Trimecaine (Trimecainum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Local Anesthetics

Antiarrhythmics

Included in the formulation
АТХ:

N.01.B.B   Amides

Pharmacodynamics:

Local anesthetic.Blockade of initiation and conduction of nerve impulses: decrease in permeability of neuronal cell membranes for Na ions+, probably by attachment to sodium channels, and an increase in permeability for K+, which reversibly stabilizes the cell membrane and depresses its depolarization, disrupts the propagation of the action potential and leads to a blockade of conductivity.

Pharmacokinetics:When topical application is not studied.
Indications:Surface anesthesia of mucous membranes.
ICD-10

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. It is not recommended to use during pregnancy and lactation (breastfeeding).

Category of recommendations for FDA is not defined.

Dosing and Administration:For surface anesthesia of mucous membranes, 2-5% solutions are used topically: in ophthalmic practice - 4-8 drops, in otorhinolaryngology - 2-8 drops, perhaps adding 0.1% solution of epinephrine (1 drop per 2 ml of trimecaine solution).
Side effects:

Possible: skin allergic reactions; with intravenous administration - short-term fainting.

Overdose:

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

Interaction:

Antimiasthenic drugs - local anesthetics, especially with rapid absorption in large quantities, inhibit the transmission of the nerve impulse, acting as antagonists of the action of antimiasthenic drugs on skeletal muscles. An adequate control of myasthenia gravis may require a temporary correction of the dose of antimiasthenic drugs.

Neuromuscular blockers - local anesthetics, especially with rapid absorption in large quantities, inhibit the transmission of a nerve impulse, which lengthens the action of neuro-muscular blockers.

Vasoconstrictors (methoxamine, phenylephrine, epinephrine) - it is not recommended to combine methoxamine and local anesthetics, since the effect of both drugs is prolonged, and prolonged exposure to methoxamine is accompanied by inhibition of circulation and skin debridement. 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 blood supply to the gangrene is more likely.

In patients receiving ganglion blocking antihypertensives (guanagrel, guanethidine, meqamylamine, trimetafan), severe hypotension and / or bradycardia may develop with spinal or epidural anesthesia with trimecaine at a level sufficient for sympathetic blockade.

Special instructions:

The effectiveness and safety of local anesthetics depends on the accuracy of their dosage and compliance with the technique of administration. Local anesthetics should be introduced by specialists with experience in the diagnosis and treatment of adverse reactions, cardiac rhythm and conduction disorders and other acute conditions. It is necessary to have equipment and medicines to stop severe toxic reactions.

Instructions
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