Jasocaine Gel 0.02

৳ 95.00

Jayson Pharma Ltd.

Lidocaine Hydrochloride

Indications

Lidocaine is a topical anesthetic used for the following purposes

  • To help prevent pain associated with minor surgical procedures in the ear, nose and throat
  • To help prevent pain and or discomfort during dental procedures (e.g., prior to an injection)
  • During general anesthesia to prevent coughing
  • To help prevent pain during the final stages of childbirth, before the cutting or stitching of the perineum (skin between the vagina and anus)

Therapeutic Class

Local & Surface anesthesia

Pharmacology

Lidocaine is an amide type local anaesth. It stabilises the neuronal membrane and inhibits Na ion movements, which are necessary for conduction of impulses. In the heart, lidocaine reduces depolarisation of the ventricles during diastole and automaticity in the His-Purkinje system. Duration of action potential and effective refractory period are also reduced.

Dosage & Administration

Intramuscular: Emergency treatment of ventricular arrhythmias: 300 mg injected into the deltoid muscle, repeat after 60-90 min if necessary.

Intraspinal: Spinal anaesthesia: As hyperbaric soln of 1.5% or 5% lidocaine in 7.5% glucose soln. Normal vaginal delivery: Up to 50 mg (as 5% soln) or 9-15 mg (as 1.5% soln). Caesarian operation: Up to 75 mg (as 5% soln). Other surgical procedures: 75-100 mg.

Intravenous: Pulseless ventricular fibrillation or ventricular tachycardia : 1-1.5 mg/kg repeated as necessary. Max: 3 mg/kg. For ventricular arrhythmias in more stable patients: Usual loading dose: 50-100 mg as an IV inj at 25-50 mg/min, may repeat once or twice up to a max of 200-300 mg in 1 hr, followed by 1-4 mg/min via continuous IV infusion. May need to reduce dose if the infusion is longer than 24 hr.

Intravenous: Intravenous regional anaesthesia: As 0.5% soln w/o epinephrine: 50-300 mg. Max: 4 mg/kg.

Parenteral: 

Percutaneous infiltration anaesthesia: As 0.5% or 1% soln: 5-300 mg.

Sympathetic nerve block: As 1% soln: 50 mg for cervical block or 50-100 mg for lumbar block.

Peripheral nerve block:

  • As 1.5% soln: For brachial plexus block: 225-300 mg.
  • As 2% soln: For dental nerve block: 20-100 mg.
  • As 1% soln: For intercostal nerve block: 30 mg;
  • For paracervical block: 100 mg on each side, repeated not more frequently than every 90 min;
  • For paravertebral block: 30-50 mg;
  • For pudendal block: 100 mg on each side.
  • As 4% soln: For retrobulbar block: 120-200 mg.

Spray:

  • The maximum dose is 200 mg (Approximately 20 spray).
  • In dentistry, the normal dose is 1-5 sprays. Two sprays per quarter of the mouth is recommended, with a maximum of 3 sprays per quarter of the mouth over 30 minutes.
  • In sinus procedures 3 sprays are used.
  • In procedures of the throat and windpipe, up to 20 sprays may be necessary.
  • Up to 20 sprays may be necessary in childbirth (cesarian procedure).
  • Lower doses are used for children aged 3-12 years. Lidocaine 10% Spray is not recommended for children under 3 years.

Topical: Anaesthesia before e.g. venepuncture (not for infants), apply a thick layer under an occlusive dressing 1-5 hours before procedure; split skin grafting, apply a thick layer under an occlusive dressing 2-5 hours before procedure; genital warts (not for children), apply up to 10 gm 5-10 minutes before removal.

Interaction

May increase serum levels with cimetidine and propranolol. Increased risk of cardiac depression with β-blockers and other antiarrhythmics. Additive cardiac effects with IV phenytoin. Hypokalaemia caused by acetazolamide, loop diuretics and thiazides may antagonise effect of lidocaine. Dose requirements may be increased with long-term use of phenytoin and other enzyme-inducers.

Contraindications

Hypovolaemia, complete heart block, Adam-Stokes syndrome, Wolff-Parkinson-White syndrome. Must not be applied to inflamed or injured skin.

Side Effects

Arrhythmia, bradycardia, arterial spasms, CV collapse, oedema, flushing, hert block, hypotension, sinus node suppression, agitation, anxiety, coma, confusion, drowsiness, hallucinations, euphoria, headache, hyperaesthesia, hypoaesthesia, lightheadedness, lethargy, nervousness, psychosis, seizure, slurred speech, unconsciousness, somnolence, nausea, vomiting, metallic taste, tinnitus, disorientation, dizziness, paraesthesia, resp depression and convulsions. Patch: Bruising, depigmentation, petechiae, irritation. Ophth: Conjunctival hyperaemia, corneal epithelial changes, diplopia,visual changes.

Pregnancy & Lactation

Category B: Either animal-reproduction studies have not demonstrated a foetal risk but there are no controlled studies in pregnant women or animal-reproduction studies have shown an adverse effect (other than a decrease in fertility) that was not confirmed in controlled studies in women in the 1st trimester (and there is no evidence of a risk in later trimesters).

Precautions

Patient with pseudocholinesterase deficiency, resp depression. Hepatic and renal impairment. Elderly or debilitated patients. Pregnancy and lactation.

Overdose Effects

Symptoms: Severe hypotension, asystole, bradycardia, apnoea, seizures, coma, cardiac arrest, resp arrest and death.
Management: Maintain oxygenation, stop convulsion and support the circulation.

Use in Special Population

Hepatic Impairment Parenteral: Dosage reduction may be needed.

Storage Conditions

Store below 25°C.

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