Panangin injection solution ampoules 10ml N5
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Active ingredients
Potassium and magnesium asparaginate
Release form
Solution
Composition
Potassium asparaginate (in the form of hemihydrate) 45.2 mg 452 mg, which corresponds to + 10.33 mg 103.3 mg magnesium asparaginate (in the form of tetrahydrate) 40 mg 400 mg, which corresponds to mg2 + 3.37 mg 33.7 mg adjuvants: water d / and - up to 10 ml .
Pharmacological effect
A drug that affects metabolic processes. The source of potassium and magnesium ions. Calium and magnesium are intracellular cations, which play a major role in the functioning of many enzymes, the interaction of macromolecules and intracellular structures, and in the mechanism of muscle contractility. The intra- and extracellular ratio of potassium, magnesium, calcium and sodium ions affects the contractility of the myocardium. Low levels of potassium and / or magnesium ions in the internal environment can have proarrhythmic effects, predispose to the development of arterial hypertension, coronary artery atherosclerosis and the occurrence of metabolic changes in the myocardium. One of the most important physiological functions of potassium is to maintain the membrane potential of neurons, myocytes and other excitable structures myocardial tissue. Imbalance between intracellular and extracellular potassium levels leads to a decrease in myocardial contractility, arrhythmia, tachycardia, and increased cardiac glycoside toxicity. Magnesium is a cofactor for> 300 enzymatic reactions of energy metabolism and the synthesis of proteins and nucleic acids. Magnesium reduces the contraction voltage and heart rate, leading to a decrease in myocardial oxygen demand. Magnesium has an anti-ischemic effect on myocardial tissue. Reduced contractility of smooth muscle myocytes of arteriole walls, incl. coronary, leads to vasodilation and to increased coronary blood flow. The combination of potassium and magnesium ions in one preparation is justified by the fact that the deficiency of potassium in the body is often accompanied by a deficiency of magnesium and requires the simultaneous correction of the content in the body of both ions. With simultaneous correction of the levels of these electrolytes, an additive effect is observed; in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting their positive inotropic effect. Endogenous aspartate (aspartine) acts as a conductor of ions inside the cells as complex compounds. Potassium asparaginate and magnesium asparaginata improve myocardial metabolism.
Pharmacokinetics
Data on the pharmacokinetics of the drug in the form of a solution for iv administration are not provided.
Indications
In the complex treatment of heart failure, myocardial infarction, cardiac arrhythmias (mainly ventricular arrhythmias). To improve the tolerance of cardiac glycosides.
Contraindications
Acute and chronic renal failure. Oliguria, anuria. Addison's disease. AV-blockade II and III degrees. Cardiogenic shock (BP <90 mm. Hg). Hyperkalemia. Hypermagnemia. Increased sensitivity to the components of the drug.
Precautionary measures
It should be used with caution in patients with an increased risk of developing hyperkalemia. In this case, it is necessary to regularly monitor the level of potassium ions in the blood plasma. Before taking the drug, the patient should consult a doctor. When fast IV injection of the drug may develop skin hyperemia. Use for renal impairment The drug is contraindicated in the following cases: acute and chronic renal failure oliguria, anuria. Influence on the ability to drive motor vehicles and control mechanisms The drug does not affect the ability to drive and engage in activities requiring increased concentration of attention and speed of psychomotor reactions.
Use during pregnancy and lactation
Data on the negative effects of the drug in the form of a solution for IV injection during pregnancy and lactation (breastfeeding) are not available.
Dosage and administration
The drug is prescribed in / in the drip, in the form of a slow infusion. Single dose - 1-2 ampoules, if necessary, you can re-enter after 4-6 hours. To prepare a solution for intravenous infusion, contents 1-2 amp. dissolved in 50-100 ml of 5% glucose solution.
Side effects
With rapid on / in the introduction: may develop symptoms of hyperkalemia and / or hypermagnesemia.
Overdose
Symptoms: with the on / in the introduction - hyperkalemia, hypermagnesemia. Treatment: discontinuation of the drug, conducting symptomatic therapy (IV injection of 100 mg / min of calcium chloride solution), if necessary - hemodialysis and peritoneal dialysis.
Interaction with other drugs
With simultaneous use with potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, heparin, ACE inhibitors, NSAIDs, the risk of hyperkalemia increases until arrhythmia and asystolia occur. The use of potassium preparations together with the corticosteroids eliminates the hypokalemia they cause.Under the influence of potassium, a decrease in the undesirable effects of cardiac glycosides is observed. The drug enhances the negative dromo- and bathmotropic action of antiarrhythmic drugs. Due to the presence of potassium ions in the preparation, Panangin is used with ACE inhibitors, beta-blockers, cyclosporine, potassium-sparing diuretics, heparin, NSA development of hyperkalemia is possible (it is necessary to control the level of potassium in the blood plasma); with anticholinergics - a more pronounced decrease in intestinal motility; with cardiac glycosides - reducing their actions. Magnesium preparations reduce the effectiveness of neomycin, polymyxin B, tetracycline and streptomycin. Anesthetics increase the inhibitory effect of magnesium on the central nervous system. When using Panangin with atracurium, dexametonium, suxametonium, an increased neuromuscular blockade is possible; with calcitriol - an increase in the level of magnesium in the blood plasma; with calcium preparations, a decrease in the action of magnesium ions is observed. With simultaneous use of Panangin with potassium-sparing diuretics and ACE inhibitors, the risk of hyperkalemia increases (potassium plasma levels should be monitored).