Шипучий порошок Пикопреп со вкусом апельсина оказывает слабительное действие. Действие препарата проявляется в сильном промывающем эффекте, который сочетается с эффектом стимулирования перистальтики кишечника, что и обусловливает его применение для очистки кишечника перед проведением радиографических исследований, колоноскопии или хирургических процедур.
Фармакологические свойства
Активными компонентами препарата Пикопреп являются натрия пикосульфат, оказывающий местное слабительное действие в толстой кишке, и цитрат магния, который образуется из лимонной кислоты и магния оксида при растворении порошка и действует как осмотическое слабительное за счет удерживания воды в толстой кишке. Очищение кишечника происходит вследствие мощного "вымывающего" эффекта в комбинации со стимуляцией перистальтики, что необходимо для проведения рентгенологических или эндоскопических (колоноскопия) исследований и хирургических манипуляций.
Показания к применению
Для очистки кишечника перед проведением рентгенологических исследований, эндоскопии или перед хирургическим вмешательством.
Противопоказания
Гиперчувствительность к любому из компонентов препарата - застойная сердечная недостаточность - нарушение опорожнения желудка, желудочно-кишечные язвы, токсический колит, токсическиймегаколон, кишечная непроходимость, тошнота и рвота, острые абдоминальныепатологии, требующие хирургического вмешательства, такиекак острый аппендицит, а также диагностированная или подозреваемаяжелудочно-кишечная обструкция или перфорация - почечная недостаточность (из-за накопления магния в плазме крови) - детский возраст до 3 лет.
Способ применения и дозы
Для приема внутрь. За день до проведения процедуры рекомендуется снизить количество приемов пищи. Во избежание обезвоживания во время приема препарата Пикопреп® рекомендуется соблюдать питьевой режим. Содержимое одного пакетика растворяют в 150 мл воды, перемешивают 2-3 минуты, охлаждают до приемлемой температуры и выпивают. Взрослые и дети старше 9 летЕсли процедура назначена на первую половину дня: Содержимое первого пакетика принимают после обеда или ранним вечером (16-18 часов), запивая не менее 5 стаканами по 250 мл воды или прозрачной жидкости (вода, негазированные безалкогольные напитки, чай, кофе, фруктовый сок без мякоти). Содержимое второго пакетика принимают на ночь (22-24 часов), запивая не менее 3 стаканами по 250 мл воды или прозрачной жидкости. Последний стакан можно выпить не позднее, чем за 1 час до процедуры. Если процедура назначена на вторую половину дня: Содержимое первого пакетика принимают вечером (в 17-21 часов) в день, предшествующий процедуре, запивая не менее 5 стаканами по 250 мл воды или прозрачной жидкости. Содержимое второго пакетика принимают утром (за 5-9 часов до процедуры), запивая не менее 3 стаканами по 250 мл воды или прозрачной жидкости. Последний стакан можно выпить не позднее, чем за 1 час до процедуры.
Побочное действие
Редко ( меньше 1/10 000) - гиперчувствительность, анафилактическая реакция - гипонатриемия - головная боль, спутанность сознания, эпилепсия, клонико-тонические судороги, конвульсии - тошнота, рвота, абдоминальная боль, диарея, прокталгия - сыпь (включая эритематозную и макулопапулярную сыпь), зуд, крапивница, пурпура Сообщалось об отдельных случаях развития афтоидных язв подвздошной кишки в легкой обратимой форме.
Особые указания
С особой осторожностью следует применять препарат посленедавно проведенных хирургических процедур на желудочно-кишечном тракте, атакже пациентам с нарушением функциипочек, сердечными заболеваниями или воспалительными заболеваниями кишечника. Препарат с осторожностью следует применять у пациентов, применяющих препараты, которые могут влиять на водный и/или электролитныйбаланс, например, диуретики, кортикостероиды, литий. Поскольку препарат Пикопреп может изменять абсорбциюлекарственных препаратов, предназначенных для регулярного пероральногоприменения, в подобных случаях его следует применять с осторожностью; так, былиполучены отдельные сообщения о приступах конвульсий у пациентов, принимающихпротивоэпилептические препараты, которые ранее позволяли успешно контролироватьтечение эпилепсии. Недостаточное пероральное потребление воды и электролитовможет привести к клинически значимому их дефициту, особенно у ослабленныхпациентов. Поэтому пациенты пожилого возраста и ослабленные пациенты, а такжепациенты с риском развития гипокалиемии должны находиться под медицинскимнаблюдением. У пациентов с признаками или симптомами гипонатриемии можетпотребоваться проведение быстрых корректирующих мер для восстановления балансажидкости и электролитов. Следует потреблять достаточное количество жидкости. Период очистки кишечника не должен превышать 24 часа, поскольку более длительная процедура может повышать риск нарушения водного илиэлектролитного баланса. Препарат содержит лактозу, поэтому его не следует применятьпациентам с непереносимостью лактозы. Препарат не предназначен для применения в качестве обычногослабительного средства. Дети Препарат применяют у детей с 3 года под контролем врача вусловиях стационара. Применение в период беременности или лактации Клинический опыт применения препарата Пикопреп в периодбеременности ограничен, поэтому препарат следует применять с осторожностью, особенно в первом триместре беременности. Натрий пикосульфат, магний цитрат не выделяются в грудноемолоко. Особенности влияния лекарственного средства на способностьуправления транспортными средствами и обслуживания движущихся механизмов Учитывая возможность возникновения конвульсий, судорог илиспутанности сознания, в период применения препарата следует воздерживаться отуправления автотранспортом или работы с другими механизмами. Передозировка Симптомы: возможно развитие профузной диареи. Лечение: проведение общего поддерживающего лечения иобеспечение достаточного потребления жидкости.
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