프로카인 및 에피네프린

투여 경로

금기

• Intravenous administration
• Use in areas supplied by end-arteries (e.g., tail, ears, digits) due to risk of ischemic necrosis
• Known hypersensitivity to ester-type local anesthetics or PABA
• Epidural use (depending on specific formulation preservatives)

이상반응

• Local tissue irritation
• Ischemia or tissue necrosis (due to epinephrine)
• CNS excitation followed by depression (at toxic doses)
• Cardiovascular depression, hypotension, or arrhythmias (at toxic doses)
• Allergic reactions (ester anesthetics are metabolized to PABA, a known allergen)

약물 상호작용

• Sulfonamide antibiotics · Procaine is metabolized to PABA, which competitively antagonizes the antibacterial effect of sulfonamides. · major
• Alpha-adrenergic blockers · May antagonize the vasoconstrictive effects of epinephrine. · moderate
• Halothane · Sensitizes the myocardium to catecholamines; increased risk of arrhythmias with epinephrine. · major

모니터링

• Heart rate and rhythm
• Blood pressure
• Signs of CNS toxicity (tremors, seizures)
• Tissue perfusion at the injection site

과용량

Overdose or accidental IV injection can lead to systemic toxicity. * **CNS signs:** Restlessness, tremors, seizures, followed by severe CNS depression. * **Cardiovascular signs:** Arrhythmias, hypotension, and cardiovascular collapse. * **Treatment:** Supportive care, oxygen therapy, control seizures with diazepam or midazolam, and manage arrhythmias. Intravenous lipid emulsion (ILE) therapy may be considered for severe local anesthetic systemic toxicity (LAST).