Active substanceDinitrogen oxideDinitrogen oxide
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  • Nitrogen oxide
    gas d / inhal. 
  • Nitrogen oxide
    gas d / inhal. 
    STIROLBIOFARM, LLC     Ukraine
  • Nitrogen oxide
    gas d / inhal. 
    LINDE GAZ RUS, LLC     Russia
  • Dosage form: & nbspcompressed gas
    Composition:

    Nitrogen oxide with a content of the main substance is not less than 98%, there are no auxiliary substances.

    Description:Colorless gas, heavier than air, without a tangible smell. Does not ignite, supports combustion.
    Pharmacotherapeutic group:Means for inhalation anesthesia
    ATX: & nbsp

    N.01.A.X.13   Dinitrogen oxide

    N.01.A.X   Other drugs for general anesthesia

    Pharmacodynamics:

    Means for inhalation of general anesthesia. Nonspecifically interacting with the membranes of neurons, inhibits the transfer of afferent impulses to the central nervous system, alters the cortical and intercurrent relationships. Has a high analgesic activity. Small concentrations cause a feeling of intoxication and mild drowsiness.

    The analgesia stage is achieved within 2-3 minutes at a concentration of up to 80% and 20% oxygen in the gas mixture. After 6-8 minutes after a short, but quite pronounced stage of excitation, 1 st. surgical anesthesia. General anesthesia is maintained at a concentration of nitrous oxide of 40-50% with a corresponding increase in oxygen supply. A sufficient relaxation of the skeletal muscles is not achieved.Therefore, nitrous oxide is combined with other means for inhalation anesthesia and muscle relaxants to achieve the desired effect. Awakening occurs in 3-5 minutes. Increases heart rate, causes constriction peripheral vessels, can increase intracranial pressure, depress respiration.

    Pharmacokinetics:Absorbed into the blood through the lungs. In the body is not metabolized, is in a dissolved state in the plasma. The half-life (T½) - 5-6 minutes; is output completely through the lungs (unchanged after 10-15 minutes), a small amount - through the skin. Permeability through the blood-brain barrier (BBB) ​​and the placental barrier is high.
    Indications:

    General anesthesia, which does not require deep anesthesia and muscle relaxation (in surgery, operative gynecology, dentistry, for anesthesia of childbirth).

    Strengthening the narcotic and analgesic effect of other anesthetics (in t, h. Therapeutic analgesic anesthesia in the postoperative period), traumatic shock (prevention).

    Pain syndrome; with acute coronary insufficiency, myocardial infarction, acute pancreatitis (cupping);

    Anesthesia in the performance of medical procedures requiring disconnection of consciousness.
    Contraindications:

    Hypersensitivity; hypoxia; diseases of the nervous system; chronic alcoholism; the state of alcoholic intoxication (possibly the emergence of excitement and hallucinations).

    Carefully:Craniocerebral trauma, increased intracranial pressure in the anamnesis, intracranial tumors.
    Pregnancy and lactation:During pregnancy and lactation doses are selected individually.
    Dosing and Administration:

    Inhalation. Nitrous oxide is used in a mixture with oxygen (with an oxygen content of at least 30%) and other means for inhalation anesthesia with the help of special devices for gas anesthesia.

    For relief and prevention of pain syndrome, medical anesthesia is carried out at a concentration of nitrous oxide 40-70%. To quickly achieve the required depth of general anesthesia (anesthesia), the concentration of nitrous oxide is 70%, maintenance of general anesthesia is 40-50%; if necessary - add more powerful drugs: barbiturates, fluorotane, ether. After stopping the supply of nitrous oxide, you should continue to supply oxygen for 4-5 minutes (to avoid diffusion hypoxia).

    For analgesia of childbirth use the method of intermittent autoanalgesia using a mixture of nitrous oxide (40-70%) and oxygen: the mother gives birth to inhaling the mixture at the appearance of harbingers of the fight and finishes inhalation at the height of the bout or to its end.

    To perform medical procedures requiring unconsciousness - inhalation 25-50% in a mixture with oxygen.

    For children, doses are selected individually.

    To reduce emotional excitement, prevent nausea and vomiting, and potentiate the effect, a premedication is shown: intramuscular injection of 1-2 ml of a 0.5% solution of diazepam (5-10 mg), 2-3 ml of 0.25% solution of droperidol (5.0- 7.5 mg).

    Side effects:During the introduction to general anesthesia - supraventricular arrhythmias, bradycardia, development or worsening of heart failure; after leaving the general anesthesia - diffuse hypoxia, postnarcosis delirium (sensation of anxiety, confusion, excitement, hallucinations, nervousness, motor excitement); nausea, vomiting, drowsiness; with prolonged use (2-4 days) - depression of bone marrow function, leukopenia, pancytopenia, respiratory depression, malignant hyperthermic crisis, postoperative chill.
    Overdose:

    Symptoms: bradycardia, arrhythmia, insufficiency blood circulation, lowering blood pressure, hypertensive crisis, respiratory depression, delirium, acute hypoxia.

    Treatment: with bradycardia - the introduction of 0.3-0.6 mg of atropine, arrhythmias - correction of the content of gases in the blood, circulatory failure and arterial hypotension - the introduction of plasma or plasma-substituting agents, reducing the depth or cessation of general anesthesia, with hyperthermic crisis - stopping inhalation, increased oxygen supply, administration of antipyretics, correction of water-salt balance disorders and metabolic acidosis, if necessary - dantrolene (1 mg / kg) IV drip and continue the administration until the symptoms of crisis (ma maximum DUTY total dose of 10 mg / kg).

    To prevent recurrence of the crisis for 1-3 days after the operation, dantrolen is administered orally or IV (4-8 mg / kg / day in 4 divided doses). Respiratory depression or inadequate ventilation postoperative necessitated dose reduction anesthetic (if it is used), airway and mechanical ventilation. In the case of delirium development, after the withdrawal from general anesthesia, small doses of the narcotic analgesic are administered.

    Interaction:

    Means for inhalation anesthesia, narcotic analgesics, tranquilizers, neuroleptics, antihistamines increase the effect. Amiodarone increases the risk of bradycardia (not stopable atropine) and arterial hypotension, xanthine - arrhythmia. Fentanyl and its derivatives increase the effect on the cardiovascular system (reduction in heart rate and minute heart volume).

    Strengthens the effects of antihypertensive drugs (especially diazoxide, ganglion blockers, chlorpromazine, diuretics) and anticoagulant (coumarin and indanedione derivatives) drugs, as well as drugs that depress the central nervous system and respiration.
    Special instructions:It is necessary to control blood pressure, heart rate, heart rate, monitor breathing and gas exchange, body temperature. Medical staff with prolonged contact increases the risk of developing leukopenia. During use, periodic pumping of gas from the cuff of the endotracheal tube is recommended. Mixtures with ether, cyclopropane, chloroethyl at certain concentrations are explosive. Patients with chronic alcoholism require higher concentrations.
    Form release / dosage:The gas is compressed.
    Packaging:In steel cylinders with a capacity of 10 liters of mass (6.2 ± 0.2) kg., (7.2 ± 0.2) kg.
    Storage conditions:Cylinders with nitrous oxide can be stored in special rooms and in open areas, in the latter case they must be protected from atmospheric precipitation and sunlight.

    The temperature in the storage room for cylinders with nitrous oxide is allowed up to + 35 ° C.

    Before using the drug, bottles with nitrous oxide, stored at a temperature below 0 ° C, must be allowed to stand for 8-10 hours at room temperature.
    Shelf life:5 years.
    Terms of leave from pharmacies:For hospitals
    Registration number:LS-001797
    Date of registration:20.10.2011 / 12.09.2016
    Expiration Date:Unlimited
    The owner of the registration certificate:MedGazServis TD, LLC MedGazServis TD, LLC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp22.06.2017
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