Gipokaliemii

Active material: Magna aspartate, potassium aspartate
When ATH: A12CX
CCF: Preparation, filling shortage of potassium and magnesium in the body
ICD-10 codes (testimony): E61.2, I21, I49.4, I50.0
When CSF: 01.11.02.02.01
Manufacturer: GEDEON RICHTER Ltd. (Hungary)

Pharmaceutical form, composition and packaging

◊ Pills, Film-coated white or nearly white, round, lenticular, a slightly shiny and uneven surface, almost odorless.

Excipients: colloidal silicon dioxide, povidone, magnesium stearate, talc, corn starch, potato starch.

The composition of the coating film: macrogol 6000, Titanium dioxide (E171), methacrylic acid copolymer (E 100%), talc.

50 PC. – vials made of polypropylene (1) – packs cardboard.

The solution for the on / in the colorless or slightly greenish, clear, without visible mechanical inclusions.

Excipients: water d / and.

10 ml – colorless glass vials (5) – contoured plastic packaging (1) – packs cardboard.

Pharmacological action

Preparation, affecting the metabolic processes. The source of potassium and magnesium.

Potassium and magnesium – intracellular cations, which play a central role in the functioning of many enzymes, interaction of molecules and intracellular structures and the mechanism of muscle contraction. Inside- and the ratio of extracellular potassium ions, Magnesium, calcium and sodium affect on myocardial contractility. Low levels of potassium and / or magnesium in the internal environment can exert effects proaritmogennoe, predisposes to the development of arterial gipertenzzii, Atherosclerosis of the coronary arteries and the appearance of metabolic changes in the myocardium.

One of the most important physiological functions potassium is to maintain the membrane potential of neurons, myocytes and other excitable myocardial tissue structures. The imbalance between the inside- and extracellular potassium leads to a reduction of myocardial contractility, arrhythmia, tachycardia and increase the toxicity of cardiac glycosides.

Magnesium is a cofactor >300 enzymatic reactions and energy metabolism and protein synthesis, nucleic acid. Magnesium reduces stress reduction and heart rate, leading to a decrease in myocardial oxygen demand. Magnesium has antiischemic effect on myocardial tissue. Reduced myocyte contractility of smooth muscle walls of the arterioles, incl. coronary, It leads to vasodilatation and enhancing coronary flow.

The combination of potassium and magnesium in one product based on the fact, that the lack of potassium in the body is often accompanied by a magnesium deficiency and requires the simultaneous correction of content in the body of both ions. In the simultaneous correction of the levels of these electrolytes is observed an additive effect, Besides, potassium and magnesium reduce the toxicity of cardiac glycosides, without affecting their positive inotropic effect.

Pharmacokinetics

Absorption

The ingestion of the drug absorption is high.

Deduction

Excreted in the urine.

The data on the pharmacokinetics of the drug in the form of a solution for the on / in the not provided.

Testimony

- In the complex therapy of heart failure, myocardial infarction, heart rhythm disorders (mostly ventricular arrhythmias);

- To improve the portability of cardiac glycosides;

- Shortfall of potassium and magnesium in reducing their content in the diet (Pill).

Dosage regimen

Orally

Assign 1-2 tab. 3 times / day. The maximum daily dose – by 3 tab. 3 times / day.

The preparation should be applied after meals, tk. the acidic environment of the stomach contents reduces its effectiveness.

The duration of treatment and the need for repeated courses of doctor determines individually.

For i / v administration

The drug is prescribed in / in the drip, as a slow infusion. Single dose – 1-2 ampoule, If necessary, it re-introduction of 4-6 no.

To prepare the solution for i / v infusion of contents 1-2 amp. dissolved in 50-100 ml 5% glucose solution.

Side effect

If ingestion

From the central and peripheral nervous system: possible paresthesia (due to hyperkalemia); giporefleksiя, convulsions (due gipermagniemiya).

Cardio-vascular system: possible AV-block, paradoxical reaction (an increase in the number of premature beats), decrease in blood pressure; redness of the skin (due gipermagniemiya).

From the digestive system: nausea, vomiting, diarrhea (in t. no. due to hyperkalemia), discomfort or a burning sensation in the area of ​​the pancreas (in patients with gastritis or cholecystitis anatsidnyh).

The respiratory system: perhaps – respiratory depression (due gipermagniemiya).

Other: feeling the heat (due gipermagniemiya).

The on / in the introduction

The rapid on / in the introduction may develop symptoms of hyperkalemia and / or hypermagnesemia.

Contraindications

For oral and / in the introduction

- Acute and chronic renal failure;

- Oligurija, anurija;

- Addison's disease;

— AV-blockade II and III degrees;

- Cardiogenic shock (FROM <90 mmHg.);

- Hyperkalemia;

- Gipermagniemiya;

- Hypersensitivity to the drug.

Orally

- Myasthenia gravis;

— AV-блокада I степени;

- Gemoliz;

- Infringement of amino acid metabolism;

- Acute metabolic acidosis;

- Dehydration.

FROM caution the drug should be used during pregnancy inside (especially in the I trimester) and lactation (breast-feeding), I / O - at AV-blockade of I degree.

Pregnancy and lactation

Data on the negative effects of the drug in the form of a solution for the on / in the pregnancy and lactation (breast-feeding) no.

Caution should be used during pregnancy drug inside (especially in the I trimester) and lactation (breast-feeding).

Cautions

It should be used with caution to patients with an increased risk of hyperkalemia. In this case it is necessary to regularly monitor the level of potassium ions in blood plasma.

Before taking this medication, the patient should consult a doctor.

The rapid on / in the introduction of the drug may develop skin redness.

Effects on ability to drive vehicles and management mechanisms

The drug does not affect the ability to drive and engage in activities, require high concentration and speed of psychomotor reactions.

Overdose

Symptoms: at / in the introduction – hyperkalemia, gipermagniemiya; ingestion – cardiac conduction disturbances (especially in the current at the time of administration of pathology of cardiac conduction system).

Treatment: removal of the drug, symptomatic therapy (in / introduction 100 mg / min solution of calcium chloride), in case of need – e pyeritonyealinyi dialysis and hemodialysis.

Drug Interactions

While the use of potassium-sparing diuretics (triamterene, spironolactone), beta-blockers, cyclosporine, geparinom, ACE inhibitors, NSAIDs increase the risk of hyperkalemia until the appearance of arrhythmias and asystole. The use of drugs in conjunction with potassium SCS eliminates they cause hypokalemia. Under the influence of potassium, a decrease adverse effects of cardiac glycosides.

The drug increases the negative Dromo- bathmotropic action and antiarrhythmic drugs.

Due to the presence in the composition of the drug potassium ions when applied to ACE inhibitor Pananginum, beta-blockers, cyclosporine, potassium-sparing diuretics, geparinom, NSAIDs may develop hyperkalemia (necessary to monitor the level of potassium in the blood plasma); with anticholinergics – greater reduction in intestinal motility; with cardiac glycosides – reduction of their actions.

The drugs reduce the effectiveness of magnesium neomycin, polymyxin B, tetracycline and streptomycin.

Anesthetics dampening effect of magnesium on the central nervous system. When applied to atracurium, deksametoniem, suxamethonium may increase neuromuscular blockade; calcitriol - raising the level of magnesium in the blood plasma; with calcium, a decrease action of magnesium ions.

In an application Pananginum with potassium-sparing diuretics and ACE inhibitors increases the risk of hyperkalemia (Potassium levels should be monitored in plasma).

Conditions of supply of pharmacies

The drug is in the form of a solution for the on / in the by prescription.

Panangin in the form of tablets is approved for use as a means of non-prescription.

Conditions and terms

The drug should be stored at room temperature 15 up to 30°C, out of reach of children. Shelf life for tablets – 5 years, for a solution for / in – 3 year.