Source:http://www4.wiwiss.fu-berlin.de/dailymed/resource/drugs/2334
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Novocaine (Injection, Solution)
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| dailymed-instance:dosage |
As with all local anesthetics, the dose of NOVOCAIN
varies and depends upon the area to be anesthetized, the vascularity
of the tissues, the number of neuronal segments to be blocked, individual
tolerance, and the technique of anesthesia. The lowest dose needed
to provide effective anesthesia should be administered. For specific
techniques and procedures, refer to standard textbooks. The diluent may be sterile normal saline, sterile
distilled water, spinal fluid; and for hyperbaric technique, sterile
dextrose solution. The usual rate of injection
is 1 mL per 5 seconds. Full anesthesia and fixation usually occur
in 5 minutes. STERILIZATION The drug in intact ampuls is sterile. The preferred method of destroying
bacteria on the exterior of ampuls before opening is heat sterilization
(autoclaving). Immersion in antiseptic solution is not recommended. Autoclave at 15-pound pressure,
at 121��C (250��F), for 15 minutes. The diluent
dextrose may show some brown discoloration due to caramelization. Protect solutions from light.
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| dailymed-instance:descripti... |
NOVOCAIN, procaine hydrochloride, is benzoic acid,
4-amino-, 2-(diethylamino) ethyl ester, monohydrochloride, the ester
of diethylaminoethanol and aminobenzoic acid, with the following structural
formula: It is a white crystalline, odorless powder that is freely soluble
in water, but less soluble in alcohol. Each mL contains 100 mg procaine
hydrochloride and 4 mg acetone sodium bisulfite as antioxidant. DO
NOT USE SOLUTIONS IF CRYSTALS, CLOUDINESS, OR DISCOLORATION IS OBSERVED.
EXAMINE SOLUTIONS CAREFULLY BEFORE USE. REAUTOCLAVING INCREASES LIKELIHOOD
OF CRYSTAL FORMATION.
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| dailymed-instance:clinicalP... |
NOVOCAIN stabilizes the neuronal membrane and prevents
the initiation and transmission of nerve impulses, thereby effecting
local anesthesia. NOVOCAIN lacks surface anesthetic activity. The
onset of action is rapid (2 to 5 minutes) and the duration of action
is relatively short (average 1 to 1��hours), depending upon
the anesthetic technique, the type of block, the concentration, and
the individual patient. NOVOCAIN is readily
absorbed following parenteral administration and is rapidly hydrolyzed
by plasma cholinesterase to aminobenzoic acid and diethylaminoethanol. A vasoconstrictor may be added to the solution of NOVOCAIN
to promote local hemostasis, delay systemic absorption, and increase
duration of anesthesia.
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| dailymed-instance:contraind... |
Spinal anesthesia with NOVOCAIN is contraindicated
in patients with generalized septicemia: sepsis at the proposed injection
site; certain diseases of the cerebrospinal system, e.g., meningitis,
syphilis; and a known hypersensitivity to the drug, drugs of a similar
chemical configuration, or aminobenzoic acid or its derivatives. The decision as to whether or not spinal anesthesia
should be used in an individual case should be made by the physician
after weighing the advantages with the risks and possible complications.
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Store at 20 to 25��C (68 to 77��F). [See
USP Controlled Room Temperature.] Revised: July,
2005 Hospira, Inc., Lake Forest, IL 60045 USA
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| dailymed-instance:precautio... |
Standard textbooks should be consulted for specific
techniques and precautions for various spinal anesthetic procedures. The safety and effectiveness of a spinal anesthetic depend
upon proper dosage, correct technique, adequate precautions, and readiness
for emergencies. The lowest dosage that results in effective anesthesia
should be used to avoid high plasma levels and possible adverse effects.
Tolerance varies with the status of the patient. Debilitated, elderly
patients, or acutely ill patients should be given reduced doses commensurate
with their weight and physical status. Reduced dosages are also indicated
for obstetric delivery and patients with increased intra-abdominal
pressure. The decision whether or not to use
spinal anesthesia in the following disease states depends on the physician's
appraisal of the advantages as opposed to the risk: cardiovascular
disease (i.e., shock, hypertension, anemia, etc.), pulmonary disease,
renal impairment, metabolic or endocrine disorders, gastrointestinal
disorders (i.e., intestinal obstruction, peritonitis, etc.), or complicated
obstetrical deliveries. NOVOCAIN SHOULD BE USED
WITH CAUTION IN PATIENTS WITH KNOWN DRUG ALLERGIES AND SENSITIVITIES.
A thorough history of the patient's prior experience with NOVOCAIN
or other local anesthetics as well as concomitant or recent drug use
should be taken (see CONTRAINDICATIONS). NOVOCAIN should not be used
in any condition in which a sulfonamide drug is being employed since
aminobenzoic acid inhibits the action of sulfonamides. Solutions containing a vasopressor should be used with
caution in the presence of diseases which may adversely affect the
cardiovascular system. NOVOCAIN should be used
with caution in patients with severe disturbances of cardiac rhythm,
shock or heartblock.
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| dailymed-instance:genericMe... |
Procaine Hydrochloride
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| dailymed-instance:fullName |
Novocaine (Injection, Solution)
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| dailymed-instance:adverseRe... |
Systemic adverse reactions involving the central
nervous system and the cardiovascular system usually result from high
plasma levels due to excessive dosage, rapid absorption, or inadvertent
intravascular injection. In addition, use of inappropriate doses or
techniques may result in extensive spinal blockade leading to hypotension
and respiratory arrest. A small number of reactions
may result from hypersensitivity, idiosyncrasy, or diminished tolerance
to normal dosage. Excitatory CNS effects (nervousness, dizziness, blurred
vision, tremors) commonly represent the initial signs of local anesthetic
systemic toxicity. However, these reactions may be very brief or absent
in some patients in which case the first manifestation of toxicity
may be drowsiness or convulsions merging into unconsciousness and
respiratory arrest. Cardiovascular system reactions include depression of the
myocardium, hypotension (or sometimes hypertension), bradycardia,
and even cardiac arrest. Allergic reactions are characterized
by cutaneous lesions of delayed onset, or urticaria, edema, and other
manifestations of allergy. The detection of sensitivity by skin testing
is of limited value. As with other local anesthetics, hypersensitivity,
idiosyncrasy and anaphylactoid reactions have occurred rarely. The
reaction may be abrupt and severe and is not usually dose related. The following adverse reactions may occur with spinal
anesthesia: Central Nervous System: postspinal headache, meningismus, arachnoiditis, palsies, or spinal
nerve paralysis. Cardiovascular: hypotension due to vasomotor paralysis and pooling of the blood
in the venous bed. Respiratory: respiratory impairment or paralysis due to the level of anesthesia
extending to the upper thoracic and cervical segments. Gastrointestinal: nausea and vomiting. Treatment of Reactions. Toxic effects of local anesthetics require symptomatic treatment:
there is no specific cure. The physician should be prepared to maintain
an airway and to support ventilation with oxygen and assisted or controlled
respiration as required. Supportive treatment of the cardiovascular
system includes intravenous fluids and, when appropriate, vasopressors
(preferably those that stimulate the myocardium, such as ephedrine).
Convulsions may be controlled with oxygen and by the intravenous administration
of diazepam or ultrashort-acting barbiturates or a short-acting muscle
relaxant (succinylcholine). Intravenous anticonvulsant agents and
muscle relaxants should only be administered by those familiar with
their use and only when ventilation and oxygenation are assured. In
spinal and epidural anesthesia, sympathetic blockade also occurs as
a pharmacological reaction, resulting in peripheral vasodilation and
often hypotension. The extent
of the hypotension will usually depend on the number of dermatomes
blocked. The blood pressure should therefore be monitored in the early
phases of anesthesia. If hypotension occurs, it is readily controlled
by vasoconstrictors administered either by the intramuscular or the
intravenous route, the dosage of which would depend on the severity
of the hypotension and the response to treatment.
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| dailymed-instance:warning |
RESUSCITATIVE EQUIPMENT AND DRUGS SHOULD BE IMMEDIATELY
AVAILABLE WHENEVER ANY LOCAL ANESTHETIC DRUG IS USED. Spinal anesthesia
should only be administered by those qualified to do so. Large doses of local anesthetics should not be used in
patients with heartblock. Reactions resulting
in fatality have occurred on rare occasions with the use of local
anesthetics, even in the absence of a history of hypersensitivity. Usage in Pregnancy. Safe use of NOVOCAIN has not been established with respect to adverse
effects on fetal development. Careful consideration should be given
to this fact before administering this drug to women of childbearing
potential particularly during early pregnancy. This does not exclude
the use of the drug at term for obstetrical analgesia. Vasopressor
agents (administered for the treatment of hypotension or added to
the anesthetic solution for vasoconstriction) should be used with
extreme caution in the presence of oxytocic drugs as they may produce
severe, persistent hypertension with possible rupture of a cerebral
blood vessel. Solutions which contain a vasoconstrictor
should be used with extreme caution in patients receiving drugs known
to produce alterations in blood pressure (i.e., monoamine oxidase
inhibitors (MAOI), tricyclic antidepressants, phenothiazines, etc.),
as either severe sustained hypertension or hypotension may occur. Local anesthetic procedures should be used with caution
when there is inflammation and/or sepsis in the region of the proposed
injection. Contains acetone sodium bisulfite,
a sulfite that may cause allergic-type reactions including anaphylactic
symptoms and life-threatening or less severe asthmatic episodes in
certain susceptible people. The overall prevalence of sulfite sensitivity
in the general population is unknown and probably low. Sulfite sensitivity
is seen more frequently in asthmatic than in nonasthmatic people.
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| dailymed-instance:indicatio... |
NOVOCAIN is indicated for spinal anesthesia.
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| dailymed-instance:name |
Novocaine
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