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LIGNOSPAN FORTE is a brand name for Epinephrine (also known as Adrenaline), supplied as a solution. The medicine, its uses, side effects and dosage are the same regardless of brand.
Used for: AND CLINICAL USE .......................................................................................................... 4 WARNINGS AND PRECAUTIONS.............................................................................................................. 5 ADVERSE REACTIONS…
Verbatim from this product's HC label. Tap a section to expand.
General LOCAL ANAESTHETICS SHOULD ONLY BE EMPLOYED BY CLINICIANS WHO ARE WELL VERSED IN DIAGNOSIS AND MANAGEMENT OF DOSE-RELATED TOXICITY AND OTHER ACUTE EMERGENCIES WHICH MAY ARISE FROM THE BLOCK TO BE PERFORMED, AND THEN ONLY AFTER ENSURING THE IMMEDIATE AVAILABILITY OF OXYGEN, OTHER RESUSCITATIVE DRUGS, CARDIOPULMONARY EQUIPMENT, AND THE PERSONNEL NEEDED FOR PROPER MANAGEMENT OF TOXIC REACTIONS AND RELATED EMERGENCIES (see ADVERSE REACTIONS and OVERDOSAGE).
DELAY IN PROPER MANAGEMENT OF DOSE-RELATED TOXICITY, UNDERVENTILATION FROM ANY CAUSE AND/OR ALTERED SENSITIVITY MAY LEAD TO THE DEVELOPMENT OF ACIDOSIS, CARDIAC ARREST AND, POSSIBLY, DEATH. THE LOWEST DOSAGE OF LOCAL ANAESTHETICS THAT RESULTS IN EFFECTIVE ANESTHESIA OR ANALGESIA SHOULD BE USED TO AVOID HIGH PLASMA LEVELS AND SERIOUS ADVERSE REACTIONS.
INJECTIONS SHOULD BE MADE SLOWLY OR IN INCREMENTAL DOSES, WITH FREQUENT ASPIRATIONS BEFORE AND DURING THE INJECTION TO AVOID INTRAVASCULAR INJECTION.
Major Peripheral Nerve Blocks:
Major peripheral nerve blocks may imply the administration of a large volume of local anaesthetic in areas of high vascularity, often close to large vessels where there is an increased risk of intravascular injection and/or rapid systemic absorption which can lead to high plasma concentrations.
Repeat Dosing:
Repeated doses of lidocaine may cause significant increases in blood levels with each repeated dose because of slow accumulation of the drug or its metabolites. Tolerance to elevated blood levels varies with the status of the patient.
Debilitated, elderly patients, acutely ill patients and children should be given reduced doses commensurate with their age and physical condition (see DOSAGE AND ADMINISTRATION-Special Populations).
Use of Parenteral Solutions containing Epinephrine:
Lignospan containing epinephrine should not be used in areas of the body supplied by end arteries, such as digits, nose, ears or penis, or otherwise having a compromised blood supply (see also DRUG INTERACTIONS).
Inflammation and Sepsis:
Local anesthetic procedures should not be used when there is inflammation and/or sepsis in the region of the proposed injection Malignant Hyperthermia: Many drugs used during the conduct of anesthesia are considered potential triggering agents for familial malignant hyperthermia.
Not medical advice. Always read the patient information leaflet and follow your prescriber or pharmacist.
Other brands of Epinephrine in Canada.
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Brand names are compiled from public regulatory records for active-ingredient mapping only. Drugvu is not affiliated with any manufacturer. This is not medical advice.
It has been shown that the use of amide local anesthetics in malignant hyperthermia patients is safe. However, there is no guarantee that neural blockage will prevent the development of malignant hyperthermia during surgery. It is also difficult to predict the need for supplemental general anesthesia.
Therefore, a standard protocol for the management of malignant hyperthermia should be available.
Acute Porphyria:
Lidocaine has been shown to be porphyrinogenic in animal models. Novocol Pharmaceutical of Canada, Inc. Page 6 of 23 Lignospan Parenteral Solutions should only be used in patients with acute porphyria when no safer alternative is available.
Appropriate precautions should be taken for all porphyric patients. Cardiovascular Lidocaine should be used with caution in patients with bradycardia or impaired cardiovascular functions since they may be less able to compensate for functional changes associated with the prolongation of A-V conduction produced by amide-type local anesthetics.
Patients with partial or complete heart block require special attention since local anaesthetics may depress myocardial conduction. To reduce the risk of potentially serious adverse reactions, attempts should be made to optimize the patient’s condition before major blocks are performed.
Dosage should be adjusted accordingly. Lidocaine should be used with caution in patients in severe shock. Solutions containing epinephrine should be used with caution in patients whose medical history and physical evaluation suggest the existence of untreated hypertension, ischemic heart disease, heart block, cerebral vascular insufficiency, peripheral vascular disorder, and any other pathological condition that may be aggravated by the effects of epinephrine.
g. amiodarone, mexiletine) should be under close surveillance and ECG monitoring, since cardiac effects of these drugs and lidocaine may be additive (see DRUG INTERACTIONS). Peri-Operative Considerations It is essential that aspiration for blood be done prior to injecting any local anesthetics, both the original and all subsequent doses, to avoid intravascular or subarachnoid injection.
However, a negative aspiration does not ensure against an intravascular or subarachnoid injection. The safety and effectiveness of LIGNOSPAN depend on proper dosage, correct technique, adequate precautions and readiness for emergencies.
Standard textbooks should be consulted for specific techniques and precautions for various regional anesthetic procedures. Resuscitative equipment, oxygen, and other resuscitative drugs, should be available for immediate use (see OVERDOSAGE).
v. fluids running via an indwelling catheter to assure a functioning intravenous pathway. The clinician responsible should have adequate and appropriate training in the procedure to be performed, should take the necessary precautions to avoid intravascular injection (see DOSAGE AND ADMINISTRATION), and should be familiar with the diagnosis and treatment of side effects, systemic toxicity and other complications (see ADVERSE REACTIONS and OVERDOSAGE).
THE LOWEST DOSAGE THAT RESULTS IN EFFECTIVE ANESTHESIA SHOULD BE USED TO AVOID HIGH PLASMA LEVELS AND SERIOUS ADVERSE EFFECTS. INJECTIONS SHOULD BE MADE SLOWLY, WITH FREQUENT ASPIRATIONS BEFORE AND DURING THE INJECTION TO AVOID INTRAVASCULAR INJECTION.
Careful and constant monitoring of cardiovascular and respiratory (adequacy of ventilation) vital signs and the patient’s state of consciousness should be performed after each […]
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