Пирацетам Раствор, ампулы, 10 шт, 5 мл, 200 мг/мл, для инъекций

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Предварительно препарат разводят в одном из совместимых инфузионных растворов: декстрозы 5% 10% или 20% фруктозы 5% 10% или 20% натрия хлорида 09% декстрана [средняя молекулярная масса 30000-40000] (10% в растворе натрия хлорида 09%) Рингера маннитола 20%. Общий объем раствора предназначенный для введения определяется с учетом клинических показаний и состояния пациента. Болюсное внутривенное введение (например неотложное лечение серповидно-клеточной анемии) выполняется в течение не менее 2 минут суточная доза при этом распределяется на несколько введений (2-4) с равномерными интервалами так чтобы доза на одно введение не превышала 3 г."}},{"type":"paragraph","data":{"text":"Внутримышечно препарат вводится если введение через вену затруднено или пациент перевозбужден. Однако количество препарата которое может быть введено внутримышечно ограничено особенно у детей и пациентов со сниженной массой тела. Кроме того введение препарата внутримышечно может быть болезненным из-за большого объема жидкости. Объем раствора вводимого внутримышечно не может превышать 5 мл. Кратность введения препарата аналогична таковой при его внутривенном или пероральном применении."}},{"type":"paragraph","data":{"text":"При появлении возможности переходят на пероральный прием препарата (см. инструкции по медицинскому применению соответствующих форм выпуска препарата)."}},{"type":"paragraph","data":{"text":"Продолжительность лечения определяется врачом в зависимости от заболевания и с учетом динамики симптомов."}},{"type":"paragraph","data":{"text":"Симптоматическое лечение психоорганического синдрома: по 4.8 г/сут в течение первой недели затем переходят на поддерживающую дозу - 1.2-2.4 г/сут."}},{"type":"paragraph","data":{"text":"Лечение головокружения и связанных с ним нарушений равновесия: по 2.4-4.8 г/сут."}},{"type":"paragraph","data":{"text":"Лечение кортикальной миоклонии: начинают с дозы 7.2 г/сут каждые 3-4 дня дозу увеличивают на 4.8 г/сутки до достижения максимальной дозы 24 г/сут. Лечение продолжают на протяжении всего периода заболевания. Каждые 6 месяцев следует пробовать снижать дозу или отменить препарат постепенно снижая дозу на 1.2 г/сут каждые 2 дня. При незначительном терапевтическом эффекте или его отсутствии лечение прекращают."}},{"type":"paragraph","data":{"text":"При купировании серповидно-клеточного вазоокклюзионного криза (у взрослых и детей): в/в по 300 мг/кг/сут разделенные на 4 равные дозы."}},{"type":"paragraph","data":{"text":"Лечение дислексии у детей старше 8 лет (в комплексе с другими методами лечения) - по 3.2 г разделенных на 2 равные дозы."}},{"type":"paragraph","data":{"text":"При хронической почечной недостаточности легкой степени (клиренс креатинина 50-79 мл/мин) - вводят 2/3 суточной дозы разделенной на 2-3 приема; средней (клиренс креатинина 30-49 мл/мин) - 1/3 дозы разделенной на 2 приема; тяжелой (клиренс креатинина 20-30 мл/мин) - 1/6 дозы однократно."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Со стороны ЦНС: двигательная расторможенность раздражительность сонливость депрессия астения головная боль бессонница психическое возбуждение нарушение равновесия атаксия обострение течения эпилепсии тревога галлюцинации спутанность сознания."}},{"type":"paragraph","data":{"text":"Со стороны пищеварительной системы: тошнота рвота диарея абдоминальная боль."}},{"type":"paragraph","data":{"text":"Со стороны обмена веществ: повышение массы тела."}},{"type":"paragraph","data":{"text":"Со стороны органов чувств: вертиго."}},{"type":"paragraph","data":{"text":"Со стороны кожных покровов: дерматит зуд крапивница."}},{"type":"paragraph","data":{"text":"Аллергические реакции: гиперчувствительность; анафилактические реакции ангионевротический отек."}},{"type":"paragraph","data":{"text":"Местные реакции: боль в месте введения тромбофлебит."}},{"type":"paragraph","data":{"text":"Прочие: лихорадка снижение артериального давления."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: абдоминальная боль диарея с примесью крови."}},{"type":"paragraph","data":{"text":"Лечение: индукция рвоты промывание желудка симптоматическая терапия гемодиализ (эффективность 50-60%). Специфического антидота нет."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"При одновременном применении с йодсодержащими гормонами щитовидной железы может возникнуть спутанность сознания раздражительность и нарушение сна."}},{"type":"paragraph","data":{"text":"В высоких дозах (9.6 г/сут) у пациентов с венозным тромбозом повышает антикоагулянтный эффект непрямых антикоагулянтов (более выраженное снижение агрегации тромбоцитов содержания фибриногена фактора Виллебранда вязкости крови и плазмы)."}},{"type":"paragraph","data":{"text":"Фармацевтически совместим с растворами декстрозы (5% 10% 20%) фруктозы (5% 10% 20%) 0.9% раствором хлорида натрия раствором Рингера 20% раствором маннитола гидроксиэтилкрахмалом (6% 10%)."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"С осторожностью назначают пациентам с нарушением гемостаза перед предстоящими обширными хирургическими вмешательствами или у пациентов с симптомами тяжелого кровотечения."}},{"type":"paragraph","data":{"text":"При лечении кортикальной миоклонии следует избегать резкого прекращения лечения т.к. это может вызвать возобновление приступов."}},{"type":"paragraph","data":{"text":"При купировании серповидно-клеточного вазоокклюзионного криза доза менее 160 мг/кг или нерегулярный прием препарата могут вызвать рецидив криза."}},{"type":"paragraph","data":{"text":"При длительной терапии у пациентов пожилого возраста рекомендуется регулярный контроль функции почек при необходимости проводят коррекцию дозы в зависимости от клиренса креатинина."}},{"type":"paragraph","data":{"text":"Проникает через фильтрующие мембраны аппаратов для гемодиализа."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"В период лечения необходимо соблюдать осторожность при управлении транспортными средствами и занятии др. потенциально опасными видами деятельности требующими повышенной концентрации внимания и быстроты психомоторных реакций."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для внутривенного и внутримышечного введения 200 мг/мл."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"В сухом защищенном от света месте при температуре не выше 25 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей месте."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"5 лет. Не использовать по истечении срока годности указанного на упаковке."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту"}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"Открытое акционерное общество \"Фармстандарт-Уфимский витаминный завод\" (ОАО \"Фармстандарт-УфаВИТА\")"}}]},{"id":23,"name":"Организация, принимающая претензии потребителей","body":[{"type":"paragraph","data":{"text":"ОАО \"Фармстандарт-УфаВИТА\""}}]}],"source":null},"description_toggle":false,"short_description":"Циклическое производное гамма-аминомасляной кислоты ноотропное средство; воздействует непосредственно на головной мозг улучшая когнитивные (познавательные) процессы такие как способность к обучению память внимание а также умственную работоспособность. Оказывает влияние на центральную нервную систему различными путями: изменяет скорость распространения возбуждения в головном мозге улучшает метаболические процессы в нервных клетках улучшает микроциркуляцию воздействует на реологические характеристики крови не оказывая при этом вазодилатирующего действия. Улучшает связь между полушариями головного мозга и синаптическую проводимость в неокортикальных структурах улучшает мозговой кровоток. Ингибирует агрегацию тромбоцитов и восстанавливает конфигурационные свойства наружной мембраны ригидных эритроцитов а также способность последних к пассажу через сосуды микроциркуляторного русла. В дозе 9.6 г снижает концентрацию фибриногена и фактора Виллебранда на 30-40% и удлиняет время кровотечения. Оказывает протекторное и восстанавливающее действие при нарушении функции головного мозга вследствие гипоксии и интоксикации. Снижает выраженность и длительность вестибулярного нистагма. Проникает через гематоэнцефалический и плацентарный барьеры удаляется при гемодиализе. Объем распределения составляет 06 л/кг. При исследовании на животных пирацетам избирательно накапливается в тканях коры головного мозга преимущественно в лобных теменных и затылочных долях в мозжечке и базальных ядрах. Не связывается с белками плазмы крови не метаболизируется в организме и выделяется почками в неизменном виде путем почечной фильтрации. Почечный клиренс пирацетама у здоровых добровольцев составляет 86 мл/мин. Период полувыведения препарата из плазмы крови составляет 4-5 часов из спинномозговой жидкости - 85 часов период полувыведения удлиняется при почечной недостаточности (при терминальной хронической почечной недостаточности - до 59 ч). 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