Lidocaine (Local)
Kelas obat: Agen Antineoplastik
Panganggone Lidocaine (Local)
Anestesi Lokal utawa Regional
Anestesi lokal utawa regional ing prosedur bedhah (kalebu operasi lisan), prosedur diagnostik lan terapeutik, lan prosedur obstetrik.
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Carane nggunakake Lidocaine (Local)
Umum
Administrasi
Injeksi
Kanggo informasi kompatibilitas solusi lan obat, deleng Kompatibilitas ing Stabilitas.
Diwenehi kanthi infiltrasi lokal, blok saraf perifer, blok paracervical, blok saraf simpatik, blok saraf pusat (contone, blok epidural), blok caudal, utawa blok subarachnoid (spinal). Wis diwenehake kanthi infus intra-artikular sing terus-terusan† [off-label] (contone, kanggo ngontrol nyeri pasca operasi); Nanging, panggunaan kasebut digandhengake karo kondrolisis. (Deleng Risiko Kondrolisis sing Digandhengake karo Infus Intra-artikular saka Anestetik Lokal miturut Ati-ati.)
Konsultasi referensi khusus kanggo teknik lan prosedur khusus kanggo administrasi anestesi lokal.
Kanggo anestesi regional IV, gunakake vial dosis tunggal 50-mL sing ngemot lidocaine hydrochloride 0,5% mung.
Kanggo blok paracervical, suntik alon-alon; ngidini interval 5 menit ing antarane sisih.
Kanggo blok epidural caudal utawa lumbar, aja injeksi kanthi cepet kanthi volume gedhe; yen bisa, gunakake kanthi dosis fraksional (tambahan).
Kanggo blok epidural utawa spinal, aja nggunakake preparat sing ngemot pengawet antimikroba (contone, methylparaben), amarga keamanan administrasi intratekal nggunakake preparat kasebut durung ditetepake.
Kanggo blok spinal, suntik alon-alon.
Aspirate sadurunge injeksi kanggo nyegah administrasi intravaskular sing ora sengaja.
Kanggo anestesi dental, solusi lidocaine hydrochloride 2% karo epinefrin 1:100.000 luwih disenengi kanggo prosedur rutin; yen luwih jero lan hemostasis sing luwih cetha dibutuhake, gunakake persiapan sing ngemot epinefrin 1:50.000.
Kanggo disinfeksi kimia ing permukaan wadhah, lembab katun utawa kasa nganggo alkohol isopropil (91%) utawa etil alkohol. (70%) lan ngilangke lumahing sak tenane sadurunge digunakake. Aja nggunakake merek alkohol sing dudu kelas USP, amarga preparat kasebut bisa ngemot denaturan sing bisa ngrusak karet.
PengenceranEncer karo injeksi natrium klorida 0,9% kanggo entuk konsentrasi sing dikarepake.
Dosis
Kasedhiya minangka lidocaine hydrochloride, minangka kombinasi tetep sing ngemot lidocaine hydrochloride lan epinephrine bitartrate utawa epinephrine hydrochloride, lan minangka lidocaine hydrochloride ing injeksi Dextrose. Dosis dituduhake ing syarat-syarat lidocaine hydrochloride.
Yen dosis (volume) sing luwih gedhe dibutuhake, gunakake preparat sing ngemot epinefrin (kajaba kontraindikasi).
Pasien Anak
Anestesi Lokal utawa Regional Infiltrasi Lokal, Blok Saraf Periferal/Simpatetik , Epidural/Caudal BlockGunakake dosis sing luwih murah tinimbang sing disaranake kanggo wong diwasa sing sehat (pirsani Dewasa ing Dosis lan Administrasi).
Anestesi ing Area Maxillary lan Mandibular (kanggo operasi lisan)Bocah <10 taun : 18–20 mg (0.9–1 mL) larutan lidocaine hydrochloride 2% cukup kanggo prosedur sing nglibatake 1 untu (infiltrasi lokal), 2–3 untu (infiltrasi maksila), utawa untu ing kabeh kuadran (blok mandibula).
Dewasa
Anestesi Lokal utawa Regional Infiltrasi LokalPerkutan: 5–300 mg (1–60 mL) lidocaine hydrochloride 0,5 utawa 1% larutan (tanpa epinefrin).
IV regional: 50–300 mg (10–60 mL) larutan lidocaine hydrochloride 0,5% (tanpa epinefrin).
Blok Saraf PeriferBraChial: 225–300 mg (15–20 mL) saka larutan lidocaine hydrochloride 1,5% (tanpa epinefrin).
Dental: 20–100 mg (1–5 mL) larutan lidocaine hydrochloride 2% (tanpa epinefrin).
Intercostal: 30 mg (3 mL) larutan lidokain hidroklorida 1% (tanpa epinefrin ).
Paravertebral: 30–50 mg (3–5 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin).
Pudendal: 100 mg (10 mL) lidocaine hydrochloride Solusi 1% (tanpa epinefrin) ing saben sisih (kanggo dosis total 200 mg).
Blok ParacervicalAnalgesia obstetrik: 100 mg (10 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin) ing saben sisih (kanggo dosis total 200 mg).
Blok Saraf SimpatisServis (ganglion stellate): 50 mg (5 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin).
Lumbar: 50–100 mg (5–10 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin).
Blok Retrobulbar120–200 mg (3–5 mL) utawa 1,7–3 mg/kg solusi lidocaine hydrochloride 4% dianjurake; bagean saka dosis disuntikake retrobulbarly lan sisane bisa digunakake kanggo mblokir syaraf rai. /p>
Yen injeksi transtrakeal lan aplikasi topikal (semprotan oropharyngeal) dibutuhake kanggo entuk analgesia lengkap, dosis total gabungan saka injeksi transtrakeal lan semprotan oropharyngeal kudu ≤200 mg (5 mL) larutan 4% utawa ≤3 mg. /kg.
Blok Saraf TengahSadurunge blok epidural lumbar, aturake dosis tes kanggo ndeteksi injeksi intravaskular sing ora disengaja. Dosis tes sing ngemot epinefrin 10-15 mcg lan 30-45 mg (2-3 mL) lidocaine hidroklorida 1,5% wis disaranake. Baleni dosis tes yen pasien dipindhah kanthi cara sing bisa ngganti kateter.
Epidural toraks: 200–300 mg (20–30 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin). Dosis ditemtokake kanthi jumlah dermatom sing bakal dibius (umume 2-3 mL saben dermatom).
Epidural lumbar (kanggo analgesia): 250-300 mg (25-30 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin).
Epidural lumbar (kanggo anestesi): 225–300 mg (15–20 mL) larutan lidocaine hydrochloride 1,5% (tanpa epinefrin) utawa 200–300 mg (10–15 mL) saka larutan lidocaine hidroklorida 2% (tanpa epinefrin). Dosis ditemtokake dening jumlah dermatom sing bakal dibius (umume 2-3 mL saben dermatom).
Blok CaudalSadurunge blok ekor, aturake dosis tes kanggo ndeteksi injeksi intravaskular sing ora disengaja. Dosis tes sing ngemot epinefrin 10-15 mcg lan 30-45 mg (2-3 mL) lidocaine hidroklorida 1,5% wis disaranake. Baleni dosis tes yen pasien dipindhah kanthi cara sing bisa ngganti kateter.
Analgesia obstetrik: 200–300 mg (20–30 mL) larutan lidocaine hydrochloride 1% (tanpa epinefrin).
Anestesi bedah: 225–300 mg (15–20 mL) larutan lidokain hidroklorida 1,5% (tanpa epinefrin).
Blok Subarachnoid (Spinal)Pangiriman vagina: Kira-kira 50 mg (1 mL) saka lidocaine hydrochloride 5% ing dextrose 7,5% injeksi.
Sectio caesar utawa pangiriman sing mbutuhake manipulasi intrauterine: 75 mg (1,5 mL) lidocaine hydrochloride 5% ing dextrose 7,5%.
Anestesi bedah (weteng): 75–100 mg (1,5–2 mL) lidocaine hydrochloride 5% ing dekstrosa 7,5%.
Anestesi ing Area Maksila lan Mandibular (kanggo operasi oral)20–100 mg (1–5 mL) larutan lidocaine hydrochloride 2% karo epinefrin 1:50.000 utawa 1:100.000.
Batesan Resep
Pasien Anak
Anestesi Lokal utawa Regional Infiltrasi Lokal, Blok Saraf Periferal/Simpatetik, Blok Epidural/KaudalKanggo bocah-bocah>3 taun kanthi massa awak tanpa lemak lan perkembangan normal, dosis maksimal ditemtokake dening umur lan bobot bocah. Contone, dosis kanggo bocah umur 5 taun sing bobote 50 lbs ora kudu ngluwihi 75-100 mg (3.3-4.4 mg / kg utawa 1.5-2 mg / lb). Kanggo anestesi regional IV, maksimal 3 mg / kg (1,4 mg / lb), nggunakake solusi sing luwih encer (contone, larutan lidocaine hydrochloride 0,25 utawa 0,5%). (Deleng Dilution ing Dosis lan Administrasi: Administrasi.)
Anestesi ing Area Maxillary lan Mandibular (kanggo operasi lisan)Kanggo bocah-bocah <10 taun kanthi massa awak tanpa lemak normal lan perkembangan normal, dosis maksimum ditemtokake dening nggunakake formula obat pediatrik standar (contone, aturan Clark). Contone, dosis kanggo bocah umur 5 taun sing bobote 50 lbs ora kudu ngluwihi 75–100 mg (3,3–4,4 mg/kg utawa 1,5–2 mg/lb).
Maksimum 4,5 mg/kg ( 2 mg/lb) bobot awak (tanpa epinefrin) utawa 7 mg/kg (3,2 mg/lb) bobot awak (karo epinefrin).
Dewasa
Anestesi Lokal utawa Regional Infiltrasi Lokal, Blok Saraf Periferal/SimpatetikMaksimum 4,5 mg/kg (2 mg/lb) bobot awak (nganti 300 mg) (tanpa epinefrin) utawa 7 mg/kg (3,2 mg/lb) bobot awak (nganti 500 mg) (karo epinefrin).
IV regional: Maksimum 4 mg/kg.
Blok ParacervicalPanganggone obstetrik utawa nonobstetrik: Maksimum 200 mg (100 mg saben sisih) saben 90 menit Periode.
Blok Epidural/Kaudal KontinuDosis maksimal sing disaranake ora kudu diwenehake kanthi interval <90 menit.
Blok Subarachnoid (Spinal)Dosis >100 mg ora dibutuhake yen teknik lan jarum panggonan sing bener.
Anestesi ing Area Maxillary lan Mandibular (kanggo operasi lisan)Maksimum 4,5 mg/kg (2 mg/lb) bobot awak (nganti 500 mg) (tanpa epinefrin) utawa 7 mg/ kg (3,2 mg/lb) bobot awak (nganti 300 mg) (karo epinefrin).
Populasi Khusus
Gangguan Hepatik
Ngurangi dosis ing pasien sing duwe gangguan hepatik.
Pasien Geriatri
Ngurangi dosis ing pasien geriatrik.
Populasi Liyane
Ngurangi dosis ing pasien sing nandhang penyakit jantung, pasien sing lemes, lan pasien sing lara akut.
Pènget
Kontraindikasi
Pènget/PanandhapPènget
Pengalaman Dokter Pengawas
Kudu digunakake mung dening dokter sing cukup ngerti babagan diagnosa lan ngatur keracunan sing ana gandhengane karo dosis lan kahanan darurat akut liyane sing bisa kedadeyan. Oksigen, peralatan resusitasi, obat-obatan, lan personel sing dibutuhake kanggo perawatan saka reaksi salabetipun kudu langsung kasedhiya. Tundha ing manajemen sing tepat kanggo keracunan sing ana gandhengane karo dosis, kurang ventilasi, lan / utawa sensitivitas sing diowahi bisa nyebabake acidosis, serangan jantung, lan, bisa uga, pati.
Resiko Kondrolisis sing Digandhengake karo Infus Intra-artikular Anestetik LokalKondrolisis (nekrosis lan karusakan saka balung rawan artikular) sing dilapurake ing pasien sing nampa infus intra-artikular terus-terusan saka anestesi lokal, diwenehake kanggo 48-72 jam liwat infus elastomer. piranti, kanggo perawatan nyeri postoperatif. Utamane diamati ing sendi bahu sawise arthroscopic utawa operasi pundhak liyane. Bisa nyebabake cacat jangka panjang; asring mbutuhake intervensi (contone, debridement, arthroplasty). Ora dingerteni manawa obat kasebut, piranti infus, lan / utawa faktor liyane nyumbang kanggo pangembangan kondrolisis. Ora ana piranti anestesi lokal utawa piranti infus elastomer sing disetujoni kanggo terapi infus intra-artikular sing terus-terusan.
Injeksi Intravaskular Tanpa SengajaInjeksi intravaskular sing ora disengaja bisa nyebabake kebingungan, kejang, kasenengan CNS lan/utawa depresi, depresi miokardial, koma, lan/utawa penahanan ambegan. (Deleng Efek Sistem Saraf lan uga deleng Efek Kardiovaskular, ing Cautions.)
Aspirate sadurunge administrasi kanggo njaga saka injeksi intravaskular.
Injeksi Sajrone Kontraksi UterineAja nyuntikake anestesi spinal sajrone kontraksi uterus, amarga arus cairan spinal bisa nggawa cephalad obat luwih saka sing dikarepake.
Administrasi EpinefrinSawetara preparat lidocaine hydrochloride ngandhut epinefrin, sing bisa uga nyebabake cedera iskemik utawa nekrosis. Coba pancegahan biasa sing ana gandhengane karo administrasi epinefrin. (Deleng Efek Kardiovaskular ing Ati-ati.)
Reaksi Sensitivitas
Reaksi Hipersensitivitas lan Hipersensitivitas SilangKamungkinan lesi kulit, urtikaria, edema, utawa reaksi anafilaktoid.
Ora ana hipersensitivitas silang sing dilapurake ing pasien sing alergi marang turunan para-aminobenzoik (contone, benzocaine, procaine [ora kasedhiya maneh ing AS], tetracaine).
Gunakake kanthi ati-ati ing pasien kanthi sensitivitas obat sing dikenal.
Sensitivitas SulfitSawetara preparat lidocaine sing ngandhut epinefrin ngandhut sodium metabisulfit, sing bisa nyebabake reaksi alergi (kalebu anafilaksis lan episode asma sing ngancam nyawa utawa kurang abot) ing individu sing rentan tartamtu.
Pancegahan Umum
Efek Sistem SarafKonsentrasi plasma beracun saka anestesi lokal (asil saka panyerepan sistemik) sing digandhengake karo efek SSP sing ala (contone, pusing, gugup, kuwatir, euforia, bingung, pusing, ngantuk, tinnitus. , kabur utawa pindho sesanti, muntah, sensasi panas, kadhemen utawa mati rasa, twitching, tremor, kejang, semaput, penahanan ambegan). Ngawasi tingkat kesadaran kanthi ati-ati sawise saben injeksi anestesi lokal.
Anestesi spinal bisa digandhengake karo efek neurologis sing ora becik (contone, kelangan sensasi perineal lan fungsi seksual, anestesi terus-terusan, paresthesia, kelemahane lan lumpuh ekstremitas ngisor, sirah).
Risiko cedera saraf kanthi nggunakake jarum cilik lan microcatheters kanggo anestesi spinal; bisa uga minangka akibat saka pooling obat lan distribusi anestesi pekat sing ora konsisten ing ruang subarachnoid. Yen pamblokiran ora lengkap utawa patchy ana lan ora responsif kanggo repositioning pasien, tamba bisa missplaced utawa ora cukup disebaraké. Panganggone jarum spinal kanthi ukuran sing cukup bisa nggampangake distribusi intratekal; ing uji klinis, jarum spinal 22- lan 25-gauge digunakake kanthi aman kanggo anestesi spinal lidocaine injeksi tunggal. Pasinaon kewan nuduhake yen pengenceran 5% lidocaine hidroklorida kanthi volume CSF sing padha utawa natrium klorida 0,9% bebas pengawet bisa nyuda resiko cedera saraf saka kumpulan obat sing dikonsentrasi.
Efek KardiovaskularKonsentrasi plasma beracun lokal. anestesi (asil saka panyerepan sistemik) sing digandhengake karo efek kardiovaskuler sing ala (umpamane, bradikardia, hipotensi, lan ambruk kardiovaskular, serangan jantung). Ngawasi kanthi ati-ati tandha vital kardiovaskular lan ambegan sawise saben injeksi anestesi lokal.
Gunakake kanthi ati-ati ing pasien sing duwe gangguan fungsi kardiovaskular, kejut abot, utawa blok jantung.
Sawetara preparat lidocaine hydrochloride ngandhut epinefrin; risiko respon vasoconstrictor exaggerated ing pasien karo penyakit pembuluh darah perifer utawa hipertensi. Gunakake kanthi ati-ati lan kanthi jumlah sing diwatesi kanthi ati-ati ing wilayah awak sing disedhiyakake dening arteri pungkasan utawa duwe gangguan pasokan getih (umpamane, digit, irung, kuping njaba, penis).
Hipertermia Malignant FamilialAkeh obatan sing digunakake sajrone nindakake anestesi bisa nyebabake hipertermia maligna familial; ora dingerteni apa anestesi lokal jinis amida nyebabake reaksi kasebut. Nanging, protokol standar kanggo manajemen kudu kasedhiya. Tandha awal tachycardia, tachypnea, BP labil, lan acidosis metabolik bisa ndhisiki kenaikan suhu. Yen hipertermia ganas famili dikonfirmasi, mungkasi agen pemicu lan miwiti terapi sing cocog (contone, oksigen, dantrolene) lan langkah-langkah pendukung liyane.
Kondisi sing wis anaGunakake blok epidural lan caudal lumbar kanthi ati-ati banget ing pasien sing nandhang penyakit neurologis sing wis ana, deformitas spinal, septicemia, lan hipertensi abot.
Kahanan sing bisa nyegah panggunaan anestesi spinal. (gumantung marang evaluasi klinis babagan kahanan lan kemampuan kanggo ngatur komplikasi potensial) kalebu penyakit CNS sing wis ana (contone, penyakit sing ana gandhengane karo anemia pernisiosa, poliomielitis, lumpuh saka ciloko saraf lan sifilis); kelainan hematologis predisposisi kanggo koagulopati; terapi antikoagulan saiki; nyeri punggung kronis; sirah preoperative; hipotensi utawa hipertensi; masalah teknis (paresthesias terus-terusan, tunyuk balung mburi getih terus-terusan); arthritis utawa deformitas balung mburi; umur ekstrem; lan psikosis utawa panyebab liya saka kerjasama pasien sing ora apik.
Risiko sing Digandhengake karo Macem-macem Teknik AdministrasiPamblokiran paracervical: Kemungkinan penyerapan sistemik kanthi cepet. Kejang ibu lan ambruk kardiovaskuler dilaporake sawise blok paracervical kanthi anestesi lokal tartamtu (digunakake kanggo ngindhuksi anestesi kanggo aborsi elektif). Ngatur dosis alon-alon; ora ngluwihi dosis maksimum sing disaranake. (Deleng Administrasi lan deleng Watesan Resep, ing Dosis lan Administrasi lan uga deleng Tenaga Kerja lan Pangiriman ing Cautions.)
Blok retrobulbar: Kemungkinan ciloko permanen ing otot ekstraokular sing mbutuhake perbaikan bedah.
Efek Ngaruhi Serius sing Gegandhengan karo Anestetik LokalRisiko efek samping sing serius (contone, kejang, koma, detak jantung sing ora teratur, depresi pernapasan) kanthi nggunakake anestesi lokal topikal; umume dilapurake sawise aplikasi preparat topikal sing disiapake sacara ekstemporan sing ngemot anestesi konsentrasi dhuwur.
Potensi efek samping sing ngancam nyawa (umpamane, detak jantung sing ora teratur, kejang, kesulitan ambegan, koma, pati) nalika anestesi lokal topikal ditindakake. ditrapake ing area kulit sing akeh, nalika area aplikasi ditutupi karo klamben occlusive, yen anestesi topikal akeh banget, yen anestesi ditrapake ing kulit sing iritasi utawa rusak, utawa yen suhu kulit mundhak (saka olahraga). utawa nggunakake pad pemanas).
Gel lidocaine 4% wis diteliti kanggo nyuda rasa ora nyaman nalika mammografi. Apa panggunaan kasebut bisa nyebabake reaksi serius durung ditemtokake. Pasien kudu ngomong karo dokter yen lagi mikir nggunakake anestesi topikal sadurunge njupuk mammogram.
Yen anestesi topikal dibutuhake kanggo prosedur, panggunaan persiapan sing disetujoni FDA wis dianjurake. Gunakake preparat sing ngemot konsentrasi anestesi paling murah sing bisa efektif; aplikasi jumlah cilik saka preparation kanggo wilayah sing magepokan kanggo wektu paling cendhak perlu kanggo efek sing dipengini, lan ora ditrapake kanggo kulit rusak utawa iritasi.
Gunakake Kombinasi TetepYen digunakake ing kombinasi tetep karo agen liyane , nimbang ati-ati, pancegahan, lan kontraindikasi sing digandhengake karo agen sing bebarengan.
Populasi Spesifik
KandhutanKategori B.
Tenaga Kerja lan PangirimanHipotensi ibu dilapurake. Kanggo nyegah nyuda tekanan getih, angkat sikil pasien lan posisi pasien ing sisih kiwa. Ngawasi denyut jantung janin terus-terusan; ngawasi janin elektronik banget dianjurake.
Injeksi intravaskular utawa intrakranial janin sing ora disengaja sawise paracervical lan/utawa bisa nyebabake depresi neonatal sing ora bisa dijelasake nalika lair utawa kejang sajrone 6 jam sawise lair.
Pemblokiran paracervical bisa nyuda durasi persalinan tahap pertama. lan nggampangake dilatasi serviks. Kemungkinan bradikardia janin lan acidosis; tansah ngawasi detak jantung janin. Kanggo pamblokiran paracervical ing prematuritas, toxemia meteng, utawa anane gangguan janin, nimbang keuntungan saka terapi versus resiko.
Anestesi epidural lan spinal bisa ndawakake tahap kapindho saka persalinan (kanthi ngilangi dorongan refleks parturient kanggo nyuda utawa kanthi ngganggu fungsi motor); bisa nambah perlu bantuan forceps.
Kekuwatan otot lan nada otot sing suda ing dina pisanan utawa kaloro bayi.
LaktasiOra dingerteni manawa lidocaine disebarake menyang susu. Ati-ati yen digunakake ing wanita nursing.
Panggunaan PediatrikKeamanan lan khasiat lidocaine hydrochloride ing injeksi dextrose ora ditetepake ing pasien pediatrik <16 taun.
Panggunaan GeriatrikDisaranake nyuda dosis.
Gagal HepatikRisiko keracunan sing bisa saya tambah, utamane ing pasien kanthi gangguan hepatik sing abot. Gunakake kanthi ati-ati. Pangaturan dosis dianjurake.
Efek Samsaya Awon
Efek sistem saraf lan kardiovaskuler. (Deleng Efek Sistem Saraf lan Efek Kardiovaskular, ing Waspada.)
Blok balung mburi: Sakit sirah posisi, hipotensi, nyeri punggung, ndredheg.
Apa obatan liyane bakal mengaruhi Lidocaine (Local)
Pertimbangake interaksi obat sing biasane ana gandhengane karo administrasi epinefrin.
Obat Spesifik lan Tes Laboratorium
Obat
Interaksi
Komentar
Anestesi, umum
Kamungkinan aritmia jantung amarga komponen epinefrin.
Gunakake kanthi ati-ati.
Antidepresan, trisiklik
Kamungkinan hipertensi sing abot lan dawa amarga komponen epinefrin.
Aja nggunakake bebarengan; yen kudu digunakake bebarengan, ngawasi ati-ati dibutuhake.
Butyrophenone
Kamungkinan nyuda utawa mbalikke efek pressor epinefrin.
Aja nggunakake bebarengan; yen kudu digunakake bebarengan, ngawasi ati-ati dibutuhake.
Oxytocics alkaloid ergot (ergonovine, methylergonovine)
Kamungkinan hipertensi abot, terus-terusan utawa kacilakan serebrovaskular amarga komponen epinefrin.
Inhibitor MAO
Kamungkinan hipertensi sing abot lan dawa amarga komponen epinefrin.
Aja nggunakake bebarengan; yen kudu digunakake bebarengan, ngawasi ati-ati dibutuhake.
Phenotiazines
Kamungkinan nyuda utawa mbalikke efek pressor epinefrin.
Aja nggunakake bebarengan; yen kudu digunakake bebarengan, ngawasi ati-ati dibutuhake.
Vasopressors
Kamungkinan hipertensi abot, terus-terusan utawa kacilakan serebrovaskular amarga komponen epinefrin.
Tes kanggo CPK
Kamungkinan konsentrasi CPK tambah sawise injeksi IM lidocaine.
Akurasi minangka tes diagnostik kanggo AMI dikompromi yen digunakake tanpa pamisahan isoenzim.
Disclaimer
Kabeh upaya wis ditindakake kanggo mesthekake yen informasi sing diwenehake dening Drugslib.com akurat, nganti -tanggal, lan lengkap, nanging ora njamin kanggo efek sing. Informasi obat sing ana ing kene bisa uga sensitif wektu. Informasi Drugslib.com wis diklumpukake kanggo digunakake dening praktisi kesehatan lan konsumen ing Amerika Serikat lan mulane Drugslib.com ora njamin sing nggunakake njaba Amerika Serikat cocok, kajaba khusus dituduhake digunakake. Informasi obat Drugslib.com ora nyetujoni obat, diagnosa pasien utawa menehi rekomendasi terapi. Informasi obat Drugslib.com minangka sumber informasi sing dirancang kanggo mbantu praktisi kesehatan sing dilisensi kanggo ngrawat pasien lan / utawa nglayani konsumen sing ndeleng layanan iki minangka tambahan, lan dudu pengganti, keahlian, katrampilan, kawruh lan pertimbangan babagan perawatan kesehatan. praktisi.
Ora ana bebaya kanggo kombinasi obat utawa obat sing diwenehake kanthi cara apa wae kudu ditafsirake kanggo nuduhake yen obat utawa kombinasi obat kasebut aman, efektif utawa cocok kanggo pasien tartamtu. Drugslib.com ora nanggung tanggung jawab kanggo aspek kesehatan apa wae sing ditindakake kanthi bantuan informasi sing diwenehake Drugslib.com. Informasi sing ana ing kene ora dimaksudake kanggo nyakup kabeh panggunaan, pituduh, pancegahan, bebaya, interaksi obat, reaksi alergi, utawa efek samping. Yen sampeyan duwe pitakon babagan obat sing sampeyan gunakake, takon dhokter, perawat utawa apoteker.
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