Новокаин Раствор, флакон, 15 шт, 400 мл, 0.25 %

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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 (в том числе внутрикостная), вагосимпатическая шейная и паранефральная блокада."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Гиперчувствительность (в том числе к парааминобензойной кислоте и другим местным анестетикам местным анестетикам-эфирам), возраст до 18 лет (эффективность и безопасность не установлены)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля анестезии методом ползучего инфильтрата\u003c/i\u003e: выраженные фиброзные изменения в тканях; \u003ci\u003eдля субарахноидальной анестезии\u003c/i\u003e: AV-блокада, кровотечения, артериальная гипотензия, шок, инфицирование места проведения люмбальной пункции, септицемия."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"Экстренные операции, сопровождающиеся острой кровопотерей, состояния, сопровождающиеся снижением печеночного кровотока (например, при хронической сердечной недостаточности, заболеваниях печени), прогрессирование сердечно-сосудистой недостаточности (обычно вследствие развития блокад сердца и шока), воспалительные заболевания или инфицирование места инъекции, дефицит псевдохолинэстеразы, почечная недостаточность, у пожилых пациентов (старше 65 лет), тяжелобольных, ослабленных больных, беременность, период родов."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Допускается применение препарата в период беременности и грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Доза и концентрация раствора зависят от характера оперативного вмешательства, способа применения, состояния и возраста пациента."}},{"type":"paragraph","data":{"text":"Для инфильтрационной анестезии используют 2,5 мг/мл, 5 мг/мл; для анестезии по методу Вишневского (тугая ползучая инфильтрация) - 1,25 мг/мл - 2,5 мг/мл. Для уменьшения всасывания и удлинения действия при местной анестезии, дополнительно вводят 0,1% раствор эпинефрина - по 1 капле на 2-5-10 мл раствора прокаина."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри паранефральной блокаде\u003c/i\u003e (по А.В. Вишневскому) в паранефральное пространство вводят 50-80 мл раствора 5 мг/мл или 100-150 мл раствора 2,5 мг/мл."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПри вагосимпатической шейной блокаде\u003c/i\u003e вводят 30-100 мл раствора 2,5 мг/мл."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля циркулярной или паравертебральной блокаде \u003c/i\u003eвнутрикожно вводят 70-100 мл раствора 2,5 мг/мл или 5-10 мл раствора 5 мг/мл."}},{"type":"paragraph","data":{"text":"Высшие разовые дозы \u003ci\u003eпри инфильтрационной анестезии\u003c/i\u003e: первая разовая доза в начале операции - не выше 1,0 г раствора 2,5 мг/мл и 0,75 г раствора 5 мг/мл (150 мл). В дальнейшем, на протяжении каждого часа операции - не выше 2,5 г (1000 мл для раствора 2,5 мг/мл) и 2 г (400 мл для раствора 5 мг/мл)."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Головная боль, головокружение, сонливость, слабость, повышение или снижение артериального давления, коллапс, периферическая вазодилатация, брадикардия, аритмия, боль в грудной клетке, 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 систему проявляется чувством страха, галлюцинациями, судорогами, двигательным возбуждением."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e поддержание адекватной легочной вентиляции, дезинтоксикационная симптоматическая терапия."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Местные анестетики усиливают угнетающее действие на центральную нервную систему другие лекарственные средства."}},{"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":"При использовании местноанестезирующих лекарственных средств для спинальной и эпидуральной анестезии с гуанадрелем, гуанетидином, мекамиламином, триметафаном повышается риск развития резкого снижения артериального давления и брадикардии."}},{"type":"paragraph","data":{"text":"Использование с ингибиторами моноаминоксидаза (фуразолидон, прокарбазин, селегилин) повышает риск развития гипотензии."}},{"type":"paragraph","data":{"text":"Усиливают и удлиняют действие миорелаксирующих лекарственных средств."}},{"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 лечения миастении."}},{"type":"paragraph","data":{"text":"Ингибиторы холинэстеразы (антимиастенические лекарственные средства, циклофосфамид, демекария бромид, экотиопата йодид, тиотепа) снижают метаболизм местноанестезирующих лекарственных средств."}},{"type":"paragraph","data":{"text":"Метаболит прокаина (парааминобензойная кислота) является антагонистом сульфаниламидов лекарственных средств."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Пациентам требуется контроль за функциями сердечно-сосудистой, дыхательной и центральной нервной систем."}},{"type":"paragraph","data":{"text":"Необходимо отменить ингибиторы моноаминоксидазы за 10 дней до введения местного анестетика."}},{"type":"paragraph","data":{"text":"Перед применением обязательное 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, 2,5 мг/мл, 5 мг/мл."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В защищенном от света и недоступном для детей месте при температуре не выше 25 °С."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года."}},{"type":"paragraph","data":{"text":"Не использовать по истечении срока, 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":"ОАО \"Биохимик\", 430030, Республика Мордовия, Саранск, Васенко, д. 15а, Россия"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"Биохимик\""}}]}],"source":null},"description_toggle":false,"short_description":"Местноанестезирующее средство с умеренной анестезирующей активностью и большой широтой терапевтического действия. Являясь слабым основанием, блокирует Na+-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 другой 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. 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 лекарственных средств и может ослабить их противомикробное действие). Период полувыведения препарата - 30 - 50 с, в неонатальном периоде - 54 - 114 с. 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