Mode of action:
Lidocaine - a drug that has a pronounced local anesthetic effect. Lidocaine is a substance of amides, has a pronounced membrane-stabilizing effect, thereby reducing the impulse conduction along nerve structures. Lidocaine inhibits the transient increase in membrane permeability of the nerve cells to sodium and potassium (less), which develops in response to the stimulus. In applying the drug observed primarily inhibition of pain sensitivity then reduced sensitivity and tactile sensation of heat.
In systemic absorption of lidocaine may stimulate or depress the central nervous system and reduce the cardiac conduction and cause the development of peripheral vasodilation.
The local application of the drug lidocaine spray active ingredient penetrates well into tissues and has a local anesthetic effect, which develops within 1-5 minutes.
Some of lidocaine topically absorbed into the systemic circulation. The peak plasma concentration is reached within 60 minutes, the therapeutically significant concentrations are maintained for 7-8 hours.
Lidocaine metabolism occurs in the liver. The half-life of lidocaine up to 1.6 hours. The active ingredient is excreted primarily by the kidneys.
Indications for use:
Aerosol Lidocaine is a local anesthetic in various areas of medicine, including:
In the dental practice during minor surgery, removal of deciduous teeth, fixing crowns, removal of tartar and other manipulations that require short-term local anesthesia.
In ENT practice during resection septum and nasal polyps, tonsillectomy (to prevent the gag reflex and the pain of the injection site) as a primary or supplementary anesthesia by puncturing the maxillary sinuses and sinus lavage.
For diagnostic procedures for anesthesia of the pharynx (including the replacement of the tracheotomy tube, the introduction of gastroduodenal probe).
In the obstetrical and gynecological practice used in aerosol episiotomy, removing welds, as well as for anesthesia during surgery on the cervix.
In dermatological practice, lidocaine spray is used to anesthetize the skin and mucous membranes during minor surgery.
How to use:
Lidocaine spray intended for topical application. Before the first use on a bottle cap put on the spray and repeatedly pressed. Spray should be sprayed with a short section of the skin, where anesthesia is required. To reduce the risk of systemic adverse effects should use the minimum effective dose of lidocaine. Avoid exposure of aerosol in the respiratory tract and eyes. When spraying the medication vial is recommended to keep upright, spray up. In the application of the aerosol in the oral cavity should be taken to avoid injury language (due to lower sensitivity of the language can hurt the teeth). It should be borne in mind that when applying the drug on the mucous membranes and skin with an impaired skin integrity is increased systemic absorption of lidocaine.
In dental and dermatological practice is usually prescribed for 1-3 doses of lidocaine 10%.
In ENT practice and craniofacial surgery is usually prescribed for 1-4 doses of lidocaine 10%.
When conducting endoscopic studies are usually given 2-3 doses of the drug lidocaine 10%.
In gynecological practice, usually on 4-5 doses of the drug, and in obstetric practice is allowed to use up to 20 doses of lidocaine 10%.
For large surfaces is recommended to use a cotton swab moistened with 10% of the drug lidocaine.
Using the drug in children is recommended to apply an aerosol with a cotton swab.
The maximum recommended dose for children is 3mg/kg body weight.
Lidocaine spray is usually tolerated well by patients. The most common adverse effect was the development of a burning sensation when applied spray, as well as the development of local allergic reactions.
In addition, we can not exclude the development of such adverse effects during treatment with lidocaine:
Of the heart and blood vessels: myocardial infarction, lower blood pressure, bradycardia, cardiac arrest.
On the part of the central nervous system depression, drowsiness, abdominal cramps, increased anxiety, irritability, loss of consciousness, respiratory paralysis.
Allergic reactions: bronchospasm, angioedema, anaphylactic shock.
Lidocaine spray is not indicated for patients with individual intolerance lidocaine and other formulation ingredients, as well as any amide local anesthetics.
Caution should be observed by assigning spray to patients suffering from epilepsy, bradycardia, liver failure or shock, and conduction disturbances.
With care prescribe lidocaine spray elderly patients, debilitated patients and children.
Children under 8 years of lidocaine spray is not indicated during tonsillectomy.
Using the drug in ENT practice for anesthesia of the larynx and trachea should be aware that lidocaine can inhibit the cough reflex, so that may develop pneumonia.
Lidocaine Spray does not have negative effects on fetal development, but the use of the drug is allowed only under the supervision of the attending physician and in case of failure of a more secure means.
During lactation Lidocaine spray may be used in standard therapeutic doses.
Interactions with other drugs:
Particular caution should be observed in the combined use of lidocaine with antiarrhythmic drugs.
Phenytoin, while the application enhances the cardiotoxic effects of lidocaine.
The combined use of lidocaine potentiates the effect of drugs, causing blockade of neuromuscular transmission.
Ethyl alcohol may enhance the inhibitory effect of lidocaine on the respiratory function.
The concomitant use of procainamide and lidocaine may develop hallucinations.
In patients with cardiac glycoside intoxication lidocaine increases the severity of atrioventricular block.
There is an increase in the plasma concentration of lidocaine combined use of imipramine, nortriptyline, amitriptyline, quinidine, bupivacaine, disopyramide, propranolol, peptidinom, cimetidine and chlorpromazine.
In the application of excessive doses of lidocaine spray increases the risk and severity of adverse effects. With an overdose of lidocaine may respiratory depression, the development of seizures, cardiac conduction disorders and cardiac arrest.
No specific antidote. In severe overdose carry out activities aimed at maintaining respiratory function and the function of the cardiovascular system. In particular, when you stop breathing conduct mechanical ventilation may also be necessary to carry out intubation and oxygen therapy.
With the development of seizures administered succinylcholine (application is permitted only in the presence of an experienced physician, and the availability of funds for intensive care as succinylcholine can cause breathing to stop).
With the development of bradycardia and conduction disturbances used intravenous atropine and sympathomimetic drugs.
Aerosol with menthol flavor to 38g in vials in a nested carton bottle and dispenser valve from a polymeric material.
Lidocaine spray should be kept for 5 years after the manufacture of a room temperature not exceeding 25 degrees Celsius.
1 bottle with 10% lidocaine spray contains:
Lidocaine - 3.8 g;
Additional ingredients, including ethyl alcohol and peppermint oil.
1 dose of lidocaine spray contains:
Lidocaine - 4.8 mg.
aerosol 10% - 38gr