anesthesia nyob rau hauv cov me nyuam.

Txhawm rau tiv thaiv cov kab mob toxicity, qhov qis tshaj qhov muaj txiaj ntsig zoo thiab cov koob tshuaj qis tshaj plaws yuav tsum tau siv txhua lub sijhawm. Qee zaum nws yuav tsim nyog los dilute cov concentrations nrog 0.9% sodium chloride txhaj txhawm rau kom tau txais qhov xav tau zaum kawg.

CEEB TOOM: Cov khoom siv tshuaj parenteral yuav tsum tau tshuaj xyuas qhov pom ntawm qhov teeb meem thiab kev hloov xim ua ntej kev tswj hwm thaum twg cov tshuaj thiab cov thawv tso cai. Kev txhaj tshuaj tsis yog yuav tsum tau siv yog tias nws cov xim yog pinkish lossis tsaus dua me ntsis daj lossis yog tias nws muaj nag lossis daus.

Table 1: Pom zoo noj tshuaj

*
koob tshuaj txiav txim los ntawm tus naj npawb ntawm cov tshuaj dermatomes yuav tsum tau tshuaj loog (2 mus rau 3 mL / dermatome).
Txheej txheem



Lidocaine Hydrochloride Txhaj Tshuaj, USP


Conc (%)



Qhov siab (mL)



Total Dose (mg)



Infiltration




Percutaneous

0,5o 1


1 rau 60


5 rau 300
Peripheral Nerve Blocks, xws li,
Intercostal ib 3 30
Paravertebral ib 3 rau 5 30 rau 50
Pudendal (txhua sab) ib 10 100
Paracervical
Obstetrical analgesia (txhua sab) ib 10 100
Sympathetic Nerve Blocks, xws li,
Lub ncauj tsev menyuam (stellate ganglion) ib 5 tsib caug
Lumbar ib 5 rau 10 50 rau 100
Central Neural Blocks
Epidural *
Thoracic ib 20 rau 30 200 rau 300
Lumbar
Kev ua xua ib 25 rau 30 250 rau 300
Ntws
Obstetrical analgesia ib 20 rau 30 200 rau 300

Cov ntaub ntawv qhia saum toj saud tsuas yog ua haujlwm raws li daim ntawv qhia.

STERILIZATION, STORAGE THIAB TECHNICAL PROCEDURES

Cov tshuaj tua kab mob uas muaj cov hlau hnyav, uas ua rau kev tso tawm ntawm cov ions (mercury, zinc, tooj liab, thiab lwm yam) yuav tsum tsis txhob siv rau kev tua kab mob ntawm daim tawv nqaij los yog mucous daim nyias nyias vim lawv tau cuam tshuam txog qhov tshwm sim ntawm o thiab edema. Thaum xav tau tshuaj tua kab mob ntawm ntau lub vials, xws li isopropyl cawv (91%) lossis ethyl cawv (70%) raug pom zoo. Ntau lub khw muag khoom ntawm cov cawv cawv, nrog rau cov kev daws teeb meem ntawm ethyl cawv tsis yog qib USP, muaj cov denaturants uas raug mob rau roj hmab thiab yog li tsis txhob siv.

Lidocaine HCl Txhaj Tshuaj, USP tshuaj yog siv rau ib koob tshuaj, thiab yogMethylPcov arabenFree (Preservative-Free).

Lidocaine muab tau li cas

1% Lidocaine HCl Txhaj Tshuaj, USP yog cov tshuaj tsis muaj xim ntshiab uas tsis muaj cov khoom pom. Nws tau muab rau hauv 5 mL ib koob tshuaj ampoule, ntim hauv ib lub thawv ntawm tsib raws li hauv qab no.

NDC Ntim / Sau
0264-9376-88 5ml ua

1% Lidocaine HCl Txhaj Tshuaj, USP tshuaj yuav tsum muab khaws cia ntawm 20 ° txog 25 ° C (68 ° txog 77 ° F) [saib USP Controlled Room Temperature].

Tiv thaiv los ntawm lub teeb.

Manufactured rau:

B. Braun Medical Inc.

Bethlehem, PA 18018-3524 USA

Npaj nyob rau hauv lub teb chaws Yelemees. API los ntawm Tebchaws Meskas.

Tsim los ntawm:

Cov Khoom Siv Tshuaj Solupharm GmbH

A4805966-2

Kho tshiab: Lub Yim Hli 2019

PRINCIPAL DISPLAY PANEL

NDC 0264-9376-88

Lidocaine HCl

Txhaj, USP

ib%

50 mg/5 mL

(10 mg/ml)

Methylparaben (Preservative) Dawb

5 ml ib

Rx xwb

Qauv: LD-563-1

Manufactured rau:

B. Braun Medical Inc.

Bethlehem, PA 18018-3524 USA

Npaj nyob rau hauv lub teb chaws Yelemees. API los ntawm Tebchaws Meskas.

LOJ

EXP

PRINCIPAL DISPLAY PANEL - 5 mL CARTON

NDC 0264-9376-88

Lidocaine HCl Txhaj, USP

ib%

50 mg/5 mL

(10 mg/ml)

INFILTRATION THIAB NERVE BLOCKsuav nrog EPIDURAL thiab CAUDAL siv

Methylparaben (Preservative) Dawb

Txhua mL muaj lidocaine hydrochloride, txhua yam 10 mg; sodium chloride 7 mg. Cov pH ntawm cov tshuaj no yog kho rau kwv yees li 6.5 (5.0 txog 7.0) nrog sodium hydroxide thiab / lossis hydrochloric acid. Noj ntau npaum li cas: Saib cov ntawv ntxig. Tsis txhob siv yog hais tias cov tshuaj yog discolored los yog muaj ib tug precipitate. Khaws ntawm 20 ° txog 25 ° C (68 ° txog 77 ° F) [saib USP Controlled Room Temperature]. Sterile, nonpyrogenic. Tiv thaiv los ntawm lub teeb. Nws tuaj yeem kho tau los ntawm autoclaving.

5 x 5 mL Ib koob tshuaj Ampoule

Rx xwb

Qauv: LD-565-1

Manufactured rau:

B. Braun Medical Inc.

Bethlehem, PA 18018-3524 USA

petarmor ntxiv rau cov kev mob tshwm sim

1-800-227-2862 ib

Npaj nyob rau hauv lub teb chaws Yelemees. API los ntawm Tebchaws Meskas.

LOJ

EXP

Lidocaine HYDROCHLORIDE
Kev txhaj tshuaj lidocaine hydrochloride
Cov ntaub ntawv khoom
Yam khoom HUMAN PRESCRIPTION DRUG LABEL Yam khoom Code (Source) NDC: 0264-9376
Txoj kev tswj hwm INFILTRATION DEA Teem caij
Cov khoom xyaw nquag / Active Moiety
Cov khoom xyaw npe Lub hauv paus muaj zog Lub zog
Lidocaine HYDROCHLORIDE ANHYDROUS (Lidocaine) Lidocaine HYDROCHLORIDE ANHYDROUS 10 mg 1 mL
Cov khoom xyaw uas tsis muaj zog
Cov khoom xyaw npe Lub zog
SODIUM chloride 7mg 1 ml
SODIUM HYDROXIDE
HYDROCHLORIC ACID
Ntim
# Yam khoom Code Pob piav qhia
ib NDC: 0264-9376-88 5 AMPULE hauv 1 CARTON
ib 5 ml hauv 1 AMPULE
Cov ntaub ntawv lag luam
Kev lag luam qeb Daim ntawv thov Number los yog Monograph Citation Hnub pib ua lag luam Hnub Kawg Ua Lag Luam
KOJ TIAB SA 208474 03/08/2018
Labeler -B. Braun Kho Mob Inc. (002397347)
B. Braun Medical Inc.