Platyphylline hydrotartrate

Pharmacological properties

platifillin is a natural alkaloid with m-anticholinergic action. Compared with atropine, it has a lesser effect on peripheral m-cholinergic receptors (the antispasmodic effect on smooth muscle cells of the digestive tract and the circular muscle of the iris is 5-10 times weaker than atropine). blocking m-cholinergic receptors, disrupts the transmission of nerve impulses from postganglionic cholinergic nerves to the effector organs and tissues innervated by them (heart, smooth muscle organs, endocrine glands). partially blocks n-cholinergic receptors. anticholinergic effect is manifested to a greater extent against the background of increased tone of the parasympathetic autonomic nervous system or the action of m-cholinomimetics. to a lesser extent than atropine, it causes tachycardia, especially when used in high doses. reducing the influence of the vagus nerve, improves cardiac conduction, increases myocardial excitability, increases moc. It has a ganglioblocking and direct myotropic antispasmodic effect, causes the expansion of small vessels of the skin. in high doses, it inhibits the vasomotor center and blocks the sympathetic ganglia, as a result of which the vessels expand and hell decreases (mainly with the on / in introduction). weaker than atropine, inhibits the secretion of endocrine glands, causes a marked decrease in smooth muscle tone, amplitude and frequency of peristaltic contractions of the stomach, duodenum, small and large intestines, moderate decrease in gallbladder tone (in patients with biliary tract hyperkinesia). with hypokinesia, the tone of the gallbladder rises to normal. causes relaxation of the smooth muscles of the uterus, bladder and urinary tract. providing an antispasmodic effect, eliminates pain. relaxes the smooth muscles of the bronchi during spasm, caused by an increase in the tone of the vagus nerve or cholinomimetics, increases the volume of breathing, inhibits the secretion of bronchial glands. with parenteral administration, causes pupil dilation due to relaxation of the circular muscle of the iris. at the same time, intraocular pressure rises and accommodation paralysis occurs (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, to a greater extent - the spinal cord (in high doses, convulsions, depression of central nervous system, vasomotor and respiratory centers are possible). penetrates the GEB.

Pharmacokinetics After parenteral administration, it quickly and easily penetrates histohematological barriers, cell and synaptic membranes. With the introduction of high doses, it accumulates in the central nervous system in significant concentrations. In the body, it undergoes hydrolysis with the formation of platinumcin and platinum acid. Excreted by the kidneys with urine and intestines with feces. When used correctly (doses, intervals between administrations) it does not cumulate.

Indications

As part of complex therapy: gastroduodenitis, functional dyspepsia, pylorospasm, cholecystitis, cholelithiasis, intestinal colic, renal colic, biliary colic. ba (to prevent bronchospasm), bronchorrhea. algodismenorea. spasm of cerebral arteries. angiotrophoneurosis.

Application

Apply s / c.

For adults and children over the age of 15, to stop spastic pain, a protracted attack of asthma, cerebral and peripheral angiospasm, introduce 1-2 ml of the solution 1-2 times a day.

During the course of treatment, administer s / c 1-2 ml 1-2 times a day for 10-15-20 days.

Single and daily doses, the frequency of administration are determined individually by the doctor, depending on the indications and age of the patient.

Maximum doses for adults: single - 10 mg, daily - 30 mg.

Contraindications

Hypersensitivity to the components of the drug.diseases of the cardiovascular system, in which an increase in heart rate may be undesirable: atrial fibrillation, tachycardia, chronic heart failure, coronary heart disease, mitral stenosis, severe ag. acute bleeding. thyrotoxicosis. hyperthermic syndrome. gastrointestinal tract diseases, accompanied by obstruction (esophageal achalasia, pyloric stenosis, intestinal atony). glaucoma. hepatic and renal failure. miastenia gravis. urinary retention or predisposition to it. brain damage.

Side effects

From the digestive tract: dry mouth, thirst, impaired taste, dysphagia, decreased intestinal motility up to atony, decreased tone of the biliary tract and gall bladder.

From the kidneys and urinary tract: difficulty and delay urination.

From the cardiovascular system: tachycardia, arrhythmia, including extrasystole, facial flushing, hot flashes, decreased blood pressure.

From the nervous system: headache, dizziness, dysarthria, central nervous system agitation, insomnia, anxiety, amnestic syndrome.

From the side of the organ of vision: mydriasis, photophobia, accommodation paralysis, increased intraocular pressure.

On the part of the respiratory system and mediastinal organs: a decrease in secretory activity and tone of the bronchi, which leads to the formation of viscous sputum, which coughs hard.

On the part of the skin and subcutaneous tissue: skin rash, urticaria, exfoliative dermatitis, dry skin, decreased sweating.

From the immune system: anaphylactic reactions, anaphylactic shock.

special instructions

Use with caution in patients with prostatic hypertrophy or urinary tract obstruction, Downs disease, cerebral palsy; with reflux esophagitis, a hiatal hernia, combined with reflux esophagitis; with ulcerative colitis, megacolon; patients over the age of 40, given the possible manifestation of undiagnosed glaucoma; with autonomic (autonomous) neuropathy; elderly patients or debilitated patients; in chronic lung diseases occurring with low production of dense sputum, or with reversible obstruction. in patients with xerostomia, prolonged use may cause a further decrease in salivation.

Use during pregnancy and lactation. During pregnancy and lactation, use the drug with caution only when the expected benefit to the mother outweighs the potential risk to the fetus or child.

Children. The drug is used for children over the age of 15 years.

The ability to influence the reaction rate when driving vehicles or other mechanisms. When using the drug, one should refrain from driving vehicles or performing other potentially dangerous activities that require increased attention and speed of psychomotor reactions.

Interactions

With simultaneous use with haloperidol in patients with schizophrenia, a decrease in the severity of the antipsychotic effect is possible.

Enhances the sedative and hypnotic effects of phenobarbital, pentobarbital, magnesium sulfate and sodium etaminal. Eliminates bradycardia caused by taking verapamil; nausea, vomiting, and bradycardia caused by taking morphine.

Blocks the effects of prozerin.

Enhances the effects of H₂-histaminolytics used orally, digoxin and riboflavin (slows down peristalsis and improves absorption).

Adrenomimetics and organic nitrates potentiate an increase in intraocular pressure.

M-anticholinergics, amantadine, haloperidol, phenothiazines, MAO inhibitors, tricyclic antidepressants, benzactisin, quinidine sulfate, isoniazid, some antihistamines (diphenhydramine), disopyramides, procainamide increase the risk of developing anticholinergic side effects.

It shows antagonism with cholinesterase inhibitors. Do not use simultaneously with anticholinesterase drugs.

Morphine enhances the inhibitory effect on the cardiovascular system, MAO inhibitors - positive chrono- and batmotropic effects, cardiac glycosides - positive batmotropic effects, quinidine, Novocaineamide - anticholinergic effect.

With pain associated with smooth muscle spasms, the effect of the drug is enhanced by analgesics, sedatives, tranquilizers, with vascular spasms - hypotensive and sedatives.

Incompatibility. Do not mix with other medicines. Use only recommended solvent.

Overdose

Symptoms: paralytic intestinal obstruction, acute urinary retention (in patients with benign prostatic hyperplasia), accommodation paralysis, increased intraocular pressure; dry mucous membranes of the mouth, nose, and throat; difficulty swallowing, mydriasis (until the iris disappears completely), tremors, convulsions, hyperthermia, central nervous system agitation followed by its inhibition, inhibition of the respiratory and vasomotor centers.

Treatment: forced diuresis, the introduction of cholinesterase inhibitors (physostigmine, galantamine or proserin), which reduce the severity of intestinal paresis and reduce tachycardia. With moderate excitement and mild cramps - the introduction of magnesium sulfate, in severe cases - sodium oxybutyrate, oxygen therapy, mechanical ventilation. With life-threatening tachycardia, quinidine sulfate, propranolol.

Storage conditions

In the original packaging at a temperature not exceeding 25 ° C. do not freeze.