The medicine "Novocaine" is an effective pain medication. The medicine is included in the list of the most important medical devices.
Pharmacological properties of the drug "Novocaine"
Instructions for use indicate that the drug has a local anesthetic moderate activity, is widely used in medical practice. The drug "Novocaine", which is a weak base, blocks the sodium channels, preventing the development and spread of nerve impulses in nerve fibers and endings. When taking the medication, the potentials of action in the nerve cells change, while there is no significant effect on the resting potentials. The medicine suppresses the spread of pain impulses.
During absorption and when it enters the bloodstream directly after intravenous administration, the excitability of cholinergic peripheral systems decreases, reproduction and release of acetylcholine from preganglionic ends are reduced. Medication "Novocaine" (instructions for use tells about this) eliminates spasms of smooth muscles, reduces the excitability of the motor zone in the cerebral cortex and myocardium.
With intravenous use, the solution has antiarrhythmic, hypotensive, anti-shock, analgesic effects, increases the refractory period, significantly reduces conductivity, automatism and excitability. When using large doses, a violation of nerve muscle conduction can occur, convulsions are observed.
The medicine removes the inhibitory downward effects of the brain stem, depressing effects on polysynaptic reflexes. It has a short-term anesthetic activity. The action of infiltration anesthesia lasts from 30 minutes to 1 hour. Novocaine solution, administered intramuscularly to elderly patients in the early stages of pathologies, can effectively deal with diseases associated with impaired functioning of the nervous system, spasms of coronary and cerebral vessels, arterial hypertension.
The medicine is poorly absorbed through the mucous membranes. When injecting, the active substance enters the blood faster, is hydrolyzed by tissue and plasma esterases, forming two main active metabolites: PABA (antagonists of chemotherapeutic sulfanilamide drugs) and diethylaminoethanol (which has a moderate vasodilating effect). It is excreted mainly by the kidneys in the form of metabolites.
The composition and release form of the drug "Novocaine"
The medicine is produced in the form of a solution for injection, which is a clear, colorless liquid, in ampoules from 1 to 20 ml in volume. The percentage of active component in them is 0.25 and 0.5. In addition, produce one and two percent solution of the drug "Novocaine". The price of this form is about 15 rubles.
Powder is also popular, as well as a sterile solution of the drug, poured into vials of 0.2 and 0.4 liters. For the treatment of many diseases, ointment of 5 and 10 percent and suppositories are used, which contain 0.1 grams of the active substance (procaine hydrochloride), as well as auxiliary components - vitepsol or solid fat. In 1 ml of the solution, the active substance is contained in a volume of 0.005 g, hydrochloric acid and water for injection are additional components.
Indications for use
The drug "Novocaine" recommends that you use the instructions for use to perform retrobulbar, terminal, spinal, conduction, epidural, infiltration anesthesia. With the help of a medication, vagosympathetic and perinephral cervical blockade is produced. The use of suppositories is effective for analgesia for cracks in the anus and hemorrhoids. The use of ointment is due to symptoms of neurodermatitis, eczema, itchy dermatosis.
The medicine "Novocaine": instructions for use
Injections for adult patients as an infiltration anesthesia are done in a volume of 300-600 mg (0.25-0.5 percent solution).
Tight creeping infiltration according to the Vishnevsky method is performed by introducing a 0.25% solution in an amount of 125 ml. Epidural anesthesia is done using a two percent solution of Novocaine. Injections, the instruction recommends a dosage of 25 ml. Spinal anesthesia is obtained through 2-3 ml of a 5% drug. In otolaryngological practice, a 10% solution of the drug is used for local anesthesia.
To increase the duration of action of the medication and reduce its absorption, as well as with local anesthesia, the drug Novocaine is diluted with a solution of epinephrine hydrochloride. To perform electrophoresis, the use of a 10% medication is recommended. When performing blockade according to Vishnevsky, 60 or 120 ml of a 0.5 or 0.25% solution, respectively, should be injected into the perinephric tissue. Vagosympathetic blockade is performed by introducing 100 ml of the drug at a 0.25% concentration.
Despite contraindications, Novocain injections are often prescribed for children as an anesthetic during the administration of other medicines. The dosage is calculated based on the weight of the child (not more than 15 mg per kilogram).
Rectal suppositories are used after a preliminary bowel cleansing with an enema or naturally. With skin pathologies, the ointment is applied in a thin layer on the affected integument up to two times in knocking.
Side effects
The drug "Novocaine" (instructions for use warns about this) can cause negative reactions of the body.
The central and peripheral nervous system react to taking the medicine with headache, weakness, drowsiness, dizziness, motor anxiety, and convulsions. In some cases, tremor, loss of consciousness, trismus, hearing and vision impairment, paresthesia, leg paralysis, nystagmus are observed. In addition, respiratory paralysis, blocking of the respiratory muscles may occur.
On the part of the cardiovascular system, a change in blood pressure occurs, pain in the chest area, arrhythmia, bradycardia, collapse, peripheral vasodilation is noted.
The urinary and digestive systems respond to the use of the drug by involuntary urination, bowel movements, vomiting and nausea.
From the circulatory system, side effects include methemoglobinemia. In addition, the medication can cause allergic manifestations:
- urticaria;
- anaphylactic reactions ;
- skin rash;
- itching
Other adverse reactions include persistent anesthesia, impotence, hypothermia, and the return of pain. During anesthesia in dentistry, anesthesia, paresthesia and insensitivity of the tongue and lips are prolonged.
Overdose
To use the drug "Novocaine", the prescription, which indicates the treatment regimen, must be prescribed by a doctor. If you do not follow the instructions, signs of an overdose may appear. Symptoms of excessive use of the drug are blanching of the mucous membranes and integuments of the skin, methemoglobinemia, apnea, a sharp drop in pressure, tachycardia, rapid breathing, vomiting, cold sweat, nausea, dizziness. Patients have a feeling of fear, motor excitement, cramps, hallucinations. To eliminate the manifestations of an overdose, it is necessary to carry out pulmonary ventilation with oxygen inhalation, in complex cases, symptomatic and detoxification therapy is prescribed.
Contraindications
Not all patients can use the drug. When performing anesthesia according to the technique of creeping infiltrate, the use of the drug for fibrotic tissue changes is prohibited. Subarachnoid anesthesia cannot be performed with septicemia, shock conditions, hypotension, and bleeding. It is not recommended to engage in informal treatment, for example, to make a compress with Novocain.
Use the drug with caution during operations in patients with acute blood loss, renal failure; in conditions accompanied by a decrease in hepatic blood supply, progressive heart and vascular insufficiency; with infection of injection sites; with inflammatory pathologies. Under special medical supervision, it is necessary to use the medicine during childbirth, for severe and debilitated patients, the elderly and children under the age of majority.
When using the medication with anticoagulants (drugs "Danaparoid", "Warfarin", "Ardeparin", "Dalteparin", "Enoxaparin", "Heparin"), the risk of bleeding increases. A decrease in pressure and bradycardia are observed with the simultaneous administration of the medication with the medicines "Trimethafan", "Mekamilamin", "Guanadrel", "Guanethidine". An increase in local anesthetic action is caused by Epinephrine, Methoxamine, and Phenylephrine.
Application features
Before diluting Novocaine and injecting, it is necessary to determine the individual sensitivity of the body to the medication. For this, a skin test is carried out, and in the presence of redness and swelling, one can judge the individual non-acceptance of the drug.
During treatment, it is necessary to monitor the functioning of the cardiovascular, nervous and respiratory systems. To reduce systemic effects, toxicity and increase the duration of the drug during local anesthesia, Lidocaine or Novocaine are used in conjunction with vasoconstrictors. To do this, one drop of a solution of epinephrine hydrochloride is added to 3 ml of the drug Novocain.
The higher the concentration of the solution used, the more toxic the drug. To reduce the strength of its effects, it is recommended to reduce the total dosage or dilute the drug to a lower concentration. This is done using a sterile isotonic sodium chloride solution.
To prevent the occurrence of a hypersensitivity reaction at the initial stages of treatment, 2 ml of a two percent solution is administered, and after three days (if there are no side effects), the dose is increased to 3 ml, after which they switch to using a full volume of 5 ml per injection.
During outpatient therapy, it is required to refuse to drive a car and carry out activities related to increased attention, speed of motor and mental reactions.
Interaction with other drugs
When administered intravenously, the drug increases the inhibitory effect on the nervous system of sedatives, hypnotics, drugs used for general anesthesia, tranquilizers and narcotic analgesics. The medication lengthens the action of muscle, nervous blockade caused by suxamethonium. The risk of hypotension increases with the combined use of Novocain with MAO inhibitors).
Anticholinesterase drugs increase the toxicity of the drug, inhibit its hydrolysis. Para-aminobenzoic acid, which is a metabolite of the drug, weakens the antimicrobial effect of sulfonamide drugs, because it acts as their competitive antagonist. The likelihood of developing local reactions in the form of edema and soreness increases when the injection site of the local anesthetic is treated with disinfectant solutions containing heavy metals.
The use of the drug "Novocaine" during pregnancy
During the period of bearing a child, many women are faced with the need for dental treatment or various unpleasant symptoms, such as back pain. In dentistry, Novocain is most often used for anesthesia. The use of the drug in such situations is permissible. It is only necessary to inform the doctor about the pregnancy so that he uses the medicine in the light of this provision. With toxicosis occurring with a change in blood pressure, it is also allowed to use the medication Novocain. In pregnancy, its use is possible only with high blood pressure after prior consultation with a doctor.
The tool facilitates the work of the heart and has a relaxing effect on the muscles. For pain in the stomach, which are associated with peptic ulcer disease, the use of suppositories is recommended. It is also possible to normalize the pressure in hemorrhoids using candles. The drug "Novocaine" during pregnancy is used only as prescribed by the doctor, self-medication is unacceptable! The specialist will calculate the necessary dose and frequency of admission by analyzing pregnancy rates. Suppositories are used twice a day, after cleansing the body with an enema.
Price and analogues of the medication "Novocain"
The cost of the drug "Novocaine" (the price may vary slightly in individual pharmacies) in ampoules (0.5%) is 22 rubles. For a bottle of 0.25% solution (200 ml) or rectal suppositories, you will have to give 27 rubles. Structural analogues of the active substance are medicines:
- "Procaine hydrochloride."
- "Novocaine base."
- Novocain Vial.
- "Novocaine Bufus".