Adrenaline prescription in Latin in ampoules

Adrenomimetics are drugs that stimulate adrenoreceptors. According to the predominant stimulating effect on a certain type of adrenergic receptors, adrenomimetics can be divided into 3 groups:

1)stimulating predominantly alpha-adrenergic receptors (alpha-adrenergic agonists);

2) predominantly stimulating beta-adrenergic receptors (beta-adrenergic agonists);

3) stimulating alpha- and beta-adrenergic receptors (alpha, beta-agonists).

Adrenomimetics have the following indications for use.

1) Sharp vascular insufficiency with severe arterial hypotension (collapse, infectious or toxic origin, shock, including traumatic, surgical interventions, etc.). In these cases, solutions of norepinephrine, mezaton, ephedrine are used. Norepinephrine and mezaton are administered intravenously, drip. Mezaton and ephedrine - intramuscularly at intervals of 40-60 minutes between injections. In cardiogenic shock with severe hypotension, the use of a-adrenergic agonists requires great caution: their administration, causing spasm of arterioles, further exacerbates the violation of blood supply to tissues.

2) Cardiac arrest. It is necessary to introduce 0.5 ml of a 0.1% solution of adrenaline into the cavity of the left ventricle, as well as heart massage and mechanical ventilation.

3) Bronchial asthma. To eliminate the attack, inhalation of solutions of isadrin, novodrin, euspiran, alupent (orciprenaline sulfate, asthmapent), adrenaline, salbutamol or intramuscular injection of adrenaline, ephedrine, as well as ingestion of salbutamol, isadrin (sublingually) are carried out. In the period between attacks, ephedrine, theofedrine, etc. are prescribed.

4) Inflammatory diseases mucous membranes of the nose (rhinitis) and eyes (conjunctivitis). Topically applied in the form of drops (to reduce discharge and inflammation) solutions of ephedrine, naphthyzine, mezaton, galazolin, etc.

5) Local anesthesia. To solutions of local anesthetics add 0.1% solution of adrenaline or 1% solution of mezaton to prolong their action.

6) Simple open-angle glaucoma. Apply 1-2% (together with pilocarpine) adrenaline solution to cause a vasoconstrictor effect, reduce secretion aqueous humor leading to a decrease in intraocular pressure.

7) Hypoglycemic coma. To enhance glycogenolysis and increase blood glucose, 1 ml of a 0.1% adrenaline solution is injected intramuscularly or intravenously 1 ml of a 0.1% adrenaline solution in 10 ml of a 40% glucose solution.

Side effects of adrenomimetics:

A sharp vasoconstrictor effect, which may result in a hypertensive crisis, stroke, acute cardiac weakness with the development of pulmonary edema (typical for a-agonists - norepinephrine, mezaton, etc.);

Neurotoxic complications - agitation, insomnia, tremor, headaches (typical for alpha-, beta-agonists - ephedrine, adrenaline; beta-agonists - isadrin, etc.);

Arrhythmogenic action leading to various violations heart rate (typical for adrenaline, ephedrine, isadrine).

Contraindications: for alpha-agonists and alpha-, beta-agonists - hypertension, atherosclerosis of cerebral and coronary vessels, hyperthyroidism, diabetes mellitus; for beta-agonists - chronic heart failure, severe atherosclerosis.

DRUGS THAT STIMULATE PREFERENTIALLY ALPHA-ADRENORECEPTORS ( ALPHA ADRENOMIMETICS )

The group of alpha-agonists includes norepinephrine, the main mediator of adrenergic synapses, secreted in small amounts (10-15%) by the adrenal medulla. Norepinephrine has a predominant stimulating effect on alpha-adrenergic receptors, to a small extent stimulates beta- and even less - beta 2 -adrenergic receptors. On the cardiovascular system The action of norepinephrine is manifested in a pronounced short-term increase blood pressure in connection with the excitation of alpha-adrenergic receptors of blood vessels. Unlike epinephrine, there is no hypotensive reaction after the pressor action due to the weak effect of norepinephrine on beta2.vascular adrenoreceptors. In response to an increase in pressure, reflex bradycardia occurs, which is eliminated by atropine. The reflex action on the heart through the vagus nerve neutralizes the stimulating effect of norepinephrine on the heart, the stroke volume increases, but the cardiac output practically does not change or decreases. Norepinephrine acts on other organs and systems like drugs that excite sympathetic nervous system. The most rational way of introducing norepinephrine into the body is intravenous drip, which allows for a reliable pressor response. In the gastrointestinal tract, norepinephrine is destroyed; when administered subcutaneously, it can cause tissue necrosis.

NORADRENALINA HYDROTARTRATE. Release form norepinephrine hydrotartrate: 1 ml ampoules of 0.2% solution.

An example of a recipe for norepinephrine hydrotartrate in Latin:

Rp.: Sol. Noradrenalini hydrotartratis 0.2% 1 ml

D.t. d. N. 10 ampull.

S. For intravenous drip; dilute 1-2 ml in 500 ml of 5% glucose solution.

MEZATON- acts mainly on a-adrenergic receptors. Mezaton causes constriction of peripheral vessels and an increase in blood pressure, but is less effective than norepinephrine. Mezaton can also cause reflex bradycardia. Mezaton has a slight stimulating effect on the central nervous system. Mezaton is more stable than norepinephrine and is effective when given orally, intravenously, subcutaneously, and topically. Indications for the use of mezaton, side effects and contraindications for use are indicated in the general part of this section. Mezaton release form: powder; 1 ml ampoules of 1% solution. List B.

An example of a mezaton recipe in Latin:

Rp.: Mesatoni 0.01 Sacchari 0.3 M. f. pulv.

D.t. d. No. 20

S. 1 powder 2-3 times a day.

Rp.: Sol. Mesatoni 1% 1ml

D.t. d. N. 10 ampull.

S. Dissolve the contents of the ampoule in 40 ml of 40% glucose solution. Administer intravenously, slowly (in shock).

Rp.: Sol. Mesatoni 1% 1ml

D.t. d. N. 10 ampull.

S. Inject under the skin or intramuscularly 0.5-1 ml.

Rp.: Sol. Mesatoni 1% 5ml

D.S. Eye drops. 1-2 drops per day in both eyes.

Rp.: Sol. Mesatoni 0.25% 10ml

D.S. Nose drops.

PHETANOL- according to the chemical structure, it is close to mezatone, being a derivative of phenylalkylamides. Compared with mezaton for a longer period, fetanol increases blood pressure, otherwise it has the properties inherent in mezaton. Fetanol release form: powder; tablets of 0.005 g - ampoules of 1 ml of a 1% solution. List B.

An example of a fetanol recipe in Latin:

Rep.: Tab. Phethanoli 0.005 N. 20

D.S. 1 tablet 2 times a day.

Rp.: Sol. Phethanoli 1% 1ml

D.t. d. N. 10 ampull. S. 1 ml subcutaneously.

NAPHTHIZIN (pharmacological analogues: nafazolin, sanorin) - used to treat acute rhinitis, sinusitis, allergic conjunctivitis, diseases of the nasal cavity and throat. Naphthyzinum has an anti-inflammatory effect. The vasoconstrictive effect of naphthyzine is longer than that of norepinephrine and mezaton. Naphthyzine release form: 10 ml bottles of 0.05% and 0.1% solutions; 0.1% emulsion.

An example of a recipe for naphthyzine in Latin:

Rp.: Sol. Naphthyzini 0.1% 10ml

D.S. 1-2 drops in the nasal cavity 2-3 times a day.

GALAZOLIN- on action is close to naphthyzinum. Galazolin is used for rhinitis, sinusitis, allergic diseases nasal cavity and throat. Release form of Galazolin: bottles of 10 ml of a 0.1% solution. List B.

An example of a recipe for Galazolin in Latin:

Rp.: Sol. Halazolini 0.1% 10 ml

D.S. 1-2 drops in the nasal cavity 1-3 times a day.

DRUGS THAT STIMULATE BETA-ADRENORECEPTORS PREdominately (BETA-ADRENOMIMETICS)

ISADRIN(pharmacological analogues: isoprenaline hydrochloride, novodrin, euspiran) is a typical beta-agonist stimulating beta1- and beta2-adrenergic receptors. Under the influence of isadrin, a strong expansion of the bronchial lumen occurs due to the excitation of beta 2 -adrenergic receptors. By stimulating the beta-adrenergic receptors of the heart, isadrin enhances its work, increases the strength and frequency of heart contractions. Isadrin acts on beta-adrenergic receptors of blood vessels, causing their expansion and lowering blood pressure. Isadrin is also active in relation to the conduction system of the heart: it facilitates atrioventricular (atrioventricular) conduction, increases the automatism of the heart. Isadrin has a stimulating effect on the central nervous system. Isadrine acts like adrenaline on metabolism. Isadrin is used to relieve spasms of the bronchi of a different etiology, as well as for atrioventricular blockade. Isadrin is prescribed 0.5-1% solution in the form of inhalation or sublingually 1 / 2 - 1 tablet containing 0.005 g of the drug. Isadrin release form: tablets of 0.005 g; novodrin - bottles of 100 ml of a 1% solution, an aerosol of 25 g, ampoules of 1 ml of a 0 5% solution; euspiran - bottles of 25 ml of a 0.5% solution. List B.

An example of an izadrin recipe in Latin:

Rep.: Tab. Isadrini 0.005 N. 20

D. S. 1 tablet (keep in the mouth until completely resorbed).

Rp.: Sol. Novodrini 1% 100ml

D. S. 0.5-1 ml for inhalation.

Rp.: Sol. Euspirani 0.5% 25ml

D. S. 0.5 ml for inhalation.

DOBUTAMIN- selectively stimulates beta-adrenergic receptors of the heart, has a strong inotropic effect on the heart muscle, increases coronary blood flow, improves blood circulation. Side effects when using dobutamine: tachycardia, arrhythmia, increased blood pressure, pain in the heart. Dobutamine is contraindicated in subaortic stenosis. Dobutamine release form: 20 ml bottles with 0.25 g of the drug.

An example of a dobutamine recipe in Latin:

Rp.: Dobutamini 0.25

D.t. d. No. 10

S. Dilute the contents of the vial in 10-20 ml of water for injection, then dilute with isotonic sodium chloride solution. Inject at a rate of 10mcg/kg body weight per minute.

DOBUTREX - combination drug containing 250 mg of dobutamine and 250 mg of mannitol (in one vial). The addition of mannitol, a potassium-sparing diuretic, eliminates such side effects of dobutamine as increased blood pressure and improves the general condition of patients. Dobutrex is used in adults for a short-term increase in myocardial contraction in case of cardiac decompensation (with organic heart diseases, surgical operations and etc.). Dobutrex is administered intravenously, at a certain rate (calculated according to a special formula for each patient). Side effects and contraindications for the use of tthe same as for dobutamine. Dobutrex release form: bottles with 0.25 g of the drug (with a solvent).

Salbutamol(pharmacological analogues: ventolin etc.) - stimulates beta2-adrenergic receptors localized in the bronchi, gives a pronounced bronchodilator effect. Salbutamol is administered orally and inhaled with bronchial asthma and other diseases respiratory tract accompanied by a spastic condition of the muscles of the bronchi. Release form of salbutamol: aerosol inhalers and tablets of 0.002 g.

Salbutamol recipe example in Latin:

Rep.: Tab. Salbutamoli sulfatis 0.002 N. 30

D.S. 1 tablet 2 times a day for bronchial asthma.

SALMETIROL(pharmacological analogues: serevent) - beta stimulant 2 long-acting adrenergic receptors. Salmetirol has a bronchodilatory and tonic effect on the cardiovascular system. Salmetirol is used to eliminate bronchospasm in bronchial asthma and other diseases with bronchospastic syndrome. Salmetirol is administered by inhalation as an aerosol 2 times a day. Side effects of salmetirol and contraindications are the same as for other drugs in this group. Release form of salmetirol: aerosol cans with dispenser (120 doses).

ORCIPRENALINE SULFATE (pharmacological analogues: alupent, asthmapent etc.) - beta-agonist. By stimulating beta 2 -adrenergic receptors of the bronchi, orciprenaline sulfate has a bronchodilatory effect. Severe tachycardia and lowering blood pressure does not cause. Orciprenaline sulfate is used to treat bronchial asthma, emphysema and other diseases with bronchospastic syndrome. Orciprenaline sulfate is also prescribed for atrioventricular conduction disorders. The drug is administered subcutaneously, intramuscularly (1-2 ml of a 0.05% solution), inhaled as an aerosol (in a single dose of 0.75 mg), and also taken orally by "/ 2 - 1 tablet 3-4 times a day. With intravenous administration of orciprenaline sulfate, a decrease in blood pressure is possible. Release form orciprenaline sulfate: tablets of 0.02 g; 1 ml ampoules of 0.05% solution; 20 ml bottles of 2% solution for aerosol (alupent); vials of 20 ml of 1.5% solution for aerosol (asthmopent). List B.

Orciprenaline sulfate recipe example in Latin:

Rp.: Sol. Alupenti 0.05% 1ml

D.t. d. N. 6 in amp.

S. 0.5-1 ml intravenously with atrioventricular blockade.

Rp.: Sol. Astmopenti 1.5% 20 ml

D.S. For inhalation: 1-2 inhalations at the time of an asthma attack.

HEXOPRENALINE(pharmacological analogues: ipradol, hexoprenaline sulfate) - compared with orciprenaline sulfate has a more selective and strong effect on beta 2 bronchial adrenoreceptors. Hexoprenaline practically does not give a cardiovascular effect in therapeutic doses. Hexoprenaline is prescribed to relieve and prevent bronchospasm in adults and children with chronic obstructive airway disease. The drug hexoprenaline is administered by inhalation using an aerosol dispenser (1 dose - 0.2 mg); intravenously (2 ml containing 5 mcg of hexoprenaline) or administered orally (1-2 tablets 3 times a day - for an adult). For children, the dose is reduced according to age. Contraindications to the use of hexoprenaline are typical for drugs in this group. Hexoprenaline release form: aerosol with dispenser (in a bottle of 93 mg of the drug - approximately 400 doses); ampoules of 2 ml (5 μg of the drug); tablets of 0.5 mg. List B.

TRONTOQUINOL HYDROCHLORIDE (pharmacological analogues: inoline) - see the Bronchodilators section.

PHENOTEROL HYDROBROMI D (pharmacological analogues: berotek, partusisten) - stimulates beta 2 -adrenergic receptors. It has a pronounced bronchodilator effect, and therefore is used for bronchial asthma, asthmatic bronchitis and other respiratory diseases with a bronchospastic component. Fenoterol hydrobromide has tocolytic properties (stimulates beta 2 - iadreno - receptors of the uterus), called "partusisten" is used to relax the muscles of the uterus (see section "Uterine drugs"). To eliminate bronchospasm, berotek inhalation is used - 1-2 doses of an aerosol (further use is possible only after 3 hours); for prophylactic purposes, appoint 1 dose 3 times a day (for adults), reduce the dose for children depending on age. Contraindications for the use of fenoterol hydrobromide: pregnancy. Release form fenoterol hydrobromide: 15 ml aerosol cans (300 doses).

BERODUAL- a combined preparation consisting of 0.05 mg of berotek (fenoterol hydrobromide) and 0.02 mg of ipratropium bromide (atrovent). Berodual has a pronounced bronchodilator effect due to the different mechanism of action of the incoming components. Berodual is used for bronchial asthma and other bronchopulmonary diseases, accompanied by a spastic condition of the muscles of the bronchi (see section "Means that affect respiratory function"). Release form of berodual: aerosol 15 ml (300 doses).

CLENBUTEROL HYDROCHLORIDE(pharmacological analogues: clenbuterol, contraspasmin, spiropent) - typical beta 2 - adrenomimetic. Clenbuterol hydrochloride causes relaxation of the bronchial muscles. Clenbuterol hydrochloride is used to treat bronchial asthma, asthmatic bronchitis, emphysema, etc. Side effects when using clenbuterol hydrochloride: sometimes there may be a slight tremor of the fingers, which requires a dose reduction. Contraindications to the use of clenbuterol hydrochloride: not recommended for use in the first 3 months of pregnancy. Clenbuterol hydrochloride is prescribed 15 ml 2-3 times a day, for children the dose is reduced according to age. Release form clenbuterol hydrochloride: bottles of 100 ml of 0.1% syrup.

TERBUTALIN SULFATE(pharmacological analogues: bricanil, arubenzene, bricaryl) - stimulates beta 2 -adrenergic receptors of the trachea and bronchi. Terbutaline sulfate has a bronchodilator effect. Terbutaline sulfate is used for bronchial asthma, bronchitis, emphysema, etc. Terbutaline sulfate is administered orally 1-2 tablets 2-3 times a day. Terbutaline sulfate can be administered subcutaneously or intravenously at 0.5-1 ml (maximum 2 ml) per day. For children, doses are reduced according to age. Side effects: there may be a tremor that disappears on its own. Release form t erbutaline sulfate: tablets of 2.5 mg and ampoules of 1 ml (0.5 mg).

DRUGS THAT STIMULATE ALPHA AND BETA ADRENORECEPTORS (ALPHA AND BETA ADRENOMIMETICS)

Among alpha- and beta-agonists, 2 groups of drugs can be distinguished:

Alpha- and beta-adrenergic agonists of direct action, directly stimulating adrenergic receptors;

Alpha and beta adrenomimetics indirect action that affect adrenoreceptors indirectly through endogenous catecholamines.

ADRENALIN(pharmacological analogues: epinephrine) is a hormone of the adrenal medulla, a typical representative of alpha-, beta-agonists of direct action. In medical practice, adrenaline salts are used: hydrochloride and hydrotartrate. By stimulating alpha and beta adrenoreceptors, adrenaline has an effect on various systems and organs, but most pronounced on the cardiovascular system. Adrenaline stimulates the beta-adrenergic receptors of the heart, increases the frequency and strength of heart contractions, while also increasing the stroke and minute volume of the heart. At the same time, oxygen consumption by the heart muscle increases, which is especially evident in pathological changes in the coronary vessels, when the administration of adrenaline is contraindicated due to the development of myocardial hypoxia. Under the influence of adrenaline, systolic blood pressure rises, which is associated with increased heart function and stimulation of alpha-adrenergic receptors in blood vessels (the latter is important when using large doses of adrenaline). With the introduction of medium doses of adrenaline, the total peripheral vascular resistance decreases, diastolic pressure decreases, but the mean arterial pressure rises due to an increase in systolic pressure. Adrenaline constricts the vessels of the intestines, skin, kidneys, dilates the coronary vessels and vessels of the skeletal muscles, slightly changes the tone of the cerebral and pulmonary vessels. An increase in blood pressure in response to the administration of adrenaline is replaced by a slight decrease, which is explained by a longer effect of the drug on beta 2 vascular adrenoreceptors. Adrenaline has a pronounced effect on the bronchi: stimulating B 2 - adrenoreceptors, it causes relaxation of the smooth muscles of the bronchi, relieves bronchospasm. Adrenaline acts on the gastrointestinal tract through alpha-adrenergic receptors, causing a decrease in its tone and motility. Due to the excitation of alpha-adrenergic receptors, the tone of the sphincters increases, secretion increases salivary glands(secretion of viscous, thick saliva). The tone of the sphincters also increases. Bladder, the tone of the ureters, the bile duct decreases. Adrenaline regulates carbohydrate and fat metabolism. Adrenaline does not penetrate the blood-brain barrier well, but when it is administered, there is a slight stimulating effect on the central nervous system. Adrenaline affects the eye through the A-drenoreceptors located in the radial muscle of the iris, the excitation of which leads to a contraction of this muscle and dilation of the pupils. In this case, accommodation is slightly disturbed and intraocular pressure decreases due to a decrease in the formation of intraocular fluid, and possibly due to an increase in its outflow. Release form of adrenaline: adrenaline hydrochloride - 1 ml ampoules and 30 ml bottles of 0.1% solution, adrenaline hydrotartrate - 1 ml ampoules of 0.18% solution. List B.

An example of a recipe for adrenaline in Latin:

Rp.: Sol. Adrenalini hydrotartratis 0.18% 1 ml

D.t. d. N. 6 in amp.

S. 0.5 ml under the skin 1-2 times a day.

Rp.: Sol. Adrenalini hydrochloridi 0.1% 10ml

Pilocarpini hydrochloridi 0.1

M.D.S. Eye drops. 2 drops 2-3 times a day (for glaucoma).

EPHEDRINE(pharmacological analogues: neophedrine etc.) - an alkaloid of the ephedra plant. In medical practice, ephedrine hydrochloride is used; unlike adrenaline, ephedrine acts on the presynaptic part of the synapse, stimulates the release of norepinephrine, which has an effect on adrenoreceptors. Another component in the mechanism of action of ephedrine is its ability to directly exert a weak stimulatory effect on adrenoreceptors. In general, giving the same effects as adrenaline, ephedrine is significantly inferior to it in activity. An exception is the stimulating effect of ephedrine on the central nervous system, which exceeds the effect of adrenaline, since ephedrine better penetrates the blood-brain barrier. With the repeated introduction of ephedrine into the body after a short interval of time, tachyphylaxis is possible. This effect is associated with a decrease in the content of deposited norepinephrine in the presynaptic part of the synapse as a result of its increased release under the action of ephedrine. In order for the reserves of norepinephrine to be replenished and the drug to have its therapeutic effect, ephedrine should be administered at intervals between doses of more than 30 minutes.

The effect of ephedrine on the eye is somewhat different from adrenaline: it, like adrenaline, dilates the pupils, but does not affect accommodation and intraocular pressure. Ephedrine has a longer-lasting effect on blood pressure than adrenaline. Unlike adrenaline, it remains active when taken orally. Deamination of ephedrine occurs in the liver, but it is resistant to the action of MAO. It is excreted by the kidneys about half of the once administered dose - unchanged. Ephedrine is used to treat bronchial asthma, urticaria and other allergic diseases, rhinitis, arterial hypotension, in ophthalmic practice to dilate the pupil for diagnostic purposes, etc. Side effects when using ephedrine: tachycardia, nausea, insomnia, nervous excitement, tremor, delay urine. Contraindications to the use of ephedrine: atherosclerosis and hypertension, hyperthyroidism, organic diseases heart, pregnancy. Release form of ephedrine: powder; tablets 0.025 g and 0.01 g; tablets of 0.01 g with diphenhydramine (0.01 g each); ampoules of 1 ml and syringe-tubes with a 5% solution; vials of 10 ml of 2% and 3% solutions. According to one prescription, release no more than 0.6 g (in terms of pure substance), leave the prescription at the pharmacy! List B.

An example of a recipe for ephedrine in Latin:

Rep.: Tab. Ephedrini hydrochloridi 0.025 N. 10

D.S. 1 tablet 2-3 times a day.

Rp.: Sol. Ephedrini hydrochloridi 5% 1ml

D.t. d. N. 10 ampull.

S. 0.5-1 ml under the skin 1-2 times a day.

Rp.: Sol. Ephedrini hydrochloridi 2% (3%) 10 ml

D.S. Nose drops. 5 drops every 3-4 hours.

DEPHEDRIN- similar in action to ephedrine, but less active, but also less toxic. Dephedrine is used for mild and moderate forms of bronchial asthma and asthmatic bronchitis. Dephedrine is administered orally at 0.03-0.06 g 2-3 times a day. The course of treatment is 10-20 days. Side effects of dephedrine and contraindications for use are the same as for ephedrine. Release form of dephedrine: tablets of 0.03 g. List B.

THEOPHEDRIN- a combined preparation containing ephedrine hydrochloride 0.02 g, theophylline 0.05 g, theobromine 0.05 g, caffeine 0.05 g, amidopyrine 0.2 g, phenacetin 0.2 g, phenobarbital 0.02 g, belladonna extract 0.004 g, cytisine 0.0001 g. Teofedrin is used as a therapeutic and prophylactic agent for bronchial asthma. Assign 1/2 or 1 tablet 1 time per day. Theofedrine release form: tablets. List B.

EFATIN- an aerosol preparation containing ephedrine hydrochloride 0.05 g, atropine sulfate 0.02 g, novocaine 0.04 g, ethanol up to 10 ml, freon 12-20 g. Efatin is used for bronchial asthma, to relieve asthmatic conditions in bronchitis, pneumonia , emphysema, etc. Efatin is used in the form of inhalations 1-5 times a day. Contraindications to the use of efatin are the same as for the components that make up the drug. Efatin release form: aerosol cans of 30 ml with a sprayer. Form A.

COFFEX- a combined preparation containing ephedrine hydrochloride, ammonium chloride and ipecac (syrup). Coffex has a bronchodilator and expectorant effect. Coffex is prescribed for diseases of the lungs and upper respiratory tract. Coffex release form: bottles of 100 ml.

SOLUTAN- a combined preparation, which includes ephedrine hydrochloride (17.5 mg in 1 ml), belladonna root alkaloid - radobelin (0.1 mg in 1 ml) and other components. Solutan is used as an expectorant and bronchodilator for bronchial asthma and bronchitis (10-30 drops 3 times a day). Side effects when using solutan: dilated pupils, dry mouth. Solutan is contraindicated in glaucoma. Solutan a release form: 50 ml bottles. List B.

Recipe (International)

Rp.: Sol. Epinephrini hydrochloridi 0.1% - 1 ml
D.t.d. N. 6 in ampullis.
S. inject 0.5 ml under the skin at anaphylactic shock

pharmachologic effect

Stimulates alpha and beta ad renoreceptors.

In terms of peripheral sympathomimetic action, ephedrine is close to adrenaline. Causes vasoconstriction, increased blood pressure, bronchial dilation, inhibition of peristalsis (wave-like movements) of the intestine, dilated pupils, increased blood glucose.

Compared with adrenaline, ephedrine has a less dramatic, but much longer effect. Due to its greater stability, ephedrine is effective when administered orally and is convenient for use in course treatment (for example, for allergic diseases).

Unlike adrenaline, ephedrine has a specific stimulating effect on the central nervous system. In this respect, it is close to phenamine, but the latter acts much more strongly.

Mode of application

For adults: Epinephrine is administered subcutaneously, intramuscularly, intravenously.

In anaphylactic shock: slowly intravenously 0.1-0.25 mg diluted in 10 ml of 0.9% sodium chloride solution, if necessary, then continue the introduction of intravenous drip at a concentration of 0.1 m / ml; if the patient's condition allows a slow action (3-5 minutes), then it is preferable to administer intramuscularly (or subcutaneously) 0.3-0.5 mg undiluted or diluted, if necessary, repeat the administration after 10-20 minutes (up to 3 times).

As a vasoconstrictor, it is administered intravenously at a rate of 1 μg / min (with a possible increase in the rate of administration to 2-10 μg / min).

In bronchial asthma: intravenously 0.1-0.25 mg diluted at a concentration of 0.1 mg / ml or subcutaneously 0.3-0.5 mg undiluted or diluted, repeated doses, if necessary, can be administered every 20 minutes (up to 3 times).

Asystole: intracardiac 0.5 mg (dilute with 10 ml of 0.9% sodium chloride solution or other solution); during the resuscitation- 1 mg (in diluted form) intravenously every 3-5 minutes; if the patient is intubated, then endotracheal administration is possible - the optimal doses have not been established, but should be 2-2.5 times the dose for intravenous administration.

Prolongation of the action of local anesthetics: at a concentration of 5 μg / ml (the dose depends on the type of anesthetic used), for spinal anesthesia - 0.2-0.4 mg.

Neonates (for asystole): IV, slowly, 10-30 mcg/kg every 3-5 minutes; children older than 1 month: intravenously, 10 mcg / kg (in the future, if necessary, every 3-5 minutes, 100 mcg / kg is administered); possible use of endotracheal administration.

Children with bronchospasm: subcutaneously 10 mcg / kg (maximum - up to 0.3 mg), if necessary, the introduction is repeated every 15 minutes (up to 3-4 times) or every 4 hours.

Children with anaphylactic shock: intramuscularly or subcutaneously - 10 mcg / kg (maximum - up to 0.3 mg), if necessary, repeat the introduction of these doses every 15 minutes (up to 3 times).
Open-angle glaucoma - 2 times a day, 1 drop of a 1-2% solution. To stop bleeding, locally, in the form of swabs that are moistened with a solution of the drug.

When carrying out infusion, it is necessary to use a device with a measuring device to control the rate of administration of the drug. Infusions should be carried out in a large vein (preferably in the central one). Intracardiac epinephrine is administered during asystole only if other methods are not available, as there is a risk of pneumothorax and cardiac tamponade. During epinephrine therapy, monitoring of serum K + levels, measurement of diuresis, blood pressure, cardiac output, central venous pressure, ECG, wedge pressure in the pulmonary capillaries and blood pressure are recommended during epinephrine therapy. pulmonary artery.

High doses of epinephrine in myocardial infarction, due to increased myocardial oxygen demand, may exacerbate ischemia. Epinephrine increases glycemia, so when diabetes higher doses of sulfonylurea and insulin derivatives are needed. When administered endotracheally, the absorption and final plasma levels of epinephrine can be unpredictable.

Epinephrine can be used in children in cardiac arrest, but care must be taken as 2 different concentrations of the drug are required in the dosing regimen. When stopping therapy, the dose should be reduced gradually, since the sudden withdrawal of treatment can cause severe hypotension.

Indications

to eliminate immediate allergic reactions (Quincke's edema, anaphylactic shock, urticaria) that have developed as a result of drug allergy, blood transfusion, use food products, the introduction of other allergens or insect bites;

With asystole, including against the background of AV blockade of the 3rd degree;
- relief of an attack of bronchial asthma;
- bronchospasm that occurred during the use of anesthesia;
- prolongation of action of local anesthetics;
- arterial hypotension, which is not treatable with replacement fluids (after trauma, in a state of shock, with bacteremia, open heart surgery, kidney failure, drug overdose, heart failure);
- hypoglycemia caused by an overdose of insulin;
- glaucoma, if required surgical intervention in front of the eyes, in order to expand the pupil, relieve intraocular pressure;
- stop bleeding;
- treatment of priapism.

Contraindications

Hypersensitivity, pheochromocytoma, HOCM, arterial hypertension, coronary heart disease, ventricular fibrillation, tachyarrhythmia, lactation, pregnancy.

Side effects

angina pectoris, tachycardia, palpitations, bradycardia, increase or decrease in blood pressure;

ventricular arrhythmia, chest pain, cardiac
arrhythmia (high dosages of the drug);

anxiety, tremor, headaches, dizziness;
less often than usual - a feeling of fatigue, a feeling of heat or cold, nervousness;

insomnia, spontaneous muscle contractions, excitation of the NS, memory lapses, disorientation, panic and aggression, paranoia, disorders similar to schizophrenia (rarely);

vomiting, problems with urination, pain during urination, nausea;

allergic skin rashes, bronchospasm, Quincke's edema, erythema multiforme;
sweating, hypokalemia - rarely;

convulsions, persistent and strong erection, muscle contraction.
During intramuscular injection at the injection site, pain and burning may occur.

Release form

Powder; tablets of 0.002; 0.003 and 0.001 g (for pediatric practice);

5% solution (for injection) in 1 ml ampoules;
2% and 3% solutions in 10 ml vials (for otorhinolaryngological practice).

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Gross formula

Pharmacological group of the substance Epinephrine

Nosological classification (ICD-10)

CAS code

Characteristics of the substance Epinephrine

White or white with a grayish tint crystalline powder, freely soluble in water, slightly soluble in alcohol, changes under the influence of light and oxygen.

Use during pregnancy and lactation

Model clinical and pharmacological article 1

Pharma action. Alpha and beta adrenostimulant.

At the cellular level, the action is due to the activation of adenylate cyclase on the inner surface of the cell membrane, an increase in the intracellular concentration of cAMP and Ca 2+. At very low doses, at an administration rate of less than 0.01 mcg / kg / min, it can reduce blood pressure due to vasodilation of the skeletal muscles. At an injection rate of 0.04-0.1 μg / kg / min, it increases heart rate and the strength of heart contractions, cardiac output and cardiac output, and reduces OPSS; above 0.02 mcg / kg / min narrows blood vessels, increases blood pressure (mainly systolic) and OPSS. The pressor effect can cause a short-term reflex slowing of the heart rate. Relaxes the smooth muscles of the bronchi. Doses above 0.3 mcg / kg / min, reduce renal blood flow, blood supply to internal organs, tone and motility of the gastrointestinal tract. It dilates the pupils, helps to reduce the production of intraocular fluid and intraocular pressure. Causes hyperglycemia (increases glycogenolysis and gluconeogenesis) and increases plasma levels of free fatty acids. Increases conductivity, excitability and automatism of the myocardium. Increases myocardial oxygen demand. It inhibits the release of histamine and leukotrienes induced by antigens, eliminates spasm of bronchioles, and prevents the development of edema of their mucosa. Acting on alpha-adrenergic receptors located in the skin, mucous membranes and internal organs, causes vasoconstriction, a decrease in the rate of absorption of local anesthetics, increases the duration and reduces the toxic effect of local anesthesia. Stimulation of beta 2 -adrenergic receptors is accompanied by an increase in the excretion of K + from the cell and can lead to hypokalemia. With intracavernous administration, it reduces the blood filling of the cavernous bodies. The therapeutic effect develops almost instantly with intravenous administration (duration of action - 1-2 minutes), 5-10 minutes after s / c administration (maximum effect - after 20 minutes), with intramuscular injection - the time of onset of the effect is variable.

Pharmacokinetics. When administered intramuscularly or s / c, it is well absorbed. Entered parenterally, quickly collapses. It is also absorbed by endotracheal and conjunctival administration. TC max with s / c and / m administration - 3-10 minutes. Penetrates through the placenta, into breast milk, does not penetrate the BBB. It is metabolized mainly by MAO and COMT in the endings of sympathetic nerves and other tissues, as well as in the liver with the formation of inactive metabolites. T 1/2 with a / in the introduction - 1-2 minutes. It is excreted by the kidneys in the main form of metabolites: vanillylmandelic acid, sulfates, glucuronides; and also in a small amount - unchanged.

Indications. Allergic reactions of the immediate type (including urticaria, angioedema, anaphylactic shock) that develop with the use of drugs, serums, blood transfusions, food intake, insect bites, or the introduction of other allergens; bronchial asthma (stopping an attack), bronchospasm during anesthesia; asystole (including against the background of an acutely developed AV blockade of the III degree); bleeding from superficial vessels of the skin and mucous membranes (including from the gums), arterial hypotension, not amenable to adequate volumes of replacement fluids (including shock, trauma, bacteremia, open heart surgery, kidney failure, CHF, drug overdose), the need to prolong the action of local anesthetics; hypoglycemia (due to an overdose of insulin); open-angle glaucoma, during surgical operations on the eyes - swelling of the conjunctiva (treatment), to dilate the pupil, intraocular hypertension, stop bleeding; priapism (treatment).

Contraindications. Hypersensitivity, GOKMP, pheochromocytoma, arterial hypertension, tachyarrhythmia, ischemic heart disease, ventricular fibrillation, pregnancy, lactation.

Carefully. Metabolic acidosis, hypercapnia, hypoxia, atrial fibrillation, ventricular arrhythmia, pulmonary hypertension, hypovolemia, myocardial infarction, non-allergic shock (including cardiogenic, traumatic, hemorrhagic), thyrotoxicosis, occlusive vascular disease (including a history of - arterial embolism, atherosclerosis, Buerger's disease, cold injury, diabetic endarteritis, Raynaud's disease), cerebral atherosclerosis, angle-closure glaucoma, diabetes mellitus, Parkinson's disease, convulsive syndrome, prostatic hypertrophy; simultaneous use of inhalation anesthetics (halothane, cyclopropane, chloroform), elderly age, childhood.

Dosing. P / c, in / m, sometimes in / in the drip.

Anaphylactic shock: IV slowly 0.1-0.25 mg diluted in 10 ml of 0.9% NaCl solution, if necessary, continue IV drip at a concentration of 0.1 m / ml. When the patient's condition allows slow action (3-5 minutes), it is preferable to administer i / m (or s / c) 0.3-0.5 mg diluted or undiluted, if necessary, re-introduction - after 10-20 minutes (up to 3 times).

Bronchial asthma: s / c 0.3-0.5 mg diluted or undiluted, if necessary, repeated doses can be administered every 20 minutes (up to 3 times), or / in 0.1-0.25 mg daily diluted at a concentration of 0.1 mg / ml.

As a vasoconstrictor, it is injected intravenously at a rate of 1 μg / min (with a possible increase to 2-10 μg / min).

To prolong the action of local anesthetics: at a concentration of 5 μg / ml (the dose depends on the type of anesthetic used), for spinal anesthesia - 0.2-0.4 mg.

With asystole: intracardiac 0.5 mg (dilute with 10 ml of 0.9% NaCl solution or other solution); during resuscitation - 1 mg (in diluted form) IV every 3-5 minutes. If the patient is intubated, endotracheal instillation is possible - the optimal doses have not been established, they should be 2-2.5 times higher than the doses for intravenous administration.

Newborns (asystole): IV, 10-30 mcg/kg every 3-5 minutes, slowly. Children older than 1 month: IV, 10 mcg/kg (subsequently, if necessary, 100 mcg/kg is administered every 3-5 minutes (after at least 2 standard doses, higher doses of 200 mcg can be used every 5 minutes) /kg) It is possible to use endotracheal administration.

Children with anaphylactic shock: s / c or / m - 10 mcg / kg (maximum - up to 0.3 mg), if necessary, the introduction of these doses is repeated every 15 minutes (up to 3 times).

Children with bronchospasm: s / c 10 mcg / kg (maximum - up to 0.3 mg), doses, if necessary, repeat every 15 minutes (up to 3-4 times) or every 4 hours.

Locally: to stop bleeding in the form of swabs moistened with a solution of the drug.

With open-angle glaucoma - 1 drop of a 1-2% solution 2 times a day.

Side effect. From the CCC: less often - angina pectoris, bradycardia or tachycardia, palpitations, increase or decrease in blood pressure, with high doses- ventricular arrhythmias; rarely - arrhythmia, chest pain.

From the nervous system: more often - headache, anxiety, tremor; less often - dizziness, nervousness, fatigue, psychoneurotic disorders (psychomotor agitation, disorientation, memory impairment, aggressive or panic behavior, schizophrenia-like disorders, paranoia), sleep disturbance, muscle twitching.

From the side digestive system: more often - nausea, vomiting.

From the urinary system: rarely - difficult and painful urination (with prostatic hyperplasia).

Local reactions: pain or burning at the injection site.

Allergic reactions: angioedema, bronchospasm, skin rash, erythema multiforme.

Others: rarely - hypokalemia; less often - increased sweating.

Overdose. Symptoms: excessive increase in blood pressure, tachycardia, followed by bradycardia, rhythm disturbances (including atrial and ventricular fibrillation), coldness and pallor skin, vomiting, headache, metabolic acidosis, myocardial infarction, craniocerebral hemorrhage (especially in elderly patients), pulmonary edema, death.

Treatment: stop the introduction, symptomatic therapy- to reduce blood pressure - alpha-blockers (phentolamine), for arrhythmia - beta-blockers (propranolol).

Interaction. Epinephrine antagonists are alpha- and beta-adrenergic blockers.

Weakens the effects of narcotic analgesics and sleeping pills.

When used simultaneously with cardiac glycosides, quinidine, tricyclic antidepressants, dopamine, inhalation anesthesia (chloroform, enflurane, halothane, isoflurane, methoxyflurane), cocaine increases the risk of developing arrhythmias (together should be used very carefully or not used at all); with other sympathomimetic agents - increased severity side effects from the CCC; with antihypertensive drugs (including diuretics) - a decrease in their effectiveness.

Simultaneous administration with MAO inhibitors (including furazolidone, procarbazine, selegiline) can cause a sudden and pronounced increase in blood pressure, hyperpyretic crisis, headache, cardiac arrhythmias, vomiting; with nitrates - weakening of their therapeutic effect; with phenoxybenzamine - increased hypotensive effect and tachycardia; with phenytoin - a sudden decrease in blood pressure and bradycardia (depending on the dose and rate of administration); with hormone preparations thyroid gland- mutual reinforcement of action; with drugs that prolong the QT interval (including astemizole, cisapride, terfenadine), - prolongation of the QT interval; with diatrizoates, iothalamic or ioxaglic acids - increased neurological effects; with ergot alkaloids - increased vasoconstrictor effect (up to severe ischemia and the development of gangrene).

Reduces the effect of insulin and other hypoglycemic drugs.

Special instructions. When infusion, a device with a measuring device should be used to control the rate of infusion.

Infusions should be carried out in a large (preferably in the central) vein.

Intracardiac is administered during asystole, if other methods are not available, because. there is a risk of cardiac tamponade and pneumothorax.

During the treatment period, it is recommended to determine the concentration of K + in the blood serum, measure blood pressure, diuresis, IOC, ECG, central venous pressure, pressure in the pulmonary artery and wedge pressure in the pulmonary capillaries.

Excessive doses in myocardial infarction may exacerbate ischemia by increasing myocardial oxygen demand.

Increases glycemia, and therefore, in diabetes mellitus, higher doses of insulin and sulfonylurea derivatives are required.

With endotracheal administration, absorption and final plasma concentration of the drug can be unpredictable.

Administration of epinephrine for shock states does not replace the transfusion of blood, plasma, blood-substituting fluids and / or saline solutions.

Epinephrine is not advisable to use for a long time (constriction of peripheral vessels, leading to the possible development of necrosis or gangrene).

Strictly controlled studies of the use of epinephrine in pregnant women have not been conducted. A statistically regular relationship between the appearance of deformities and inguinal hernia in children whose mothers used epinephrine during the first trimester or throughout pregnancy, it was also reported in one case of the occurrence of anoxia in the fetus after intravenous administration of epinephrine to the mother. Epinephrine should not be used in pregnant women with blood pressure above 130/80 mm Hg. Animal studies have shown that when administered at doses up to 25 times the recommended human dose, it causes a teratogenic effect.

When used during breastfeeding, the risk and benefit should be assessed due to the high likelihood of side effects in the child.

Use to correct hypotension during labor is not recommended as it may delay the second stage of labor; when administered in high doses to weaken uterine contractions, it can cause prolonged atony of the uterus with bleeding.

May be used in children in cardiac arrest, however caution should be exercised as 2 different concentrations of epinephrine are required in the dosing regimen.

When stopping treatment, the dose should be reduced gradually, because. abrupt discontinuation of therapy may lead to severe hypotension.

Easily destroyed by alkalis and oxidizing agents.

If the solution has acquired a pinkish or brown color or contains a precipitate, it should not be administered. The unused part should be destroyed.

State Register medicines. Official publication: in 2 volumes - M .: Medical Council, 2009. - V.2, part 1 - 568 p.; part 2 - 560 p.

Interactions with other active substances

Trade names

Have there been seizures?
back pain before?

Compound

The solution for injection contains the active ingredient: pyridoxine hydrochloride, 0.01 or 0.05 g each. And also water for injection.

One tablet contains 0.002, 0.005 or 0.01 g of pyridoxine.

Release form

Pyridoxine hydrochloride is produced in the form of an injection solution, packaged in 1 ml ampoules, 10 pieces per pack.

Tablets with different content active substance Packed 50 pieces in a jar.

pharmachologic effect

The drug has an action that compensates for the lack of vitamin B6.

Pharmacodynamics and pharmacokinetics

Pyridoxine hydrochloride is a vitamin B6 that has great importance for a complete metabolism. Once in the body, the substance is phosphorylated, being converted into a coenzyme, which is an organic non-protein compound pyridoxal-6-phosphate, which activates the activity of enzymes. This component is a component of many enzymes necessary for decarboxylation and transamination of amino acids. It is also required for the metabolism of lipids - fats, prevents a lack of vitamins in women during pregnancy and children during the period of active growth.

Indications for use

Appointed this drug at:

• alimentary and secondary insufficiency of pyridoxine;
• toxicosis of pregnant women;
• postencephalitic parkinsonism;
• some diseases of the nervous system;
• hypochromic microcytic anemia;
• radiation sickness;
• acute and chronic hepatitis;
• dermatitis, including in children;
• shingles, neurodermatitis;
• exudative diathesis and so on.

Contraindications for use

The main contraindication is hypersensitivity to vitamin B6.

Side effects

Usually patients tolerate this drug well, but the development of allergic reactions is not excluded.

Instructions for use Pyridoxine hydrochloride (Method and dosage)

According to the instructions for use, the tablets are intended for oral administration, after meals. At the same time, the prophylactic dosage for adults is 0.02-0.05 mg, for children - 0.02 mg per day. Therapeutic daily dose for adult patients is 0.2-0.3 mg to be taken 1-2 times. In the treatment of children, the dosage is reduced depending on age.

The drug in solution for injection is prescribed at 0.05-0.1 g per day, for children 0.2 mg for 1-2 doses. Duration of treatment: adults - 1 month, children - 2 weeks. In the treatment of parkinsonism, 2 ml per day is prescribed, with a general course of 20-25 injections.

Overdose

Cases of vitamin B6 overdose medical practice not described.

Interaction

Simultaneous use with hormonal contraceptives may increase the content of pyridoxine in the blood plasma. Vitamin B6 is able to potentiate the action of diuretics.

The combination of pyridoxine with levodopa reduces or completely inhibits the effect of this substance.

Isonicothing hydrazide, penicillamine and cycloserine may reduce the effectiveness of pyridoxine.

Combined treatment with phenytoin and phenobarbital significantly reduces the concentration of these components in the blood plasma.

Terms of sale

The drug is sold without a prescription.

Storage conditions

You need to store the vitamin in a dark, cool place, protected from children.

Shelf life

Analogues

Coincidence in the ATX code of the 4th level:

This substance is part of such drugs as: Adermin, Becilan, Bedoxin, Benadon, Hexabetalin, Hexabion, Hexavibex, Pyrivitol, Pyridobene, Pyradoxin. Magne B6 contains a combination of magnesium lactate + pyridoxine hydrochloride.

Alcohol

At overuse alcohol reduces the absorption of vitamin B6, increasing the body's need for it.

Reviews for Pyridoxine hydrochloride

As the reviews of Pyridoxine hydrochloride show, it is often used in clinical practice as part of combination treatment. For example, with: hypovitaminosis B6, leukopenia, atherosclerosis, diabetes mellitus, herpes zoster, psoriasis, neurodermatitis, and so on. In most cases, a significant acceleration of the therapeutic effect was noted.

However, some users are wondering what it is - Pyridoxine hydrochloride? The fact is that not everyone knows this name of vitamin B6.

Patients who took this vitamin note its high efficiency. But sometimes it is possible to develop allergic reactions due to intolerance to this substance. Therefore, you should not take it yourself, since it is possible to determine the lack of vitamin B6 only after examination by a specialist.

The price of Pyridoxine hydrochloride, where to buy

The price of Pyridoxine hydrochloride in tablets of 10 mg for 50 pieces is 35-45 rubles.

Solution for injection 5% in ampoules can be bought at a cost of 20 rubles.

Find nearest pharmacies

• Internet pharmacies in RussiaRussia
• Internet pharmacies of KazakhstanKazakhstan

ZdravZone

• Pyridoxine hydrochloride 10mg No. 50 tabletsOzone OOO37 rub. to order
• Pyridoxine hydrochloride 5% injection 1ml No. 10 ampoulesBiosintez OAO30 rub. to order

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Release form and composition

Dosage form - a solution for intramuscular (i.m.) administration: a liquid with a transparent structure, slightly colored or colorless, with a characteristic faint odor (in ampoules: 1 ml or 2 ml - in a carton pack of 10 pcs.; plastic packaging 5 or 10 pcs., in a carton pack 1 or 2 packs; 1 ml - in a carton tray 5 pcs., in a carton pack 1 or 2 trays).

1 ml of solution contains:

• active ingredient: thiamine hydrochloride - 25 mg or 50 mg;
• excipients: unithiol (sodium dimercaptopropanesulfonate monohydrate), water for injection.

Pharmacological properties

Pharmacodynamics

Thiamine - vitamin B1 - is a water-soluble vitamin. It is a coenzyme of enzymes responsible for the regulation of protein and carbohydrate metabolism. Thiamine is characterized by a moderate ganglion-blocking effect and ensures the conduction of nerve impulses in synapses. It also has an antioxidant effect and increases the protection of cell membranes from toxic action peroxidation products.

Pharmacokinetics

When taken orally on an empty stomach, thiamine is almost completely absorbed from the gastrointestinal tract. Before absorption, it is released from its bound state by digestive enzymes. 15 minutes after ingestion, vitamin B1 is determined in the blood plasma, and 30 minutes later - in other tissues. In the blood, its concentration remains relatively low, and free thiamine is predominantly found in plasma, and its phosphate esters are found in leukocytes and erythrocytes.

The substance is distributed throughout all tissues: more than 50% of the administered amount is contained in the striated muscles, approximately 40% in the internal organs. There is a relative predominance of thiamine concentration in the liver, skeletal muscles, nervous tissue and myocardium, which is probably due to the increased consumption of the compound by these structures.

Vitamin B1 is metabolized in the liver by phosphorylation, forming thiamine diphosphate (cocarboxylase), which has coenzymatic activity and plays an important role in the participation of thiamine in fat and carbohydrate metabolism. The drug is excreted through the intestines and kidneys.

Indications for use

According to the instructions, Thiamine is indicated for B1 avitaminosis and hypovitaminosis, as well as in the composition complex therapy the following diseases:

• sciatica, neuritis, neuralgia;
• paralysis, peripheral paresis;
• decrease in secretory and motor functions of the stomach;
• peptic ulcer and duodenum;
• atonic constipation;
• intestinal atony;
• anorexia;
• violation of coronary circulation;
• myocardial dystrophy;
• diabetes;
• dermatoses (psoriasis, eczema, lichen planus, neurodermatitis), accompanied by neurotrophic changes and metabolic disorders.

Contraindications

Individual intolerance to the drug.

With caution should be used in Wernicke's encephalopathy, in women in the pre-menopausal period and after the onset of menopause.

Instructions for the use of Thiamine: method and dosage

Thiamine solution in ampoules is intended for deep intramuscular administration.

Therapy should be started with the appointment of low doses (up to 0.5 ml of a 5% solution), then, with good tolerance, the dose is increased.

• adults: 25–50 mg;
• children: 12.5 mg (0.5 ml of a 2.5% solution).

Multiplicity of application - 1 time per day, duration of treatment - 10-30 days.

Side effects

Against the background of the use of vitamin B1, the appearance of increased sweating, development of tachycardia, allergic reactions in the form of skin itching, urticaria, angioedema, anaphylactic shock; sometimes - a feeling of soreness at the injection site.

Overdose

Cases of overdose of Thiamine solution when administered in high doses are not described. If necessary, symptomatic treatment is prescribed.

special instructions

When using high doses of the drug, it is possible to distort the results of the spectrophotometric method for determining theophylline in blood serum, laboratory research urine with Ehrlich's urobilinogen reagent.

An anaphylactic reaction often develops in patients after intravenous administration of high doses.

Dextrose in Wernicke's encephalopathy should be taken before the administration of Thiamine.

The use of the drug during pregnancy and breastfeeding admissible.

drug interaction

With simultaneous parenteral use of Thiamine with pyridoxine (vitamin B6), the process of converting thiamine hydrochloride into a biologically active form is hindered, cyanocobalamin (vitamin B12) increases the risk of an allergic effect of the drug, so these combinations are not recommended.

The drug should not be mixed in the same syringe with benzylpenicillin or streptomycin (this causes the destruction of antibiotics), solutions containing sulfites (thiamine hydrochloride completely decomposes), nicotinic acid(due to the destruction of thiamine).

When combined with phentolamine, suxamethonium iodide, propranolol, sleeping pills, sympatholytics (reserpine) reduces their pharmacological activity.

Vitamin B1 is unstable in neutral and alkaline solutions.

Analogues

Thiamine analogues are: Thiamine-Vial, vitamin B1, Thiamine chloride, Thiamine chloride-UVI.

Terms and conditions of storage

Keep away from children.

To store in the place protected from light at a temperature up to 25 °C.

Shelf life - 3 years.

Terms of dispensing from pharmacies

Released by prescription.

Reviews about Thiamine

Reviews of Thiamin vary greatly. Doctors note that the introduction of the drug gives good results in the treatment alcohol addiction accompanied by withdrawal syndrome, neuritis, encephalopathy, as well as in the prevention of pathogenetic effect. The advantages of Thiamine are low price and wide scope of application in psychology and psychiatry. However, the effect of the treatment does not appear immediately: for a steady improvement in the condition, it is necessary to undergo at least 2-3 courses of therapy.

It is also possible the formation of infiltrates, especially in elderly patients, manifestations of reactions of individual intolerance and allergic responses (itching, skin rashes).

Patients note that thiamine allows you to cope with severe pain in the back and improves tolerance to intense physical activity helping the body recover after exercise. At the same time, the drug has no toxic properties, does not impair liver function and is quickly excreted from the body. It is believed that vitamin B1 improves immunity, but some patients claim that its introduction did not affect their condition in any way.

The price of Thiamine in pharmacies

On average, the price of Thiamine in ampoules ranges from 29 to 35 rubles (for a pack of 10 1 ml ampoules).

Indications

• Hypovitaminosis, avitaminosis. Lack of vitamin B1 in the body;
• Periods when the vitamin is especially lacking - lactation, as well as pregnancy;
• Anorexia or underweight;
• Intestinal diseases associated with rejection of food;
• Other diseases gastrointestinal tract;
• Nausea, vomiting;
• Psychological disorders: stress, overwork, neurasthenia, anxiety, irritability and others;
• Sores on the skin caused by a disorder of the nervous system;
• Other skin lesions such as: eczema, psoriasis, dermatitis, lichen;
• Metabolic disease;
• Intoxication;
• Violation of the functioning of the liver;
• Diabetes;
• Heart disease, including heart failure;
• Myocardial dystrophy;
• Gastritis;
• Delay of physiological formation;
• Gait disorders;
• Atherosclerosis.

Dosage and administration

Thiamine injections can be administered intramuscularly, intravenously, or subcutaneously. Please note: an injection of vitamin B1 should be administered slowly or drip.

Daily intake of thiamine

• Adults of the stronger sex require 1.2 - 2.1 mg of the vitamin;
• Elderly males - 1.2 - 1.4 mg;
• Female representatives need 1.1 - 1.5 mg of thiamine, but mothers in position require more by 0.4 mg, and lactating women need more by 0.6 mg;
• For children, the dose is administered regardless of age - 0.3 - 1.5 mg.

Intramuscularly (deep into the muscle), intravenously (slowly), less often - subcutaneously. Adults use 20 - 50 mg of the drug (1 ml of 2.5 - 5% of the substance) once a day, every day, gradually can be used orally. Minors are prescribed 12.5 mg of thiamine (0.5 ml of a 2.5% substance) every other day.

Inside, after meals, for adults for prevention - 5-10 milligrams per day, for the purpose of treatment - 10 milligrams per dose 1-5 times a day, the dosage should not exceed 50 milligrams per day. Treatment is 30-40 days.

Use for children under three years old - 5 milligrams every other day; from three to eight years - 5 milligrams 3 doses per day, also every other day. You need to apply 20 - 30 days.

The course of treatment with vitamin B1 is 10-30 injections, regardless of the age category.

Overdose

If the dose of thiamine is excessively exceeded, the following manifestations may appear: sleep disturbance, increased heart rate, agitation, headache, and some side effects of taking the drug may also increase.

In case of an overdose of thiamine, you should stop taking the vitamin, as well as treat the symptoms caused by the solution.

Contraindications

This drug is practically harmless, it does not accumulate in the body, but is quickly excreted in the urine. That is why vitamin B1 has no special contraindications, with the exception of:

• Thiamine intolerance;
• hypersensitivity;
• Menopause in women.

Side effects:

• Painful sensation at the injection site of the drug;
• allergic reactions such as hives, rash, itching;
• Shock (very rare);
• Feeling how the heart beats;
• Tachycardia;
• excessive sweating;
• Headaches;
• restless state;
• visual impairment;
• Chills;
• Weakness of the whole organism;
• Changes in the liver;
• Deterioration of breathing, shortness of breath;
• Difficulty in swallowing;
• Nausea.

Compatibility with other substances

According to the instructions, Thiamine should never be combined with the use of solutions containing sulfites, otherwise it will not bring any benefit (it will simply disintegrate).

If an injection of vitamin B1 is administered with other vitamins, then there is a high probability that the vitamin will not be completely absorbed by the body.

Drinking alcohol reduces the rate of exposure to thiamine after ingestion.

If you administer the drug intramuscularly, while using solutions that include sodium hydrosulfite, which acts as an antioxidant or preservative, then thiamine will act unstably.

The interaction of thiamine with carbonates, citrates, barbiturates with Cu2+ is prohibited, since the vitamin loses its stability in alkaline and neutral solutions.

The use of a thiamine injection with pyridoxine or cyanocobalamin at the same time as parenteral administration is not recommended: pyridoxine will slow the breakdown of thiamine into a more suitable form for absorption into the body, and cyanocobalamin may increase the allergic effects of thiamine.

In one injection, do not mix benzylpenicillin or streptomycin with vitamin B1 (antibiotics will be violated), as well as nicotine and thiamine (thiamine will be destroyed).

Release form

AT cardboard box there are 10 glass ampoules with a label glued on or with text on the ampoule. Each ampoule has a volume of 1 milliliter.

Release form and composition

Dosage forms of release of Pyridoxine hydrochloride:

• tablets: flat-cylindrical, from almost white to white, on one side of the risk, on both sides of the chamfer (in polymer containers of 10, 20, 30, 40, 50 or 100 pieces, in a carton pack 1 container; in blister packs of 10 or 50 pieces, in a carton box 1–5 or 10 packs);
• solution for injection 5%: clear, colorless or slightly yellowish (in ampoules of 1 ml, in a carton box of 10 ampoules).

Composition of 1 tablet:

• active substance: pyridoxine hydrochloride - 10 mg;
• auxiliary components: talc - 1 mg; colloidal silicon dioxide - 0.5 mg; calcium stearate - 1 mg; dextrose monohydrate (glucose) - 77.5 mg; microcrystalline cellulose - 10 mg.

Composition of 1 ml solution:

• active substance: pyridoxine hydrochloride - 50 mg;
• auxiliary component: water for injection - up to 1 ml.

Pharmacological properties

Pharmacodynamics

Vitamin B6 (pyridoxine) is involved in metabolism; it is important for the functioning of the central and peripheral nervous system.

It is part of the enzymes that carry out the transamination and decarboxylation of amino acids. Upon entry into the body, pyridoxine is phosphorylated, turning into pyridoxal-5-phosphate. It takes part in the metabolism of cysteine, methionine, tryptophan, glutamic and other amino acids, and also plays an important role in the metabolism of histamine. Contributes to the normalization of lipid metabolism, increases diuresis and enhances the effect of diuretics.

Isolated pyridoxine deficiency is observed in very rare cases, mainly in children who are on a special artificial nutrition. It manifests itself in the form of diarrhea, convulsions, anemia, and the development of peripheral neuropathy is also possible.

Pharmacokinetics

Pyridoxine is rapidly absorbed throughout small intestine, more of it is absorbed in the jejunum.

Metabolism occurs in the liver with the formation of two pharmacologically active metabolites - pyridoxaminophosphate and pyridoxal phosphate. Pyridoxal phosphate binds to plasma proteins by 90%. It penetrates well into all tissues; accumulates mainly in the liver, to a lesser extent - in the central nervous system and muscles.

It crosses the placenta and is secreted in breast milk. T1 / 2 (half-life) varies in the range from 15 to 20 days. It is excreted by the kidneys, as well as during hemodialysis.

Indications for use

• a- and hypovitaminosis B6 (therapy and prevention) associated with malnutrition, long-term infections and stressful conditions, diarrhea, enteritis, malabsorption syndrome, conditions after removal of large sections of the intestine and stomach, hemodialysis;
• exudative diathesis, dermatitis (including seborrheic and atopic), psoriasis, herpetic infections(Herpes simplex, Varicella zoster) (simultaneously with other drugs);
• microcytic/hypochromic anemia, neuritis (including on the background of diabetes mellitus), congenital pyridoxine-dependent convulsive syndrome in newborns, sciatica, parkinsonism, Little's disease, Meniere's syndrome and disease, neuralgia, prevention of seizures in patients while taking ftivazide, alcoholism, preeclampsia, lesions liver while taking ethanol and drugs with anti-tuberculosis action, hepatitis in acute and chronic course, the need to increase diuresis and enhance the action of diuretics (simultaneously with other drugs).

Contraindications

Absolute:

• age up to 18 years (tablets);
• pregnancy and breastfeeding period (tablets);
• individual intolerance to any of the components of the drug.

Relative (Pyridoxine hydrochloride is prescribed under medical supervision):

• peptic ulcer of the stomach and duodenum (associated with a likely increase in the acidity of gastric juice);
• coronary artery disease;
• severe liver damage (tablets).

Instructions for use Pyridoxine hydrochloride: method and dosage

Pills

Pyridoxine hydrochloride is taken orally, preferably after meals.

For the prevention of B6-hypovitaminosis, the drug is used in a daily dose of 5 mg. With a therapeutic purpose, it is usually prescribed 1-2 times a day, 20-30 mg in a course of 1-2 months.

Against the background of the use of isoniazid, ftivazid or other derivatives of isonicotinic acid hydrazide, it is advisable to prescribe pyridoxine at 5-10 mg per day for prevention (in order to prevent disorders of the functions of the central nervous system).

With sideroblastic anemia, Pyridoxine hydrochloride is taken daily at 100 mg (preferably with riboflavin, cyanocobalamin and folic acid).

Injection

Pyridoxine hydrochloride in this dosage form used in cases where oral administration is not possible / impractical (with vomiting / malabsorption in the intestine).

Method of administration: s / c (subcutaneously), i / m (intramuscularly), i / v (intravenously).

For adults, the drug is usually prescribed in a daily dose of 50-100 mg in 1-2 doses, for children - 20 mg. The duration of use in adults is 1 month, in children - 2 weeks. With concomitant therapy with ftivazid, isoniazid, the drug should be used at 5-10 mg per day.

The use of Pyridoxine hydrochloride for other indications:

• sideroblastic anemia: intramuscularly 2 times a week, 100 mg (it is advisable in combination with folic acid, cyanocobalamin, riboflavin);
• parkinsonism: IM 100 mg per day, the course is 20-25 injections with a repeat in 2-3 months. It is also possible to use another scheme - at the beginning of therapy, Pyridoxine hydrochloride is prescribed daily at 50–100 mg per day, then daily dose increase by 50 mg to reach 300-400 mg per day (in the form of a single injection for 12-15 days);
• depression of involutionary age: IM 200 mg per day;
• pyridoxine-dependent convulsive syndrome: intravenously or intramuscularly, 30-600 mg daily (adults) or 10-100 mg (children).

Side effects

Possible adverse reactions: reduced lactation (can be used as a therapeutic effect), hypersecretion of hydrochloric acid, allergic reactions, numbness, the appearance of a feeling of pressure in the limbs (manifested as a symptom of "stocking" and "gloves").

With the rapid introduction of the solution in rare cases, convulsions may occur.

Overdose

No information.

special instructions

The need for vitamin B6 is met by food (it is partly synthesized by the intestinal microflora).

Vitamin B6 is found in animal and plant organs, especially vegetables, whole grains, yeast, egg yolk, meat, milk, fish, bovine liver, and codfish.

Need for pyridoxine (per day):

• men: 2–2.5 mg;
• women: 2 mg; additionally during pregnancy - 0.3 mg, during lactation - 0.5 mg;
• children: 6-12 months - 0.5 mg; 1–1.5 years - 0.9 mg; 1.5–2 years - 1 mg; 3-4 years - 1.3 mg; 5-6 years - 1.4 mg; 7-10 years - 1.7 mg; 11-13 years - 2 mg; 14-17 years old (girls / boys) - 1.9 / 2.2.

In patients with severe liver damage, large doses of pyridoxine hydrochloride may lead to a deterioration in liver function.

When determining urobilinogen using the Ehrlich reagent, the results may be distorted.

In the treatment of tuberculosis with isonicotinic acid hydrazide and its derivatives, in addition to 1000 mg of the administered isonicotinic acid hydrazide, 100 mg of pyridoxine is prescribed in order to prevent violations of the functions of the central nervous system.

The composition of the tablets includes glucose, which must be taken into account in diabetes.

Use during pregnancy and lactation

According to the instructions, Pyridoxine hydrochloride in the form of tablets is not prescribed for pregnant / lactating women.

Application in childhood

The drug in the form of tablets should not be taken by patients under the age of 18 years.

drug interaction

Pyridoxine hydrochloride can be used in combination with cardiac glycosides (it increases the synthesis of contractile proteins in the myocardium), glutamic acid, and magnesium and potassium asparaginate (asparkam).

Possible interactions:

• penicillamine, isonicotine hydrazide, cycloserine and oral contraceptives containing estrogen: weakening the action of pyridoxine;
• levodopa: weakening of its activity;
• diuretics: strengthening their action;
• isoniazid and other drugs with anti-tuberculosis activity: prevention / reduction of their toxic manifestations, including liver damage.

Analogues

Analogues of Pyridoxine hydrochloride are: Pyridoxine, Pyridoxine-Vial, Pyridoxine bufus.

Terms and conditions of storage

Store in a place protected from light and moisture, at temperatures up to 25 °C. Keep away from children.

Shelf life - 3 years.

Recipe: Solutionis Adrenalini hydrochloridi 0.1% - 1 ml

D.t.d.N. 10 in ampullis

signa. Subcutaneously, 0.5 ml 1-2 times a day.

Adrenaline is a biogenic catecholamine. Contained in the chromaffin cells of the adrenal medulla. Adrenaline has a direct stimulating effect on 7a 0-7 0 and 7b 0-adrenergic receptors, causing the corresponding effects.

The effect of adrenaline on the cardiovascular system is especially pronounced. By stimulating the 7b 0-adrenergic receptors of the heart, adrenaline increases the strength and frequency of heart contractions and, as a result, systolic and cardiac output. This sharply increases myocardial oxygen consumption. Systolic blood pressure rises. The pressor reaction usually causes reflex bradycardia, but it is short-lived. Total peripheral resistance may decrease, increase, or remain unchanged. Most often, with the introduction of medium doses of adrenaline, a decrease in OPS is observed (manifested by a decrease in diastolic blood pressure), which is associated with the predominance of the effect of excitation of 7b 0-adrenergic receptors of the vessels of muscles and other areas and their expansion. However, mean arterial pressure rises due to an increase in systolic blood pressure. In high doses, adrenaline can also increase the OPS. The pressor effect of adrenaline is usually replaced by a depressor effect, which is associated with the excitation of vascular 7b 42 0-adrenergic receptors. Adrenaline dilates the pupils of the eyes, reduces intraocular pressure. By stimulating 7b 42 0-adrenergic receptors of the bronchi, it relaxes smooth muscles and eliminates bronchospasm. The tone and motility of the gastrointestinal tract under the influence of adrenaline are reduced. sphincters are toned.

Adrenaline potentiates neuromuscular transmission, apparently due to the increased release of acetylcholine from presynaptic endings, as well as the direct action of adrenaline on the muscle.

Adrenaline stimulates glycogenolysis (hyperglycemia occurs, the content of lactic acid and potassium ions increases in the blood) and lipolysis (an increase in the content of free fatty acids in the blood plasma).

Under the influence of adrenaline on the central nervous system, mild excitation effects predominate. Anxiety, tremor, stimulation of the center of vomiting, etc. are noted.

Apply adrenaline in anaphylactic shock, allergic laryngeal edema, bronchial asthma, etc. allergic reactions, to increase blood pressure in shock and collapse, however, selective 7 a 0-agonists are preferable. Adrenaline is used to eliminate atrioventricular block, with sharp decline excitability of the myocardium, with cardiac arrest. Locally used to constrict blood vessels during bleeding, add to local anesthetics. It is also used to dilate the pupil and treat open-angle glaucoma.

Side effects: tachycardia, increased cardiac output, a sharp increase in blood pressure, deterioration in myocardial oxygen supply, arrhythmias, pain in the heart.

Adrenalin contraindicated with hypertension, severe atherosclerosis, aneurysms, thyrotoxicosis, diabetes mellitus, pregnancy. Adrenaline should not be used during anesthesia with halothane and cyclopropane.

Since at oral administration adrenaline is destroyed; it is used parenterally (subcutaneously, intramuscularly and intravenously) and locally, sometimes intracardiac. Adrenaline acts for a short time, as its rapid neuronal capture occurs, as well as enzymatic destruction.

Release form: 1 ml ampoules of 0.1% solution; vials of 10 ml of a 0.1% solution. List B.