Артикаин-Бинергия с адреналином Раствор, 10 шт, 2 мл, 20 мг + 0.005 мг

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Продолжительность анестезии для растворов с добавлением эпинефрина составляет от 120 до 420 минут. Для поверхностной анестезии артикаин обладает очень небольшим анестезирующим эффектом."}},{"type":"header","data":{"text":"Фармакокинетика:","level":3}},{"type":"paragraph","data":{"text":"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."}},{"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 с адреналином применяется для местной и регионарной блокады нервных окончаний."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к артикаину, эпинефрину, сульфитам (в частности, у пациентов, страдающих бронхиальной астмой с повышенной чувствительностью к сульфитам, так как возможны острые аллергические реакции с симптомами анафилактического шока, такими как бронхоспазм), или к любому другому из вспомогательных компонентов препарата."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПротивопоказания, относящиеся к артикаину\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"- Повышенная чувствительность к другим местноанестезирующим средствам амидного типа;"}},{"type":"paragraph","data":{"text":"- тяжелые нарушения функции синусового узла или тяжелые нарушения проводимости (такие, как тяжелая 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."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПротивопоказания, относящиеся к эпинефрину\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"- Анестезия концевых фаланг пальцев рук и ног (риск ишемии);"}},{"type":"paragraph","data":{"text":"- пароксизмальная тахикардия, тахиаритмия;"}},{"type":"paragraph","data":{"text":"- недавно перенесенный (3-6 месяцев назад) инфаркт миокарда;"}},{"type":"paragraph","data":{"text":"- недавно проведенное (3 месяца назад) аортокоронарное шунтирование;"}},{"type":"paragraph","data":{"text":"- одновременный прием неселективных бета-адреноблокаторов, например, пропранолола (риск развития гипертонического криза и тяжелой брадикардии);"}},{"type":"paragraph","data":{"text":"- закрытоугольная глаукома;"}},{"type":"paragraph","data":{"text":"- гипертиреоз;"}},{"type":"paragraph","data":{"text":"- феохромоцитома;"}},{"type":"paragraph","data":{"text":"- тяжелая артериальная гипертензия;"}},{"type":"paragraph","data":{"text":"- одновременный прием трициклических антидепрессантов или ингибиторов моноаминоксидазы (МАО), так как эти активные вещества могут усиливать действие эпинефрина на сердечно-сосудистую систему. Это касается периода времени до 14 дней после окончания лечения ингибиторами МАО."}},{"type":"paragraph","data":{"text":"Внутривенные инъекции противопоказаны."}}]},{"id":10,"name":"С осторожностью","slug":"cautions","body":[{"type":"paragraph","data":{"text":"- У пациентов с нарушениями свертываемости крови;"}},{"type":"paragraph","data":{"text":"- у пациентов с тяжелыми нарушениями функции печени или почек;"}},{"type":"paragraph","data":{"text":"- при одновременном применении с галогенсодержащими средствами при проведении ингаляционной анестезии (см. раздел \"Взаимодействие с другими лекарственными средствами\");"}},{"type":"paragraph","data":{"text":"- у пациентов с эпилепсией в анамнезе;"}},{"type":"paragraph","data":{"text":"- у пациентов с хронической сердечной недостаточностью, ишемической болезнью сердца, стенокардией, инфарктом миокарда в анамнезе, нарушениями ритма сердца, артериальной гипертензией;"}},{"type":"paragraph","data":{"text":"- у пациентов с атеросклерозом;"}},{"type":"paragraph","data":{"text":"- у пациентов с цереброваскулярными нарушениями, инсультом в анамнезе;"}},{"type":"paragraph","data":{"text":"- у пациентов с хроническим бронхитом, эмфиземой легких;"}},{"type":"paragraph","data":{"text":"- у пациентов с сахарным диабетом;"}},{"type":"paragraph","data":{"text":"- у пациентов с тяжелыми формами тревожного невроза."}}]},{"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."}},{"type":"paragraph","data":{"text":"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. Результаты исследования на животных продемонстрировали, что эпинефрин обладает токсичностью в отношении репродуктивной функции у животных в дозах, превышающих максимальную рекомендованную дозу. Артикаин и эпинефрин проникают через плацентарный барьер в меньшей степени по сравнению с другими местными анестетиками."}},{"type":"paragraph","data":{"text":"Концентрация артикаина в сыворотке крови у новорожденных (после введения препарата матери) составляет приблизительно 30% от концентрации артикаина в сыворотке крови матери."}},{"type":"paragraph","data":{"text":"При случайном внутрисосудистом введении эпинефрин может уменьшать кровоснабжение матки."}},{"type":"paragraph","data":{"text":"Решение о применении препарата Артикаин-Бинергия с адреналином может быть принято врачом только в том случае, если потенциальная польза от его применения для матери оправдывает потенциальный риск для плода."}},{"type":"paragraph","data":{"text":"Негативного влияния артикаина на новорожденных при использовании родовспомогательной анестезии не выявлено."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПериод грудного вскармливания\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"В связи с коротким периодом полувыведения эпинефрина, а также с очень быстрым падением уровня в сыворотке крови и быстрым выведением из организма артикаина, в грудном молоке не обнаруживается клинически значимых концентраций артикаина и эпинефрина. Поэтому при краткосрочном применении препарата в период грудного вскармливания, как правило, не требуется прерывать кормление грудью."}},{"type":"paragraph","data":{"text":"\u003ci\u003eФертильность\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Экспериментальные исследования применения артикаина 40 мг/мл + эпинефрин 0,01 мг/мл на животных (что в несколько раз больше, чем в препарате Артикаин-Бинергия с адреналином) не показали воздействия 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 с адреналином применяется для эпидуральной и направленной локальной анестезии."}},{"type":"paragraph","data":{"text":"Следует вводить минимальную дозу, с помощью которой достигается желаемая достаточная анестезия."}},{"type":"paragraph","data":{"text":"Дозировку следует осуществлять индивидуально в соответствии с особенностями каждого конкретного случая."}},{"type":"paragraph","data":{"text":"\u003ci\u003eДля детей и пациентов пожилого возраста \u003c/i\u003eнеобходим подбор дозы."}},{"type":"paragraph","data":{"text":"\u003ci\u003eРекомендуемая максимальная доза для взрослых:\u003c/i\u003e 5-6 мг/кг массы тела (не более 600 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 (не может быть определена по имеющимся данным)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны нервной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧасто\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Парестезия, гипестезия, головная боль (вследствие наличия в составе препарата эпинефрина)."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНечасто\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Головокружение."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота неизвестна\u003c/i\u003e"}},{"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 вплоть 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":"\u003ci\u003eЧастота неизвестна\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Зрительные расстройства (нечеткость зрительного восприятия, мидриаз, слепота, двоение в глазах), обычно обратимые и возникающие во время или через короткое время после инъекции местноанестезирующего средства."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны желудочно-кишечного тракта\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧасто\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Тошнота, рвота."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны сердечно-сосудистой системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eНечасто\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Тахикардия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота неизвестна\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Ощущение сердцебиения, аритмия, признаки стенокардии, повышение артериального давления, артериальная гипотензия, брадикардия, сердечная недостаточность и шок (при определенных обстоятельствах с угрозой для жизни)."}},{"type":"paragraph","data":{"text":"В процессе родовспомогательной анестезии, в частности, при парацервикальной блокаде, у плода может появиться брадикардия. Рекомендуется тщательно контролировать тоны сердца плода."}},{"type":"paragraph","data":{"text":"\u003ci\u003eНарушения со стороны иммунной системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eЧастота неизвестна\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"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, отечность лица (ангионевротический отек)."}},{"type":"paragraph","data":{"text":"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."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПрочие\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Из-за наличия в составе препарата натрия дисульфита (натрия метабисульфита), очень редко могут возникать аллергические реакции в виде рвоты, диареи, тяжелого дыхания, острого приступа астмы, расстройства сознания или шока, в частности у пациентов, страдающих бронхиальной астмой."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003e\u003cb\u003eСимптомы передозировки\u003c/b\u003e\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\u003e чувство 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 паралича дыхательных путей."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eУгнетение сердечно-сосудистой системы\u003c/i\u003e: брадикардия, аритмия, мерцание желудочков, падение артериального давления, цианоз, остановка сердца."}},{"type":"paragraph","data":{"text":"\u003ci\u003e\u003cb\u003eЭкстренная помощь и противодействующие средства\u003c/b\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При появлении первых признаков побочного действия или интоксикации, таких как головокружение, моторное 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 препаратов."}},{"type":"paragraph","data":{"text":"При нарушениях дыхания, в зависимости от их тяжести, рекомендуется подача кислорода, в случае необходимости - искусственное дыхание, а при определенных обстоятельствах - эндотрахеальная интубация и контролируемая искусственная вентиляция легких."}},{"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 легких (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). Должны 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 давление (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."}},{"type":"paragraph","data":{"text":"Сильную тахикардию и тахиаритмию можно снимать антиаритмическими средствами, исключая неселективные бета-адреноблокаторы, такие, например, как пропранолол. В таких случаях необходимы подача кислорода и контроль кровообращения."}},{"type":"paragraph","data":{"text":"Повышение артериального давления у пациентов с артериальной гипертензией, при необходимости, купируется с помощью периферических сосудорасширяющих средств."}}]},{"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":"\u003ci\u003e\u003cb\u003eПротивопоказанные комбинации\u003c/b\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eС неселективными бета-адреноблокаторами, например, пропранололом\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Риск развития гипертонического криза и выраженной брадикардии."}},{"type":"paragraph","data":{"text":"\u003ci\u003eС трициклическими антидепрессантами или ингибиторами моноаминоксидазы\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Возможно усиление гипертензивного действия эпинефрина (в период до 14 дней после прекращения лечения ингибиторами моноаминоксидазы)."}},{"type":"paragraph","data":{"text":"\u003ci\u003e\u003cb\u003eВзаимодействие, которое следует принимать во внимание\u003c/b\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eС гипогликемическими средствами для приема внутрь\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Эпинефрин может ингибировать высвобождение инсулина из β-клеток поджелудочной железы и уменьшать эффекты гипогликемических средств для приема внутрь."}},{"type":"paragraph","data":{"text":"\u003ci\u003eС некоторыми средствами для ингаляционной анестезии (галотан)\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Галотан может повышать чувствительность миокарда к катехоламинам и увеличивать риск развития нарушений сердечного ритма после инъекций препарата Артикаин-Бинергия с адреналином."}},{"type":"paragraph","data":{"text":"\u003ci\u003eС антикоагулянтами и другими препаратами, уменьшающими свертываемость крови\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При проведении инъекций препарата Артикаин-Бинергия с адреналином пациентам, получающим, например, гепарин или ацетилсалициловую кислоту, возможно развитие серьезных кровотечений при непреднамеренной перфорации сосуда, так как у таких пациентов склонность к кровотечениям выше."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Регионарная и местная анестезия должна проводиться опытными специалистами в соответствующем 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":"Внутривенные инъекции противопоказаны!"}},{"type":"paragraph","data":{"text":"Нельзя вводить препарат Артикаин-Бинергия с адреналином в воспаленные (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 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 нельзя использовать повторно."}},{"type":"paragraph","data":{"text":"Лекарственный препарат не следует применять, если раствор изменил свой цвет или стал мутным."}},{"type":"paragraph","data":{"text":"Препарат Артикаин-Бинергия с адреналином содержит натрия дисульфит, поэтому его применение противопоказано у пациентов с бронхиальной астмой с повышенной чувствительностью к сульфитам, так как возможно развитие острых аллергических реакций, таких как бронхоспазм (см. раздел \"Противопоказания\")."}},{"type":"paragraph","data":{"text":"В 1 мл препарата Артикаин-Бинергия с адреналином раствор для инъекций (10 мг + 0,005 мг)/мл содержится 0,127 ммоль (2,9 мг) натрия."}},{"type":"paragraph","data":{"text":"В 1 мл препарата Артикаин-Бинергия с адреналином раствор для инъекций (20 мг + 0,005 мг)/мл содержится 0,096 ммоль (2,2 мг) натрия."}},{"type":"paragraph","data":{"text":"Эти данные следует учитывать при применении препарата Артикаин-Бинергия с адреналином 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+0.005 мг/мл, 20 мг/мл+0.005 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":"3 года."}},{"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-Бинергия с адреналином является комбинированным препаратом, в состав которого входит артикаин (местноанестезирующее средство амидного типа) и эпинефрин (сосудосуживающее средство), который добавляют в состав препарата для пролонгации анестезии. 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. 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 для растворов с добавлением эпинефрина составляет от 120 до 420 минут. Для поверхностной анестезии артикаин обладает очень небольшим анестезирующим эффектом. 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":1269,"title":"Эпинефрин","title_latin":"Epinephrinum","slug":"epinefrin_1269"},{"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 с адреналином - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/203179/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/203179/share_default/"}},"diseases":[],"other_packages":[{"id":283245,"title":"Артикаин-Бинергия с адреналином","subtitle":{"full":"Раствор, 10 шт, 1.7 мл, 20 мг + 0.005 мг","short":"Раствор, 10 шт, 1.7 мл, 20 мг + 0.005 мг","package":"10 шт, 1.7 мл, 20 мг + 0.005 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