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

M-holinoblokator, in comparison with atropine has less influence on peripheral m-holinoretseptory (on action on smooth muscle cells of the organs of the gastrointestinal tract and circular muscle of the iris is 5-10 times weaker than atropine). Blocking m-holinoretseptory, violates the transmission of nerve impulses from postganglionic cholinergic nerves to the innervated effector organs and tissues (heart, smooth muscle organs,glands of external secretion); suppresses also n-holinoretseptory (much weaker). Holin-blocking effect is more pronounced against a background of increased tone of the parasympathetic part of the autonomic nervous system or the action of m-cholinostimulators. To a lesser extent than atropine, causes tachycardia, especially when used in large doses. Decreasing the effect of n.vagus, improves the conductance of the heart, increases the excitability of the myocardium, increases the minute volume of blood.

It has a direct myotropic antispasmodic effect, causes the expansion of small vessels of the skin. In high doses, the vasomotor center depresses and blocks sympathetic ganglia, as a result of which vessels dilate and blood pressure decreases (mainly with intravenous administration).

Weaker atropine depresses the secretion of endocrine glands; causes a marked decrease in the tone of smooth muscles, the amplitude and frequency of peristaltic contractions of the stomach, duodenum, small and large intestine, a moderate decrease in the tone of the gallbladder (in persons with hyperkinesia of bile ducts).It causes relaxation of the smooth muscles of the uterus, bladder and urinary tract; providing spasmolytic action, eliminates pain syndrome. Relaxes the smooth muscles of the bronchi, caused by increased n.vagus tone or holinostimuljatorami, increases the minute volume of breathing, inhibits the secretion of the bronchial glands; reduces the tone of sphincters.

When instilled in the conjunctival sac of the eye and parenteral administration, the pupil dilates due to relaxation of the sphincter of the pupil. At the same time, the intraocular pressure rises and paralysis of accommodation sets in (relaxation of the ciliary muscle of the ciliary body). In comparison with atropine, the effect on accommodation is less pronounced and shorter. Excites the brain and respiratory center, mostly - the spinal cord (in high doses, cramps, depression of the central nervous system, vasomotor and respiratory centers are possible). Penetrates through the blood-brain barrier.

Indications:

Peptic ulcer of stomach and duodenum, pylorospasm, cholecystitis, cholelithiasis, intestinal colic, renal colic, biliary colic; bronchial asthma (for the prevention of bronchial and laryngospasm),bronchorrhea; algodismenorea; spasm of cerebral arteries; disease / Raynaud's syndrome; arterial hypertension, angina pectoris (as part of combination therapy); enlargement of the pupil with a diagnostic purpose (including examination of the fundus, determination of the true refraction of the eye); acute inflammatory diseases of the eyes (including iritis, iridocyclitis, keratitis), eye trauma.

Contraindications:

Hypersensitivity.

Carefully:

Pregnancy; lactation period;

diseases of the cardiovascular system, in which an increase in the number of heartbeats may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary heart disease, mitral stenosis, hypertension, acute bleeding; thyrotoxicosis (tachycardia may be worse); increased body temperature (may still increase due to suppression of activity of sweat glands); reflux-esophagitis, hernia of the esophageal opening of the diaphragm, combined with reflux esophagitis (decreased esophageal and gastric motility and relaxation of the lower esophageal sphincter may contribute to slowing the emptying of the stomach and enhancing gastroesophageal reflux through the sphincter with impaired function); diseases of the gastrointestinal tract,accompanied by obstruction: achalasia and stenosis of the pylorus (there may be a decrease in motor and tone, leading to obstruction and delay in stomach contents); atony of the intestine in elderly patients or weakened patients (possible the development of obstruction), paralytic ileus (possible the development of obstruction); diseases with increased intraocular pressure: closed-angle (mydriatic effect leading to increased intraocular pressure, can cause acute attack) and open-angle glaucoma (mydriatic effect may cause some increase in intraocular pressure, correction of therapy may be required), age over 40 (risk of undiagnosed glaucoma ); nonspecific ulcerative colitis (high doses can inhibit intestinal motility, increasing the likelihood of paralytic intestinal obstruction, and possibly the manifestation or exacerbation of such a serious complication as a toxic megacolon); dry mouth (prolonged further increase in the severity of xerostomia); hepatic insufficiency (decreased metabolism) and renal failure (risk of side effectseffects due to decreased elimination); chronic lung diseases, especially in young children and weakened patients (a decrease in bronchial secretion can lead to a thickening of the secret and the formation of congestion in the bronchi); myasthenia gravis (the condition may worsen due to inhibition of the action of acetylcholine); autonomic neuropathy (urinary retention and paralysis of accommodation may be exacerbated), prostatic hypertrophy 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) ; gestosis (hypertension is possible); brain damage in children (effects from the central nervous system may increase); Down's disease (possibly an unusual dilatation of the pupils and an increase in the number of heartbeats); central paralysis in children (reaction to anticholinergic drugs may be most pronounced).

If you have any of these diseases, consult a doctor before taking the drug.

Dosing and Administration:

Subcutaneously, for the relief of acute pain in gastric and duodenal ulcer, as well as intestinal, hepatic and renal colic, prolonged attack of bronchial asthma, cerebral and peripheral angiopasms, adults are injected 1-2 ml of the drug 1-2 times a day (for vasodilation and lowering blood pressure is indicated by intravenous administration); children; newborn and breast - 0.0175 ml / kg; 1-5 years - 0.015 ml / kg, 6-10 years - 0.0125 ml / kg; 11-14 years - 0,01 ml / kg.

Side effects:

Dry mouth, thirst, lowering of arterial pressure, tachycardia, mydriasis, accommodation paralysis, intestinal atony, dizziness, headache, photophobia, convulsions, urinary retention, acute psychosis (in high doses), lung atelectasis.

If any of the side effects listed in the manual are aggravated, or if you notice any other side effects not listed in the instructions, tell your doctor.

Overdose:

Symptoms: paralytic intestinal obstruction; acute urinary retention (in patients with prostatic hyperplasia); paralysis of accommodation; increased intraocular pressure; dryness of the mucous membrane of the mouth, nose, throat; difficulty swallowing,speech; mydriasis (until the iris disappears completely); tremor, convulsions, hyperthermia, excitation, suppression of the central nervous system, inhibition of respiratory and vasomotor centers.

Treatment: gastric lavage, forced diuresis, parenteral administration of cholinostimulators and anticholinesterase agents. At a hyperthermia - wet wipes, antipyretic agents; with excitation - intravenous injection of sodium thiopental or rectal - chloral hydrate; with mydriasis - topically, in the form of eye drops; phosphacol, physostigmine, pilocarpine. In case of an attack of glaucoma immediately 1% solution of pilocarpine is injected into the conjunctival bag every 2 drops and subcutaneously - 1 ml of 0.05% solution of prosirin (neomycin methylsulfonate) 3-4 times a day.

Interaction:

Strengthens the sedative and hypnotic effect of phenobarbital, pentobarbital, magnesium sulfate. Other m-holinoblokatory, amantadine, haloperidol, phenothiazine, monoamine oxidase inhibitors (MAO), tricyclic antidepressants, and some antihistamines increase the risk of side effects. Antagonism - with anticholinesterase drugs. Morphine intensifies the inhibitory effect on the cardiovascular system; MAO inhibitors - positive chrono- and batmotropic effects; cardiac glycosides - a positive Batmotrope action; quinidine, procainamide - m-holinoblokiruyuschee action, with pain associated with spasms of smooth muscles, the action intensifies analgesics, sedatives, tranquilizers; with vascular spasms - hypotensive and sedative drugs.

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

During the treatment period it is necessary to refrain from potentially dangerous activities requiring increased attention.

Form release / dosage:Solution for subcutaneous administration 2 mg / ml.

Packaging:1 ml in an ampoule of neutral glass or in an ISO vial. For 5 ampoules in a keshurka cell box (with foil or paper, or without foil and paper). 2 contour squares in a pack of cardboard. For 10 ampoules in a pack of cardboard with a loose leaf of paper or with special pockets. In each pack you put the instruction on application and scarifier. When using ampoules with notches, rings and fracture points, the scarifiers do not insert into the pack.

Storage conditions:

In the dark place at a temperature of no higher than 25 ° C. Keep out of the reach of children.

Shelf life:

5 years.

Do not use after the expiration date.

Terms of leave from pharmacies:On prescription

Registration number:LSR-010929/09

Date of registration:31.12.2009

The owner of the registration certificate:VIFITEH, CJSC VIFITEH, CJSC Russia

Manufacturer: & nbsp

VIFITEH, CJSC Russia

Information update date: & nbsp10.08.2015

Illustrated instructions

Instructions

Platyphylline (Platyphyllin)