Prilocaine + Felypressin


Thông tin thuốc gốc
Chỉ định và Liều dùng
Injection
Local anaesthesia
Adult: Available preparation:
Each mL of solution for inj contains prilocaine 30 mg and felypressin 0.54 mcg

Dental infiltration and dental nerve block techniques: Usual dose: 1-5 mL. Max: 10 mL. Doses are administered slowly; aspirate the syringe after tissue penetration and before inj to avoid inadvertent intravascular inj. Dose is individualised based on the physical condition of the patient, anaesthesia technique, vascularity of the oral tissue, and the area of the oral cavity to be anaesthetised. Use the lowest effective dose.
Child: Available preparation:
Each mL of solution for inj contains prilocaine 30 mg and felypressin 0.54 mcg

Dental infiltration and dental nerve block techniques: <10 years Usual dose: 1-2 mL (Max: 10 mL); ≥10 years Same as adult dose. Doses are administered slowly; aspirate the syringe after tissue penetration and before inj to avoid inadvertent intravascular inj. Dose is individualised based on the physical condition of the patient, anaesthesia technique, vascularity of the oral tissue, and the area of the oral cavity to be anaesthetised. Use the lowest effective dose.
Elderly: Dosage reduction may be required.
Nhóm bệnh nhân đặc biệt
Debilitated patients: Dosage reduction may be required.
Chống chỉ định
Hypersensitivity to prilocaine and other anaesthetics of the amide-type, or felypressin. Congenital or idiopathic methaemoglobinaemia; inflammation or sepsis in the region of proposed inj.
Thận trọng
Patient with severe anaemia; CV disease (e.g. severe bradycardia, impaired cardiac conduction, severe or untreated hypertension, circulatory failure of any cause), impaired respiratory function, diabetes; history of seizure, genetic predisposition to malignant hyperthermia, G6PD deficiency. Avoid intravascular inj. Debilitated and acutely ill patients. Renal and hepatic impairment. Children and elderly. Pregnancy and lactation.
Tác dụng không mong muốn
Significant: CV effects particularly with excessive doses (e.g. cardiac vasoconstriction, increased blood pressure); methaemoglobinaemia, cyanosis; neurological reactions (e.g. numbness, paraesthesia, sensory disturbances); risk of oral trauma.
Cardiac disorders: Bradycardia, cardiac insufficiency.
Ear and labyrinth disorders: Tinnitus.
Eye disorders: Blurred vision.
Gastrointestinal disorders: Nausea, vomiting.
Immune system disorders: Rarely, hypersensitivity reaction.
Nervous system disorders: Dizziness, drowsiness, headache, tremor, seizure, loss of consciousness.
Psychiatric disorders: Nervousness, disorientation.
Vascular disorders: Hypotension.
Potentially Fatal: Rarely, cardiac or respiratory arrest.
Thông tin tư vấn bệnh nhân
This drug may temporarily impair locomotion and coordination, if affected, do not drive or operate machinery. This medicine may also increase the risk of accidental trauma by the patient to the lips, tongue, cheek mucosa or soft palate; to avoid inadvertent injury, refrain from food ingestion until normal oral function and sensation return.
Quá liều
Symptoms: Nervousness, dizziness, blurred vision and tremors, followed by drowsiness, unconsciousness, convulsions and possibly respiratory arrest. CV reactions such as peripheral vasodilation, hypotension, myocardial depression, bradycardia and possibly cardiac arrest may also occur. Management: Ensure patent airway. If ventilation is inadequate, provide assisted or controlled ventilation with oxygen. IV diazepam or thiopentone Na may be administered to control convulsions. Supportive treatment for circulatory depression such as administration of fluids and/or vasopressor (e.g. ephedrine) may be required. Initiate effective CV resuscitation if cardiac arrest occurs.
Tương tác
Prilocaine: Increased risk of methaemoglobinaemia with sulfonamides (e.g. sulfamethoxazole), antimalarials (e.g. chloroquine) and certain nitric compounds (e.g. nitric oxide, Na nitrite). Enhanced adverse effects with other local anaesthetics and agents structurally related to amide-type local anaesthetics. May increase the risk of cardiac toxic effects with antiarrhythmics (e.g. amiodarone).
Tác dụng
Description: Prilocaine is an amide-type local anaesthetic. It stabilises the neuronal membrane by reversibly blocking the Na ion influx through the nerve membrane required for the initiation and conduction of nerve impulses.
Felypressin is a synthetic vasopressin analogue. It reduces the absorption rate of prilocaine from the site of inj.
Onset: 2 minutes (infiltration); 4 minutes (block).
Duration: Infiltration: 40 minutes (pulp); 2.5 hours (soft tissue). Block: 90 minutes (pulp); 3.5 hours (soft tissue).
Pharmacokinetics:
Distribution: Prilocaine: Crosses the placenta and blood-brain barrier; enters breast milk. Volume of distribution: 190-260 L. Plasma protein binding: 40-55%, mainly to α1-acid glycoprotein.
Metabolism: Prilocaine: Rapidly metabolised mainly in the liver and to a lesser extent in the kidneys by amidases to form o-toluidine and N-propylalanine.
Excretion: Prilocaine: Via urine (<5% as unchanged drug). Elimination half-life: 1.6 hours.
Đặc tính

Chemical Structure Image
Prilocaine

Source: National Center for Biotechnology Information. PubChem Database. Prilocaine, CID=4906, https://pubchem.ncbi.nlm.nih.gov/compound/Prilocaine (accessed on Jan. 23, 2020)


Chemical Structure Image
Felypressin

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 14257662, Felypressin. https://pubchem.ncbi.nlm.nih.gov/compound/Felypressin. Accessed Nov. 25, 2021.

Bảo quản
Store below 25°C. Protect from light.
Phân loại MIMS
Thuốc gây mê-gây tê
Phân loại ATC
N01BB54 - prilocaine, combinations ; Belongs to the class of amides. Used as local anesthetics.
Tài liệu tham khảo
Anon. G6PD - Prilocaine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/10/2021.

Anon. Prilocaine and Felypressin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/10/2021.

Anon. Prilocaine. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 22/10/2021.

Buckingham R (ed). Felypressin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/10/2021.

Buckingham R (ed). Prilocaine. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/10/2021.

Citanest with Octapressin Dental Solution for Injection (Dentsply Limited). MHRA. https://products.mhra.gov.uk. Accessed 22/10/2021.

Dentsply Sirona (N.Z.) Limited. 3% Citanest Dental with Octapressin Injection data sheet 14 May 2019. Medsafe. http://www.medsafe.govt.nz. Accessed 22/10/2021.

Joint Formulary Committee. Prilocaine with Felypressin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/10/2021.

Preston CL (ed). Prilocaine. Stockley’s Drug Interactions [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 22/10/2021.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Prilocaine + Felypressin từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2022 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in