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

It blocks m-cholinergic receptors and has a direct relaxing effect on smooth muscles. It dilates blood vessels, lowers the tone of the smooth muscles of the bile duct and gallbladder, bronchi, causes mydriasis.

Pharmacokinetics:

Quickly and fairly fully absorbed in the digestive tract. Easily passes through the histogematic barriers, cellular and synaptic membranes. When large doses are administered, it accumulates in significant concentrations in the tissues of the central nervous system. Excreted by urinary and digestive systems.With the correct appointment (dose, intervals between doses) does not cumulate.

Indications:Spasms of smooth muscles with peptic ulcer of stomach and duodenum, intestinal, hepatic and renal colic, bronchial asthma, hypertension, angina pectoris, spasm of cerebral vessels, pain syndrome in pancreatitis, pancreatic coma, biliary dyskinesia, reflux esophagitis, bradyarrhythmias, poisonings acetone, boric acid, strong acids, arsenic, reserpine, diarrhea (mandatory urges), in ophthalmic practice - to expand the pupil for diagnostic and therapeutic purposes.

ICD-10

XI.K20-K31.K26 Duodenal ulcer

XI.K20-K31.K25 Stomach ulcer

XI.K80-K87.K86.1 Other chronic pancreatitis

XI.K80-K87.K85 Acute pancreatitis

IX.I10-I15.I15 Secondary Hypertension

IX.I10-I15.I10 Essential [primary] hypertension

XVIII.R50-R69.R52.2 Another constant pain

XVIII.R00-R09.R07.2 Pain in the region of the heart

XI.K80-K87.K80.5 Stones of the bile duct without cholangitis or cholecystitis

XIV.N20-N23.N23 Renal colic, unspecified

X.J40-J47.J45 Asthma

XI.K20-K31.K21 Gastroesophageal reflux

XVIII.R00-R09.R00.1 Bradycardia, unspecified

XVIII.R10-R19.R10.4 Other and unspecified abdominal pain

IX.I20-I25.I20 Angina pectoris [angina pectoris]

Contraindications:

Glaucoma, insufficiency of liver and kidney function, paralytic obstruction or intestinal atony, ulcerative colitis, myasthenia gravis.

Carefully:

Use with caution in renal failure (risk of side effects due to decreased excretion). Use with caution in case of liver failure.

Use with caution in chronic lung diseases in young children (a decrease in bronchial secretion can lead to a thickening of the secret and the formation of congestion in the bronchi); brain damage in children (effects from the central nervous system may be intensified); Down's disease (possibly an unusual dilatation of the pupils and an increase in heart rate), infantile cerebral palsy (a reaction to anticholinergics may be most pronounced).

Use with caution in patients with cardiovascular disease, in which an increase in the heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, IHD, mitral stenosis, hypertension,acute bleeding; with thyrotoxicosis (tachycardia may be increased); elevated temperature (may still increase due to suppression of the activity of sweat glands); in reflux esophagitis, hiatal hernia, combined with the reflux oesophagitis (decreased motility of the esophagus and stomach and lower esophageal sphincter relaxation may help slow gastric emptying and increased gastroesophageal reflux through sphincter with impaired function); with gastrointestinal diseases accompanied by obstruction - achalasia of the esophagus, stenosis of the pylorus (there may be a decrease in motor and tone, leading to obstruction and retention of the contents of the stomach), intestinal atony in elderly patients or weakened patients (possible obstruction), paralytic ileus; with an increase in intraocular pressure, a closed-angle (mydriatic effect leading to increased intraocular pressure, can cause an acute attack) and open-angle glaucoma (mydriatic effect may cause some increase in intraocular pressure, correction of therapy may be required); with nonspecific ulcerativecolitis (high doses can inhibit intestinal peristalsis, increasing the likelihood of paralytic intestinal obstruction, in addition, manifestation or exacerbation of such a serious complication as a toxic megacolon); when dry in the mouth (prolonged use may cause a further increase in the severity of xerostomia); with myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); hypertrophy of the prostate without obstruction of the urinary tract, urinary retention or predisposition to it or diseases accompanied by obstruction of the urinary tract (including the bladder neck due to prostatic hypertrophy); at gestosis (hypertension is possible).

Pregnancy and lactation:

Category of recommendations FDA is not defined. Adequate and well-controlled studies in humans and animals have not been conducted. Carefully!

There is no information on the penetration into breast milk. Carefully!

Dosing and Administration:

Applied internally, parenterally (subcutaneously, intravenously), rectally, topically in ophthalmology. The dose depends on the indications, the route of administration, the age of the patient.

For spasms of smooth muscles (pain relief) - 1-2 ml of 0.2% solution subcutaneously. For course treatment - inside before the meal to 0,003-0,005 g (children 0,0002-0,003 g) 2-3 times a day for 15-20 days. Higher doses: single 0.01 g, daily 0.03 g.

Side effects:

From the side digestive system: dry mouth, thirst, intestinal atony.

From the side of cardio-vascular system: reduction of blood pressure, tachycardia.

From the side CNS and peripheral nervous system: excitation of the central nervous system, dizziness, dilated pupils, paralysis of accommodation, headache, photophobia, convulsions, acute psychosis.

From the side urinary system: difficulty urinating, urinary retention.

Other: atelectasis of the lung.

Adverse reactions are most likely when using platifillin in high doses.

Overdose:

Symptoms: dry mouth, hoarseness, swallowing, dilated pupils with no response to light, tachycardia, hyperthermia, redness of the skin, CNS excitement followed by depression, impaired consciousness, hallucinations, convulsive syndrome, respiratory failure, intestinal paresis, acute urinary retention.

Treatment: forced diuresis, the introduction of inhibitors of cholinesterase (physostigmine, galantamine or proserin), weakening intestinal paresis and reducing tachycardia; with moderate excitation and unexpressed convulsions, the administration of magnesium sulfate is recommended, in severe cases - sodium oxybutyrate, oxygen therapy, IVL.

Interaction:

With simultaneous use with haloperidol in patients with schizophrenia may reduce the antipsychotic effect.

Platifillin is a proserin antagonist.

When used simultaneously with MAO inhibitors, a positive chrono- and batmotropic effect is observed; with cardiac glycosides - a positive butmotropic effect.

When the pain associated with spasms of smooth muscles, the action platifillina strengthen analgesics, sedatives, and anxiolytics, vascular spasm - hypotensive and sedative.

Increases the duration of the hypnotic effect of phenobarbital and ethaminal sodium, blocks the effects of proserin, increases - administered intravenously H2-histaminolytics, digoxin and riboflavin (slows peristalsis and improves absorption).

Adrenomimetiki (strengthen mydriasis) and nitrates potentiate increased intraocular pressure, amisyl, diphenhydramine, tricyclic antidepressants, quinidine sulfate, novocainamide, disopyramide, isoniazid, MAO inhibitors, midantan - anticholinergic activity.

Eliminates bradycardia, nausea and vomiting caused by morphine, bradycardia when taking verapamil. Morphine enhances the inhibitory effect of platyphylline on the cardiovascular system.

Special instructions:

It is necessary to refrain from potentially dangerous activities requiring increased attention and speed of psychomotor reactions.

Instructions

Platyphylline (Platyphyllinum)