Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..
PHARMACHOLOGIC EFFECT
Cardiac glycoside, contained in the digitalis woolly. Has a positive inotropic effect, which is associated with the inhibitory effect of the cardiomyocyte membrane on the Na + -K + -ATPase, which leads to an increase in the intracellular content of sodium ions and a decrease in potassium ions. As a result, there is an increase in intracellular calcium content, responsible for the contractility of cardiomyocytes, as a result of contractility of the myocardium increases. Increases the work of the heart, while lengthening the diastole, increases the shock and minute volumes, along with an increase in the tone of the myocardium leads to a reduction in its size and thus to a decrease in myocardial oxygen demand.
A negative dromotropic effect is manifested by an increase in the refractivity of the AV node. At a ciliary tachyarrhythmia, cardiac glycosides slow down diastole, improving intracardiac and systemic hemodynamics. Negative chronotropic action is due to direct and indirect influence on the regulation of the heart rhythm.
In patients with chronic heart failure, mediated vasodilating effect, reduces venous pressure, increases diuresis; reduces swelling, shortness of breath.
Positive batmotropic effect is manifested in sub-toxic and toxic doses.
PHARMACOKINETICS
When ingested, absorption is 20-60%, binding to plasma proteins is 25-40%, T 1/2 - 28-36 hours. It is excreted from the body by the kidneys in unchanged form.Characterized by a relatively small capacity for cumulation.
INDICATIONS
Chronic heart failure, acute left ventricular failure, chronic pulmonary heart, tachysystolic form of atrial fibrillation, atrial flutter (for the reduction of heart rate or atrial flutter in fibrillation with controlled frequency of impulses through the AV node), paroxysmal supraventricular tachycardia.
DOSING MODE
Established individually, depending on the clinical picture of the disease and the dynamics of the clinical effect.
Adults with rapid digitalization - in / m or / in a daily dose of 1.4 mg, divided into 2 injections; with slow digitalization - in / m or / in a daily dose of up to 800 mcg, divided into 3 injections. When saturation is reached, they switch to maintenance treatment - iv or in / m to 400 mcg / day. When performing saturating therapy - inside up to 6-8 mg / day in 3-4 doses. For maintenance therapy - up to 1 mg / day in 2 divided doses.
SIDE EFFECT
From the digestive system: anorexia, nausea, vomiting, diarrhea.
From the cardiovascular system: arrhythmia, slowing AV-conduction.
From the central nervous system and peripheral nervous system: drowsiness, confusion and delirium, sleep disturbances, headache, dizziness, decreased visual acuity.
From the hemopoietic system and the coagulating system of blood: thrombocytopenia, thrombocytopenic purpura, nosebleeds, petechiae.
Other: gynecomastia; rarely - skin rash.
CONTRAINDICATIONS
Absolute: glycoside intoxication; hypersensitivity to lanthoside C.
Relative: severe bradycardia, AV blockade and SSSU without pacemaker, hypertrophic obstructive cardiomyopathy, paroxysmal ventricular tachycardia, hypertrophic subaortic stenosis, isolated mitral stenosis, acute myocardial infarction, unstable angina, WPW syndrome, cardiac tamponade, extrasystole, cardiac asthma in patients with mitral stenosis (in the absence of tachysystolic form of atrial fibrillation), marked dilatation of the heart cavities, pulmonary heart, presence of an arteriovenous shunt, infa CT myocardium.
APPLICATION FOR FUNCTIONS OF THE LIVER
Use with caution in patients with renal insufficiency.
APPLICATION FOR VIOLATIONS OF THE FUNCTION OF KIDNEYS
Use with caution in patients with hepatic insufficiency.
APPLICATION IN ELDERLY PATIENTS
Be wary of lamotrigine in elderly patients.
SPECIAL INSTRUCTIONS
Use with caution in patients with electrolyte disorders (including after dialysis, diarrhea, malnutrition, prolonged vomiting, with diuretics), or with other drugs that cause electrolyte disorders (hypokalemia, hypomagnesemia, hypercalcemia, hypernatremia) , hypothyroidism, alkalosis, myocarditis, obesity, in elderly patients, hypoxia, renal / hepatic insufficiency.
The likelihood of intoxication is increased with hypokalemia, hypomagnesemia, hypercalcemia, hypernatremia, hypothyroidism, marked dilatation of the heart cavities, pulmonary heart, myocarditis.
If symptoms of an overdose occur (nausea, vomiting, bradycardia, extrasystole, bigemnia, visual impairment), treatment should be stopped for several days, and then resumed at a lower dose.
With more pronounced signs of glycosidic intoxication, it is recommended to prescribe potassium - 2-4 g / day in the form of potassium salts (chlorides, citrates, phosphates and asparagines), antiarrhythmic drugs (diphenine) and 5% dextrose solution with vitamins (B 1 , B 6 , C ).
DRUG INTERACTION
With simultaneous use with antacids, sulfasalazine, colestyramin, absorption of lantozide C from the digestive tract decreases.
Simultaneous intake of calcium preparations, catecholamines, diuretics increases the risk of developing glycosidic intoxication.
With simultaneous use with quinidine, methyldopa, spironolactone, amiodarone, verapamil, nifedipine, the concentration of cadavir in the blood plasma increases.
Beta-adrenoblockers and verapamil increase the disturbances of AV-conduction.
When used simultaneously with GCS, diuretics increase the risk of electrolyte disorders (hypokalemia, hypomagnesemia).
With simultaneous use with thiazide diuretics, calcium preparations (especially with intravenous administration), the risk of hypercalcemia increases.
Amiodarone, mercazolilum with simultaneous application with lantoside C increase the risk of hypothyroidism.
