The common name of the drug is articain + epinephrine. It is made in ampoules with a piston mechanism made of durable transparent glass. It is supplied with a protective foil, which is used in Western countries for this group of drugs - articaine-containing. Each capsule of anesthetic has a transparent film containing information about the use, composition and dosage of the medication, as well as storage methods (this should be a dark place, out of the reach of children and temperature extremes). The standard is a shaded, dry box or box, protected from light, drafts. The temperature is not higher than 25 degrees, as this leads to a quick damage to the medication. Shelf life - about two years, is released (should, at least) as prescribed by the attending physician.
Pharmacokinetics
"Artikain INIBSA" is a local anesthetic. It is used for small operations, dental surgery (in particular for the treatment of pulpitis and tooth extraction) and for suturing. It is a strong painkiller, so the first dose is carried out under the supervision of medical personnel, since the drug has many side effects.
It acts very quickly and for a long time, providing strong anesthesia of the injection site, side effects, despite their multiplicity, are infrequent and therefore articaine is considered the best pain medication for everyone who does not suffer intolerance to such drugs.
The specificity of the properties and therapeutic effect gives a high anesthetic ability to articaine and the necessary duration of the analgesic effect for most dental procedures associated with work in the immediate vicinity of the pulp. Moreover, due to the speed of disintegration and elimination of the drug, there is no cumulative effect - multiple injections practically do not increase anesthesia at the site of intervention.
A sufficiently effective remedy is considered to be Artikain INIBSA. The manufacturer, the Spanish medical laboratory Laboratory INIBSA SA, supplies various anesthetics to Russia, as well as equipment for conduction anesthesia, etc. Due to the introduction of sanctions in 2016, the import of drugs was very complicated. Recently, it began to be replaced by the Russian-made articaine Septanest brand.
Structure
The composition of one ampoule means "Artikain INIBSA" includes:
- 1.8 ml of solution;
- articaine - 72 mg (in 1 ml - 40 mg);
- epinephrine - 0.018 mg (in 1 ml - 0.01 mg).
Doses
In dentistry - 0.5-1.8 ml, depending on the severity of the damage and the size of the tooth, in other cases of local anesthesia - it depends on the situation. The maximum dosage in adults is 7 mg per kilogram of weight, for children under 12 - 5 mg.
"Artikain INIBSA" (1: 200000) provides the main anesthetic effect by blocking nerve endings at the injection site. Disabling sensitivity means that there is a chance of accidentally damaging the anesthetized area. Most often, the tongue and cheek suffer from this during dental treatment - two out of ten patients manage to bite through something for themselves because of this.
Epinephrine (adrenaline in the Russian medical nomenclature) accelerates blood flow, strengthens the work of the heart, thereby reducing the time required to start the action of the drugs. However, in large quantities (from 3 μg / kg / min), it causes vasoconstriction and, as a result, an increase in the duration of action of anesthetics. It is released in the form of a package with one hundred ampoules, each weighing 1.8 g.
With subcutaneous administration of the drug, the effect occurs after about 5-10 minutes. With intramuscular administration, the onset of action depends on the condition of the patient and his muscle tissue.
Instruction manual
"Artikain INIBSA" instructions for use are advised to apply as follows.
The drug is drawn into the syringe through an ampoule with a pump-action mechanism. The injection is carried out nearby, or directly into the intervention zone, depending on the type of action.
Contraindications
- High sensitivity to the main components of the drug, bordering on allergic reactions (articaine, epinephrine, tartaric acid salts, sulfites, etc.).
- Tachycardia and other disorders associated with cardiac rhythm.
- Heart failure.
- Glaucoma in a closed-angle form.
- Bronchial asthma, in particular - provoked by sulfites.
- Anemia due to a lack of vitamin B12.
- Deficiency of blood cholinesterase.
- Diseases of the central nervous system, myasthenia gravis.
- Severe hepatic impairment (porphyria).
- A pronounced form of hyperthyroidism (excessive activity of the thyroid gland).
- Early age (under four years old).
Dangers associated with taking the drug
- Intravenous administration of the drug (specifically, Artikain 4 with Epinephrine INIBSA) is undesirable, as this can provoke a sharp change in pressure, as well as a shutdown of the nervous system for most of the body.
- The introduction of articaine directly into the focus of inflammation is unacceptable, since the injection itself will be extremely painful, and the drug will not be able to disperse in the area due to severe edema.
- Do not reuse opened ampoules, as the solution may be spoiled or unsterilized.
- With caution, the drug should be used by children under 12 years of age, elderly people, people suffering from endocrine diseases, or receiving similar drugs (myoblockers, anesthetics, etc.).
- Pregnant and lactating women can take articaine almost without fear for the health of children. In special laboratory studies, it was found that the drug has a low penetrating ability relative to the placenta around the fetus and is not found in breast milk in concentrations that can affect the development of the baby.
Possible side effects from the use of the drug "Artikain INIBSA" 1: 200000:
- Allergic reactions (from urticaria to anaphylactic shock).
- Edema and inflammation at the injection site.
- Minor cardiac arrhythmias.
- Headache, dizziness, disorientation with the introduction of the drug into the area near the vestibular center.
- Nausea, vomiting, loose stools.
- A very low chance of ischemia in the injection zone, sometimes reaching tissue necrosis (with intravenous administration or overdose).
The highest level of articaine concentration in the blood is reached after 10-15 minutes, regardless of the presence of a vasoconstrictor in the composition of the drug. It is excreted 6 hours after the introduction of the kidneys, neutralized by the liver to inactive components.
Interaction with other drugs
- In combination with antidepressants and MAO inhibitors, the hypertensive effect intensifies, blood pressure rises sharply (steadily rises to 150/100), which is dangerous for most people, especially for hypertensive patients.
- Vasoconstrictors increase pain relief and prolong its effect.
- Adrenergic blockers in combination with articaine increase the chance of developing a hypertensive crisis and bradycardia.
Overdose symptoms
- Weakening of the central nervous system after its short-term excitation, severe trembling of the limbs.
- Sensation of stupor, concussion, severe dizziness, accompanied by vomiting.
- Various hallucinations, hearing impairment and spatial orientation.
- Vascular pressure loss, heavy breathing.
- Loss of consciousness.
If signs appear, stop using articaine, put it on your back or side and allow free, unhindered breathing (it is advisable to lay in a half-lateral position - in case of vomiting, the patient will not choke in his own secretions). Then you need to start measuring your pulse and vascular pressure, interview a person to identify symptoms, call an emergency room to call a team and prepare special medications in order to urgently restore body functions in case of deterioration (using a resuscitation kit is still undesirable without medical supervision )
Reviews
In Russia "Artikain INIBSA" reviews I received good ones from many doctors and patients, as it is an easy-to-use, relatively inexpensive tool (given the release form of 100 cartridges of anesthetic).
For the drug "Artikain INIBSA" 1: 200000, the price varies depending on the form of release and place of purchase. For a pack of one hundred cartridges in pharmacies in Moscow and the Moscow region ask from 2.9 to 3.7 thousand rubles. There is a tendency to piece trade with one-time need: on average, the Artikain INIBSA ampoule price - 33 rubles.
It is rare in pharmacies in Siberia and the Far East, since a small amount of goods is imported into the country, and it is distributed to medical centers and hospitals in Central Russia.
Recently, import has declined even more due to international sanctions, one of the points of which was a ban on the export of medicines of foreign origin to Russia. However, at this time, this issue is being actively addressed.
And do not forget that self-medication with any drug can lead to negative consequences, starting from the lack of a treatment result and ending with a tragic outcome. Therefore, any medication should be taken only as directed by a specialist, treatment should be under the supervision of a doctor.