Фармакологическое действие — жаропонижающее, анальгезирующее... Инструкция
Показания к применению
болевой синдром умеренной интенсивности, особенно после хирургического вмешательства;лихорадочный синдром на фоне инфекционных заболеваний. Препарат показан для быстрого снятия боли, в т.ч. когда пероральный путь введения затруднен.
Противопоказания
гиперчувствительность к парацетамолу или пропацетамола гидрохлориду (пролекарство парацетамола) или любому другому компоненту препарата;выраженные нарушения функции печени;детский возраст до 1 года.С осторожностью:при назначении парацетамола больным с тяжелой почечной недостаточностью (Cl креатинина <30мл/мин);доброкачественными гипербилирубинемиями ...
Прозрачный, бесцветный или слегка желтоватый раствор без видимых механических включений.
Фармакологические свойства
Фармакологическое действие — жаропонижающее, анальгезирующее.
Показания к применению
болевой синдром умеренной интенсивности, особенно после хирургического вмешательства;лихорадочный синдром на фоне инфекционных заболеваний. Препарат показан для быстрого снятия боли, в т.ч. когда пероральный путь введения затруднен.
Противопоказания
гиперчувствительность к парацетамолу или пропацетамола гидрохлориду (пролекарство парацетамола) или любому другому компоненту препарата;выраженные нарушения функции печени;детский возраст до 1 года.С осторожностью:при назначении парацетамола больным с тяжелой почечной недостаточностью (Cl креатинина <30мл/мин);доброкачественными гипербилирубинемиями (в т.ч. синдром Жильбера, вирусный гепатит, алкогольное поражение печени);алкоголизмом;с дефицитом глюкозо−6-фосфатдегидрогеназы;пациентам пожилого возраста.
Применение при беременности и в период грудного вскармливания
Следует с осторожностью применять при беременности и грудном вскармливании. Не отмечено каких-либо нежелательных явлений у детей при использовании парацетамола в период грудного вскармливания.
Способ применения и дозы
В/в, однократно, в виде инфузии в течение 15 мин.Открытый и неиспользованный препарата должен быть уничтожен. Допускается дополнительное разведение 0,9% раствором натрия хлорида, максимально— в 10 раз. Такой разведенный раствор следует использовать в течение часа после его приготовления (включая время инфузии).Дети от 1 года до 11 лет (с массой тела до 34 кг)— по 15 мг/кг парацетамола на инфузию, т.е. 1,5 мл раствор на 1 кг массы тела до 4 раз в сутки. Минимальный интервал между введениями— 4 ч. Максимальная суточная доза— не более 60 мг/кг.Взрослым и подросткам (старше 12 лет) с массой тела 35–50 кг по 15мг/кг на введение (1,5мл/кг). Максимальная суточная доза— не более 60мг/кг массы тела. Минимальный интервал между введениями— 4ч.Взрослым и подросткам (старше 12 лет) с массой тела более 50 кг максимальная разовая доза— 1г (1 фл. 100 мл), суточная— 4г. Интервал между введениями препарата— не менее 4ч.У пациентов с нарушениями функции печени или почек, с синдромом Жильбера и пожилых— суточную дозу уменьшают и вводят ее с интервалами не менее 8ч.
Побочное действие
Со стороны кожных покровов: кожный зуд, сыпь на коже и слизистых (обычно эритематозная или уртикарная), отек Квинке.Со стороны органов ЖКТ: повышение активности печеночных ферментов (как правило без развития желтухи).Со стороны сердечно-сосудистой системы: артериальная гипотензия.Со стороны органов кроветворения: тромбоцитопения.
Передозировка
Симптомы острой передозировки (развиваются в течение 24ч после введения парацетамола): желудочно-кишечные расстройства (диарея, снижение аппетита, тошнота и рвота, дискомфорт в брюшной полости и/или абдоминальная боль), бледность кожных покровов. Через 12–13ч после введения парацетамола отмечается повышение активности печеночных трансаминаз, лактатдегидрогеназы и уровня билирубина, а также снижение уровня протромбина. При одномоментном введении взрослым 7,5г и более или детям более 140мг/кг происходит цитолиз гепатоцитов с полным и необратимым некрозом печени, развитием печеночной недостаточности, метаболического ацидоза и энцефалопатии, которые могут привести к коме и летальному исходу.Симптомы хронической передозировки (проявляются через 2–4 суток после превышения дозы препарата): гепатотоксический эффект, характеризующийся общими (боль, слабость, адинамия, повышенное потоотделение) и специфическими (со стороны печени) симптомами. Гепатотоксический эффект может приводить к развитию гепатонекроза и осложняться развитием печеночной энцефалопатии (нарушение мышления, угнетение высшей нервной деятельности, ажитация и ступор), судорог, угнетения дыхания, комы, отека мозга, нарушения свертываемости крови, развития ДВС-синдрома, гипогликемии, метаболического ацидоза, аритмии, коллапса.Редко нарушение функции печени развивается молниеносно и осложняется почечной недостаточностью (тубулярный некроз).Лечение острой передозировки: введение донаторов SH-групп и предшественников синтеза глутатиона— метионина (через 8–9ч после передозировки) и N-ацетилцистеина (через 12 ч). Необходимость дальнейшего введения метионина и N-ацетилцистеина определяется в зависимости от концентрации парацетамола в крови, а также от времени, прошедшего после его введения.
Взаимодействие с другими лекарственными средствами
Индукторы микросомального окисления в печени (фенитоин, этанол, барбитураты, рифампицин, фенилбутазон, трициклические антидепрессанты) увеличивают продукцию гидроксилированных активных метаболитов, что обуславливает возможность развития тяжелой интоксикации даже при небольшой передозировке парацетамола. Длительное использование барбитуратов снижает эффективность парацетамола. Ингибиторы микросомального окисления (в т.ч. циметидин) снижают риск гепатотоксического действия.Длительное совместное использование с другими НПВС повышает риск развития нефропатии, почечного папиллярного некроза и терминальной стадии почечной недостаточности. Длительное совместное использование высоких доз парацетамола с салицилатами повышает риск развития рака почки или мочевого пузыря.Дифлунисал повышает концентрацию парацетамола в плазме крови на 50% (риск развития гепатотоксичности).
Условия хранения
При температуре 15–30°C. Хранить в недоступном для детей месте.
Срок годности
2 года. Не применять по истечении срока годности, указанного на упаковке.2000-2017. Регистр лекарственных средств России
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Интервал между введениями препарата— не менее 4ч.У пациентов с нарушениями функции печени или почек, с синдромом Жильбера и пожилых— суточную дозу уменьшают и вводят ее с интервалами не менее 8ч."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Со стороны кожных покровов: кожный зуд, сыпь на коже и слизистых (обычно эритематозная или уртикарная), отек Квинке.Со стороны органов ЖКТ: повышение активности печеночных ферментов (как правило без развития желтухи).Со стороны сердечно-сосудистой системы: артериальная гипотензия.Со стороны органов кроветворения: тромбоцитопения."}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы острой передозировки (развиваются в течение 24ч после введения парацетамола): желудочно-кишечные расстройства (диарея, снижение аппетита, тошнота и рвота, дискомфорт в брюшной полости и/или абдоминальная боль), бледность кожных покровов. Через 12–13ч после введения парацетамола отмечается повышение активности печеночных трансаминаз, лактатдегидрогеназы и уровня билирубина, а также снижение уровня протромбина. При одномоментном введении взрослым 7,5г и более или детям более 140мг/кг происходит цитолиз гепатоцитов с полным и необратимым некрозом печени, развитием печеночной недостаточности, метаболического ацидоза и энцефалопатии, которые могут привести к коме и летальному исходу.Симптомы хронической передозировки (проявляются через 2–4 суток после превышения дозы препарата): гепатотоксический эффект, характеризующийся общими (боль, слабость, адинамия, повышенное потоотделение) и специфическими (со стороны печени) симптомами. Гепатотоксический эффект может приводить к развитию гепатонекроза и осложняться развитием печеночной энцефалопатии (нарушение мышления, угнетение высшей нервной деятельности, ажитация и ступор), судорог, угнетения дыхания, комы, отека мозга, нарушения свертываемости крови, развития ДВС-синдрома, гипогликемии, метаболического ацидоза, аритмии, коллапса.Редко нарушение функции печени развивается молниеносно и осложняется почечной недостаточностью (тубулярный некроз).Лечение острой передозировки: введение донаторов SH-групп и предшественников синтеза глутатиона— метионина (через 8–9ч после передозировки) и N-ацетилцистеина (через 12 ч). Необходимость дальнейшего введения метионина и N-ацетилцистеина определяется в зависимости от концентрации парацетамола в крови, а также от времени, прошедшего после его введения."}}]},{"id":9,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Индукторы микросомального окисления в печени (фенитоин, этанол, барбитураты, рифампицин, фенилбутазон, трициклические антидепрессанты) увеличивают продукцию гидроксилированных активных метаболитов, что обуславливает возможность развития тяжелой интоксикации даже при небольшой передозировке парацетамола. Длительное использование барбитуратов снижает эффективность парацетамола. Ингибиторы микросомального окисления (в т.ч. циметидин) снижают риск гепатотоксического действия.Длительное совместное использование с другими НПВС повышает риск развития нефропатии, почечного папиллярного некроза и терминальной стадии почечной недостаточности. Длительное совместное использование высоких доз парацетамола с салицилатами повышает риск развития рака почки или мочевого пузыря.Дифлунисал повышает концентрацию парацетамола в плазме крови на 50% (риск развития гепатотоксичности)."}}]},{"id":10,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При температуре 15–30°C. Хранить в недоступном для детей месте."}}]},{"id":11,"name":"Срок годности","slug":"expiry_date","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"2 года. Не применять по истечении срока годности, указанного на упаковке.2000-2017. 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