Lidocaine-Vial, 10% spray 38 g

Lidocaine is a local anesthetic and antiarrhythmic drug.

The antiarrhythmic activity is due to inhibition of phase 4 (diastolic depolarization) in Purkinje fibers, reduction of automaticity, suppression of ectopic foci of excitation. The rate of rapid depolarization (phase 0) is not affected or slightly reduced.

increases membrane permeability to potassium ions, accelerates the process of repolarization and shortens the action potential. It does not change the excitability of the sinus-atrial node and has little effect on conduction and myocardial contractility. When administered intravenously it works quickly and shortly (10-20 min).

The mechanism of local anesthetic effect consists in stabilization of neuronal membrane, reduction of its permeability to sodium ions, which prevents the emergence of action potential and impulse conduction. Antagonism with calcium ions is possible.

It is rapidly hydrolyzed in a weakly alkaline environment of tissues and after a short latent period acts for 60-90 minutes. In inflammation (tissue acidosis) anesthetic activity decreases.

Effective in all types of local anesthesia. It dilates the blood vessels. It has no irritating effect on the tissue.

Indications

The drug may be used for local anesthesia in the following cases:

• in dentistry for terminal (superficial) anesthesia: anesthetization of the injection area before local anesthesia; opening of superficial abscesses; before mucosal sutures; before fixation of crowns and bridges; in the treatment of inflamed gums, paradontopathies; extirpation of milk teeth; removal of tartar;
• in otorhinolaryngology: nasal septum surgery and removal of nasal polyps; electrocoagulation in the treatment of nasal bleeding; elimination of pharyngeal reflex and anesthesia of the injection needle site before removal of tonsils; opening of peritonsillar abscesses;
• in obstetrics and gynecology: episiotomy and incision treatment; removal of sutures; minor vaginal and cervical surgery; rupture of the hymen; treatment of thread abscesses;
• in instrumental and endoscopic examinations: before insertion of a probe through the nose or mouth (duodenal probing and fractional examination of gastric secretion); in rectoscopy, intubation;
• in radiographic examination: elimination of nausea and glottic reflex; as analgesic medication in burns (including sunburns); bites; contact dermatitis (incl.
• surface anesthesia of the skin in small surgical procedures

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Active ingredient

Lidocaine

Composition

Active ingredient:

Lidocaine 4.8 mg;

Excipients:

Ethanol (96%),

Pearmint oil,

Propylene glycol

How to take, the dosage

The aerosol is sprayed onto mucous membranes.

In each spraying of 1 portion of the aerosol, 4.8 mg of lidocaine is released to the surface.
The dose depends on the indication and the surface area to be anesthetized. In order to avoid high plasma concentrations of lidocaine the lowest dose that provides a satisfactory effect should be used. Usually 1-3 sprays are sufficient, although 15-20 sprays are used in obstetrics (maximum dose is 40 sprays/70 kg body weight).

The drug can be applied to large surfaces using an impregnated swab.

In children under 2 years of age, the drug is preferably administered by swabbing to avoid the fear associated with spraying and the burning sensation.

For patients with hepatic and/or cardiac insufficiency, a 40% dose reduction is recommended.
When using the aerosol, the can should be held upright.

Interaction

It is undesirable to combine lidocaine with the following drugs:

With beta-adrenoblockers because of increased toxic properties of lidocaine, with digitoxin because of weakened cardiotonic effect, with curare-like drugs because muscle relaxation is increased.
It is not rational to prescribe lidocaine together with aymalin, amiodarone, verapamil or quinidine due to increased cardiodepressant effect.

The combined use of lidocaine and novocainamide may cause CNS agitation and hallucinations.
When hexenal or thiopental sodium are administered intravenously against the background of lidocaine action, respiratory depression may occur.

Impact of MAO inhibitors may increase the local anesthetic effect of lidocaine. Patients taking MAO inhibitors should not administer lidocaine parenterally.

The simultaneous administration of lidocaine and polymyxin-B may increase the inhibitory effect on neuromuscular transmission, so the respiratory function of the patient should be monitored in this case.

The simultaneous use of lidocaine with hypnotics or sedatives may increase their CNS depressant effect. When lidocaine is administered intravenously to patients taking cimetidine such unwanted effects as stunned state, somnolence, bradycardia, parasthesias and others are possible. This is associated with increased plasma levels of lidocaine, which is explained by the release of lidocaine from bonding with blood proteins, as well as a slowdown of its inactivation in the liver. If combined therapy with these drugs is necessary, the dose of lidocaine should be reduced.

Pharmaceutical interaction
The following drugs increase the concentration of lidocaine in blood serum when used simultaneously: aminazin, cimetidine, propranolol, pethidine, bupivacaine, quinidine, disopyramide, amitriptyline, imipramine, nortriptyline.

Special Instructions

Please note that children have a much more frequent swallowing reflex than adults.

Lidocaine aerosol is not recommended for local anesthesia before tonsillectomy and adenotomy in children under 8 years of age.

Contraindications

• Sinus node weakness syndrome.
• Developed bradycardia.
• Antrioventricular block of degree 2 and 3 (except when a ventricular simulation probe is inserted).
• Cardiogenic shock.
• Myasthenia gravis.
• High individual sensitivity to lidocaine.
• A history of lidocaine-induced epileptiform seizures.
• Developed impairment of liver function.

If plaster is used in dentistry as an impression material, aerosol is contraindicated because of the risk of aspiration.

Side effects

Allergic reactions: rarely – rash, itching, exfoliative dermatitis, anaphylactic shock, hyperthermia.

Local reactions: a slight burning sensation, which disappears as the anesthetic effect develops (within 1 minute).

Overdose

Symptoms: Increased sweating, pale skin, dizziness, headache, blurred vision, tinnitus, diplopia, decreased BP, bradycardia, arrhythmia, drowsiness, chills, numbness, tremor, anxiety, agitation, seizures, methemoglobinemia, cardiac arrest.

Treatment: In case of the first signs of intoxication (dizziness, nausea, vomiting, euphoria), further administration is stopped, the patient is transferred to a horizontal position; inhalation of oxygen is prescribed; in convulsions, IV 10 mg diazepam; in bradycardia, m-choline blockers (atropine), vasoconstrictors (norepinephrine, phenylephrine). Dialysis is ineffective.

Pregnancy use

Lidocaine aerosol can be used during pregnancy because it is not dangerous in the recommended doses.

It is not known whether lidocaine is excreted with the breast milk. Caution should be exercised when prescribing the drug to a nursing mother.

In lactation, the use of the drug is possible after careful assessment of the expected benefit to the mother and the potential risk to the infant.

Similarities

Lidocaine, Versatis