Dicikloverin

When ATH:
A03AA07

Characteristic.

Dicycloverine hydrochloride - white crystalline powder, practically odorless, bitter taste. Soluble in water, slightly soluble in ethanol, xloroforme, very slightly soluble in ether. Molecular weight - 345,96.

Pharmacological action.
Holinoliticheskoe, myotropic, antispasmodic.

Application.

What (E., hepatic et al.).

Contraindications.

Hypersensitivity, obstructive diseases of the digestive tract, liver and urinary tract, severe ulcerative colitis (when used in high doses may decrease intestinal peristalsis, until the development of paralytic ileus; use can contribute to the emergence or aggravation of such serious complications as toxic megacolon), gastric ulcer and duodenal ulcer, reflux esophagitis, unstable state of the cardiovascular system in acute hemorrhage, glaucoma, myasthenia gravis, childhood (to 6 Months).

Restrictions apply.

Vegetativnaya neuropathy, the liver and kidneys (reduction of excretion by the kidneys may increase the risk of side effects), tachycardia, incl. hyperthyroidism (may increase), hypertension (may increase), Heart Disease (incl. CHD, congestive heart failure, integuments), hiatal hernia, prostatauxe.

Pregnancy and breast-feeding.

During pregnancy, use is possible only if necessary. There are no adequate and well-controlled studies in humans have not held. In reproductive studies in rats and rabbits, receiving ditsikloverina hydrochloride doses, to 33 times exceeds the MRDC (160 mg/day or 3 mg / kg), revealed no effect on fertility or undesirable effects on the fetus.

Contraindicated during breast-feeding (It reported that, that ditsikloverina hydrochloride is excreted into breast milk; may develop respiratory distress syndrome in children, breastfed).

Side effects.

Dry mouth, dizziness, blurred vision, nausea, drowsiness, weakness, nervousness, constipation, ageusia, anorexia, increased intraocular pressure, tachycardia, decreased sweating, allergic reactions.

Cooperation.

Effects ditsikloverina, incl. side, may enhance drug with anticholinergic activity: amantadin, Class I antiarrhythmics (eg quinidine), antihistamine drugs, antipsychotic drugs (eg phenothiazines), benzodiazepines, MAO inhibitors, narcotic analgesics, nitrates and nitrites, sympathomimetic, tricyclic antidepressants. Anticholinergic drugs counteract the effects of antiglaucoma agents. In the presence of elevated intraocular pressure anticholinergic drugs can be dangerous while the use of corticosteroids. Anticholinergic drugs may interfere with the absorption of digoxin in the gastrointestinal tract and resulting increase in the concentration of digoxin in the serum. Anticholinergic drugs may counteract the effects of substances, that alter the motor activity of the digestive tract (metoclopramide). Antacids may affect the absorption of anticholinergic drugs, so avoid their joint application. Inhibition of anticholinergics secretion of hydrochloric acid counteracts the active substance, used to treat achlorhydria or gastric secretion test.

Overdose.

Symptoms: headache, nausea, vomiting, prolonged blurred vision, dilated pupils, fever, xerosis, dizziness, dry mouth, difficulty weight management, CNS excitation. Perhaps kurarepodobnoe effect (ie. neuromuscular block, resulting in muscle weakness and, perhaps, Paralič).

Treatment: induction of vomiting, gastric lavage, activated carbon. For relief of excitation - drugs with sedative effects (short-range barbiturates, benzodiazepines). Where indicated, as an antidote can be used corresponding cholinergic agent.

Dosing and Administration.

/ M, 20 mg dose; if necessary, reintroduce after 4-6 hours.

Precautions.

Be wary appointed to high ambient temperatures (due to decreased sweating and hyperthermia increases the probability of heat stroke). It should be taken into account, that diarrhea may be an early symptom of incomplete intestinal obstruction, especially in patients with iliostoma or kolonostomoy. In these cases, treatment is not shown ditsikloverina hydrochloride and, perhaps, It would be dangerous.

In connection with the possible emergence of drowsiness and blurred vision, ditsikloverina hydrochloride in the treatment should be careful not to be at risk if activity, require rapid mental and motor responses, incl. when driving. It has been reported, that patients with hypersensitivity anticholinergic drugs can cause psychosis. Effects on the CNS manifested in the development of symptoms, like confusion, disorientation, short-term memory loss, hallucinations, dysarthria, ataxia, coma, euphoria, reduction of anxiety, weakness, insomnia, agitation and mannerisms, inappropriate emotional responses. These symptoms usually decrease within 12-24 hours after stopping dicycloverin hydrochloride..

Before applying ditsikloverina hydrochloride need to be clarified, whether the patient has tachycardia, tk. ditsikloverina hydrochloride may increase heart rate.