Adrenalina.

Concentratii
CONCENTRATI
ANESTEZICE FOLOSIRE
I
doar Urgente in soc anafilactis sau acriza acuta de astm
1 : 1000
Epinephrina
Most commonly used concentration
1 : 100,000 4% Articaine Bun pentru hemostaza.
Controlul durerii similara ca i in alte preparate
Cea mai diluata.
4% Articaine
Ofera o buna hemostaza dar mai slaba ca 1:100,000
4% Prilocaine
1 : 200,000 Controlul durerii similara ca i in alte preparate
0.5%
Folosita la pacinetii cu boli de inima
Bupivacaine
Folosita la pacinetii batrani

Mepivacaina
Durata anestezie pulpa - infiltatie 20 de min
- block 40 de min
cu vasoconstrictor 60 de min
Potenta egala cu prilocaina
2/3 din articaina
1/4 bupivacaina
Toxicitate egala cu articaina
2x mai toxica ca prilocaina
1/4 din bupivacaina
Durata instalare 1.52 min
Timp de injumatatire Approximately 114 min (1.9 hours)
Dozaj 4.4 mg/kg
2 mg/lb
Gravide C, sigura cand alapteaza

Mepivacaine 3%
Tips Precautiuni
Durata scurta de actiune Boli ale ficatului
Dureaza mai mult cand e folosita ca block Pacineti care iau beta-blocante
Se foloseste cand e contraindicata utilizarea Pacineti care iau deprimante ale SNC
unui vasoconstrictor

Articaine
Durata anestezie 6075 min (1 : 100,000)
4560 min (1 : 200,000)
Potenta 1/3 mai puternica, ca mepivacaina si prilocaina
Toxicitate egal cu mepivacaina
Durata instalare Infiltratie (1 : 200,000) 12 min
Block 23 min
Infiltratie (1 : 100,000) 12 min
Block 22:30 min
Timp de injumatatire 45 min
Gravide C, nu se stie cat de sigura e

Articaina 4% 1:100,000 Epinephrina

 Tips Precautiuni
Durata anesteziei- cu putin mai mult ca boli grave de inima
mepivacaina 3% depresante ale SNC
Buna in controlul sangerarii alergii la sulfiti
In doze mici se poate folosi si la pacinetii cu astmaci
boli de inima (maxim 2 cartuse) antidepresanti triciclici
Indicata la pacinetii cu boli ale ficatului cocaina metamfetamina
diabet
hipertiroidism
hipertensiune
gaucom
infarct miocardic
accident vasc cer
bypass
angina

Articaine 4% 1:200,000 Epinephrine

Tips Precautiuni
boli grave de inima
In doze mici se poate folosi si la pacinetii cu depresante ale SNC
boli de inima ( max 4 cartuse ) alergii la sulfiti
Cea mai buna alegere la pacinetii cu boli de astmaci
inima si pacinetii batrani antidepresanti triciclici
O alegere mai sigura la pacinetii cu boli de cocaina metamfetamina
ficat diabet
Adrenalina e la jumate fata de dozajul de hipertiroidism
1:100,000 hipertensiune
gaucom
infarct miocardic
accident vasc cer
bypass
angina

MODIFICATIONS TO THE USE OF VASOCONSTRICTORS

CONDITION SIGNIFICANCE DOSE MODIFICATION
ASA III patients are treatable with Limit vasoconstrictor to cardiac
appropriate dose; 0.04 mg per appointment for
Cardiovascular
Modifications epinephrine; 0.2 mg per
disease
appointment for levonordefrin; do
not use 1 : 50,000 epinephrine
Increases effects of Avoid levonordefrin; limit
vasoconstrictor; both epinephrine epinephrine to cardiac dose of 0.04
Patients taking
and levonordefrin may cause mg per appointment; do not use 1 :
tricyclic
acute hypertension and cardiac 50,000 epinephrine
antidepressants
dysrhythmia but levonordefrin to a
greater degree
Vasoconstrictors directly oppose Limit the dose of vasoconstrictor for
effect of insulin, possible changes patients with uncontrolled brittle
in blood levels of glucose; amounts diabetes
Diabetes
used in dentistry are generally
safe and do not significantly raise
blood sugar levels
Sensitivity to vasoconstrictors Surgically corrected or medication
Controlled
increasing their effect controlled respond normally to
hyperthyroidism
vasoconstrictors.
Phenothiazines Haloperidol (Haldol): Limit vasoconstrictor to cardiac
chlorpromazine (Thorazine) may dose; 0.04 mg per appointment for
 reverse the pressor effect of
vasoconstrictors resulting in an
increased risk of hypotension, and
have been noted to antagonize the
peripheral vasoconstrictive effects
of epinephrine
Digitalis Epinephrine increases the
glycosides potential for cardiac arrhythmias
epinephrine; 0.2 mg per
appointment for levonordefrin; do
not use 1 : 50,000 epinephrine
Use epinephrine in consultation with
patients physician

ABSOLUTE CONTRAINDICATIONSDO NOT USE

VASOCONSTRICTORS
CONDITION
Recent myocardial infarction within 6
months
Recent coronary bypass surgery within
6 months
Uncontrolled high blood pressure
Uncontrolled angina
Sulfite allergies
Pheochromocytoma:
catecholamineproducing tumors
Uncontrolled hyperthyroidism
Cocaine or methamphetamine
abusers
Glaucoma
SIGNIFICANCE
Increase cardiovascular effects to dangerous levels;
ASA IV until recuperation
Avoid all dental care until condition is under control
Increase cardiovascular effects to dangerous levels;
ASA IV until recuperation
Avoid all dental care until condition is under control
Increase blood pressure to dangerous levels
Avoid all dental care until condition is under control
Increase risk of severe angina attack
Avoid all dental care until condition is under control
Avoid vasoconstrictor in true allergic reaction
Tumor of the adrenal gland, causes adrenal
insufficiency
Avoid all dental care until condition is under control
Risk of thyroid crisis, thyroid storm
Avoid all dental care until condition is under control
Avoid use of vasopressors; may lead to myocardial
infarction
Vasoconstrictors increase the amount of ocular
pressure
Avoid use of vasopressors