Trimecaine trade name. Trimecaine: instructions for use. Contraindications for use

Included in the preparations

ATX:

N.01.B.B Amides

Pharmacodynamics:

Local anesthetic. Blockade of initiation and conduction of nerve impulses: reduction in the permeability of neuron cell membranes for Na + ions, probably through attachment to sodium channels, and an increase in permeability to K +, which reversibly stabilizes the cell membrane and inhibits its depolarization, disrupts the propagation of the action potential and leads to conduction block.

Pharmacokinetics:At local application not studied. Indications: Superficial anesthesia of mucous membranes.

XXI.Z40-Z54.Z51.4 Preparatory procedures for subsequent treatment, not elsewhere classified

Contraindications:

Hypersensitivity, including to other amide local anesthetics.

Carefully:Hypersensitivity. Pregnancy and lactation:

Adequate and well-controlled studies in humans and animals have not been conducted. Use during pregnancy and lactation is not recommended ( breastfeeding).

Directions for use and dosage:For superficial anesthesia of mucous membranes, 2-5% solutions are used topically: in ophthalmological practice- 4-8 drops, in otorhinolaryngology - 2-8 drops, it is possible to add a 0.1% epinephrine solution (1 drop per 2 ml of trimecaine solution). Side effects:

Possibly: skin allergic reactions; at intravenous administration- short-term fainting.

Overdose:

Apnea, collapse (low blood pressure, low or irregular pulse, pallor, sweating, possible cardiac arrest), methemoglobinemia, central neurotoxicity (double vision, confusion, convulsions, dizziness, ringing or buzzing in the ears, trembling, irritability, agitation, nervousness ; possible stimulation and then depression of the central nervous system, as well as loss of consciousness and respiratory arrest).

Interaction:

Antimyasthenic drugs are local anesthetics, especially with rapid absorption in large quantities, inhibit the transmission of nerve impulses, acting as antagonists of the action of antimyasthenic drugs on skeletal muscles. Adequate control of myasthenia gravis may require temporary dosage adjustments of antimyasthenic medications.

Neuromuscular transmission blockers - local anesthetics, especially when rapidly absorbed in large quantities, inhibit the transmission of nerve impulses, which prolongs the effect of neuromuscular transmission blockers.

Vasoconstrictors (methoxamine, ) - it is not recommended to combine methoxamine and local anesthetics, since the effect of both drugs is prolonged, and long-term exposure to methoxamine is accompanied by inhibition of circulation and desquamation of the skin. When combining trimecaine with other vasoconstrictors, it is necessary to carefully observe the proportions, especially when anesthetizing areas of peripheral arteries (fingers, nose, penis), where disturbances in the blood supply to tissues, including gangrene, are more likely.

Patients receiving ganglion-blocking antihypertensive agents (guanagrel, guanethidine, mecamylamine, trimethaphan) may develop severe hypotension and/or bradycardia when receiving spinal or epidural anesthesia with trimecaine at levels sufficient to produce sympathetic blockade.

special instructions:

Efficiency and safety local anesthetics depends on the accuracy of their dosing and compliance with the administration technique. Local anesthetics should be administered by specialists experienced in diagnosis and treatment adverse reactions, violations heart rate and conductivity and others acute conditions. It is necessary to have equipment and medications to relieve severe toxic reactions.

Instructions

Gross formula

C15H24N2O

Pharmacological group of the substance Trimecaine

Nosological classification (ICD-10)

CAS code

616-68-2

Characteristics of the substance Trimecain

White or white with a yellowish tint crystalline powder. Soluble in water and alcohol.

Pharmacology

pharmachologic effect- local anesthetic, antiarrhythmic.

Possessing sufficient lipophilicity, it penetrates the nerve fiber sheath, binds to receptors and disrupts depolarization processes, blocking the conduction of a nerve impulse. It has antiarrhythmic activity due to the stabilization of cardiomyocyte membranes and inhibition of the “slow” sodium current. Promotes the release of potassium, suppresses the automaticity of ectopic pacemakers, shortens the duration of the action potential and the effective refractory period.

Use of the substance Trimecain

Local anesthesia - superficial, infiltration, conduction and spinal; ventricular extrasystoles, tachycardia.

Contraindications

Hypersensitivity, sinus node weakness, AV block, severe bradycardia, cardiogenic shock, liver pathology.

Side effects of the substance Trimecain

Hypotension, headache, dizziness, drowsiness, anxiety, tinnitus, numbness of the tongue and mucous membrane oral cavity, blurred vision, convulsive twitching, tremor, bradycardia.

Interaction

Vasoconstrictors enhance and prolong the effect.

Routes of administration

Parenterally.

Interactions with other active ingredients

Trade names

Name	The value of the Vyshkowski Index ®

pharmachologic effect

Local anesthetic. Causes fast-onset long-term conduction, infiltration, epidural, spinal anesthesia. The mechanism of action is due to the stabilization of neuronal membranes and the prevention of the occurrence and conduction of a nerve impulse. Provides more intense and long action than procaine. Low toxicity, does not cause local tissue irritation.

It has an antiarrhythmic effect and belongs to class IB. Experimental studies have shown that its antiarrhythmic effect is 1.5 times stronger than that of lidocaine. However, when ventricular extrasystole in patients with acute myocardial infarction, it is less effective than lidocaine.

Pharmacokinetics

With intravenous administration, T1/2 in the α-phase is about 8.3 minutes, in the β-phase - about 168 minutes.

Dosage

Individual, depending on the type of anesthesia and indications.

Drug interactions

Norepinephrine, which is often used in combination with trimecaine, causes local vasoconstriction, which leads to a slowdown in the absorption of trimecaine, providing an increase and prolongation of its anesthetic effect, reducing the systemic effect.

Pregnancy and lactation

The safety of trimecaine during pregnancy and lactation (breastfeeding) has not been established.

Side effects

From the side of the central nervous system: headache, dizziness.

Allergic reactions: urticaria, anaphylactic shock.

Other: pale skin, nausea.

Indications

Conduction, infiltration, epidural and spinal anesthesia.

Ventricular arrhythmias in acute myocardial infarction, ventricular arrhythmias (independent of the concentration of potassium in the blood) during intoxication with digitalis preparations, ventricular tachycardia, arrhythmias during surgical interventions and cardiac catheterization.

Contraindications

Hypersensitivity to trimecaine.

special instructions

Trimecaine (like other local anesthetics) in combination with vasoconstrictors is not used in patients with arterial hypertension, diseases of peripheral vessels, as well as for anesthesia of tissues supplied by terminal arteries (terminal phalanges, penis).

Trimeakin belongs to a number of drugs that are organotropic, antiarrhythmic, neurotropic drugs. The medication is widely used in local anesthesia. Despite its prevalence, Trimekain has its own side effects, a list of contraindications that must be taken into account when prescribing treatment.

Trimecain - main characteristics

As a rule, Trimecain is used for local anesthesia. Experts say that this drug has a stronger effect than the well-known “Novocaine”. The formula of the substance is as follows: “C15H24N2O”.

The product is presented in the form of a light powdery mass, has a yellow tint. The drug is administered parenterally. The medicine is not intended for free use and is available only to doctors.

Before use, please read the instructions included in the package. The package also indicates the date, terms and storage conditions of the substance.

It is important to comply with everything necessary measures, which allow you to keep the drug in proper condition.

Pharmacology

"Trimecain" is characterized by the manifestation of antiarrhythmic activity, which is due to the possibility active substance influence the stabilization of the cardiomyocyte membrane, as well as the inhibition of slow sodium currents.

The drug has a suppressive effect on the level of automaticity of the ectopic rhythmic driver, and the active release of potassium particles begins. During the operation of the medication, the duration of refractory periods and exposure potentials noticeably decreases.

It has been proven that Trimecaine is almost 2 times stronger than lidocaine. However, there is one exception. If a patient has ventricular extrasystole, it is diagnosed acute heart attack myocardium, then the doctor may prescribe “lidocaine”, since it is precisely this clinical case this drug will give a stronger effect.

"Trimekain" has strong lipophilicity, which allows active components The medication easily passes into the nerve fibers, in which they form a strong relationship with the receptors. As a result, a disruption occurs in the implementation of depolarization processes, and a blockage of nerve impulses is established.

In combination with auxiliary particles, the main substances provide reliable anesthesia, which can be:

• Infiltrated;
• Provodnikova;
• Spinal;
• Epidural.

It is important to note that the analgesic effect occurs very quickly, the effect of the drug is particularly long-lasting, which makes Trimecain one of the “favorites” among its analogues.

If we compare it with the effect of “procaine,” then “trimecaine” works much longer. In addition, the huge advantage of the medication in question is the lack of toxicity and safety for tissues (irritation does not occur).

Indications for use of "Trimekain"

In what cases is it necessary to use trimecaine?

Doctors say that the medication should be used for:

1. Tachycardia;
2. Detection of ventricular extrasystoles;
3. Severe overdose of products containing digitalis;
4. Ventricular arrhythmia;
5. Myocardial infarction;
6. Carrying out catheterization of internal organs;
7. Surgical manipulations of a variable nature;
8. Any local anesthesia.

It is prohibited to use the drug in the treatment of those patients who:

• Has hypersensitivity to particles included in chemical composition facilities. Otherwise, severe adverse reactions may occur;
• Suffering from atrioventricular block;
• Has a weakened sinus node;
• Suffered from cardiogenic shock;
• Susceptible to severe bradycardia;
• Suffering from liver pathologies;
• Has heart failure;
• Is in a state of pregnancy;
• Breastfeed.

Application

In order to stop the disturbed rhythm, the specialist must administer from 85 to 120 mg of solution (2%), the recommended rate is 2 mg per minute.

If there is superficial anesthesia, then it is allowed to use a 5% solution, conduction anesthesia involves the use of a 2% solution in a volume of up to 200 ml, infiltration anesthesia is carried out using a 0.5% solution, the volume cannot exceed 400 ml, spinal anesthesia requires a 5% solution in the amount of up to 3 ml.

1. Hives will begin;
2. The patient may experience severe itching on the epidermis, redness of the upper layer, inflammatory process in the dermis;
3. Severe pain in the heart area, increased heart rate, resuscitation may be required;
4. Severe nausea, vomiting will begin, the frequency of which sometimes reaches 6-7 times;
5. Consciousness becomes clouded, external receptivity is impaired;
6. Numbness in lower limbs patient;
7. A headache that spreads to the shoulders may radiate to the left arm;
8. Swelling;
9. Difficulty in breathing.

Adverse reactions

The drug may cause the following side effects:

• Hypotension;
• Increased drowsiness;
• The appearance of noise in the hearing organs;
• Feelings of restlessness and increased anxiety;
• Loss of sensitivity on the mucous membranes of the mouth;
• The onset of seizures;
• Manifestations of anaphylactic shock;
• Severe pallor of the epidermis on the face;
• Mild tremor.

It is worth noting that during the studies it was found that the probability of developing adverse reactions is 2%.

Trimecaine - considered reliable, effective and safe drug. Many experts prefer this particular product, since it has the least toxicity, guarantees long-lasting action, and does not violate normal work hearts.

Trimecaine hydrochloride is a drug that belongs to the group of local anesthetics and antiarrhythmic drugs. It is used for superficial anesthesia and is available in the form of a solution. The main active ingredient is trimecaine, the instructions for use of which contain information about how the drug works.

Trimekain

Description and properties of the drug

Being a local anesthetic, trimecaine has a pronounced analgesic effect. With its help, the following types of pain relief are performed:

• superficial;
• conductive;
• epidural;
• spinal;
• infiltration

The drug is lipophilic, so it easily penetrates the membranes of nerve fibers. Subsequently, the molecules of the active substance bind to the receptors, which entails a disruption of the depolarization processes.

Trimecaine acts longer and more intensely than, for example, procaine. When using the described product, local tissue irritation does not occur because the substance is non-toxic. The activity of Trimecain against arrhythmia is determined by the stabilization of cardiomyocyte membranes and inhibition of the “slow” sodium current.

The use of the drug promotes the removal of potassium from the body (its level can be determined in a laboratory), shortening the duration of the action potential and effective period refraction. It is important that the antiarrhythmic effect of Trimecaine is one and a half times stronger than lidocaine, however, when diagnosing ventricular extrasystole in a patient who has suffered an acute myocardial infarction, the drug has a much weaker effect. In this case, according to doctors, it is recommended to prefer lidocaine.

Indications for use

Trimecaine is a drug whose release form is a solution. Supplied in ampoules, where the concentration of the active substance is either 2.0 or 5.0 percent of the component that has the main effect. The package contains 10 ampoules of 2 milliliters each. There is a variation of the drug that combines a 2.0% solution of Trimecaine and a 0.004% solution of norepinephrine. Each ampoule also contains 2 ml of the drug. Sold by prescription.

Ampoules

In medicine, Trimecain is intended to perform various types pain relief: conduction and epidural, infiltration and spinal. Indications for use of the drug are as follows:

1. Cardiology. The drug is used for arrhythmia during cardiac catheterization, during surgical intervention. Trimecaine is indicated to relieve symptoms ventricular arrhythmia in the event of a myocardial infarction. The drug is also recommended in the treatment of ventricular tachycardia.
2. Plastic surgery. Trimecaine is one of the main drugs used for pain relief during plastic surgery.
3. Dentistry.

Important! The drug is quite effective if the body is poisoned with drugs belonging to the group of cardiac glycosides. It should be prescribed by the attending physician, based on the instructions for use of the substance and data from scientific articles.

There are situations when the use of Trimecaine is contraindicated. This is, first of all, increased sensitivity to the main thing active substance and other components of the drug. The drug is not used for AV blockade, cardiogenic shock. If the patient has a history liver failure and chronic renal failure Trimecaine is used with great caution.

Side effects

Side effects may occur when using this anesthetic varying degrees gravity:

• Strong headache;
• drowsiness;
• visual impairment;
• tremor of the limbs;
• anxiety attacks;
• muscle twitching;
• nausea and vomiting;
• pale skin tone;
• lowering blood pressure;
• manifestations of allergic reactions.

These signs can also manifest themselves if the doctor carefully followed the rules for using the drug. If there has been an overdose, the consequences can be more severe:

• collapse;
• heart failure;
• double vision;
• irritability;
• confusion;
• shiver;
• buzzing in the ears;
• stimulation nervous system followed by oppression;
• loss of consciousness;
• in some cases - respiratory arrest.

In case of an overdose, convulsions and dizziness may occur (according to the information in the instructions), which does not go away for a long time.

special instructions

The described drug should be used taking into account some nuances. It's about that patients suffering from arterial hypertension should not take the drug in combination with vasoconstrictors. The same applies to people suffering from peripheral vascular diseases. You should not use Trimecain when surgical manipulation is planned on tissues that are equipped with terminal artery(phalanxes of fingers, penis).

Administration of the drug should be stopped immediately if the patient experiences clonic convulsions. If necessary, you should assign him vasoconstrictors, supply oxygen. If convulsions become difficult character, the patient is indicated for artificial ventilation.

Artificial ventilation lungs

Carefully! During pregnancy, the use of Trimecaine should be extremely careful, because the effectiveness of the drug for representatives of this group has not been established.

It often happens that Trimecaine is used in conjunction with norepinephrine. This provokes vasoconstriction at the local level. The consequence of the process is this: the rate of absorption of the drug decreases, the duration of the analgesic effect is prolonged. The same effect occurs in the case sharing Trimecaine and vasoconstrictors.

Analogues of the drug

The drug can be found in a slightly different form and, accordingly, under a different name. Use other trademark forces manufacturers to replace one of the auxiliary components or change the dosage of the drug. Trimecaine in modern pharmacology can be replaced by one of the analogues:

• aerosol Dioxysol;
• solution for external use Dioxyzol;
• Levosin - ointment;
• Rectal suppositories Simetrid.

Trimecaine hydrochloride is found in combined agents in combination with hydroxymethylquinoxaline dioxide, sulfadimethoxine and chloramphenicol. When purchasing, you should carefully check the authenticity of the drug, because it is produced a large number of counterfeits, which may have a lower price.

More:

List of tablets for the treatment of cardiac arrhythmia, what drugs are taken for this pathology