Mardex 25 Kit

DEXAMETHASONE SODIUM PHOSPHATE, BUPIVACAINE HYDROCHLORIDE, POVIDINE IODINE

Manufacturer: Asclemed USA, Inc.

Score: 142.0

Quick Summary

Mardex 25 Kit is used for various medical procedures, including local or regional anesthesia, analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and obstetrical procedures. The kit contains bupivacaine hydrochloride, an amide local anesthetic, and dexamethasone sodium phosphate, a corticosteroid. Bupivacaine blocks nerve impulses, producing numbness or loss of sensation, while dexamethasone is used to treat various conditions such as endocrine disorders, rheumatic disorders, and allergic states. However, the kit has several warnings and contraindications, including the risk of cardiac arrest, dose-related toxicity, and methemoglobinemia. The recommended dosage varies depending on the procedure, and special considerations are needed for pediatric, geriatric, and pregnant patients.

Key Clinical Findings and Indications

Local or regional anesthesia
Analgesia for surgery, dental and oral surgery procedures, diagnostic and therapeutic procedures, and obstetrical procedures
Treatment of endocrine disorders, rheumatic disorders, and allergic states

Important Safety Information

Warning

Risk of cardiac arrest, dose-related toxicity, and methemoglobinemia

Contraindications

Obstetrical paracervical block anesthesia
Intravenous regional anesthesia (Bier Block)
Patients with a known hypersensitivity to bupivacaine or to any local anesthetic agent of the amide-type

Adverse Reactions

Cardiovascular effects, such as hypotension and bradycardia
Neurologic effects, such as seizures and respiratory arrest
Allergic-type reactions, such as urticaria and angioneurotic edema

Dosing Recommendations

General Guidance

Dose adjustments may be necessary for elderly patients, patients with hepatic or renal impairment, and patients with cardiovascular disease

Local infiltration

Adult Dose

0.25% (25 mg/10 mL) (2.5 mg/mL) in single-dose teartop vials

Pediatric Dose

Not recommended for pediatric patients younger than 12 years

Epidural anesthesia

Adult Dose

0.5% (50 mg/10 mL) (5 mg/mL) in single-dose teartop vials

Pediatric Dose

Not recommended for pediatric patients younger than 12 years

Special Population Considerations

Pregnancy

Bupivacaine Hydrochloride Injection/Bupivacaine Hydrochloride and Epinephrine Injection is contraindicated for obstetrical paracervical block anesthesia
Use in pregnancy only if the potential benefit justifies the potential risk to the fetus

Nursing Mothers

Corticosteroids are excreted in breast milk
Use with caution in nursing mothers

Pediatric Use

Not recommended for pediatric patients younger than 12 years
Continuous infusions of bupivacaine in pediatric patients have been reported to result in high systemic levels of bupivacaine and seizures

Geriatric Use

Elderly patients may require lower doses of Bupivacaine Hydrochloride Injection/Bupivacaine Hydrochloride and Epinephrine Injection
Use with caution in elderly patients with hypertension, as they may be at increased risk for developing hypotension

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