Bupivacaine

그림문자(GHS)

• 그림문자(GHS)

  

• 신호 어

  Danger

• 유해·위험 문구

  H300：삼키면 치명적임

  H310：피부와 접촉하면 치명적임

  H315：피부에 자극을 일으킴

  H318：눈에 심한 손상을 일으킴

  H330：흡입하면 치명적임

• 예방조치문구

  P260：분진·흄·가스·미스트·증기·...·스프레이를 흡입하지 마시오.

  P262：눈, 피부, 의복에 묻지 않도록 하시오.

  P264：취급 후에는 손을 철저히 씻으시오.

  P264：취급 후에는 손을 철저히 씻으시오.

  P270：이 제품을 사용할 때에는 먹거나, 마시거나 흡연하지 마시오.

  P271：옥외 또는 환기가 잘 되는 곳에서만 취급하시오.

  P280：보호장갑/보호의/보안경/안면보호구를 착용하시오.

  P284：호흡 보호구를 착용하시오.

  P301+P310：삼켰다면 즉시 의료기관(의사)의 진찰을 받으시오.

  P302+P350：피부에 묻은 경우,비눗물로 부드럽게 씻기

  P302+P352：피부에 묻으면 다량의 물로 씻으시오.

  P304+P340：흡입하면 신선한 공기가 있는 곳으로 옮기고 호흡하기 쉬운 자세로 안정을 취하시오.

  P305+P351+P338：눈에 묻으면 몇 분간 물로 조심해서 씻으시오. 가능하면 콘택트렌즈를 제거하시오. 계속 씻으시오.

  P310：즉시 의료기관(의사)의 진찰을 받으시오. 삼켰다면 즉시 의료기관(의사)의 도움을 받으시오.

  P320：긴급히 (…) 처치를 하시오.

  P321：(…) 처치를 하시오.

  P322：특정 조치(라벨의 … 참조)

  P330：입을 씻어내시오.

  P332+P313：피부 자극이 생기면 의학적인 조치· 조언을 구하시오.

  P361：즉시 오염된 의복을 모두 벗을 것

  P362：오염된 의복을 벗고 세척 후에 재사용하기

  P363：다시 사용전 오염된 의류는 세척하시오.

  P403+P233：용기는 환기가 잘 되는 곳에 단단히 밀폐하여 저장하시오.

  P405：밀봉하여 저장하시오.

  P501：...에 내용물 / 용기를 폐기 하시오.

Bupivacaine 화학적 특성, 용도, 생산

• 용도

  Like lidocaine and mepivacaine, bupivacaine is used in infiltration, spinal, and epidural anesthesia in blocking nerve transmission. Its most distinctive property is its long-lasting action. It is used for surgical intervention in urology and in lower thoracic surgery from 3 to 5 h in length, and in abdominal surgery lasting from 45 to 60 min. It is used to block the trifacial nerve, the sacral and brachial plexuses, in resetting dislocations, in epidural anesthesia, and during Cesarian sections.

• 일반 설명

  Bupivacaine was synthesized simultaneously with mepivacainein 1957 but was at first overlooked because of the increasedtoxicity compared with mepivacaine. When themethyl on the cyclic amine of mepivacaine is exchanged fora butyl group the lipophilicity, potency and the duration ofaction all increase. Literature reports of cardiovascular toxicity,including severe hypotension and bradycardia, areabundant in the literature.91 Bupivacaine is highly bound toplasma proteins (95%), and thus the free concentration mayremain low until all of the protein binding sites are occupied.After that point, the plasma levels of bupivacaine rise rapidlyand patients may progress to overt cardiac toxicity withoutever showing signs of CNS toxicity. The cardiotoxicity ofbupivacaine is a result of its affinity to cardiac tissues and itsability to depress electrical conduction and predispose theheart to reentry types of arrhythmias. The cardiotoxicity ofbupivacaine was found to be significantly more prominentwith the “R” isomer, or the racemic mixture, thus the “S”stereoisomer is now on the market as levobupivacaine.

• Mechanism of action

  Bupivacaine is a local anaesthetic containing a chiral centre and adopts dextro and laevo forms. The enantiopure l form is less cardio- and neurotoxic and has an equivalent potency to the racemic mixture; therefore levobupivacaine is often preferred to reduce the potential for toxicity. Stereoselectivity describes the differences in response at a given receptor for the different enantiomers (such as the response discussed for S(+) ketamine). The opioid and NMDA receptors also exhibit stereoselectivity.

• Pharmacology

  Bupivacaine is a chiral compound used clinically for 50 years, with a slower onset, greater potency and longer duration of action than lidocaine. Initial benefits of bupivacaine were sensory–motor separation and minimal tachyphylaxis, unlike repeated doses of lidocaine. However, it has greater potential for cardiac toxicity, related to its avid binding to and slow dissociation from cardiac N a+ channels. Inadvertent intravenous administration may result in systemic toxicity (see later), and it is contraindicated for intravenous regional anaesthesia.
  Bupivacaine is commonly used for epidural administration in obstetrics and postoperative pain management. A hyperbaric preparation containing 80 mg ml^-1 glucose is available for spinal anaesthesia.

• 부작용

  Common side effects of bupivacaine include:
  weakness, long-lasting numbness or tingling;
  feeling restless or drowsy;
  tremors;
  headache, blurred vision;
  fast or slow heartbeats;
  breathing problems;
  chills or shivering;
  back pain;
  nausea, vomiting.

Bupivacaine 준비 용품 및 원자재

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