Panangin - instructions for use, dose, side effects, contraindications

Active substances: Potassium asparaginate (in the form of potassium asparaginate hemihydrate) 452 mg (corresponding to 103.3 mg of potassium ions), magnesium asparaginate (in the form of magnesium aspartate tetrahydrate) 400 mg (corresponding to 33.7 mg of magnesium ions);

Excipients: water for injection - up to 10 ml.

Description:Colorless or slightly greenish, clear solution.

Pharmacotherapeutic group:Potassium and magnesium preparation

ATX: & nbsp

A.12.C.X Preparations of other minerals

Pharmacodynamics:

Panangin is a source of important electrolytes: potassium and magnesium ions. One of the most important functions of potassium ions is to maintain the membrane potential of neurons, myocytes and excitable structures of myocardial tissue. Violation of the balance between intracellular and extracellular potassium leads to a decrease in the contractility of the heart, arrhythmia, tachycardia and an increase in the toxicity of cardiac glycosides.

Magnesium is an important cofactor of more than 300 enzyme reactions, including energy metabolism and the synthesis of proteins and nucleic acids. In addition, magnesium plays an important role in the work of the heart: improves contractility and heart rate, leading to a decrease in myocardial oxygen demand. Reduction of contractility of smooth myocytes of arterioles leads to vasodilation, including coronary vessels, and to an increase in coronary blood flow. Magnesium has an anti-ischemic effect on the tissue of the myocardium.

The combination of potassium and magnesium ions in one preparation is based on the fact that potassium deficiency in the body is often accompanied by a deficiency of magnesium and requires simultaneous correction of the levels of both ions. Further, with the simultaneous correction of the levels of these electrolytes, an additive effect is observed (low potassium and / or magnesium levels have a pro-arrhythmic effect), in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting the positive inotropic effect of the latter.

Pharmacokinetics:No data.

Indications:

To eliminate the deficiency of potassium and magnesium as an auxiliary for various manifestations of coronary heart disease,including acute myocardial infarction; chronic heart failure; heart rhythm disturbances (including arrhythmias caused by an overdose of cardiac glycosides).

Contraindications:

Hypersensitivity to the drug, acute and chronic kidney failure; Addison's disease; atrioventricular blockade II, III degree; cardiogenic shock (blood pressure <90 mmHg); hyperkalemia; hypermagnesia; insufficiency of the adrenal cortex; severe myasthenia gravis; dehydration; pregnancy; the period of breastfeeding; age to 18 years (efficacy and safety not established).

Carefully:

Atrioventricular block of the 1st degree, marked violations of the liver function; metabolic acidosis; danger of edema; renal dysfunction if regular monitoring of magnesium in serum is impossible (danger of cumulation, toxic magnesium content); cardiogenic shock (systolic blood pressure less than 90 mmHg); hypophosphatemia; urolithic diathesis associated with impaired calcium, magnesium and ammonium phosphate metabolism.

Pregnancy and lactation:

There is no evidence of adverse effects of the drug during pregnancy.

Dosing and Administration:

For intravenous administration only.

Content 1-2 ampoules must be diluted in 50-100 ml of 5% dextrose (glucose), and enter into a slow intravenous drip infusion (20 drops per minute). If necessary, you can repeat the dose after 4-6 hours.

The drug is suitable for combination therapy.

Side effects:

With rapid intravenous possible development of hyperkalemia symptoms (fatigue, myasthenia gravis, paresthesias, confusion, abnormal heart rhythm (bradycardia, atrioventricular block, arrhythmia, heart failure) and hypermagnesemia (falling neuromuscular excitability, retching, vomiting, lethargy, lowering blood pressure ). It is also possible to develop phlebitis, atrioventricular block and paradoxical reaction (increase in the number of extrasystoles).

Overdose:

To date, cases of overdose have not been described. In case of an overdose, the risk of symptoms of hyperkalemia and hypermagnesemia increases.

Symptoms of hyperkalemia: fatigue, myasthenia gravis, paresthesia, confusion,disturbance of the heart rhythm (bradycardia, atrioventricular blockade, arrhythmias, cardiac arrest).

Symptoms of hypermagnesemia: the fall of neuromuscular excitability, the urge to vomit, vomiting, lethargy, lowering blood pressure (BP). With a sharp increase in the content of magnesium ions in the blood - the suppression of deep tendon reflexes, respiratory paralysis, coma.

Treatment: In case of symptoms of overdose, treatment with Panangin should be stopped and symptomatic therapy should be given (intravenous calcium chloride administration at a dose of 100 mg / min, hemodialysis if necessary).

Interaction:

Strengthens the negative dromo- and batmotropic effect of antiarrhythmic drugs. Eliminates hypokalemia caused by glucocorticoids.

Due to the content of magnesium reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin. Cyclosporin, potassium-sparing diuretics, heparin, ACE inhibitors may increase the risk of hyperkalemia.

Anesthetics increase the inhibitory effect of magnesium on the central nervous system. May enhance neuromuscular blockade caused by depolarizing muscle relaxants (atracurium bezylate, decamethonium bromide, suxamethonium (chloride, bromide, iodide)).

Calcitriol increases the concentration of magnesium in the blood plasma, calcium preparations - reduce the effect of magnesium.

Beta-blockers, non-steroidal anti-inflammatory drugs increase the risk of hyperkalemia up to the development of arrhythmia and asystole.

It is pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerability, reduces undesirable effects of cardiac glycosides).

Special instructions:

With rapid administration, it is possible to develop skin hyperemia.

Care should be taken if there are diseases accompanied by hyperkalemia. In these cases it is recommended to control the content of potassium ions in the blood.

Effect on the ability to drive transp. cf. and fur:

Not studied.

Form release / dosage:

Concentrate for the preparation of a solution for infusions, 45.2 mg / ml +40 mg / ml.

Packaging:

For 10 ml of the drug in a colorless glass ampoule (1 hydrolytic class), 5 ampoules in a plastic pallet. 1 plastic pallet in a cardboard box with instructions for medical use.

Storage conditions:

Store at temperatures between 15 and 30 ° C.

Keep out of the reach of children!

Shelf life:

3 years.

Do not use at the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:П N013093 / 01

Date of registration:26.08.2010

The owner of the registration certificate:GEDEON RICHTER, OJSC GEDEON RICHTER, OJSC Hungary

Manufacturer: & nbsp

GEDEON RICHTER, Plc. Hungary

Representation: & nbspGEDEON RICHTER OJSC GEDEON RICHTER OJSC Hungary

Information update date: & nbsp15.08.2012

Illustrated instructions

Instructions

Panangin (Panangin)