Articaine, Epinephrine

The drug is intended for use in the oral cavity and can be administered only in

tissues where there is no inflammation.

Injection into inflamed tissue is not allowed.

The drug can not be administered intravenously.

In order to avoid accidental ingestion of the drug in the blood vessels, before

its introduction should always be carried out aspiration test (in two stages).

Major systemic reactions that may develop as a result of random

intravascular administration of the drug can be avoided by following the injection technique:

after the aspiration test, 0.1-0.2 ml of the drug is slowly injected, then, not

earlier than 20-30 seconds, slowly inject the rest of the dose. Pressure

injections should match the sensitivity of the tissue.

For anesthesia with uncomplicated removal of the teeth of the upper jaw in the absence of

inflammation is usually sufficient to create a depot of the drug in the area of ​​the transition fold

by introducing it into the submucosa from the vestibular side (1.7 ml of the drug per

tooth). In rare cases, complete anesthesia may be required.

additional administration from 1 ml to 1.7 ml. In most cases, this allows not

carry out painful palatal injections. When deleting several near

placed teeth, it is usually possible to limit the number of injections.

For anesthesia with cuts and suturing in the palate to create the palatine

A depot requires about 0.1 ml of the drug per injection.

In the case of removal of premolars of the lower jaw, in the absence of inflammation,

do without mandibular anesthesia, as is usually sufficient

infiltration anesthesia provided by the injection of 1.7 ml per tooth. If so

by not achieving the desired effect, additional

injection of 1-1.7 ml of anesthetic into the submucosa in the region of the transitional fold of the lower

jaws from the vestibular side. If in this case it was not possible to achieve complete

anesthesia, it is necessary to conduct a conductive blockade of the mandibular nerve.

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When processing cavities and grinding teeth under the crowns, with the exception of the lower

molars, depending on the volume and duration of treatment is shown

the introduction of the drug Certacainum 40 mg / ml + 0.005 mg / ml in the transition fold region with

vestibular side in a dose of 0.5-1.7 ml per tooth.

During surgery, the drug Certacainum 40 mg / ml + 0.01 mg / ml in

Depending on the severity and duration of the intervention is dosed individually.

When performing a single medical procedure, adults can enter Articaine in a dose up to

7 mg per 1 kg of body weight. Patients were well tolerated in doses up to 500 mg.

(corresponds to 12.5 ml of solution for injection).

For pediatric patients (over 4 years old), minimal doses should be applied,

necessary to achieve adequate anesthesia, the dose of the drug Certacain

is selected depending on the age and body weight of the child, but the dose of articaine is not

should exceed 7 mg per 1 kg of body weight (0.175 ml / kg). Use of the drug in children

younger than 1 year has not been studied.

For elderly patients and all patients with severe renal and hepatic

insufficiency may create elevated plasma concentrations

Articaine. For these patients, the minimum dose required for

achieve sufficient depth of anesthesia

Regional and local anesthesia should be performed by experienced professionals in

an appropriately equipped room with the availability of ready to

immediate use of equipment and preparations necessary for

monitoring of cardiac activity and resuscitation. Staff,

performing anesthesia must be qualified and trained

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performing anesthesia, must be familiar with the diagnosis and treatment of systemic

toxic reactions, adverse events, reactions and other complications.

To prevent infection (including the hepatitis virus)

make sure that new solutions are always used when taking the solution from the ampoules

sterile syringes and needles.

In order to avoid the development of adverse reactions, it is necessary to apply minimal

effective doses of the drug and before the introduction of the drug to conduct a two-step

aspiration test (see the section "Route of Administration and Doses").

When using the drug may inadvertently injuring the lips, cheeks,

mucous membrane and tongue, especially in children, due to reduced sensitivity.

The patient should be warned that food is possible only after

termination of local anesthesia and recovery of sensitivity.

The drug is intended for use in dentistry. Use for anesthesia

distal extremities is unacceptable due to the risk of ischemia due to

epinephrine content.

Impact on the ability to drive vehicles and mechanisms

The possibility of admission of the patient to the management of vehicles and mechanisms

determined by a doctor.

Symptoms

The most common symptoms are cardiovascular reactions.

system and nervous system, nausea, motor restlessness, clouding of consciousness

during injection, respiratory disorders, muscle twitching, convulsions, shock.

Treatment

Symptomatic treatment. When first signs of overdose appear or

side effects such as nausea, motor restlessness, turbidity

consciousness during the injection, it should be interrupted, the patient transferred to the horizontal

position, clear airway, monitor heart rate and blood pressure.

It is recommended, even if the symptoms do not seem too severe, to ensure

intravenous access. For respiratory disorders, depending on the severity, give

oxygen, in some cases, conduct artificial respiration. Central

analeptics are contraindicated. Muscle twitching or generalized cramps

removed by intravenous injection of short or ultrashort barbiturates

actions. Falling blood pressure, tachycardia or bradycardia often

are eliminated when the patient is placed in a horizontal position. With severe

circulatory disorders and shock of any genesis after stopping the injection

emergency measures are shown: ensuring the airway (oxygen

insufflation), intravenous fluids (electrolyte solution),

glucocorticosteroids. Additionally, you can enter plasma substitutes, albumin.

With a threatening circulatory disorder and increasing bradycardia, it is administered from

0.25 ml to 1 ml epinephrine. An intravenous injection of epinephrine should be made.

slowly under the control of heart rate and blood pressure.

A single dose of intravenous injection of epinephrine should not exceed 0.1 mg, in

Further, if necessary, epinephrine can be administered dropwise (rate of infusion

through dropper is adjusted depending on the pulse rate and blood pressure).

Severe forms of tachycardia and tachyarrhythmias can be eliminated by using

antiarrhythmic drugs, but do not use non-selective beta

adrenergic blockers. Oxygen supply and blood circulation control are needed in

anyway. With an increase in blood pressure in patients suffering

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hypertension, should, if necessary, apply peripheral

vasodilators