Lox 2% WITH ADRENALINE

Lox 2% WITH ADRENALINE is indicated in the management of cardiac arrhythmias, particularly those of ventricular origin, such as occur with acute myocardial infarction.

The selection of the intramuscular route of administration (single dose) is justified in the following circumstances:

1. By a physician in whose opinion the potential benefits outweigh the possible risks even when ECG equipment is not available to verify the arrhythmia.
2. By, or under the supervision of, a physician, including mobile coronary care units, when facilities for intravenous administration are not readily available, or under circumstances where maintaining continuous intravenous therapy is difficult or impossible.
3. For use in the pre-hospital phase of suspected acute myocardial infarction by a patient who has transmitted his electrocardiogram with a CardioBeeper®, whose electrocardiogram demonstrates the presence of a ventricular arrhythmia and who is instructed by qualified medical personnel to self-administer the Lox 2% WITH ADRENALINE® Auto-Injector.

Lox 2% WITH ADRENALINE topical jelly or ointment is used on different parts of the body to cause numbness or loss of feeling for patients having certain medical procedures. It is also used to relieve pain and itching caused by conditions such as sunburn or other minor burns, insect bites or stings, poison ivy, poison oak, poison sumac, minor cuts, or scratches.

Lox 2% WITH ADRENALINE viscous topical solution is also used to treat sore mouth or throat and also reduce gagging during the taking of X-ray pictures and dental impressions.

Lox 2% WITH ADRENALINE skin patch is used to relieve pain caused by shingles (postherpetic neuralgia).

Lox 2% WITH ADRENALINE belongs to the family of medicines called local anesthetics. Lox 2% WITH ADRENALINE prevents pain by blocking the signals at the nerve endings in the skin. Lox 2% WITH ADRENALINE does not cause unconsciousness as general anesthetics do when used for surgery.

Lox 2% WITH ADRENALINE is available only with your doctor's prescription.

A physician who prescribes this device for the patient, must take appropriate steps to insure that his patient understands the indications and use of this device including review with the patient, in detail, the patient package insert and operation of the Auto-Injector.

Inject the contents of 1 Lox 2% WITH ADRENALINE® Auto-Injector (300 mg Lox 2% WITH ADRENALINE, 3 mL, 10% solution) intramuscularly into the anterolateral aspect of the thigh or deltoid region of the arm. See DETAILED INSTRUCTIONS below.

As soon as possible, and when indicated, patients should be changed to an intravenous infusion of Lox 2% WITH ADRENALINE or to an oral antiarrhythmic preparation for maintenance therapy. However, if necessary, an additional intramuscular injection may be made after an interval of 60-90 minutes. IT SHOULD BE MADE CLEAR TO THE PATIENT THAT THIS SECOND INJECTION SHOULD NOT BE MADE WITHOUT FURTHER INSTRUCTIONS BY QUALIFIED MEDICAL PERSONNEL.

DETAILED INSTRUCTIONS

NOTE: A separate booklet containing information regarding self-administration of the Lox 2% WITH ADRENALINE®Auto-Injector by patients equipped with a CardioBeeper®will be made available to the patient.

Introduction:

As part of the early management of a heart attack, your physician has prescribed for you a drug — Lox 2% WITH ADRENALINE contained in an automatic injector — The Lox 2% WITH ADRENALINE® Auto-Injector.

This drug has been shown to be valuable in the management of certain abnormal heart rhythms which sometimes accompany heart attacks. As with all other drugs, it is not without risk. UNDER NO CIRCUMSTANCES SHOULD IT BE USED WITHOUT SPECIFIC INSTRUCTIONS TO DO SO BY QUALIFIED MEDICAL PERSONNEL.

Therefore, your physician has taken steps to provide you with a CardioBeeper® with which to transmit your heart rate and rhythm by conventional telephone.

Be certain to review the information contained in this booklet and practice with the use of the CardioBeeper®.

The Lox 2% WITH ADRENALINE® Auto-Injector:

The Lox 2% WITH ADRENALINE® Auto-Injector is a disposable, prefilled automatic injection device containing 300 mg Lox 2% WITH ADRENALINE.

• Keep the Lox 2% WITH ADRENALINE® Auto-Injector with you at all times.
• It should not be kept in excessive heat or cold.
• You should note the expiration date on the Lox 2% WITH ADRENALINE® Auto-Injector and make sure yours is replaced prior to that date.

If you experience the signs and symptoms described to you by your physician as suggesting a possible heart attack, immediately telephone your physician, or center designated by your physician, and transmit your electrocardiogram by CardioBeeper®. You will then be instructed whether or not you are to use the Lox 2% WITH ADRENALINE® Auto-Injector.

Directions for Use:

When as described above, you have been instructed to use the Lox 2% WITH ADRENALINE® Auto-Injector, proceed as follows:

UNLESS ABSOLUTELY NECESSARY, DO NOT ATTEMPT TO OPERATE A MOTOR VEHICLE AFTER USE OF THE Lox 2% WITH ADRENALINE® Auto-Injector.

Proceed as instructed by physician.

See also:
What is the most important information I should know about Lox 2% WITH ADRENALINE?

Severe bleeding, shock, hypotension, infection of the proposed injection site, marked bradycardia, cardiogenic shock, severe forms of chronic heart failure, SSS in elderly patients, AV-block II and III degree (except in cases when the probe was introduced to stimulate the ventricles), severe liver function abnormalities.

For subarachnoid anesthesia - complete heart block, bleeding, hypotension, shock, infection of the venue lumbar puncture, septicemia.

Increased sensitivity to Lox 2% WITH ADRENALINE Euro-Med Laboratories Phil and other amide type local anesthetics.

Use Lox 2% WITH ADRENALINE as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• Wash and completely dry the affected area. Apply a thin layer of Lox 2% WITH ADRENALINE to the affected area. Gently rub the medicine in until it is evenly distributed.
• Wash your hands immediately after using Lox 2% WITH ADRENALINE, unless your hands are part of the treated area.
• Lox 2% WITH ADRENALINE is for external use only. Avoid contact with eyes. If contact occurs, wash out the eye at once with water or saline and protect it until the numbness is gone.
• Do not apply to broken, infected, or severely irritated skin.
• Do not bandage or wrap the affected area, unless directed otherwise by your doctor.
• If you miss a dose of Lox 2% WITH ADRENALINE and you are using it regularly, use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule.

Ask your health care provider any questions you may have about how to use Lox 2% WITH ADRENALINE.

It is used to numb an area of body for temporary relief of pain caused by recurrent mouth ulcers, denture irritation, anal or rectal problems. It is also used before minor surgeries as local anesthetic.

See also:
What other drugs will affect Lox 2% WITH ADRENALINE?

Beta-blockers increase the risk of bradycardia and hypotension. Norepinephrine and beta-blockers by reducing hepatic blood flow decrease (increased toxicity), isadrine and glucagon - increase the clearance of Lox 2% WITH ADRENALINE. Cimetidine increases the plasma concentration of Lox 2% WITH ADRENALINE Euro-Med Laboratories Phil (displaces from its association with proteins and slows inactivation in the liver). Barbiturates causing induction of microsomal enzymes stimulate the degradation of Lox 2% WITH ADRENALINE and reduce its activity. Anticonvulsants (hydantoin derivatives) accelerate the biotransformation in the liver (decreased concentration in the blood), for IV injections it may increases cardiodepressive action of Lox 2% WITH ADRENALINE. Antiarrhythmics (amiodarone, verapamil, quinidine, aymalin) potentiate cardiac depression. Combination with novocainamide may cause CNS excitement and hallucinations. Lox 2% WITH ADRENALINE Euro-Med Laboratories Phil strengthens the inhibitory effect of anesthesia (hexobarbital, thiopental sodium), hypnotics and sedatives on the respiratory center, weakens the cardiac effects of digitoxin, enhances muscle relaxation caused by drugs curare like (possible paralysis of respiratory muscles). MAO inhibitors prolong local anesthesia.

See also:
What are the possible side effects of Lox 2% WITH ADRENALINE?

Systemic

Adverse experiences following the administration of Lox 2% WITH ADRENALINE are similar in nature to those observed with other amide local anesthetic agents. These adverse experiences are, in general, dose-related and may result from high plasma levels caused by excessive dosage, rapid absorption or inadvertent intravascular injection, or may result from a hypersensitivity, idiosyncrasy or diminished tolerance on the part of the patient. Serious adverse experiences are generally systemic in nature. The following types are those most commonly reported:

Central Nervous System

CNS manifestations are excitatory and/or depressant and may be characterized by lightheadedness, nervousness, apprehension, euphoria, confusion, dizziness, drowsiness, tinnitus, blurred or double vision, vomiting, sensations of heat, cold or numbness, twitching, tremors, convulsions, unconsciousness, respiratory depression and arrest. The excitatory manifestations may be very brief or may not occur at all, in which case the first manifestation of toxicity may be drowsiness merging into unconsciousness and respiratory arrest.

Drowsiness following the administration of Lox 2% WITH ADRENALINE is usually an early sign of a high blood level of the drug and may occur as a consequence of rapid absorption.

Cardiovascular System

Cardiovascular manifestations are usually depressant and are characterized by bradycardia, hypotension, and cardiovascular collapse, which may lead to cardiac arrest.

Allergic

Allergic reactions are characterized by cutaneous lesions, urticaria, edema or anaphylactoid reactions. Allergic reactions may occur as a result of sensitivity to local anesthetic agents. Allergic reactions as result of sensitivity to Lox 2% WITH ADRENALINE are extremely rare and, if they occur, should be managed by conventional means. The detection of sensitivity by skin testing is of doubtful value.

Neurologic

The incidences of adverse reactions associated with the use of local anesthetics may be related to the total dose of local anesthetic administered and are also dependent upon the particular drug used, the route of administration and the physical status of the patient. In a prospective review of 10,440 patients who received Lox 2% WITH ADRENALINE for spinal anesthesia, the incidences of adverse reactions were reported to be about 3 percent each for positional headaches, hypotension and backache; 2 percent for shivering; and less than 1 percent each for peripheral nerve symptoms, nausea, respiratory inadequacy and double vision. Many of these observations may be related to local anesthetic techniques, with or without a contribution from the local anesthetic.

In the practice of caudal or lumbar epidural block, occasional unintentional penetration of the subarachnoid space by the catheter may occur. Subsequent adverse effects may depend partially on the amount of drug administered subdurally. These may include spinal block of varying magnitude (including total spinal block), hypotension secondary to spinal block, loss of bladder and bowel control, and loss of perineal sensation and sexual function. Persistent motor, sensory and/or autonomic (sphincter control) deficit of some lower spinal segments with slow recovery (several months) or incomplete recovery have been reported in rare instances when caudal or lumbar epidural block has been attempted. Backache and headache have also been noted following use of these anesthetic procedures.

There have been reported cases of permanent injury to extraocular muscles requiring surgical repair following retrobulbar administration.

A local anesthetic and cardiac depressant used as an antiarrhythmia agent. Its actions are more intense and its effects more prolonged than those of procaine but its duration of action is shorter than that of bupivacaine or prilocaine. [PubChem]