Platifillin hydrotartrate - 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 organs of the gastrointestinal tract (GIT) and circular muscle of the iris 5-10 times weaker than atropine). Blocking m-holinoretseptory,disrupts transmission of nerve impulses from postganglionic cholinergic nerves to the effector organs and tissues innervated by them (heart, smooth muscle organs, external secretion glands); inhibits, but to a lesser extent, n-holinoretseptory.

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 conductivity 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 pronounced decrease in the tone of smooth muscles, 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 the bile ducts); at a hypokinesia - a tonus of a cholic bubble raises to the normal maintenance.

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.

Causes the dilatation of the pupil due to relaxation of the circular muscle of the iris. 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 and shorter in time.

Excites the brain and respiratory center, more - the spinal cord (in high doses, cramps, depression of the central nervous system (CNS), vasomotor and respiratory centers) are possible. Penetrates through the blood-brain barrier.

Indications:

Stomach ulcer and duodenal ulcer, pylorospasm, cholecystitis, cholelithiasis. intestinal, renal and biliary colic; bronchial asthma (for the prevention of bronchial and laryngospasm), bronchorrhea; algodismenorea; spasm of cerebral arteries; angiotrophoneurosis; 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:

Diseases of the cardiovascular system, in which an increase in the heart rate (heart rate) may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, ischemic heart disease, mitral stenosis, hypertension, acute bleeding.

Thyrotoxicosis (tachycardia may be worse).

Increased body temperature (may still increase due to suppression of sebaceous glands activity).

Reflux-esophagitis, hernia of the esophageal 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 retention of stomach contents).

Atony of the intestine in elderly patients or weakened patients and paralytic ileus (possible the development of obstruction).

Diseases with increased intraocular pressure: closed-angle glaucoma (mydriatic effect leading to increased intraocular pressure, can cause acute attack), open-angle glaucoma (mydriatic effect may cause some increase in intraocular pressure, correction of therapy may be required), age over 40 years (danger of undiagnosed glaucoma).

Nonspecific ulcerative colitis (high doses can inhibit intestinal peristalsis, increasing the probability of paralytic intestinal obstruction, possibly manifestation or worsening of complications such as megacolon).

Dry mouth (prolonged use may cause further xerostomia).

Hepatic insufficiency (decreased metabolism), renal failure (risk of side effects due to reduced excretion).

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 (condition may worsen due to inhibition of acetylcholine).

Autonomic neuropathy (urinary retention and paralysis of accommodation may be aggravated), prostatic hypertrophy without urinary tract obstruction, 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).

Damage to the brain in children (effects from the central nervous system may be strengthened).

Down's disease (possibly an unusual dilatation of the pupils and an increase in heart rate).

Central paralysis in children (the reaction to anticholinergics can be most pronounced)

Pregnancy, lactation.

Dosing and Administration:

Subcutaneously.

To relieve 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 given 1 to 2 ml of the drug 1 to 2 times a day (to dilate blood vessels and reduce arterial pressure indicated intravenous administration).

For course treatment (10-20days), subcutaneously inject 1-2 ml of the drug 2-3 times a day.

The highest dose for adults: single-10 mg, daily - 30 mg,

Single doses for children per 1 kg of body weight:

newborns and nurses - 0,03 5 m g / kg (0,0175 ml / kg);
1-5 years - 0.03 mg / kg (0.015 ml / kg);
6-10 years - 0.02.5 mg / kg (0.0125 ml / kg);
11-14 years - 0,02 mg / kg (0,01 ml / kg).

Side effects:

Dry mouth, thirst, lower blood pressure, mydriasis, accommodation paralysis, tachycardia, intestinal atony, dizziness, headache, photophobia, convulsions; retention of urine; acute psychosis (in high doses); atelectasis of the lung.

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 oral cavity of the nose of the throat, difficulty swallowing, speech, mydriasis (until the iris completely disappears), tremor, convulsions, hyperthermia, excitation, central nervous system depression, suppression of respiratory and vasomotor centers.

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

Interaction:

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

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 per ampoule. 10 ampoules are placed in boxes of cardboard together with an instruction for use and a scarifier ampoule.

Storage conditions:

In the dark place at a temperature of 0 to 25 C.

Keep out of the reach of children.

Shelf life:

2 years. Do not use after the expiry date printed on the package.

Terms of leave from pharmacies:On prescription

Registration number:P N002256 / 01

Date of registration:19.01.2009

The owner of the registration certificate:DALHIMFARM, OJSC DALHIMFARM, OJSC Russia

Manufacturer: & nbsp

DALHIMFARM, OJSC Russia

Information update date: & nbsp10.08.2015

Illustrated instructions

Instructions

Platifillin hydrotartrate (Platyphyllin hydrotartrate)