"Lidocaine" (amafutha): incwadi yokufundisa, ukubuyekezwa

Ukuze kuqedwe ubuhlungu, kusetshenziswe izinhlobo ezihlukahlukene ze-anesthetics. Uma isifo sobuhlungu sidinga ukususwa ngokuqondile endaweni yomzimba, ukulungiselela amalungiselelo asetshenziswayo. Ngokuyinhloko, i-sprays, amafutha, ama-gel. "I-Lidocaine" inezinhlobo ezahlukene zokukhululwa. Ukuze ususe ubuhlungu endaweni esithintekile, kuvame ukusetshenziswa njengamafutha angama-5%.

Ukwakhiwa kanye nesimo sokukhululwa kwe "Lidocaine"

"Lidocaine" (amafutha) adalwe kuphela ukusetshenziswa kwangaphandle. Ukwakhiwa kwalesi sidakamizwa kuhlanganisa izithako ezisebenzayo njenge- lidocaine hydrochloride ne-chlorhexidine dihydrochloride. Isidakamizwa sinezingxenye ezengeziwe, njenge-hyethellosis (i-hydroxyethylcellulose) ne-glycerol.

Isidakamizwa i-gel ecacile.

Futhi, umkhiqizo ugcwele ama-tubes aluminium nge-volume 15 no-30 g no-25 g emanzini omgcozi omnyama. Imfundo ihlanganiswe ebhokisini lekhadibhodi kanye namafutha okugcoba "Lidocaine".

Lesi sidakamizwa akhiqizwa nje ngesimo samafutha, kodwa futhi ngesimo se-spray, naku-ampoules okuhloswe ukuze kujowe.

Isidakamizwa kufanele sigcinwe endaweni epholile futhi singenakufinyeleleka kubantwana. Ukupheka kompheme wamafutha okugcoba kuyiminyaka emithathu, emva kokuphela komkhiqizo ongasetshenziswa.

Isenzo semithi yesidakamizwa

Isidakamizwa sibhekisela ku-IB-class antiarrhythm. Isebenza njenge-anesthetic yendawo futhi ivela ku-acetanilide. Ibonakala ngokusebenza kwe-membrane-stabilizing.

I-agent "Lidocaine" (amafutha okugcoba) kunciphisa isikhathi somthelela ongase ube khona futhi isikhathi esikhiqizayo emafibeni e- Purkinje, sivimbela umsebenzi wabo ozimele. Isidakamizwa sivimbela umsebenzi kagesi wezingxenye zokuphefumula, ezihlelekile, kodwa ngesikhathi esifanayo kunomphumela omncane emsebenzini wegesi wezicubu ezivamile.

Uma isetshenziswe kuma-medication, i-drug does not affect the contractual myocardial and does not slow conduction. Uma "i-Lidocaine" isetshenzisiwe njengesidakamizwa sokulwa futhi ilawulwa iv, ukuqala kwesenzo sayo kwenzeka ngemva kwamasekhondi angu-45-90 kamuva, futhi umphumela uhlala cishe imizuzu engu-10-20. Ngesethulo / m m isidakamizwa, umphumela ungazwakala emva kwemizuzu engu-5-15, futhi ubude bawo buyimaminithi angu-60-90.

Isidakamizwa senzelwe ukuphela, ukungena kanye nokuqhuba i-anesthesia.

Isidakamizwa singasetshenziswa ngaphandle kwenkinga yenkinga izikhathi eziningana ngosuku. Inani eliphakanyisiwe lezinhlelo zokusebenza izikhathi ezingu-3-4 ngosuku.

Kuvame ukusetshenziselwa i-2% gel "i-Lidocain" ukuze kungenwe isingeniso noma i-larynx yensiza yezokwelapha. Isidakamizwa sisetshenziswa ngenduku ekhethekile yezokwelapha. Uma i-anesthesia ingazange isebenze noma umphumela walesi sidakamizwa yayingenasidingo, inqubo yesicelo iphindaphindwa.

Ngesikhathi sokuhlushwa okufanayo, amafutha okugcoba asetshenziselwa izifundo endaweni yokuhlukumezeka yabesifazane, lapho igcwele khona i-mucosa ye-urethral. Ukusetshenziswa kwemithi kuleso simo kuthintwa yisakhiwo ngasinye se-urethra. Elinye i-gel lisetshenzisiwe lapho umcengezi efakwa emgodini emadodeni, kuyilapho kufika ku-100 mg wezidakamizwa.

Ukuze unciphise ubuhlungu ezinkambeni zokuvuvukala kulesi sifo, iziguli zinikezwa umthamo owodwa wamafutha okushiswa kanye neminye imithi kanye. Ukwelapha okunjalo kuqhubeka kuze kube yizinsuku ezinhlanu.

I-gel ne-lidocaine nayo isetshenziselwa ukuhlolwa kwesisu ngesifo se-endoscope. Ngakho, ukuze ugcwalise futhi ukwandise i-urethra, sebenzisa kufika ku-30 ml yalesi sidakamizwa. Leli dose lilawulwa ngezigaba ezimbili nge-interval encane. I-urethra okwesikhashana iphoqa.

Ibuye isetshenziswe ku-cosmetology "i-Lidocaine" (amafutha okugcoba) - ukukhishwa ngamabhayisikili nezinye izindawo ezibucayi zomzimba.

Ngemuva kokujova nge-intramuscular of the drug, itholakala cishe ngokuphelele. Isakazwa ngokushesha. Ukusebenzisana kwalo namaprotheni kuthinteka ekugxileni kwezinto ezisebenzayo egazini, okuyi-60-80%. Isidakamizwa sisetshenzisiwe ikakhulukazi esibindi, kuyilapho sibangela ukubonakala kwamatabolite asebenzayo, okuthinta imiphumela yokwelapha kanye neyingozi, ikakhulukazi emva kokumnika (usuku noma ngaphezulu).

Ingxenye yokuphila yesidakamizwa ijwayele ukuba yi-biphasic nesigaba sokusabalalisa samaminithi angu-7-9. Kuxhomeke emthamo wokuphatha futhi u-1-2 amahora, kancane kancane ukwanda amahora amathathu noma ngaphezulu ngesikhathi sokukhulelwa kwe-IV eside (amahora angaba ngu-24). Ixoshwa yizinso ngendlela yama-metabolites, kuphela ku-10% kukhishwe okungashintshi.

Amafutha "Lidocaine": isicelo

Amafutha "Lidocaine" (5%) anesicelo sendawo kuphela. Kuncishisa ubuhlungu ezindaweni zokulimala esikhumbeni (amanxeba, iziphazamiso) nasemagqumeni amancane omlomo. Isetshenziswa endaweni ye-perianal.

Ukungahambisani nokusetshenziswa

Ukusebenzisa i-gel "Lidocaine" (imfundo ngaphambi kokusetshenziswa kufanele ifundwe) cishe ayibangeli ukuphendula okungalungile, kodwa naphezu kwalokhu, i-agent ngeke isetshenziswe uma i-membrane ye-mucous ibonakalisiwe. Kulesi simo, ukwanda kwe-anesthetic kwenyuka, okungabangela ukutholakala kobuhlungu besistimu.

Ungasebenzisi lesi sidakamizwa ebuntwaneni (kuze kube seminyaka emibili) futhi u-hypersensitivity kuya ku-lidocaine.

I-Lidocaine (amafutha): imiyalelo yokusetshenziswa

Isibalo somuthi esetshenziselwa ukuphatha isikhumba sincike esimweni sesiguli kanye nendawo okumele iphathwe ngayo, isisulu samathambo. Ukusetshenziswa kwamafutha okugcoba kuthinteka ukubekezelelana komuntu ngamunye. Phela, ungasebenzisa imithi ngokulinganisa okuncane noma isikhathi esithile ukwenqaba ukuyisebenzisa.

"I-Lidocaine" -eal (imfundo ichaza ngokuningiliziwe, lapho izimo ezingasetshenziselwa khona imithi) inqunywe lapho kukhona khona izinkomba ezithile kubantu abadala kanye nezingane, kusukela eneminyaka eyishumi nambili.

Ukuze unciphise ubuhlungu, amafutha kufanele asetshenziswe ngomthamo we-1-2 amagremu izikhathi eziningana ngosuku. Okusebenzayo - 3-4 izinhlelo zokusebenza.

Izingane ezineminyaka engaphansi kwengu-12 kufanele zisebenzise i-gel ngokuqapha. Nakhu kuyadingeka ukuba uqaphele iqiniso lokuthi ezinganeni zalesikhathi ukutholakala kwe-bioavailability kuyinto eyi-100%. Ngakho-ke, inani elivunyelwe kakhulu elingavumelekile lingafanele lidlule u-0.1 g / kg wesisindo somntwana, okusho ukuthi u-5 mg we-lidocaine ngekhilimu ngayinye yesisindo somzimba. Isikhathi esiphakathi kwesicelo samafutha asifanele sibe ngaphansi kwamahora ayisishiyagalombili.

Isidakamizwa sisetshenziswa ku-mucosa phakathi nezinqubo ezifana nokuhlola i-trachea, i-larynx ne-oophagus. Amafutha avame ukugcoba ngezixhobo zokuhlolwa. Ukucubungula kwezinsimbi zikaLidocaine nakho kwenziwa ngesikhathi somcimbi. Ngalesi sikhathi, kudliwe u-0.2-2 g wamafutha. Uma i-anesthesia enjalo ingasebenzi, emva kwemizuzu engu-2-3 inqubo iphinda iphindwe futhi.

Umthamo omkhulu wansuku zonke omuntu omdala ungama 300 mg (6 g wejel). Amantombazane emnyangweni we-urology aphathwa nge-urethra enamaqabunga e-3-5 ml wezidakamizwa. Kwabesilisa, amafutha asetshenziselwa ngokushesha ngaphambi kokucwiliswa ngesamba esingu-5-10 ml. I-dose yansuku zonke ephezulu yabantwana yi-4.5 mg / kg.

Emathambo wamazinyo, amafutha asetshenziswa ku-oral mucosa ye-anesthesia elandelayo. Isikhathi esiphakathi kwesicelo samafutha sinemizuzu engu-2-3. Enye i-gel isetshenziselwa ukususa i-tartar. Ngenxa yalokhu, lesi sidakamizwa sigxiliwe emaphethelweni wezinsini kanye nentamo yamazinyo emaminithi angu-2-3. Faka isicelo se-ovalo embranini emlonyeni emlonyeni ngokubunjwa kwe-aphthae kanye nezimo.

Ngokuvame ukusetshenziswa "i-Lidocaine" (amafutha okugcoba) okukhishwa izinwele. Lokhu kulungiswa kuhle ngokukhethekile ekuqotheni indawo ye-bikini. Njengengculaza yendawo, lesi sidakamizwa sisetshenziswa amahora amathathu kuya ku-3.5 ngaphambi kwenqubo yokususa izinwele. Okokuqala, i-gel iyasetshenziswa ebusweni besikhumba, bese isonga indawo efunayo ngefilimu yokudla.

Izenzakalo ezimbi

"I-Lidocaine" (amafutha) kwezinye izimo kungabangela ukucasula isikhumba, ngoba umuthi, ngaphezu kwe-lidocaine, uqukethe i-propylene glycol. Futhi, ukubukeka kwemiphumela emibi njengemifantu, ukuvuvukala. Ezimweni ezingavamile, ukuphazamiseka kwe-anaphylactic kwaqashelwa.

Lapho ubuthi obuhle bukhona ngenxa yokusetshenziswa kwe-analgesics yangaphandle, imiphumela emibi ibonakala emiphakathini yomzwelo neyesifo senhliziyo.

I-symptomatology yesistimu yezinzwa eziphakathi ibonakala ngesimo sokukhathazeka, ukwesaba, ukukhathazeka, ukuvuka nokulahleka kokuma. Kwezinye izimo kukhona ukudideka kwemicabango, umsindo ezindlebeni, umbono ongenangqondo, i-miosis, isisindo sokuhlanza nokuhlanza, ukuxubha, ukuthuthumela. Kwakukhona izibonakaliso zokucasuka, ukulahlekelwa ukuzwela kolimi kanye nendawo ezungeze isigxobo somlomo.

Esikhathini senqubo yesifo senhliziyo, kwezinye izimo, ukucindezeleka kwemisebenzi ye-myocardial kwaphawulwa ezigulini, kanye ne-peripheral vasodilation, eyenzeka ngemva kokushisa komfutho wegazi kanye ne-bradycardia. Isithombe esifanayo singabangela ukuguquka komzimba futhi, ngenxa yalokho, ukuboshwa komzimba. Ngokuvamile kakhulu kukhona i-methemoglobinemia.

Ukusebenzisana nezinye izidakamizwa

"I-Lidocaine" (amafutha) uma kuhlangene nezidakamizwa eziphikisana nezidakamizwa kungabangela ukukhubazeka noma ukuboshwa kwengqondo ephelele. Lesi simo sabonakala ezigulini ezazisebenzisa i-lidocaine kanye ne-amiodarone, i-tokaine, noma i-procaine.

Izidakamizwa ze-Antiepileptic ezihambisana ne-lidocaine zinganciphisa ukuhlushwa kwezidakamizwa egazini. "I-Phenytoin", ephathwe nge-intravenously, iyakwazi ukwandisa izakhiwo ze-cardiodepressive zezinto ezisebenzayo.

Ukuhlanganiswa ne-beta-blockers kwandisa ukuhlushwa kwe-lidocaine egazini. Umphumela ofanayo ubangelwa ngu "Nadolol".

Ama-H2-antagonists, isibonelo "i-Cimetidine", ukwandisa umzimba we-hepatic we-component esebenzayo, okwandisa izinga lobuhlungu be-lidocaine.

I-Hypokalemia, eyabangelwa ukusetshenziswa kwe- "Acetazolamide", i-diuretics, ivimbela isenzo se-lidocaine.

Ukusetshenziswa ngesikhathi esisodwa kwesidakamizwa nge-vasoconstrictors kubangela imiphumela emibi.

Imiyalo ekhethekile

Ungasebenzisi i-Lidocaine (amafutha ama-5%) kumlomo we-oral mucosa, uma kukhona ukuvuvukala noma isiguli sitholwa sine-sepsis.

Ukuze ugweme ukumiswa kwe-systemic, kubalulekile ukusebenzisa ngokuqapha okukhulu umuthi we-anemia, methemoglobinemia, kanye nokuntuleka kwe-glucose-6-phosphate dehydrogenase.

Uma umanyolo oshisayo kufanele ume ngokushesha ukuwusebenzisa futhi ubhekane nokuqedwa kwemiphumela emibi.

"I-Lidocaine" ayinqunyelwe iziguli eziphethwe yi-hypovolemia, kanye nokuvinjelwa kwemisipha yomzimba nezinye izifo ezimbi zokuziphatha komzimba.

Ngokuqapha sebenzisa lesi sidakamizwa uma kunesifo senhliziyo esiphumelelayo, i-bradycardia noma kukhona ukucindezeleka kokuphefumula.

Uma ulandela imiyalelo, ingozi yemiphumela emibi evela ku-CNS ayilutho. Uma kukhona ukuzwela okhethekile ezigulini ezidakamizwa "i-Lidocaine", imithi isetshenziswa ngokuqapha okukhulu. Nge-reaction okwehliswayo ku-derivatives ye-para-aminobenzoic acid, akukho ukuzwela okukhulu ku-lidocaine okutholiwe.

Isidakamizwa kufanele sisetshenziswe ngokuqapha okukhulu ngesikhathi sokukhulelwa, ngoba izifundo ezibonisa umphumela wezinto ezisebenzayo emfubusheni azenzanga. Ochwepheshe batusa ukuthi ekuthomeni kokuqala kokukhulelwa, noma kunokwenzeka, gwema ukusebenzisa izidakamizwa.

"I-Lidocaine" ingena ubisi lwebele ngesilinganiso esincane kakhulu, esingenayo imiphumela emibi ekuthuthukiseni ingane.

Ukungaphumeleli kwe-Renal akubanga ukuthi ushintsho oluphawulekayo ku-pharmacokinetics uma usebenzisa i- "Lidocaine" (amafutha angama-5%).

Ngaphambi kokuhluleka kwesibindi, kuzomele ulahle ngokuphelele ukusetshenziswa kwesidakamizwa, noma unciphise isicelo kumazinga amancane. Uma usebenzisa umkhiqizo ebusweni, kudingeka uqiniseke ukuthi imithi ayifuni emehlweni akho.

Ukudlula izidakamizwa kungase kwenzeke ngenxa yobuthi obuhle be-anesthetics bendawo futhi kubangelwa ukugxila okuphezulu kwezinto ezisebenzayo egazini. Lokhu kubangela ukubonakala kwemiphumela emibi ehlotshaniswa nesenzo sezinzwa eziphakathi kwezinzwa nezinhliziyo.

Kulesi simo, ukwelashwa okufanele kwenziwe. Ukuhlinzeka nge-airway patency, zama ukukhipha i-carbon dioxide. Emzimbeni wesiguli, i-oksijeni isungulwa noma ukuphefumula okufakelwayo.

Uma kunezidakamizwa, zisuswa ngokuhambisa i-sucinylcholine ngesamba esingu-50-100 mg kanye / noma i-diazepam ngesilinganiso sika-5-15 mg. Kwezinye izimo, kusetshenziselwa amabhajiturates ama-short acting. I-Dialysis kulesi simo ayiniki umphumela oyifunayo ngakho-ke ayisebenzi.

Ama-analogue we "Lidocaine"

Uma, ngenxa yezizathu ezithile, i-Lidocaine (amafutha) angakhulumi ukuqhutshwa noma ezinye izinjongo, ungaphelelwa ithemba, kwanele ukunaka ukufaka izidakamizwa, phakathi kwazo oku:

• I-Naropin;
• Bulivacaine;
• "Ultracaine DS";
• Novokain;
• I-Emla cream;
• "Midokalm";
• "Zaldiar";
• I-Artifrin;
• "Nalbuphine";
• "Diprofol".

Ukusetshenziswa kwemithi ngayinye kunezici zayo, ngakho-ke ukushintshwa kufanele kwenziwe kuphela ngudokotela. Kuphela kulesi simo kungenzeka ukuthi sincike ekukhetheni okunempilo komuthi.

Impendulo yabesifazane ekusetshenzisweni kwamafutha okugcoba

Izibuyekezo eziningi zithola lesi sidakamizwa "Lidocaine" (amafutha). Ama-Epilations asetshenziswa ngalolu remedy ayeke ukuba abe buhlungu. Isusa kahle ubuhlungu, isuse ukuzwela, okwenza kube lula ukwenza izinqubo zokususa izinwele ziphephe ngokwanele futhi zikhululekile ngangokunokwenzeka. Abesifazane basebenzisa ukhilimu endaweni yonke, ezocubungulwa, futhi i-polyethylene ifakwe phezulu futhi ibanjwe amahora angu-2-3. Ngemuva kokusebenza okunjalo, njengomthetho, ubuhlungu phakathi nokususwa kwezinwele akusekho ngisho nasezindaweni ezibucayi kakhulu zomzimba.

Kodwa akubona wonke umuntu ojabule ngesenzo semithi "Lidocaine" (amafutha). Ukubuyekeza okungalungile kusho ukuthi lokhu kuyisisombululo esingenasidingo ngokuphelele, futhi cishe asisusa ubuhlungu. Kwamanye abesifazane, i-gel yaqeda ubuhlungu, kodwa ukuzwela okuncane kwakusabonakala ngesikhathi senqubo yokuqothula. Abaningi bakhetha ukusebenzisa i-spray "Lidocaine" futhi bathi kuthatha izikhathi eziningana ngokuphumelelayo kunamafutha. Lokhu kungenxa yezici zomzimba zomuntu ngamunye.