Wabain (Uabainum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Cardiac glycosides and non-glycosidic cardiotonic agents

Included in the formulation
  • Strophantine-G
    solution in / in 
    EXPERIMENTAL FACTORY ГНЦЛС, ООО     Ukraine
    • АТХ:

    C.01.A.C.01   Strophantine

    Pharmacodynamics:

    Formation of complex with Na+/TO+-ATPase, suppression of transport of sodium and potassium ions through the membranes of cardiomyocytes, increased release of calcium ions inside cardiomyocytes, increased activity of myofibrils - positive inotropic effect; increased parasympathetic and weakened sympathetic tone - a decrease in the speed of conduction and an increase in the effective refractory period of the atrioventricular node. Pharmacological effects: cardiotonic, antiarrhythmic.

    Pharmacokinetics:

    Connection with plasma proteins 40-60%. It is not metabolized. Elimination by the kidneys (unchanged).

    Indications:

    Acute heart failure or decompensated chronic heart failure, supraventricular tachycardia, flutter and atrial fibrillation.

    ICD-10

    IX.I30-I52.I47.1   Nadzheludochkovaya tachycardia

    IX.I30-I52.I50.0   Congestive heart failure

    IX.I30-I52.I48   Atrial fibrillation and flutter

    Contraindications:

    Hypersensitivity, pregnancy, breast-feeding, glycoside intoxication, acute myocardial infarction, ventricular tachycardia, atrioventricular blockade of II and III degrees,syndrome of weakness of the sinus node, isolated mitral stenosis, hypertrophic cardiomyopathy with obstruction in the left ventricular outflow tract, carotid sinus syndrome, thoracic aortic aneurysm, Wolff-Parkinson-White syndrome, dilated type of myocardial damage, chronic renal failure, severe electrolyte imbalance (hypokalemia, hypomagnesemia, hypercalcemia, hypernatremia), pulmonary hypertension.

    Carefully:

    Bradycardia, atrioventricular block and withsyndrome of weakness of the sinus node without pacemaker, paroxysmal ventricular tachycardia, unstable angina, chronic heart failure with diastolic dysfunction (restrictive cardiomyopathy, amyloidosis of the heart, constrictive pericarditis, cardiac tamponade), extrasystole, cardiac asthma in patients with mitral stenosis (in the absence of tachysystolic form atrial fibrillation), marked dilatation of the cavities of the heart, a "pulmonary" heart. Electrolyte disorders (condition after dialysis, diarrhea, diuretics or other means that cause electrolyte disorders, malnutrition,prolonged vomiting, etc.): hypokalemia, hypomagnesemia, hypercalcemia, hypocalcemia. Hypothyroidism, alkalosis, myocarditis, obesity, old age, arteriovenous shunt, hypoxia, chronic renal failure.

    Pregnancy and lactation:

    The category of recommendations for the FDA is not defined.

    Adequate and well-controlled studies in humans and animals have not been conducted. Do not apply! There is no information on the penetration into breast milk. Do not apply!

    Dosing and Administration:

    Intravenously, slowly. The dosage regimen is set individually, depending on the nosology and patient response to therapy. At an average rate of digitalization, 1 ml (0.25 mg) 2 times a day (with a 12-hour interval) is administered during the saturation period. The duration of the saturation period averages 2 days. If necessary, you can enter an additional dose - 0.1-0.15 mg with an interval of 0.5 to 2 hours. The daily dose should not exceed 1 mg, which corresponds to 4 ml of solution for injection. The maintenance dose, as a rule, does not exceed 0.25 mg (1 ml) per day.

    Side effects:

    Arrhythmia, dyspeptic phenomena (nausea, vomiting), mesenteric infarction, CNS disorders (headache, fatigue, insomnia, depression, hallucinations, psychosis, changes in vision), gynecomastia.

    Overdose:

    Symptoms: arrhythmias, including bradycardia, ventricular tachycardia or extrasystole, ventricular fibrillation, and atrioventricular conduction disorders; anorexia, nausea, vomiting, diarrhea, headache, fatigue, dizziness, change in vision: dyeing surrounding objects in green and yellow colors, flickering before the eyes, decreased visual acuity, cattle appearance, macro and micropsia, confusion, syncopal state.

    Treatment: the appointment of potassium preparations, the introduction of dimercaprol, with ectopic arrhythmias - lidocaine, maintenance of vital functions.

    Interaction:

    Sympathomimetics, methylxanthines, reserpine, tricyclic antidepressants, phosphodiesterase blockers (for example, theophylline) increase arrhythmogenicity, diuretics, glucocorticoids, insulin, calcium preparations - the risk of developing glycosidic intoxication. Quinidine, amiodarone, captopril, calcium antagonists, erythromycin and tetracycline increase the concentration in the plasma.

    Special instructions:

    Given the small therapeutic latitude during treatment, careful medical supervision and individual dose selection are necessary.If the impaired excretory function of the kidneys should reduce the dose (prevention of glycosidic intoxication). The likelihood of overdose increases with hypokalemia, hypomagnesemia, hypercalcemia, hypernatremia, severe dilatation of the heart cavities, pulmonary heart, alkalosis, in elderly patients. Particular caution and ECG monitoring are required in case of violation of atrioventricular conductivity of the 1st degree.

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