Anesthetic drugs (local anesthetics). Local anesthetic drugs Means for all types of local anesthesia

Local anesthetics - means for local anesthesia, local anesthetics are substances that reduce the sensitivity of nerve endings due to direct contact with electrically excitable membranes nerve cells and slow down the conduction of excitation along sensitive nerve fibers.

When in contact with tissue, local anesthetics primarily eliminate pain sensitivity and block the transmission of impulses. As anesthesia deepens, temperature and other types of sensitivity are switched off, least of all tactile sensitivity (reception of touch and pressure). This action is reversible and selective.

Classification

1) By chemical structure

Esters (procaine, tetracaine, benzocaine)

Amides (trimecaine, lidocaine, mepivacaine)

2) By duration of action

Short acting– 20-30 minutes (procaine);

Medium duration action – 45-90 minutes (lidocaine, trimecaine, ultracaine);

Long-lasting– 90 minutes or more (bupivacaine).

Mechanism of action

It has been established that the action of these drugs blocks voltage-gated sodium channels and reduces membrane permeability nerve fibers for sodium ions, as a result of competition with calcium ions, the calcium current is disrupted, the potassium current slows down and the surface tension of membrane phospholipids increases. Energy supply is decreasing transport systems ions through the membranes of nerve fibers (as a result of disruption of redox processes in tissues, the production of ATP and other energy substrates decreases). Local anesthetics form a complex with ATP, which also reduces the energy supply to functional processes in the cell. The release of mediators is disrupted, as well as the axonal transport of proteins. This leads to inhibition of action potential formation and, therefore, prevents the generation and conduction of nervous excitation.

Requirements for anesthetics

High selectivity and breadth of action;

Low toxicity;

Do not irritate tissue;

Withstand sterilization;

Sufficient tissue anesthesia for long-term operations;

It is advisable that they do not act on the vessels (do not dilate them).

Vasoconstrictors (adrenaline, nor-adrenaline, vasopressin) are added to solutions of local anesthetics. Vasoconstrictors, slowing down the resorption of the anesthetic from the injection site, prolong and enhance anesthesia, and reduce the toxicity of the drug.

Local anesthetics used to anesthetize the mucous membranes of the oral cavity, hard tissues and dental pulp. Side and toxic effects of local anesthetics, their prevention and elimination.

Local anesthetics are substances that reduce the sensitivity of nerve endings due to direct contact with electrically excitable membranes of nerve cells and slow down the conduction of excitation along sensitive nerve fibers.

During medical manipulations in the oral cavity, the patient may experience conditions that require immediate assistance. Such conditions may be: vomiting, respiratory failure, angina attack, anaphylactic shock (sharp drop in pressure), hypertensive crisis, bronchial asthma attack, drug-induced burns of the oral mucosa.

If vomiting occurs, you can administer neuroleptics, aminazine, haloperidol, thiethylperazine. If breathing becomes difficult or even stops, you can use artificial respiration and administer bemegride or cititon. If an attack of angina pectoris begins, then you need to offer the patient validol or nitroglycerin; to more quickly relieve the attack, you can use inhalation of amyl nitrite. You can try to relieve a hypertensive crisis by administering hygronium or benzohexonium. Whenever anaphylactic shock should first be administered subcutaneously or intravenously solution of adrenaline, simultaneously administer an antihistamine (diphenhydramine, suprastin, pipolfen), as well as hydrocortisone, and, in case of weak cardiac activity, cardiac glycosides (strophanthin). If an attack of bronchial asthma begins, then the patient can be offered the use of the usual medications: isadrin, salbutamol, and intal. For drug-induced burns of the oral mucosa, antidotes are used individually for each damaging substance. In case of a burn with arsenic, the burn site is treated with magnesium oxide or iodine solution. For a burn with phenol-50% alcohol or castor oil. In case of a burn with trichloroacetic acid, the lesion is washed with a large amount of 0.5-1% sodium bicarbonate solution, 0.25% chloramine solution. In case of a burn with iodine, the mucous membrane is treated with magnesium oxide (powder) and a solution of sodium bicarbonate. For a fluoride burn, the burn site is moistened with 10% calcium chloride solution.

4. Cocaine and its substitutes from the group of esters (dicaine, anesthesin). Novocaine. Possible applications in dentistry .

Cocaine - benzoylecgonine methyl ester, a tropane alkaloid, has a local anesthetic and narcotic effect.

Cocaine acts on 3 neurotransmitter systems that are fundamentally important for nervous activity: dopamine, norepinephrine, and serotonin. By binding to monoamine transporters, cocaine disrupts the neuronal reuptake of neurotransmitters by the presynaptic membrane. As a result, the neurotransmitter remains in the synaptic cleft and with each passage of a nerve impulse its concentration increases, which leads to increased effects on the corresponding receptors of the postsynaptic membrane. At the same time, the supply of neurotransmitter in the presynaptic membrane depot is depleted; this effect is especially pronounced with repeated use of cocaine. With each nerve impulse, fewer and fewer neurotransmitters are released and the density of receptors for a given catecholamine on the postsynaptic membrane increases compensatoryly, this phenomenon especially characteristic of dopamine receptors.

The euphoria and psychological dependence caused by cocaine are mainly associated with blocking the dopamine transporter in the central nervous system.

Tachycardia;

Increased blood pressure;

Increased body temperature;

Sweating;

Pupil dilation;

Addiction appears.

Not used in medical practice.

Dicaine (synonym: tetracaine hydrochloride) - parabutylaminobenzoic acid 2-domethylaminoethyl ester hydrochloride. This is a strong local anesthetic, it is quite toxic, because... easily penetrates through intact mucous membranes, is quickly absorbed and can cause intoxication, therefore the highest dose is 3 ml of 3% solution. To slow down absorption, add a 0.1% solution of adrenaline to the drug, 1 drop per 1-2 ml of dicaine. For anesthesia of mucous membranes, use 0.5% dicaine solution, and for anesthesia of hard dental tissues, 3% solution.

Anestezin (ethyl ester of para-aminobenzoic acid) is a slightly water-soluble powder, therefore it is most often used in the form of ointments, pastes, powders, and tablets. In dental practice, 5-20% oil solutions, 5-10% ointments or powders are used to anesthetize the mucous membranes of the oral cavity. To anesthetize hard dental tissues, anesthesin powder or paste (50-70%) is used, and for stomatitis and glossitis, a mixture of anesthesin and hexamethylenetetramine is used. Anesthesin tablets also have an antiemetic effect.

Novocaine(synonym: Procaine hydrochloride) is an ester of diethylaminethanol and para-aminobenzoic acid. It is inferior in activity to other drugs, but it is also less toxic. Novocaine penetrates poorly through intact tissue, so it is used only for infiltration and conduction anesthesia. It not only does not narrow, but even dilates blood vessels, therefore, to reduce absorption, it is recommended to add 1 drop of 0.1% adrenaline solution to 2-10 ml of anesthetic. The duration of novocaine anesthesia is 30-40 minutes, and with the addition of adrenaline it can increase to 1.5-2 hours. In dental practice, it is most often used in the form of 0.5-2% solutions.

5. Local anesthetics from the amide group: trimecaine, lidocaine, articaine (ultracaine), pyromecaine, bupivacaine, mepivacaine. Features of their local and resorptive action, application, specific use in dentistry.

Local anesthetics of the amide group interact more firmly with tissue receptors, act faster, and provide a larger zone of anesthesia. Most drugs in this group are xylidine derivatives.

Trimekain 2-3 times more effective than novocaine, acts faster and lasts longer (not destroyed by blood estras). It is used for infiltration and conduction anesthesia in combination with vasoconstrictors, as it dilates blood vessels. In dental practice, 2-5% trimecaine solutions and ointments are used for superficial anesthesia of the oral mucosa. It has resorptive effects: sedative, anticonvulsant, hypnotic, antiarrhythmic. Allergic reactions Trimecaine is much less common than novocaine. Sometimes after using trimecaine, headaches, nausea, and pale skin are observed.

Lidocaine It has high rate fat solubility, penetrates well through phospholipid cell membranes and is used for all types local anesthesia. It is more active than trimecaine. It has a strong and long-lasting effect, does not irritate tissues, dilates blood vessels, which is why it is used in combination with vasoconstrictors. It has resorptive effects (sedative, analgesic, antiarrhythmic). Less common than other anesthetics, it causes allergic reactions. Intoxication causes drowsiness, blurred vision, nausea, tremors, convulsions, cardiovascular disorders and respiratory depression.

Pyromecaine irritates tissue. Used for superficial anesthesia. (5% ointment) To improve tissue regeneration, metuluracil is added to pyromecaine.

Mepivacaine its action is similar to lidocaine, but does not dilate blood vessels and can be used without a vasoconstrictor, which allows its use in patients with severe cardiovascular and endocrine pathology. Penetrates poorly into tissue and is not effective for superficial anesthesia. Rarely gives allergic reactions. There is no cross-sensitization with other local anesthetics.

Bupivacaine is a butyl analogue of mepivacaine. This structural modification results in a fourfold increase in the effectiveness and duration of anesthesia. It has a pronounced vasodilating effect, and therefore it is used in combination with vasoconstrictors. Bupivacaine is rarely used for routine dental procedures. It is mainly used during extensive operations in the maxillofacial area, when its long-lasting action provides postoperative pain relief. In case of overdose - convulsions and depression of cardiac activity.

Ultracaine– a thiophene derivative, one of the most active local anesthetics. Used for infiltration, conduction and intraligamentary anesthesia. The drug acts quickly, for a long time, has a high diffusion ability and low toxicity, which allows it to be used for pain relief in pediatric dentistry. Contraindicated in patients with bronchial asthma with hypersensitivity to sodium bisulfate.

6. Astringents: organic (plant preparations) and inorganic (metal salts). Mechanism of action, main effects, application, use for inflammatory diseases oral cavity.

Astringents are classified as local anti-inflammatory drugs. They are used in the treatment of inflammatory processes of mucous membranes and skin. At the site of application of these drugs, compaction of colloids of extracellular fluid, mucus, exudate, and the surface of cell membranes occurs. The resulting film protects the endings of the sensory nerves from irritation, and the feeling of pain weakens. In addition, there is a local narrowing of blood vessels, a decrease in their permeability, a decrease in exudation, as well as enzyme inhibition. All this prevents the development of the inflammatory process.

Astringents are divided into the following groups:

1) Organic: Tannin, oak bark decoction, St. John's wort, sage leaf, chamomile flowers, blueberries and bird cherry fruits, tea leaves, arnica flowers, cinquefoil, etc.

2) Inorganic: lead acetate, basic bismuth nitrate, alum, zinc oxide, zinc sulfate, copper sulfate, silver nitrate.

Tannin is halodinic acid. It is obtained from ink nuts, which are growths of the Asia Minor oak and some plants of the sumac family. Prescribed in the form of solutions and ointments. In dentistry, it is used as an anti-inflammatory agent for rinsing with stomatitis and gingivitis (1-2% solution), for lubricating gums (10% solution in glycerin), as a hemostatic agent for bleeding (5%), for treating pathological gum pockets for periodontal diseases.

Oak bark, St. John's wort, etc. contain a significant amount of tannins, which provide the astringent effect of the corresponding decoction. Solutions and decoctions of these plants are used for rinsing, “baths,” and lotions for inflammatory diseases of the oral cavity, sore throat, pharyngitis, burns, and skin cracks. For gastrointestinal diseases, it is used orally.

Inorganic substances in small concentrations they have an astringent effect, and in high concentrations they have a cauterizing effect (albuminates are formed, proteins are precipitated). They have a tanning effect and dry out the mucous membrane. In this case, cracks may form, which limits their use in dental practice. Astringents of organic nature do not have a pronounced tanning effect, dry out tissue to a lesser extent, they are more preferable in the treatment of stomatitis, gingivitis, glossitis, periodontitis and other inflammatory processes in the oral cavity.

ANESTHETICS(anesthetics), drugs used for artificial anesthesia - suppression of pain and other types of sensitivity. In anesthesiology, A. s. is distinguished. for local and general anesthesia (anesthesia). The earliest were inhalation methods of general anesthesia, which began to be used in the mid-19th century - ether, chloroform, nitrous oxide (laughing gas). Since 1868, anesthesia with nitrous oxide began to be combined with the supply of oxygen. These inhalational anesthetics were used until ser. 1950s In 1951, fluotane (halothane, ftorotan) was synthesized in Great Britain, which began to be used for inhalation anesthesia in 1956. In subsequent years, they were synthesized and introduced into clinical practice new inhalation anesthetics - methoxyflurane (pentran), enflurane, isoflurane, sevoflurane, desflurane, xenon.

For quantification activity of inhaled A. s. they use the MAC indicator - the minimum concentration of anesthetic in the pulmonary alveoli, at which 50% of patients have no motor response to a standard painful stimulus (skin incision).

Inhalation A. s. used primarily to maintain anesthesia; for induction of anesthesia they are used only in children. In modern anesthesiology, two gaseous inhalation agents are used. (nitrous oxide and xenon) and five liquid [halothane (fluorothane), isoflurane (foran), enflurane (ethrane), sevoflurane (sevorane), desflurane]. Cyclopropane, trichlorethylene (trilene), methoxyflurane (pentrane) and ether are not used in most countries (ether for anesthesia is still used in small hospitals in the Russian Federation). Specific gravity various methods General inhalation anesthesia in modern anesthesiology accounts for up to 75% of the total number of anesthesias.

Means for non-inhalation general anesthesia are used for short-term surgical operations and diagnostic procedures ( endoscopic examinations), as well as for carrying out artificial ventilation lungs, induction of anesthesia and maintenance of general anesthesia. Some of them are used for basic anesthesia in combination with other A. s. The main representatives of A. s. for non-inhalation general anesthesia - propofol, diprivan, recofol, sodium thiopental, hexenal, ketamine, etomidate (hypnomidate, radenarcon).

A. s. for local anesthesia they are used to turn off pain and other types of sensitivity when performing various surgical interventions, painful diagnostic procedures, as well as for the treatment of arrhythmias. Local anesthetics cause a reversible blockade of receptors and conduction of excitation along nerve fibers when introduced into tissues or delimited anatomical spaces, applications to the skin and mucous membranes. By interacting with specific receptors of sodium channels in the membrane, they block the latter, which reduces the permeability of the membrane to sodium ions and prevents the formation of an action potential and the conduction of excitation. Local anesthetics are used for various types anesthesia, vagosympathetic and perinephric blockades, pain relief for gastric ulcers and duodenum, hemorrhoids. The main representatives of local anesthetics are novocaine, procaine, tetracaine (used for surface anesthesia in ophthalmological and otorhinolaryngological practice; in surgery only for spinal anesthesia), dicaine, lidocaine, leocaine, xylocaine, emla, marcaine, anecaine, trimecaine, bumecaine (used only for surface anesthesia or as an ointment in dentistry), pyromecaine, articaine, ultracaine, cytokartin, ropivacaine.

Local anesthetics can have different side effects(for example, novocaine and anesthesin cause various allergic reactions, trimecaine causes a burning sensation at the injection site, dicaine irritates the mucous membranes). In case of overdose, acute poisoning may occur (pallor of the skin, nausea, vomiting, dizziness, general weakness, convulsions). In severe cases, excitation of the central nervous system is replaced by its depression, breathing disorders and a drop in blood pressure occur.

Anesthetics, or otherwise anesthetics, are indispensable in medical practice. They have the ability to cause anesthesia and are painkillers. But is their use 100% justified? What are the advantages and disadvantages of these medications? Read about this and much more below.

general characteristics

Anesthetics, according to their mechanism of action, are local and intended for anesthesia. Anesthetic drugs are used for artificial anesthesia, that is, they suppress sensitivity and pain after administration of various nature. Pain is an extremely unpleasant sensory and emotional state that occurs when tissue is damaged. Painful sensations cause changes in the human body during and after surgery: metabolism, hemodynamics, and breathing are disrupted. All this can lead to the death of the patient, but pain relief is used to eliminate such changes.

It is a reversible elimination of pain sensitivity. Anesthesia is synonymous with pain relief and means loss of sensation. Anesthesia causes inhibition of the central nervous system, and local anesthesia eliminates the sensitivity of a certain area on the body.

Peculiarities

Local anesthetics penetrate well through mucous membranes, quickly act on nerve fibers, are destroyed and excreted by the kidneys. Local medications remove sensitivity to pain, affect vascular tone- expand or narrow them. The resistive effect means that anesthetics are also antispasmodic, antiarrhythmic, analgesic, hypotensive, and anti-inflammatory. They all have five main characteristics:

• quickly penetrate nerve tissue;
• act for a long time;
• the strength of the effect increases depending on the dosage;
• rapid elimination from the body;
• toxicity.

Efficiency

Anesthetics ( general characteristics and types of anesthesia are discussed in the article) are not always the drugs that help the patient. Many of them are either not suitable or are used incorrectly. Demonstration of the effects of anesthetics and low temperature shows how anesthetics work. Known fact, What narcotic substances and alcohol can disrupt human thermoregulation. The drugs in question act in a similar way.

They develop hypothermia. Experts have learned to use this property of anesthetics for controlled hypothermia during brain and heart surgery. Hypothermia lowers the metabolic rate, which reduces the patient's need for oxygen. The effectiveness of anesthesia depends on several factors, which include the correct choice of drug and high-quality pain relief.

When is it needed and to whom is it prescribed?

Typically, anesthetics are used in medical institutions during surgical intervention when applying sutures, in dental offices for treatment and extraction of teeth, for induction of anesthesia, during labor. For example, external anesthetics are widely used in cosmetology.

1. "Novocaine" is used quite often. It has minimal toxicity and has a good effect. Renders positive influence on the metabolism of nerve tissue. Disadvantages: it does not last long and may cause an allergic reaction.
2. "Prilocaine." Provides deep local anesthesia and is suitable for therapeutic blockades. There is virtually no toxicity. Can be used to treat children and pregnant women.
3. "Carbocaine". A toxic drug, but quite strong in terms of impact. Causes adverse reactions. It should be used carefully, observing the dosage.
4. "Lidocaine." The toxicity of the drug is minimal. Vascular and allergic reactions to the product are practically absent. The main feature is that it acts quickly.

Types of anesthesia

Anesthetics are different - stronger and weaker. Anesthesia is a collective concept, that is, the process of suppression pain in the patient with the help of medications. This procedure is performed by a doctor; the choice of type of anesthesia depends on many factors: age, state of health of the person, gender.

1. General anesthesia (anesthesia). This is enough strong look procedure that is used during operations. Completely disables the patient, he becomes immune to external stimuli. Anesthesia is considered an induced coma. A combination of anesthetic drugs is used to inject it. They immobilize the patient, paralyze the nerve endings, body muscles and respiratory muscles.
2. Local anesthesia (nerve block). Blocks nerve sensitivity in the area of ​​the body where surgery is performed. In dentistry, local anesthetics are widely used. The patient does not fall asleep, he sees and is aware of all actions. Local anesthesia is divided into spinal, conduction, epidural, monitoring and application.

During spinal injection, the drug is injected into the nerve. During conduction, the nerve impulse is blocked. With an epidural, an anesthetic is injected into the epidural space. Monitoring blocks pain, the patient relaxes. Application is a new type of anesthesia, when ointment or cream is applied to an area of ​​skin.

Local anesthetics

Local anesthetics are good because they block the feeling of pain in a specific area. These substances block nerve conduction if injected near a nerve. Local medications are divided into alkyd and ether. The first substances include ultracaine, trimecan, lidocaine, methivacan; to the second novocaine, anestezin, dicaine.

All local anesthetics include three units. Structurally, they consist of three units: an amino group, an intermediate chain, and an aromatic group. These medicinal substances have their own classification:

• agents used for superficial anesthesia (“Promecain”);
• medications that are used for infiltration anesthesia (for example, Novocain);
• generic drugs (“Lidocaine”).

Local anesthetics are anesthetic agents that reduce the sensitivity of nerve endings. They slow down the processes of excitation that travel along nerve fibers. Capable of eliminating completely painful sensations, block the transmission of nerve impulses. In pharmacology, anesthetics are defined as drugs that relieve pain, and these are their main function.

Flaws

Unfortunately, anesthetics are not at all safe drugs. They can cause an allergic reaction, anaphylactic shock. In addition, some of them have a serious list of contraindications and side effects. That is why only a doctor should select the dosage. For example, local anesthetics have a number of significant disadvantages:

• it is impossible to control body functions during severe traumatic operations;
• lack of muscle relaxation during operations on abdominal cavity;
• complete pain relief does not always occur;
• in patients with unstable psyche, consciousness is preserved.

pros

Local anesthesia has huge advantages: it is safe, simple, and inexpensive. As for painkillers that are sold in pharmacies without a prescription, they also serve their purpose, effectively eliminating pain. After all, it is known that she cannot be tolerated.

Anesthesia is an introduction to artificial sleep, and it is used to perform surgery to completely immobilize a person and turn off his consciousness. The patient does not feel anything during the operation under anesthesia, that is, he is not able to feel pain. And this is the main advantage of general anesthesia.

List

Anesthetics are divided into general anesthesia and local anesthesia. The first group includes halogenated hydrocarbons, barbiturates, opioid analgesics, ethers, and other drugs for general anesthesia. Among the means:

• "Aerran."
• "Lunaldine."
• "Recofol".
• "Halothane."
• "Drug."
• "Sevoran".
• "Diprivan."
• "Calipsol".
• "Fentanyl."
• "Propovan" and so on.

The second group includes alkyds, benzoic acid esters, aminobenzoic acid esters, and other local anesthetics. The following drugs are used for local anesthesia:

• "Alfacaine".
• "Novocaine Bufus"
• "Anekain."
• "Markain."
• "Artifrin."
• "Septanest" with adrenaline.
• "Lidocaine" 2% adrenaline.
• "Naropin".
• "Ubestizin".
• "Ultracaine".
• "Novocaine".
• "Leocaine" and others.

The classification of anesthetics is discussed above.

Terms of use

Anesthetics must be administered by a specialist in a medical facility, as these are quite serious medications. For example, male anesthetics are needed to perform general and selective lidocaine tests if there is a problem with early ejaculation. In the first case, the head of the penis is treated with lidocaine solution or ointment, then there will be a loss of surface sensitivity. After the anesthesia is washed off and sexual intercourse is performed.

By conducting a lidocaine test, the quality of erection, the duration of sexual intercourse, the preservation of orgasm and ejaculation are assessed. In the second case, a cotton pad soaked in a lidocaine solution is applied to the frenulum until sensitivity is lost, the product is washed off, and then sexual intercourse follows. The test results are interpreted by a doctor.

Anesthetics are also administered intravenously to put the patient into artificial sleep. Anesthetic agents also include some medications that are generally available in pharmacies. There are drugs with anesthetics for children, but they are as safe as possible.

Contraindications

Local anesthesia is used for minor operations to temporarily eliminate pain syndrome. This type of pain relief is used when anesthesia cannot be used. Local anesthesia has absolute and relative contraindications. The first include:

• intolerance to this type of anesthesia;
• surgery that requires controlled breathing;
• state of shock.

The second ones include:

• nervous overexcitement;
• mental illness;
• diseases of the spine;
• bad condition health, well-being;
• hypertension;
• hypotension;
• cardiac disorders;
• obesity;
• infection;
• childhood;
• if the patient himself refuses pain relief.

Other anesthetics have similar contraindications. When using one or another type of anesthesia, the patient must take into account his state of health, current illnesses and well-being.

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Local anesthetic facilities- these are substances that reduce the sensitivity of nerve endings and slow down the conduction of excitation along sensitive nerve fibers.

When in contact with tissues, they eliminate pain sensitivity and block the transmission of impulses. As anesthesia deepens, temperature and other types of sensitivity are switched off, last but not least, the reception of touch and pressure. This action is reversible and selective.

Pharmacokinetics . Basically, drugs in this group have similar pharmacokinetic properties. They are well absorbed through the mucous membranes (the use of vasoconstrictors, for example, adrenaline, can help reduce their absorption and thereby enhance and prolong the effect, as well as reduce toxic manifestations). In tissues, drugs are hydrolyzed at pH 7.4 (therefore, inflammatory tissues, in which the environment is more acidic, are less susceptible to the effects of drugs). Hydrolysis products - bases, which act on nerve fibers, are quickly destroyed and excreted mainly by the kidneys.

Pharmacodynamics. Drugs in this group have a local and resorptive effect. Local action: eliminate pain sensitivity and affect vascular tone (vasoconstrictor effect - cocaine, vasodilator effect - dicaine, novocaine). Resorptive effects: analgesic, antiarrhythmic, hypotensive, anticholinergic, adrenergic blocking, antispasmodic, anti-inflammatory effects.

Mechanism of action local anesthetics have not been fully elucidated. It has been established that the action of these drugs reduces the permeability of nerve fiber membranes to sodium (as a result of competition with calcium ions and increased surface tension membrane phospholipids). The energy supply of ion transport systems through the membranes of nerve fibers also decreases (as a result of disruption of redox processes in tissues, the production of ATP and other energy substrates decreases. This leads to inhibition of the formation of the action potential and, therefore, prevents the generation and conduction of nervous excitation.

Anesthetics are used to obtain different types anesthesia.

1. Superficial or terminal anesthesia - an anesthetic is applied to the mucous membranes, skin, wound, ulcerative surface.

2. Infiltration anesthesia – layer-by-layer “impregnation” of tissues with anesthetic.

3. Conduction anesthesia - the introduction of an anesthetic along the nerve, which interrupts the conduction of the nerve impulse and leads to loss of sensitivity in the area innervated by it. A variety of conduction anesthesia is spinal (the anesthetic is injected subarachnoidally) and epidural (the drug is injected into the space above the dura mater spinal cord) anesthesia.

By practical application Local anesthetics are divided into the following groups.

1. Agents used for superficial anesthesia: cocaine (2-5%), dicaine (0.25-2%), anesthesin (5-10%), lidocaine (1-2%).

2. Agents used for infiltration anesthesia: novocaine (0.25-0.5%), trimecaine (0.25-0.5%), lidocaine (0.25-0.5%).

3. Agents used for conduction anesthesia: novocaine (1-2%), trimecaine (1-2%), lidocaine (0.5-2%).

4. Agents used for spinal anesthesia: trimecaine (5%).

The first anesthetic used in medical practice was cocaine. It was proposed for use by Anrep V.K. in 1879. Currently, it is not used for local anesthesia, as it is a highly toxic drug, and also due to the development of drug addiction to it (cocaineism).

Dicaine refers to drugs used primarily for superficial anesthesia. This is due to its high toxicity. The drug is used only with vasoconstrictors, since dicaine dilates blood vessels and thereby enhances its own absorption and increases toxicity. Dicaine poisoning occurs in two stages. At the first stage, motor agitation, anxiety, convulsions, nausea and vomiting are observed. The stage of excitation passes into the stage of depression with the development of hypotension, cardiovascular failure, and respiratory depression. Death occurs from paralysis of the respiratory center. Help should be provided at the first stage. It is necessary to remove the drug by washing the mucous membranes isotonic solution sodium chloride. Analeptics (caffeine, cordiamine, etc.) are administered parenterally to prevent depression of the vasomotor and respiratory centers.

Anestezin. The drug is poorly soluble in water, so it is used externally in the form of powders, pastes, ointments (on the affected skin surface); enterally in the form of powders, tablets (for stomach pain); rectally in the form rectal suppositories(for hemorrhoids and anal fissures).

Novocaine– a drug used mainly for infiltration and conduction anesthesia.

Pharmacokinetics . The drug penetrates poorly through mucous membranes and does not constrict blood vessels. The effect lasts 30-60 minutes. In the body it is hydrolyzed by liver enzymes. Metabolic products are excreted by the kidneys.

Pharmacodynamics . The drug has a local anesthetic and resorptive effect. Main effects on absorption.

1. Impact on the central nervous system: inhibits the sensitivity of the motor cortex, suppresses visceral reflexes, stimulates the activity of the respiratory center.

2. Effect on the autonomic nervous system: the anticholinergic effect is due to a decrease in the release of acetylcholine under the influence of novocaine and the manifestation of acetylcholinesterase activity in the drug.

3. Effect on the functions of the digestive canal: reduces the tone of smooth muscles and reduces peristalsis, inhibits the secretion of the digestive glands.

4. Impact on cardiovascular system: hypotensive and antiarrhythmic actions.

5. Reduces diuresis.

6. Inhibits carbohydrate and fat metabolism.

Indications. Used for local anesthesia, relief of hypertensive crisis, renal colic (perinephric blockade according to Vishnevsky), for the treatment of gastric ulcer and 12th intestine, ulcerative colitis, hemorrhoids, anal fissures.

Side effects. The most serious side effects of novocaine are associated with allergic reactions, the manifestation of which varies from skin rash to anaphylactic shock. Therefore, when using the drug, careful collection is required. allergy history and testing for individual sensitivity.

Trimekain. A drug primarily used for infiltration and conduction anesthesia. Somewhat more toxic than novocaine, but 2-3 times more active. Can be used for spinal anesthesia.

Lidocaine. A drug universal application(for all types of anesthesia). It has an effect 2.5 times stronger and 2 times longer than novocaine. Toxicity is not high. Does not affect vascular tone. Widely used in cardiology as an antiarrhythmic agent.

ANESTHESIN (Anaestesinum)

Synonyms: Benzocaine, Anestalgin, Anestetsin, Anestin, Egoform, Norcaine, Parathesin, Retocaine, Toponalgin.

Pharmachologic effect.

Indications for use. For anesthesia of mucous membranes, for spasms and pain in the stomach, increased sensitivity of the esophagus, for pain relief of wound and ulcerative surface of the skin; for urticaria and skin diseases accompanied by itching. Sometimes with primary vomiting, vomiting of pregnant women.

Method of administration and dose. Orally for stomach pain, increased sensitivity of the esophagus, 0.3 g 3-4 times a day; externally in the form of 5-10% ointment and powder for urticaria and skin diseases accompanied by itching, for anesthesia of ulcerative and wound surfaces; in the form of a 5-20% oil solution for anesthesia of mucous membranes.

Contraindications. Individual hypersensitivity.

Release form. Powder; tablets of 0.3 g in a package of 10 pieces; tablets containing anesthesin and dermatol 0.1 g and magnesium oxide 0.3 g, in a package of 50 pieces.

Storage conditions. List B. In a cool, dry place.

AEROSOL "AMPROVISOL" (Aerosolum "Amprovisolum")

Contains anesthesin, menthol, ergocalciferol solution (vitamin D2 in alcohol, glycerin, propolis and ethyl alcohol.

Indications for use. Used for local anesthesia, as an anti-inflammatory and cooling agent for solar and thermal (burns with hot liquids, steam, flame, etc.) burns of I and II degrees.

Method of administration and dose. A stream of aerosol is applied to the affected surface by pressing the head of the balloon for 1-5 seconds, from a distance of 20-30 cm. Depending on the degree of burn and tolerability of the drug, the skin is treated one or more times.

Contraindications. The drug is contraindicated for widespread second-degree burns and skin abrasions. Avoid getting the aerosol into your eyes.

Release form. 50 g in polymer-coated glass aerosol cans or 80 or 170 g in aluminum aerosol cans with spray valve, head and safety cap.

Storage conditions. In a dry place at a temperature not exceeding +35 ° C, away from fire and heating devices; protect from direct sunlight.

BELLASTHESIN (Bellasthesinum)

Indications for use. Gastralgia (pain in the stomach), spasms of the stomach and intestines.

Method of administration and dose. 1 tablet 2-3 times a day.

Side effects and contraindications are the same as for anesthesin and belladonna preparations. .

Release form. Tablets containing 0.3 g of anesthesin and 0.015 g of belladonna extract.

Storage conditions. List B. In a dry place, protected from light.

Anestezin is also included in the composition Almagel-A drugs, heparin ointment, fastin ointment, zinc naphthalan ointment with anesthesin, menovazin, sodium usinate, olazol, bellalgin tablets, pavestezin tablets, anestezol suppositories.

Bupivacaine hydrochloride

Synonyms: Marcaine, Carbostezin, Duracaine, Narcaine, Sensorcaine, Svedocaine.

Pharmachologic effect. It is one of the most active and long-acting local anesthetics.

Indications for use. Used for local anesthesia.

Method of administration and dose. Used for local infiltration anesthesia (pain relief by soaking tissue surgical field local anesthetic solution) - 0.25% solution, peripheral nerve blockade - 0.25-0.5%, epidural (injection of local anesthetic into the epidural space spinal canal for the purpose of anesthesia of areas innervated by the spinal nerves) - 0.75% and caudal (introduction of an anesthetic substance into the space of the sacral canal for the purpose of anesthesia of areas innervated by nerves passing through the sacral canal) anesthesia - 0.25-0.5%, retrobulbar blockade (injection of local anesthetic into the area of ​​the ciliary corner of the eye) - 0.75%. In obstetric and gynecological practice, only 0.25-0.5% solutions are allowed, but not 0.75%. Caution should be exercised when using a 0.75% solution.

Side effect. At correct use the drug provides strong and long-lasting anesthesia. If doses are exceeded, convulsions and depression of cardiac activity (up to cardiac arrest) are possible.

Release form. In ampoules and vials in the above concentrations, as well as with the addition of adrenaline hydrochloride (1:200000).

Storage conditions.

DICAINE (Dicainum)

Synonyms: Tetracaine hydrochloride, Amethocaine, Anetaine, Decicaine, Felicaine, Foncaine, Intercaine, Medicaine, Pantocaine, Rexocaine.

Pharmachologic effect. Strong local anesthetic. It is significantly more active than novocaine and cocaine, but is more toxic. Well absorbed through mucous membranes.

Indications for use. Dicaine is used only for superficial anesthesia (pain relief).

Method of administration and dose. IN ophthalmological practice used as a 0.1% solution when measuring intraocular pressure(one drop 2 times with an interval of 1-2 minutes). Anesthesia usually develops within 1-2 minutes. When deleting foreign bodies and surgical interventions, use 2-3 drops of 0.25-0.5-1% or 2% solution. After 1-2 minutes, pronounced anesthesia develops. It must be taken into account that solutions containing more than 2% dicaine can cause damage to the epithelium (outer layer) of the cornea ( transparent shell eyes) and significant dilation of the vessels of the conjunctiva (outer shell of the eye). Usually for anesthesia surgical interventions on the eyes it is enough to use a 0.5% solution. To lengthen and enhance the anesthetic effect, add a 0.1% solution of adrenaline (3-5 drops per 10 ml of dicaine).

For keratitis (inflammation of the cornea / transparent membrane of the eye /) Dicaine is not used.

In ophthalmological practice, when long-term anesthesia is necessary, eye films with dicaine are used. Each film contains 0.00075 g (0.75 mg) of dicaine.

Dicaine is also used for surface anesthesia in otorhinolaryngological practice during certain surgical interventions (puncture of the maxillary sinus, removal of polyps, conchotomy / removal of the lower or middle turbinate /, surgery on the middle ear). Due to the rapid absorption of dicaine by the mucous membranes respiratory tract Great care should be taken when using it and the patient's condition should be carefully monitored. Children under 10 years of age are not anesthetized with Dicaine. In older children

use no more than 1-2 ml of a 0.5-1% solution, in adults - up to 3 ml of a 1% solution (sometimes a 0.25-0.5% solution is sufficient) and only if absolutely necessary - a 2% or 3% solution. To a solution of dicaine (in the absence of contraindications to the use of vasoconstrictors), add 1 drop of a 0.1% solution of adrenaline hydrochloride per 1-2 ml of dicaine. The highest doses of dicaine for adults for anesthesia of the upper respiratory tract are 0.09 g once (3 ml of 3% solution).

Side effect. The drug is very toxic; caution is required when using it.

Contraindications. Age up to 10 years, general serious condition of patients. When working with Dicaine, tools and syringes should not contain any alkali residues. Dicaine precipitates in the presence of alkali.

Release form. Ophthalmic powder and films with dicaine, 30 pieces in dispensing cases.

Storage conditions. List A. In a well-closed container.

COCAINE HYDROCHLORIDE (Cocainihydrochloridum)

Synonyms: Cocaine is hydrochloric.

Pharmachologic effect. Local anesthetic.

Indications for use. For superficial local anesthesia of the mucous membranes of the mouth, nose, and larynx; for pulp anesthesia ( soft fabric) tooth, cornea (clear layer of the eye) and conjunctiva (outer layer) of the eye.

Method of administration and dose. For superficial local anesthesia of the mucous membrane and cornea of ​​the eye, 1-3% solutions are used, for the mucous membranes of the oral cavity, nose, and larynx - 2-5% solutions.

Side effect. Possible increase in intraocular pressure, acute attack glaucoma ( sharp increase intraocular pressure). Caution is required during bronchoscopy (examination of the bronchi using optical instruments).

Release form. Powder.

Storage conditions. List A (according to the rules established for morphine and other narcotic drugs). In a place protected from light in well-sealed orange glass jars.

LIDOCAINE (Udocain)

Synonyms: Xylocaine, Xycaine, Lidestin, Acetoxyline, Alocaine, Anestacon, Anestecaine, Astracaine, Docaine, Dulsicaine, Fastocaine, Leostesin, Lidocard, Lidocatone, Lignocaine, Maricaine, Nulicaine, Octocaine, Remicaine, Xylocard, Xylocytin, Xyloton, Esracaine, Solcaine, Sterica in, Xilesin, Xylotox, etc.

Pharmachologic effect. Active local anesthetic; has a pronounced antiarrhythmic effect.

Indications for use. For infiltration (pain relief by soaking the tissue of the surgical field with a solution of local anesthetic) and conduction (pain relief by exposure of the anesthetic substance to the area of ​​the nerve trunk innervating the surgical field or painful area) anesthesia.

To prevent and eliminate arrhythmia (heart rhythm disturbances).

Method of administration and dose. When using lidocaine aerosol, the dose of the drug can vary widely depending on the size and nature of the surface being treated. In adults, to achieve anesthesia, as a rule, a single dose is 1-3 presses on the bottle valve. In gynecological practice it is sometimes necessary

10-20 or more presses on the valve. A maximum of 40 clicks is allowed. Children over 2 years of age in dental practice, otorhinolaryngology (treatment of diseases of the ear, nose and throat) and dermatology (treatment of skin diseases) are prescribed 1-2 presses on the bottle valve once. After application (application) of lidocaine in aerosol form to the mucous membrane of the oral cavity, larynx, pharynx or bronchi, local anesthesia is provided for 15-20 minutes.

For infiltration anesthesia, 0.125%, 0.25% and 0.5% solutions are used; for anesthesia of peripheral nerves - 1% and 2% solutions; for epidural anesthesia (introduction of a local anesthetic into the epidural space of the spinal canal to anesthetize areas innervated spinal nerves) - 1%-2% solutions; for spinal anesthesia (introduction of a local anesthetic into the subarachnoid space of the spinal cord to anesthetize areas innervated by the spinal nerves) - 2% solutions.

The amount of solution and the total dose of lidocaine depend on the type of anesthesia and the nature of the surgical intervention. As the concentration increases, the total dose of lidocaine is reduced.

When using a 0.125% solution maximum amount the solution is 1600 ml and the total dose of lidocaine is 2000 mg (2 g); when using a 0.25% solution - 800 ml and 2000 mg (2 g), respectively; 0.5% solution - total 80 ml, and the total dose is 400 mg; 1% and 2% solutions - the total amount is 40 and 20 ml, respectively, and the total dose is 400 mg (0.4 g).

To lubricate the mucous membranes (during tracheal intubation / insertion of a special tube into the trachea /, bronchoesophagoscopy / examination of the bronchi or esophagus /, removal of polyps, punctures of the maxillary sinus, etc.) use 1%-2% solutions, less often -5% solution in a volume of not over 20 ml.

Lidocaine solutions are compatible with adrenaline; add extempore (before use) a 1% solution of adrenaline hydrochloride, 1 drop per 10 ml of lidocaine solution, but not more than 5 drops for the entire amount of solution.

Side effect. Headache, dizziness, sleep disturbance, anxiety. With excessively rapid intravenous administration and in patients with hypersensitivity, convulsions, tremor (trembling of the limbs), paresthesia (a feeling of numbness in the limbs), disorientation, euphoria (unreasonable high spirits), tinnitus, and slow speech are possible. When using high doses of lidocaine, bradycardia (rare pulse), slowing of conduction (impaired conduction of excitation through the conduction system of the heart) are possible. arterial hypotension(lowering blood pressure). Allergic reactions.

Contraindications. Severe bradycardia, severe arterial hypotension (low blood pressure), cardiogenic shock, severe forms chronic heart failure, hypersensitivity to the drug. Prescribe with caution when pronounced violations liver and kidney functions.

Release form. Solution for injection 0.5%, 1%, 2%, 5% and 10% (1 ml - 0.005 g, 0.01 g, 0.02 g, 0.05 g and 0.1 g) in ampoules and vials ; dosed aerosol for external use (1 dose -0.01 g); metered dose aerosol for local application(1 dose - 4.8 mg). In ampoules of 2 ml of 2% solution.

Storage conditions. List B. In a place protected from light.

Lidocaine is also included in the preparations Ambene, Aurobin, ear drops with prednisolone, Otipax, Proctoglivenol.

NOVOCAIN (Novocainum)

Synonyms: Procaine hydrochloride, Etocaine, Allocaine, Ambocaine, Aminocaine, Anestocaine, Atoxicaine, Cerocaine, Hemocaine, Cytocaine, Etonacaine, Neocaine, Pancaine, Paracaine, Planocaine, Syntocaine, Genocaine, Gerocaine, Isocaine, Yenakaine, Marecaine, Minocaine, Naukaine, Polocaine, Procaine , Protocain, Sevikain, Sincain, Topocain, etc.

Pharmachologic effect. Local anesthetic.

Indications for use. Infiltration (pain relief by soaking the tissue of the surgical field with a solution of local anesthetic), conduction (pain relief by exposure of the anesthetic substance to the area of ​​the nerve trunk innervating the surgical field or painful area), epidural (introduction of a local anesthetic into the epidural space of the spinal canal to anesthetize the areas innervated by the spinal cords). nerves) and spinal (introduction of a local anesthetic into the subarachnoid space of the spinal cord in order to anesthetize the areas innervated by the spinal nerves) anesthesia, vagosympathetic blockade (introduction of a local anesthetic solution to the anterolateral surface of the cervical vertebrae) and paranephric (introduction of a local anesthetic into the perirenal tissue in order to anesthetize the internal organs /intestines, kidney, etc./) blockade; to potentiate (strengthen) the action of basic narcotic drugs for general anesthesia; for relieving (relieving) pain from peptic ulcers of the stomach, duodenum, anal fissures, hemorrhoids (bulging and inflammation of the veins of the rectum), etc.

Method of administration and dose. For infiltration anesthesia, the highest doses at the beginning of the operation are no more than 500 ml of 0.25% solution or 150 ml of 0.5% solution, then for every hour up to 1000 ml of 0.25% solution or 400 ml of 0.5% solution for every hour . For conduction anesthesia, 1-2% solutions are used, for epidural (introduction of a local anesthetic into the epidural space of the spinal canal to anesthetize areas innervated by the spinal nerves) - 20-25 ml of a 2% solution, for spinal anesthesia - 2-3 ml of a 5% solution, for perinephric blockade - 50-80 ml of 0.5% solution, for vagosympathetic blockade - 30-100 ml of 0.25% solution, as a local anesthetic and antispasmodic (relieving spasms) agent, the drug is used in suppositories of 0.1 g.

Side effect. Dizziness, weakness, hypotension (low blood pressure), allergies.

Contraindications. Individual intolerance.

Release form. Powder; 0.25% and 0.5% solutions in ampoules of 1; 2; 5; 10 and 20 ml and 1% and 2% solutions, 1; 2; 5 and 10 ml; 0.25% and 0.5% sterile solutions novocaine in bottles of 200 and 400 ml; 5% and 10% ointment; suppositories containing 0.1 g of novocaine.

Storage conditions. List B. Powder - in a well-closed dark container, ampoules and candles - in a cool place, protected from light.

Novocaine is also included in the combination drugs menovazin, novocindol, syntomycin (1%) liniment with novocaine, solutan and efatin.

NUPERCAINAL

Pharmachologic effect. Nuperkainal causes rapid and lasting local anesthesia.

Indications for use. Hemorrhoids (bulging and inflammation of the veins of the rectum), anal fissures, insect bites, senile itch, itching of female external

genitals, premature ejaculation (sperm discharge).

Method of administration and dose. The drug is applied to the painful area of ​​skin and lightly rubbed.

Release form. Ointment 1% in packages of 20 and 30 g.

Storage conditions. In a cool place.

Pyromecainum

Synonyms: Bumecaine hydrochloride.

Pharmachologic effect. Pyromecaine has anesthetic properties. It causes a rapid onset, deep and long-lasting anesthesia.

In addition to anesthetic properties, pyromecaine has antiarrhythmic activity in cases of cardiac arrhythmias. of various origins(origin). In terms of antiarrhythmic effect, pyromecaine is close to lidocaine.

Pyromecaine has a sedative (calming), analgesic and anti-inflammatory effect.

Indications for use. Pyromecaine is prescribed as an anesthetic for surface anesthesia during therapeutic and diagnostic procedures in dentistry, ophthalmology, otorhinolaryngology, surgery, bronchology, gastroenterology, and urology.

In dentistry, pyromecaine is prescribed for acute and chronic inflammatory diseases of the oral mucosa and periodontal tissue (tooth tissue): aphthous stomatitis, polymorphic exudative erythema and etc.

Pyromecaine is also used as an antiarrhythmic agent.

Method of administration and dose. Pyromecaine is used topically in the form of 0.5%, 1% and 2% solutions and 5% ointment or intravenously in the form of a 1% solution in a 5% glucose solution.

For surface anesthesia in ophthalmology, 0.5% solutions of 1-2 drops are used, in otorhinolaryngology - 1%-2% solutions of 1-5 ml (in some cases with the addition of a 0.1% solution of adrenaline hydrochloride, 1 drop for every 2 .0-3.0 ml of pyromecaine solution); for endoscopic diagnostic studies(methods for studying body cavities and channels using optical instruments equipped with a lighting device) and medical procedures - 2% solution 2-5 ml; with bronchography (x-ray examination of the bronchi) 10-15 ml; with separate bronchial intubation (insertion of a tube into the lumen of the bronchi) from 14 to 35 ml (average 20 ml). In dentistry, pyromecaine is used in the form of 1% and 2% solutions (1-5 ml each) and 5% pyromecaine ointment - 0.1-1 g each (depending on the volume of treatment). Pyromecaine ointment is applied with a spatula, gauze or cotton swab to the site of anesthesia of the oral mucosa. When curettage (cleaning purulent pockets) of pathological periodontal pockets, ointment is injected into them with a syringe with a blunt cannula. After 2-5 minutes, without removing the ointment, you can begin manipulation. When treating inflammatory diseases of the oral cavity, the ointment is used 1-3 times a day. The duration of treatment depends on the form of the disease and ranges from 3 to 10 days.

Side effect. When using pyromecaine, paleness of the skin and mucous membranes, general weakness, nausea, vomiting, headache, dizziness, fainting, and a drop in blood pressure are possible. If hypotension (low blood pressure) develops, the use of ephedrine or other vasoconstrictors is recommended.

When pyromecaine is applied topically in large doses, pallor, nausea, headache, and dizziness may occur.

Contraindications. Intravenous administration pyromecaine is contraindicated in cases of impaired liver and kidney function.

Release form. Pyromecaine is available in the form of 0.5%, 1% and 2% solutions in 10 ml ampoules; 1% solution in 5% glucose solution (for intravenous injections) in ampoules of 10 ml; 5% pyromecaine ointment in metal tubes of 30 g.

Storage conditions. List B. In a place protected from light.

TRIMECAIN (Trimecainum)

Synonyms: Mesocaine, Trimecaine hydrochloride, Mesdicaine, Mezidicaine.

Pharmachologic effect. Local anesthetic; acts stronger and longer than novocaine.

Indications for use. Conduction (pain relief by applying an anesthetic to the area of ​​the nerve trunk innervating the surgical field or painful area) or infiltration (pain relief by soaking the tissue

surgical field with a local anesthetic solution) anesthesia.

Method of administration and dose. For infiltration anesthesia, up to 800 ml of a 0.25% solution is administered; up to 400 ml of a 0.5% solution or up to 100 ml of a 1% solution; for conduction anesthesia - up to 100 ml of 1% or up to 20 ml of 2% solution.

Side effect. Facial paleness, headache, nausea.

Contraindications. Increased individual sensitivity to the drug. Severe liver and kidney diseases.

Release form. Powder.

Storage conditions. List B. In well-closed glass jars.

Trimecaine is also included in the preparations dioxykol, Levosin ointment, and tsimizol.

Medicines of various groups

BOROMENTHOL (Boromentholum)

Pharmachologic effect. Antiseptic (disinfectant) and analgesic.

Indications for use. Used as an analgesic and antiseptic for lubricating the skin during itching, neuralgia (pain spreading along the nerve), as well as for lubricating the nasal mucosa during rhinitis (inflammation of the nasal mucosa).

Method of administration and dose. Apply a thin layer.

No side effects or contraindications have been identified.

Release form. In metal tubes, 5 g of ointment contains the following composition: menthol -0.5 parts, boric acid- 5 parts, Vaseline - 94.5 parts.

Storage conditions. In a cool place.

DIMEXIDUM

Synonyms: Dimethyl sulfoxide, Demasorb, Dromizol, Giadur, DMSO, Brosorb, Damul, Deltan, Demavet. Dermasorb, Dolikur, Dolokur, Durasorb, Mastan, Somipront, Sinteksan.

Pharmachologic effect. It has a pronounced local anesthetic effect, as well as anti-inflammatory and antimicrobial, changes the sensitivity of microflora that are resistant to antibiotics.

Indications for use. For bruises, sprains, inflammatory swelling, burns, arthritis (inflammation of the joint), radiculitis, etc.; in skin plastic surgery (for preservation of skin homografts /intended for transplantation of tissue taken from another person/), for erysipelas, eczema, trophic ulcers (slow-healing skin defects), pustular diseases skin, etc.

Method of administration and dose. Externally aqueous solutions(30-50-90%) in the form of compresses and tampons for skin diseases; in skin-plastic surgery, dressings with a 20-30% solution throughout postoperative period until stable engraftment of the graft (transplanted tissue); for storing grafts (taken for tissue transplantation) - 5% solution.

Side effect. A slight burning sensation, small skin rashes, and itching are possible.

Contraindications. Pregnancy, severe lesions parenchymal organs(internal organs /liver, kidneys, spleen, etc./), angina pectoris, comatose (unconscious) states, myocardial infarction, severe atherosclerosis, stroke.

Release form. In bottles of 100 ml.

Storage conditions. In a well-closed container.

M.J. MAGIC BALSAM (M. J. Magicbalsam)

Pharmachologic effect. Combination drug for external use. It has a local irritant, warming and analgesic effect.

Indications for use. Headache, sinusitis (inflammation of the paranasal sinuses), neuralgia (pain spreading along the nerve), myositis (muscle inflammation), arthralgia (joint pain), lumbago (paroxysmal intense pain in the lumbar region), catarrhal (inflammatory) conditions.

Method of administration and dose. Apply topically. Apply 1-2 g of ointment to the appropriate area of ​​skin.

Side effect. Hives, nausea.

Contraindications. Increased sensitivity to the drug. Do not use on the nose area in children younger age(possible development of collapse / sharp drop in blood pressure /).

Release form. Ointment containing capsicum oil 1.8%, methyl salicylate 2%, menthol 2%, terpene oil 6%, camphor oil 0.5%, fir oil 0.85%, eucalyptus oil 1%, in bottles of 20 and 35 g.

Storage conditions. In a cool place.

MENOVAZIN (Menovasinum)

Pharmachologic effect. Local anesthetic (local anesthetic) agent.

Indications for use. Prescribed externally as a local anesthetic for neuralgia (pain spreading along the nerve), myalgia (muscle pain), arthralgia (joint pain), and as an antipruritic for itchy dermatoses (skin diseases).

Method of administration and dose. Painful areas of the skin are rubbed with menovazine 2-3 times a day.

Side effect. With prolonged use, dizziness, general weakness, and decreased blood pressure are possible.

Contraindications. The drug is contraindicated in case of hypersensitivity to novocaine.

Release form. In glass bottles of 40 ml. Contains 2.5 g of menthol, 1 g of novocaine, 1 g of anesthesin, ethyl alcohol 70% up to 100 ml.

Storage conditions. List B. In a cool place.

METHYLSALICYLATE (Methyliisalicylas)

Pharmachologic effect. Has anti-inflammatory and analgesic activity.

Indications for use. Used externally as an analgesic and anti-inflammatory agent

perse (pure form) and mixed with chloroform, turpentine oil, fatty oils for rubbing in joint and muscle rheumatism, arthritis (inflammation of the joint), exudative pleurisy(inflammation of the membranes of the lung, accompanied by accumulation between them rich in protein fluid coming out of small vessels).

Method of administration and dose.

Side effect.

Contraindications.

Release form. Liquid in bottles of 100 ml.

Storage conditions. In a well-closed container, protected from light.

BEN-GAY

Pharmachologic effect. Combined preparation for local use. It has an analgesic (pain-relieving) and warming effect.

Indications for use. Myalgia (muscle pain) due to joint diseases, injuries, lumbago (paroxysmal intense pain in the lumbar region). Warm-up massage when playing sports.

Method of administration and dose. Required amount ointments are applied to the painful area and rubbed in gently. The procedure is repeated 3-4 times a day. It is not recommended to use ben-gay in conjunction with thermal procedures.

Side effect. Hyperemia (redness), itching, skin rash, urticaria, angioedema(allergic edema).

Contraindications. Hypersensitivity to the drug. Do not apply to damaged or irritated skin.

Release form. Ben-gay anesthetic rubbing (1 ml -0.1 g menthol and 0.15 g methyl salicylate). Ben-gay rubbing for arthritis (1 ml - 0.08 g menthol and 0.3 g methyl salicylate). Ben-gay rubbing for sports and exercises (1 ml - 0.03 g menthol). Cream in tubes. Ointment in tubes. Gel in tubes.

Storage conditions. In a cool place.

CAMPHOCIN (Camphocinum)

Indications for use. Used for rheumatism, arthritis (joint inflammation).

Method of administration and dose. Rub liniment into the painful area.

Release form. In orange glass bottles of 80 ml, liniment has the following composition: methyl salicylate - 10 g, camphor - 15 g, salicylic acid - 3 g, castor oil - 5 g, purified turpentine oil - 10 g, capsicum tincture - up to 100 g.

Storage conditions. In a place protected from light.

CAPSIN (Capsinum)

Indications for use. For radiculitis, neuritis (nerve inflammation), myositis (muscle inflammation), arthritis (joint inflammation), etc.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicypate.

Release form. Liniment containing 1 part methyl salicylate, bleached oil and tincture of capsicum 2 parts each, in bottles of 50 or 100 ml.

Storage conditions. In a cool place.

METHYLSALICYLATE LINIMMENT COMPLEX (Linimentum methyl" salicylatiscompositum)

Indications for use.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Liniment containing methyl salicylate and chloroform 33.3 g each, bleached (or intoxicating) oil 33.4 g (per 100 g) in bottles of 50 g.

Storage conditions. In a cool place.

Linimentum "Naphthalginum"

Indications for use. As an analgesic and anti-inflammatory agent for rheumatism, arthritis (joint inflammation), etc.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Liniment containing methyl salicylate, analgin and naftalan oil 2.5 parts each, a mixture of fatty alcohols of sperm whale oil 3 parts, emulsifier 13 parts, water up to 100 parts, in bottles of 100 g.

Storage conditions. In a cool place.

Linimentum /Balsamum/ "Sanitas")

Indications for use. As an analgesic and anti-inflammatory agent for rheumatism, arthritis (joint inflammation), etc.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Liniment composition: methyl salicylate - 24 g, eucalyptus oil - 1.2 g, purified turpentine oil - 3.2 g, camphor - 5 g, lard and petroleum jelly - 33.3 g each.

Storage conditions. In a cool place.

OINTMENT "BOUM-BENGE" (Ungventum "Boum-Benge")

Indications for use. Prescribed to adults and children as an analgesic and anti-inflammatory agent for inflammatory diseases of the upper respiratory tract with tracheitis (inflammation of the trachea) as a skin irritant and a distraction, as well as for rheumatism and arthritis (inflammation of the joint).

Method of administration and dose. Rub into areas of inflammation. Children under 5 years old use it instead of mustard plasters.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Ointment composition: menthol - 3.9 g (or peppermint oil - 7.8 g), methyl salicylate - 20.2 g, medical petrolatum - 68.9 g, medical paraffin - 7 g (per 100 g), in aluminum tubes (25-50 g each) or in glass jars (25-60 g each).

Storage conditions. In a cool place.

RENERVOLE (Renervol)

Indications for use. It is used for rubbing in rheumatic pain, neuralgia (pain spreading along the nerve), lumbago (paroxysmal intense pain in the lumbar region), etc.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Ointment containing 100 g of methyl salicylate 0.5 g, camphor 3.5 g, ethylene chloride 75 g, thyme oil 0.5 g, isobornyl acetate 1 g, in tubes of 90 g.

Storage conditions. In a cool place.

SALIMENTUM

Indications for use. As an analgesic and anti-inflammatory agent for rubbing for joint and muscle rheumatism, arthritis (inflammation of the joint), radiculitis, neuralgia (pain spreading along the nerve), etc.

Method of administration and dose. Rub into areas of inflammation.

Side effects and contraindications are the same as for methyl salicylate.

Release form. Liniment containing methyl salicylate and chloroform 20 g each, bleached (or intoxicating) oil 60 g (per 100 g), in bottles of 50 g.

Storage conditions. In a cool place.

Methyl salicylate is also included in the preparations apizartron and M.J. magic balm.

MIOSPRAY

Pharmachologic effect. Combined preparation for external use. It has a local vasodilating and warming effect (due to benzyl nicotinate), improves blood supply to tissues at the site of application. Menthol has a local analgesic (pain-relieving) effect and cools the wound surface due to evaporation.

Indications for use. M nalgi (muscle pain), myositis (muscle inflammation), muscle spasms, sports injuries, bruises.

Method of administration and dose. The drug is applied to the skin from a distance of 10-15 cm until a thick, moist layer is formed. Then the treated surface is massaged until the skin becomes slightly hyperemic (red). The drug can be used several times a day.

Be careful when using the drug near the eyes, nose, mouth, ears, genitals, anus (anus) and avoid contact with mucous membranes.

Side effect. Allergic reactions in the form of mild itching, hyperemia. These phenomena are usually mild and do not require discontinuation of the drug.

Contraindications. Do not use on affected or damaged areas of skin, do not spray on mucous membranes.

Release form. Aerosol for external use in a spray bottle of 150 g. Contains 0.18 g of benzyl nicotinate and nicotinamide and 0.16 g of menthol.

Storage conditions. Keep away from fire and high temperature sources.