"Lidocaine" (tshuaj pleev): cov lus qhia rau kev siv, tiag tiag

Nyob rau hauv thiaj li yuav tshem tawm qhov mob, siv ib tug ntau yam ntawm anesthetics. Yog hais tias tus mob yuav tsum tau muab tshem tawm ncaj qha los ntawm lub cev ib feem, thov tshuaj pleev npaj lo lus uas peb. Yeej nws sprays, tshuaj pleev, tshuaj kua. "Lidocaine" nyias muaj nyias tso tawm cov ntaub ntawv. Rau kev tshem tawm ntawm kev mob nrog rau cov cheeb tsam no yog feem ntau siv nws nyob rau hauv ib tug 5% tshuaj pleev.

Muaj pes tsawg leeg thiab rau hauv daim ntawv ntawm "lidocaine"

"Lidocaine" (tshuaj pleev) yog tsim heev dua lwm yam rau lwm siv. Cov kev npaj muaj xws li active tshuaj xws li lidocaine hydrochloride thiab chlorhexidine dihydrochloride. Ntau cov tshuaj muaj ntxiv Cheebtsam xws li gietelloza (hydroxyethylcellulose) thiab glycerol.

Cov tshuaj yog ib tug pob tshab gel.

Nyob rau hauv lem, qhov txhais tau tias yog tau ntim rau hauv txhuas hlab ntawm 15 thiab 30 g thiab 25 g ntawm dub khob rhawv zeb. Lub cardboard lub thawv yog kos nrog rau cov tshuaj pleev "lidocaine" kev qhia ntawv.

Qhov no tshuaj yog tso tawm tsis tau tsuas yog nyob rau hauv daim ntawv ntawm cov tshuaj pleev, tab sis tseem nyob rau hauv daim ntawv ntawm ib cov tshuaj tsuag, thiab nyob rau hauv ampoules npaj cov kev txhaj tshuaj.

Cov tshuaj yuav tsum tau muab cia rau hauv ib lub txias, qhuav qhov chaw thiab yuav muaj rau cov me nyuam. Txee lub neej yog peb lub xyoos nyob rau hauv lub tshuaj pleev, nyob rau hauv nws tom qab cov tshuaj yuav siv tsis tau.

Lub pharmacological kev txiav txim ntawm cov tshuaj

Cov tshuaj belongs rau lub chav kawm ntawv IB-antiarrhythmic. Nws ua raws li ib lub zos ua kom loog thiab yog ib tug derivative ntawm acetanilide. Yus muaj los ntawm daim nyias nyias stabilizing kev ua si.

Txhais tau hais tias "lidocaine" (tshuaj pleev) thiaj li qhov ntev ntawm tej yam zoo thiab lub sij hawm nyob rau hauv Purkinje fibers, siab rau lawv tus kheej kev ua ub no. Cov tshuaj blocks qhov hluav taws xob kev ua si depolarized, arrhythmogenic aav, tab sis marginally muaj feem xyuam rau cov hluav taws xob ua hauj lwm ntawm tej ntaub so ntswg.

Thaum siv nyob rau hauv srednelechebnyh koob tshuaj ntawm cov tshuaj tsis muaj teeb meem loj ntxim rau cov myocardial contractility thiab slows AV-conduction. Yog hais tias "lidocaine" yog siv raws li ib tug antiarrhythmic tshuaj thiab cov tswv yim / v, qhov pib ntawm qhov kev txiav txim tshwm sim tom qab 45-90 vib nas this, thiab cov nyhuv kav txog 10-20 feeb. Thaum lub / m medicament nyhuv yuav muaj tom qab 5-15 feeb thiab lub caij yog 60-90 feeb.

Cov tshuaj no yog rau cov davhlau ya nyob twg, infiltration thiab conduction tshuaj loog.

Cov tshuaj yuav tsum muaj ntaub ntawv topically rau qhov teeb meem cheeb tsam ob peb zaug ib hnub twg. Pom zoo tus naj npawb ntawm daim ntaub ntawv - 3-4 lub sij hawm ib hnub twg.

Heev feem ntau siv 2% "lidocaine" gel rau zoo mus rau hauv cov hlab pas los yog lub suab kho mob ntsuas. Cov tshuaj coated kho mob tshwj xeeb wand. Yog hais tias tshuaj loog twb tsis ntxim los yog cov nyhuv ntawm cov tshuaj yog negligible, ntawm daim ntawv thov ntawm cov nyiaj yog rov qab.

Nyob rau hauv tib concentration tshuaj pleev yog siv rau cov kev tshawb fawb nyob rau hauv lub teb ntawm urology rau cov poj niam, qhov twg nws lubricates lub txheej membrane ntawm lub qhov zis. Nyob rau tshuaj noj nyob rau hauv cov ntaub ntawv no yog los ntawm tus neeg qauv ntawm lub qhov zis. Ntau gel siv rau zoo ntawm lub catheter rau hauv lub qhov zis nyob rau hauv cov txiv neej, yog li haus mus txog 100 mg ntawm yeeb tshuaj.

Nyob rau hauv thiaj li yuav txo tau qhov mob mob ntawm lub zais zis neeg mob muab txhaj ib koob tshuaj pleev nrog rau lwm yam tshuaj singly. Qhov no txoj kev kho kav mus txog tsib hnub.

Gel nrog lidocaine siv thaum lub sij hawm txoj kev kawm ntawm lub zais zis endoscope. Yog li, nyob rau hauv thiaj li yuav sau thiab ntug hauv lub qhov zis siv 30 ml ntawm kev npaj no. Qhov no tshuaj yog muab nyob rau hauv ob qhov chaw nrog ib tug luv luv luv. Cov zis yog ib tug me ntsis lub sij hawm thaum clamped.

Yog tseem siv nyob rau hauv tshuaj pleev ib ce, "lidocaine" (tshuaj pleev) - rau cov plaub hau tshem tawm bikini thiab lwm yam rhiab qhov chaw ntawm lub cev.

Tom qab intramuscular txhaj nws yog absorbed yuav luag tag. Sai faib. Thaum nws sis raug zoo nrog cov nqaijrog muaj feem xyuam rau lub concentration ntawm active muaj nyob rau hauv cov ntshav, uas yog 60-80%. Drug metabolized mas nyob rau hauv lub siab, thaum nws provokes cov tsos ntawm active metabolites uas muaj feem xyuam rau cov tshuaj thiab tshuaj lom los, tshwj xeeb yog tom qab Txoj kev lis ntshav (tshaj hnub los yog ntau tshaj).

Lub ib nrab-lub neej ntawm cov tshuaj nyhav biphasic nrog ib tug muab faib rau theem 7-9 min. Nws yog nyob ntawm cov tshuaj thiab cov thawj coj no yog rau 1-2 xuab moos, maj nce mus rau peb teev los yog ntau tshaj nyob rau hauv ib lub sij hawm ntawm / Txoj kev lis ntshav (tshaj 24 xuaj moos). Tas los ntawm ob lub raum nyob rau hauv daim ntawv ntawm cov metabolites, tsuas 10% tawm unchanged.

Tshuaj pleev "lidocaine": daim ntawv thov

Tshuaj pleev "lidocaine" (5%) muaj tsuas tshuaj pleev daim ntawv thov. Nws thiaj li mob nyob rau hauv cov cheeb tsam ntawm daim tawv nqaij raug mob (wounds, doog) thiab nyob rau hauv txheej nyias nyias ntawm lub qhov ncauj. Nws yog siv nyob rau hauv lub perianal cheeb tsam.

Contraindications rau kev siv ntawm

Kev siv cov gel "lidocaine" (cov lus qhia ua ntej yuav siv yuav tsum tau nyeem) suab tsis ua phiv tshuaj, tab sis, dua li no, lub cuab tam yuav siv tsis tau yog tias puas mucosa. Nyob rau hauv cov ntaub ntawv no, muaj zog haum ntawm kev ua kom loog, uas yuav ua raug nyob rau hauv qhov tshwm sim ntawm muaj quag toxicity.

Tsis txhob siv cov tshuaj nyob rau hauv cov me nyuam (txog li ob lub xyoo) thiab nyob rau hauv cov ntaub ntawv ntawm npau taws me ntsis rau lidocaine.

"Lidocaine" (tshuaj pleev): cov lus qhia rau kev siv

Tus nqi ntawm cov tshuaj siv rau cov kev kho mob ntawm daim tawv nqaij, nyob ntawm qhov kev mob ntawm tus neeg mob thiab lub cheeb tsam yuav tsum tau kho, cov ntaub so ntswg vascularity. Nyob rau hauv kev noj ntawm ib tug tshuaj pleev muaj feem xyuam rau ib tug neeg kam Cheebtsam. Tom qab tag nrho, koj muaj peev xwm siv cov tshuaj nyob rau hauv lub qis tshaj koob los yog thaum lub sij hawm mus tso tseg rau nws daim ntawv thov.

"Lidocaine" -maz (phau ntawv hais txog zaj uas nyob rau hauv tej rooj plaub tsis yooj yim sua kom muab cov tshuaj) yog muab nyob rau hauv lub xub ntiag ntawm tej yam indications rau cov neeg laus thiab cov me nyuam los ntawm cov muaj hnub nyoog ntawm kaum ob.

Rau yooj yim mob tshuaj pleev yuav tsum tau ua ntawv thov rau ntawm ib koob tshuaj 1-2 grams ib tug ob peb zaug ib hnub twg. Optimally - 3-4 daim ntawv thov.

Cov me nyuam nyob rau hauv kaum ob xyoos ntawm hnub nyoog yuav tsum siv ib tug gel nrog ceev faj. Ntawm no nws yog tsim nyog los ua kom lwm tus fact tias cov me nyuam ntawm no muaj hnub nyoog bioavailability yog 100%. Yog li ntawd, lub siab tshaj plaws pub koob tshuaj yuav tsum tsis txhob ntau tshaj 0.1 g / kg lub cev hnyav ntawm tus me nyuam uas yog 5 mg lidocaine ib kilogram lub cev hnyav. Lub caij nyoog nruab nrab ntawm daim ntawv thov tshuaj pleev yuav tsum tsis txhob yuav tsawg tshaj li yim lub sij hawm.

Cov tshuaj ua ntawv thov mus rau lub mucosa thaum lub sij hawm cov txheej txheem xws li diagnosing lub raj cua, lub suab thiab txoj hlab nqos mov. Tsis tas li ntawd feem ntau smeared tshuaj pleev cov cuab yeej rau cov daim ntawv ntsuam xyuas. Ua cov cuab yeej "lidocaine" yog nqa tawm thiab thaum lub sij hawm cov kev tshwm sim. Thaum lub sij hawm no npaum 0.2-2 g tshuaj pleev. Yog hais tias qhov no tshuaj loog yog muab cov kev tshwm sim, ces tom qab 2-3 feeb rau txoj kev twb rov qab dua.

Qhov siab tshaj plaws txhua txhua hnub koob tshuaj rau ib tug neeg laus yog 300 mg (6 g ntawm gel). Tej kho nyob rau hauv lub tuam tsev ntawm urology urethral mucosa 3-5 ml ntawm cov kev npaj. Rau cov txiv neej siv tshuaj pleev tam sim ntawd ua ntej hnab cug zis nyob rau hauv ib tug npaum li ntawm 5-10 ml. Qhov siab tshaj plaws txhua txhua hnub koob tshuaj rau cov me nyuam yog 4.5 mg / kg.

Nyob rau hauv kev kho hniav, cov tshuaj pleev yog thov mus rau lub qhov ncauj mucosa rau tom ntej tshuaj loog. Lub caij nyoog nruab nrab daim ntaub ntawv ntawm tshuaj pleev yog 2-3 feeb. Ntau gel yog siv nyob rau hauv qhov kev tshem tawm ntawm tartar. Rau kev npaj no yog txawm lig los plhws rau hauv lub gingiva thiab cov hniav caj dab rau 2-3 feeb. Daim ntawv thov ntawm ointments thov mus rau mucosa ntawm qhov ncauj kab noj hniav aphthas cov tsim thiab erosions.

Feem ntau siv "lidocaine" (tshuaj pleev) rau cov plaub hau kev tshem tawm. Tshwj xeeb yog haum rau qhov kev npaj ntawm cov plaub hau kev tshem tawm bikini cheeb tsam. Raws li ib tug hauv zos ua kom loog tshuaj no yog siv rau 3-3.5 xuab moos ua ntej lub plaub hau hle txoj kev. Thawj lub gel yog thov rau ntawm daim tawv nqaij nto, thiab tom qab ntawd qhwv nrog cov yam cheeb tsam ntawm cov zaub mov qhwv.

phiv

"Lidocaine" (tshuaj pleev), nyob rau hauv tej rooj plaub, yuav ua rau daim tawv nqaij voos, raws li cov tshuaj, nyob rau hauv tas li ntawd mus lidocaine, muaj ntau thiab propylene glycol. Nws tseem yog tau tshwm sim ntawm sab los xws li urticaria, edema. Nyob rau hauv es tsawg zaus anaphylactic poob siab.

Nyob rau hauv cov kev tshwm sim ntawm muaj quag toxicity vim rau daim ntawv thov ntawm lwm analgesic tshuaj phiv muaj cai nyob rau hauv lub central tshee thiab plawv systems.

Cns symptomatology manifested raws li kev ntxhov siab vim, nervousness, ntxhov siab vim, ntxhov siab, thiab tsis meej pem. Nyob rau hauv tej rooj plaub muaj tsis meej pem, tinnitus, qhov muag plooj tsis pom kev, tu-sauv, xeev siab thiab lub gag reflex, convulsions, co. Muaj tej yam tshwm sim ntawm voos mob, tsis hais lus rhiab heev thiab lub cheeb tsam ib ncig ntawm lub qhov ncauj.

Nyob rau hauv ib feem ntawm cov hlab plawv system nyob rau hauv cov neeg mob, nyob rau hauv tej rooj plaub, myocardial kev nyuaj siab zog raug kaw, raws li zoo raws li peripheral vasodilatation, uas tshwm sim tom qab lub tawg thiab bradycardia. Zoo ib yam li yuav ua rau arrhythmia thiab, raws li ib tug tsim nyog tau - lub plawv tsis ua hauj lwm. Heev tsis tshua methemoglobinemia.

Sis nrog lwm yam tshuaj

"Lidocaine" (tshuaj pleev) nyob rau hauv ua ke nrog nrog anti-arrhythmic tshuaj yuav ua rau tuag tes tuag taw los yog tiav mob raug ntes. Xws li ib tug lub xeev muaj cai nyob rau hauv cov neeg mob uas siv lidocaine nrog amiodarone, tocainide los yog procaine.

Antiepileptic tshuaj nyob rau hauv ua ke nrog nrog lidocaine yuav txo tau cov tshuaj nyob rau hauv concentration ntshav txhais tau tias. "Phenytoin" muab intravenously, yuav ua rau kom cardiodepressivny thaj chaw ntawm lub active ingredient.

Ua ke nrog nrog beta-blockers kom lub concentration ntawm lidocaine nyob rau hauv cov ntshav. Ib tug zoo xws li cov nyhuv yog "nadolol."

H2-antagonists, xws li "Cimetidine", ua hepatic metabolism ntawm lub active tivthaiv, uas tsub kom cov neeg kawm ntawv ntawm lidocaine toxicity.

Hypokalemia, uas txhais los ntawm kev siv ntawm "acetazolamide" diuretic, tiv thaiv qhov kev txiav txim ntawm lidocaine.

Nws ua rau kev phiv simultaneous siv ntawm cov tshuaj nrog vasoconstrictors.

Tshwj xeeb cov lus qhia

Tsis txhob muab txim "lidocaine" (5% tshuaj pleev) nyob rau hauv mucosa ntawm lub qhov ncauj kab noj hniav, los yog yog hais tias muaj yog ib tus mob o ntawm tus neeg mob kuaj sepsis.

Kom tsis txhob mauj haum, nws yog tsim nyog los siv huab ceev faj kho rau anemia, methemoglobinemia, raws li zoo raws li tsis muaj glucose-6-phosphate dehydrogenase.

Thaum kev tsis haum tshuaj pleev yuav tsum tam sim ntawd txhob muab nws siv thiab saib xyuas cov kev phiv.

"Lidocaine" yog tsis muab rau cov neeg mob kev txom nyem los ntawm hypovolemia, raws li zoo raws li muaj ib tug txhaws ntawm lub plawv nqaij thiab lwm yam disruptions ntawm mob conduction.

Ceev faj siv yeeb tshuaj, yog hais tias muaj yog txhaws lub plawv tsis ua hauj lwm, bradycardia cai los yog ua pa nyuaj siab.

Raws li cov lus qhia txoj kev pheej hmoo ntawm kev phiv los ntawm cov Cns yog tsawg heev. Yog hais tias muaj yog ib tug rhiab heev mus rau yeeb tshuaj nyob rau hauv cov neeg mob "lidocaine" tshuaj siv nrog huab ceev faj. Nyob rau hauv kev tsis haum cov tshuaj tiv thaiv nyob rau hauv lub derivatives ntawm para-aminobenzoic acid ntoo khaub lig nyhav rau lidocaine twb tsis kuaj.

Cov tshuaj yuav tsum tau siv nrog ceev faj thaum lub sij hawm cev xeeb tub, raws li kev tshawb fawb uas qhia tej yam uas cov active tshuaj rau tom ntej no txiv hmab txiv ntoo, twb tsis ua. Kws txawj pom zoo kom hais tias nyob rau hauv thawj peb lub hlis uas cev xeeb tub li sai tau mus refrain los ntawm kev siv ntawm cov tshuaj.

"Lidocaine" kis mus rau hauv niam cov kua mis nyob rau hauv heev me me koob tshuaj uas tsis muaj ib tug tsis zoo feem on me nyuam txoj kev loj hlob.

Raum tsis ua hauj lwm tsis ua rau kuv haj hloov nyob rau hauv lub tshuaj thaum uas siv cov "lidocaine" (5% tshuaj pleev).

Nyob rau hauv lub xub ntiag ntawm daim siab tsis ua hauj lwm yuav tsum yog kiag li tso tseg rau daim ntawv thov ntawm cov tshuaj, los yog los txo kom tsawg li tsawg siv ntawm koob tshuaj. Thaum ua ntawv thov mus rau lub ntsej muag txhais tau tias koj yuav tsum ua kom paub tseeb tias cov tshuaj yog tsis ntaus nyob rau hauv lub qhov muag.

Ib tug overdose ntawm cov tshuaj tej zaum yuav tshwm sim vim mauj toxicity thiab daim ntawv thov ntawm lub zos anesthetics yog tshwm sim los ntawm END ntawm active tshuaj nyob rau hauv cov ntshav. Nws provokes cov tsos ntawm phiv nrog qhov kev txiav txim ntawm lub hauv paus poob siab thiab plawv systems.

Nyob rau hauv no qhov teeb meem no, nqa tawm uas tsim nyog kho mob. Muab caj pas, sim tshem tawm cov pa roj carbon dioxide. Tus neeg mob lub cev yog tswvcuab oxygen los dag respiration.

Yog hais tias muaj convulsions, ces lawv raug muab tshem tawm los ntawm qhia rau hauv tus kab mob ntawm succinylcholine nyob rau hauv ib tug npaum li ntawm 50-100 mg, thiab / los yog diazepam ntawm ib koob tshuaj 5-15 mg. Nyob rau hauv tej rooj plaub, cov kev siv ntawm luv luv-kuj barbiturates. Lim Ntshav Hauv Lub nyob rau hauv xws li ib tug teeb meem no tsis muab cov nyhuv thiab yog li ntawd tsis thov kev pab.

Analogs "lidocaine"

Yog hais tias rau ib co yog vim li cas, "lidocaine" (tshuaj pleev) rau plaub hau hle los yog tsis mus txog rau lwm yam hom phiaj, tsis txhob tag kev cia siab, nws yog txaus them sai sai mus hloov no txhais tau tias cov tshuaj, cov uas yog:

• "Naropin";
• "Bulivakain";
• "Ultrakain DS";
• "Novocaine";
• Cov tshuaj nplaum "Emla";
• "Mydocalm";
• "Zaldiar";
• "Artifrin";
• "Nalbuphine";
• "Diprofool".

Kev siv ntawm txhua cov tshuaj nws muaj nws tus yam ntxwv, yog li cov kev hloov yuav tsum tau ua los ntawm ib tug kws kho mob. Tsuas yog nyob rau hauv cov ntaub ntawv no, koj yuav suav tau rau ib tug competent xaiv ntawm cov tshuaj.

Xyuas cov poj niam txog txoj kev siv cov tshuaj pleev rau depilation

Muaj ntau cov lus tau txais tshuaj "lidocaine" (tshuaj pleev). Cov plaub hau tshem tawm siv no neeg sawv cev tau ceased mus yuav mob heev. Nws yog zoo tshem tawm qhov mob, relieves rhiab heev, uas koj yuav ua rau cov plaub hau kev tshem tawm txoj kev yog heev ruaj ntseg thiab nyiam li sai tau. Cov poj niam qab zib yog thov mus rau tag nrho cheeb tsam uas yuav tsum tau ua thiab muab tso rau hauv sab saum toj polyethylene thiab tuav 2-3 teev. Tom qab no manipulations yog feem ntau mob thaum lub sij hawm plaub hau hle yog tsis muaj txawm nyob rau lub feem ntau rhiab qhov chaw ntawm lub cev.

Tab sis tsis yog txhua tus yuav zoo siab nrog qhov kev txiav txim ntawm "lidocaine" tshuaj (tshuaj pleev). Tsis zoo xyuas hais tias nws yog lig puas lub cuab tam, thiab nws yuav luag tsis tshem tawm qhov mob. Ib txhia poj niam gel tshem tawm qhov mob, tab sis ib tug me ntsis rhiab heev yog tseem coj lub sij hawm cov plaub hau kev tshem tawm txoj kev. Muaj coob tus neeg xav siv "lidocaine 'tsuag thiab hais tias nws yog ua yeeb yam nyob rau hauv ob peb lub sij hawm zoo tshaj lub tshuaj pleev. Qhov no yog vim tus neeg yam ntxwv ntawm tus kab mob.