Добавление фосфокреатина в кардиоплегические растворы в конц... Инструкция
Показания к применению
Неотон применяется в составе комбинированной терапии следующих заболеваний:
• острого инфаркта миокарда;
• хронической сердечной недостаточности;
• интраоперационной ишемии миокарда;
• интраоперационной ишемии нижних конечностей,
а также в спортивной медицине для профилактики развития синдрома острого и хронического
физического перенапряжения и улучшения адаптации спортсменов к...
• повышенная чувствительность к препарату;
• хроническая почечная недостаточность (при применении препарата в дозах 5 – 10 г/день);
• возраст до 18 лет (эффективность и безопасность не установлены).
Активное вещество: фосфокреатина натрия тетрагидрат 1 г.
Описание
Фосфокреатин играет важную роль в энергетическом механизме мышечного сокращения. Он
является резервом энергии в клетках миокарда и скелетных мышц и используется для повторного
синтеза аденозинтрифосфорной кислоты (АТФ), при гидролизе которой высвобождается энергия
для обеспечения процесса сокращения актомиозина.
Недостаточное поступление энергии в кардиомиоциты, связанное с замедлением окислительных
процессов, - это ключевой механизм развития и прогрессирования повреждения миокарда.
Недостаток фосфокреатина приводит к снижению силы сокращения миокарда и способности его к
функциональному восстановлению. При повреждении миокарда существует тесная корреляция
между количеством богатых энергией фосфорилированных соединений в клетках,
жизнеспособностью клеток и их способностью восстанавливать сократительную способность.
Доклинические и клинические исследования позволили продемонстрировать кардиопротективное
влияние фосфокреатина, что проявляется в дозозависимом положительном эффекте при
токсическом воздействии на миокард изопреналина, тироксина, эметина, п-нитрофенола; в
положительном инотропном действии при дефиците глюкозы, ионов кальция или при
передозировке ионов калия; в снижении отрицательного инотропного действия, обусловленного
аноксией.
Фармакологические свойства
Добавление фосфокреатина в кардиоплегические растворы в концентрации
10 ммоль/л улучшает кардиопротективный эффект:
• снижается риск развития ишемии миокарда при кардиопульмональном обходном
шунтировании;
• снижается риск развития реперфузионной аритмии при инфузионном введении до развития
экспериментальной регионарной ишемии в результате наложения лигатуры на переднюю
нисходящую ветвь левой коронарной артерии на 15 мин;
• снижает деградацию АТФ и фосфокреатина в клетках миокарда, сохраняет структуру
митохондрий и сарколеммы, улучшает процесс функционального восстановления миокарда после
остановки сердца, вызванной введением большой дозы калия, и снижает частоту реперфузионной
аритмии.
Фосфокреатин оказывает кардиопротективное действие в эксперименте при инфаркте миокарда и
аритмии, вызванных окклюзией коронарной артерии: сохраняет клеточный пул адениннуклеотидов
за счет ингибирования ферментов, обусловливающих их катаболизм, подавляет деградацию
фосфолипидов, возможно, улучшает микроциркуляцию в зоне ишемии, что, обусловлено
подавлением опосредованной аденозиндифосфорной кислотой агрегации тромбоцитов,
стабилизирует гемодинамические показатели, предотвращает резкое снижение функциональных
показателей сердца, оказывает антиаритмическое действие, снижает частоту и длительность
фибрилляции желудочков и ограничивает зону инфаркта миокарда.
Показания к применению
Неотон применяется в составе комбинированной терапии следующих заболеваний:
• острого инфаркта миокарда;
• хронической сердечной недостаточности;
• интраоперационной ишемии миокарда;
• интраоперационной ишемии нижних конечностей,
а также в спортивной медицине для профилактики развития синдрома острого и хронического
физического перенапряжения и улучшения адаптации спортсменов к экстремальным физическим
нагрузкам
Противопоказания
• повышенная чувствительность к препарату;
• хроническая почечная недостаточность (при применении препарата в дозах 5 – 10 г/день);
• возраст до 18 лет (эффективность и безопасность не установлены).
Применение при беременности и в период грудного вскармливания
Клинических данных о применении Неотона при беременности нет. Однако исследования на
животных не показали токсического действия препарата на фертильность крыс и эмбриофетальное
развитие кроликов. Неотон можно применять при беременности только тогда, когда польза для
матери превышает потенциальный риск для плода.
При необходимости применения препарата в период лактации, грудное вскармливание необходимо
прекратить.
Способ применения и дозы
ТОЛЬКО ВНУТРИВЕННО (капельно или в виде быстрой инфузии)
Острый инфаркт миокарда
1 сутки: 2-4 г препарата, разведенного в 50 мл воды для инъекций, в виде в/в быстрой инфузии с
последующей в/в инфузией 8-16 г в 200 мл 5% раствора декстрозы (глюкозы) в течение 2 ч.
2 сутки: 2-4 г в 50 мл воды для инъекций в/в капельно (длительность инфузии не менее 30 минут) 2
раза/сут.
3 сутки: 2 г в 50 мл воды для инъекций в/в капельно (длительность инфузии не менее 30 минут) 2
раза/сут. При необходимости курс инфузий по 2 г препарата 2 раза/сут. можно проводить в течение
6 дней.
Хроническая сердечная недостаточность
В зависимости от состояния пациента можно начать лечение «ударными» дозами по 5-10 г
препарата в 200 мл 5% раствора декстрозы (глюкозы) в/в капельно со скоростью 4-5 г/ч в течение
3-5 дней, а затем перейти на в/в капельное введение (длительность инфузии не менее 30 минут) 1-
2 г препарата, разведенного в 50 мл воды для инъекций, 2 раза/сут. в течение 2-6 недель или сразу
начать в/в капельное введение поддерживающих доз препарата Неотон (1-2 г в 50 мл воды для
инъекций 2 раза/сут. в течение 2-6 недель).
Интраоперационная ишемия миокарда
Рекомендуется курс в/в капельных инфузий длительностью не менее 30 минут по 2 г
препарата в 50 мл воды для инъекций 2 раза/сут. в течение 3-5 дней, предшествующих
хирургическому вмешательству, и в течение 1-2 дней после него. Во время хирургического
вмешательства препарат Неотон добавляют в состав обычного кардиоплегического раствора в
концентрации 10 ммоль/л или 2,5 г/л непосредственно перед введением.
Интраоперационная ишемия нижних конечностей
2-4 г препарата Неотон в 50 мл воды для инъекций в виде в/в быстрой инфузии до хирургического
вмешательства с последующим в/в капельным введением 8-10 г препарата в 200 мл 5% раствора
декстрозы (глюкозы) со скоростью 4-5 г/ч во время хирургического вмешательства и в период
реперфузии.
В спортивной медицине для профилактики развития синдрома острого и хронического физического
перенапряжения и улучшения адаптации спортсменов к экстремальным физическим нагрузкам
препарат Неотон следует применять в дозе 1 г/сут в 50 мл воды для инъекций в/в капельно
(длительность инфузии не менее 30 минут) в течение 3-4 недель.
Побочное действие
Повышенная чувствительность к препарату, снижение артериального давления (при быстром
внутривенном введении).
Передозировка
В настоящее время о случаях передозировки препарата Неотон не сообщалось.
Взаимодействие с другими лекарственными средствами
При применении в составе комбинированной терапии препарат Неотон способствует повышению
эффективности антиаритмических, антиангинальных средств и средств с положительным
инотропным действием. Неотон сохраняет стабильность в воде для инъекций, растворе 5%
декстрозы (глюкозы) и в кардиоплегических растворах.
Особые указания
Препарат следует вводить в максимально короткие сроки с момента появления признаков ишемии,
что обеспечивает более благоприятный прогноз заболевания. Применение препарата Неотон в высоких
дозах (5-10 г/сут) сопровождается повышенным захватом фосфатов в почках, что влияет на обмен кальция,
секрецию гормонов, регулирующих гомеостаз, функцию почек и обмен пуринов, поэтому не
рекомендуется длительное применение препарата Неотон в высоких дозах.
Условия хранения
3 года.
Не использовать после истечения срока годности, указанного на упаковке.
Срок годности
Хранить при температуре не выше 30º С.
Хранить в недоступном для детей месте.
Условия отпуска
По рецепту.
Для описания товара использована информация от партнера 36.6
Мобильное приложение «Все аптеки»
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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вещество: фосфокреатина натрия тетрагидрат 1 г."}}]},{"id":2,"name":"Описание","slug":"common_description","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Фосфокреатин играет важную роль в энергетическом механизме мышечного сокращения. Он\nявляется резервом энергии в клетках миокарда и скелетных мышц и используется для повторного\nсинтеза аденозинтрифосфорной кислоты (АТФ), при гидролизе которой высвобождается энергия\nдля обеспечения процесса сокращения актомиозина.\u003cbr /\u003e\nНедостаточное поступление энергии в кардиомиоциты, связанное с замедлением окислительных\nпроцессов, - это ключевой механизм развития и прогрессирования повреждения миокарда.\u003cbr /\u003e\nНедостаток фосфокреатина приводит к снижению силы сокращения миокарда и способности его к\nфункциональному восстановлению. При повреждении миокарда существует тесная корреляция\nмежду количеством богатых энергией фосфорилированных соединений в клетках,\nжизнеспособностью клеток и их способностью восстанавливать сократительную способность.\nДоклинические и клинические исследования позволили продемонстрировать кардиопротективное\nвлияние фосфокреатина, что проявляется в дозозависимом положительном эффекте при\nтоксическом воздействии на миокард изопреналина, тироксина, эметина, п-нитрофенола; в\nположительном инотропном действии при дефиците глюкозы, ионов кальция или при\nпередозировке ионов калия; в снижении отрицательного инотропного действия, обусловленного\nаноксией."}}]},{"id":3,"name":"Фармакологические свойства","slug":"pharmacologic_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Добавление фосфокреатина в кардиоплегические растворы в концентрации\n10 ммоль/л улучшает кардиопротективный эффект:\u003cbr /\u003e\n• снижается риск развития ишемии миокарда при кардиопульмональном обходном\nшунтировании;\u003cbr /\u003e\n• снижается риск развития реперфузионной аритмии при инфузионном введении до развития\nэкспериментальной регионарной ишемии в результате наложения лигатуры на переднюю\nнисходящую ветвь левой коронарной артерии на 15 мин;\u003cbr /\u003e\n• снижает деградацию АТФ и фосфокреатина в клетках миокарда, сохраняет структуру\nмитохондрий и сарколеммы, улучшает процесс функционального восстановления миокарда после\nостановки сердца, вызванной введением большой дозы калия, и снижает частоту реперфузионной\nаритмии.\u003cbr /\u003e\nФосфокреатин оказывает кардиопротективное действие в эксперименте при инфаркте миокарда и\nаритмии, вызванных окклюзией коронарной артерии: сохраняет клеточный пул адениннуклеотидов\nза счет ингибирования ферментов, обусловливающих их катаболизм, подавляет деградацию\nфосфолипидов, возможно, улучшает микроциркуляцию в зоне ишемии, что, обусловлено\nподавлением опосредованной аденозиндифосфорной кислотой агрегации тромбоцитов,\nстабилизирует гемодинамические показатели, предотвращает резкое снижение функциональных\nпоказателей сердца, оказывает антиаритмическое действие, снижает частоту и длительность\nфибрилляции желудочков и ограничивает зону инфаркта миокарда."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Неотон применяется в составе комбинированной терапии следующих заболеваний:\u003cbr /\u003e\n• острого инфаркта миокарда;\u003cbr /\u003e\n• хронической сердечной недостаточности;\u003cbr /\u003e\n• интраоперационной ишемии миокарда;\u003cbr /\u003e\n• интраоперационной ишемии нижних конечностей,\u003cbr /\u003e\nа также в спортивной медицине для профилактики развития синдрома острого и хронического\nфизического перенапряжения и улучшения адаптации спортсменов к экстремальным физическим\nнагрузкам"}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"• повышенная чувствительность к препарату;\u003cbr /\u003e\n• хроническая почечная недостаточность (при применении препарата в дозах 5 – 10 г/день);\u003cbr /\u003e\n• возраст до 18 лет (эффективность и безопасность не установлены)."}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Клинических данных о применении Неотона при беременности нет. Однако исследования на\nживотных не показали токсического действия препарата на фертильность крыс и эмбриофетальное\nразвитие кроликов. Неотон можно применять при беременности только тогда, когда польза для\nматери превышает потенциальный риск для плода.\u003cbr /\u003e\nПри необходимости применения препарата в период лактации, грудное вскармливание необходимо\nпрекратить."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"ТОЛЬКО ВНУТРИВЕННО (капельно или в виде быстрой инфузии)\u003cbr /\u003e\nОстрый инфаркт миокарда\u003cbr /\u003e\n1 сутки: 2-4 г препарата, разведенного в 50 мл воды для инъекций, в виде в/в быстрой инфузии с\nпоследующей в/в инфузией 8-16 г в 200 мл 5% раствора декстрозы (глюкозы) в течение 2 ч.\u003cbr /\u003e\n2 сутки: 2-4 г в 50 мл воды для инъекций в/в капельно (длительность инфузии не менее 30 минут) 2\nраза/сут.\u003cbr /\u003e\n3 сутки: 2 г в 50 мл воды для инъекций в/в капельно (длительность инфузии не менее 30 минут) 2\nраза/сут. При необходимости курс инфузий по 2 г препарата 2 раза/сут. можно проводить в течение\n6 дней.\u003cbr /\u003e\nХроническая сердечная недостаточность\u003cbr /\u003e\nВ зависимости от состояния пациента можно начать лечение «ударными» дозами по 5-10 г\nпрепарата в 200 мл 5% раствора декстрозы (глюкозы) в/в капельно со скоростью 4-5 г/ч в течение\n3-5 дней, а затем перейти на в/в капельное введение (длительность инфузии не менее 30 минут) 1-\n2 г препарата, разведенного в 50 мл воды для инъекций, 2 раза/сут. в течение 2-6 недель или сразу\nначать в/в капельное введение поддерживающих доз препарата Неотон (1-2 г в 50 мл воды для\nинъекций 2 раза/сут. в течение 2-6 недель).\u003cbr /\u003e\nИнтраоперационная ишемия миокарда\u003cbr /\u003e\nРекомендуется курс в/в капельных инфузий длительностью не менее 30 минут по 2 г\nпрепарата в 50 мл воды для инъекций 2 раза/сут. в течение 3-5 дней, предшествующих\nхирургическому вмешательству, и в течение 1-2 дней после него. Во время хирургического\nвмешательства препарат Неотон добавляют в состав обычного кардиоплегического раствора в\nконцентрации 10 ммоль/л или 2,5 г/л непосредственно перед введением.\u003cbr /\u003e\nИнтраоперационная ишемия нижних конечностей\u003cbr /\u003e\n2-4 г препарата Неотон в 50 мл воды для инъекций в виде в/в быстрой инфузии до хирургического\nвмешательства с последующим в/в капельным введением 8-10 г препарата в 200 мл 5% раствора\nдекстрозы (глюкозы) со скоростью 4-5 г/ч во время хирургического вмешательства и в период\nреперфузии.\u003cbr /\u003e\nВ спортивной медицине для профилактики развития синдрома острого и хронического физического\nперенапряжения и улучшения адаптации спортсменов к экстремальным физическим нагрузкам\nпрепарат Неотон следует применять в дозе 1 г/сут в 50 мл воды для инъекций в/в капельно\n(длительность инфузии не менее 30 минут) в течение 3-4 недель."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Повышенная чувствительность к препарату, снижение артериального давления (при быстром\nвнутривенном введении)."}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"В настоящее время о случаях передозировки препарата Неотон не сообщалось."}}]},{"id":10,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"При применении в составе комбинированной терапии препарат Неотон способствует повышению\nэффективности антиаритмических, антиангинальных средств и средств с положительным\nинотропным действием. Неотон сохраняет стабильность в воде для инъекций, растворе 5%\nдекстрозы (глюкозы) и в кардиоплегических растворах."}}]},{"id":11,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат следует вводить в максимально короткие сроки с момента появления признаков ишемии,\nчто обеспечивает более благоприятный прогноз заболевания. Применение препарата Неотон в высоких\nдозах (5-10 г/сут) сопровождается повышенным захватом фосфатов в почках, что влияет на обмен кальция,\nсекрецию гормонов, регулирующих гомеостаз, функцию почек и обмен пуринов, поэтому не\nрекомендуется длительное применение препарата Неотон в высоких дозах."}}]},{"id":12,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"3 года.\u003cbr /\u003e\nНе использовать после истечения срока годности, указанного на упаковке."}}]},{"id":13,"name":"Срок годности","slug":"expiry_date","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Хранить при температуре не выше 30º С.\u003cbr /\u003e\nХранить в недоступном для детей месте."}}]},{"id":14,"name":"Условия отпуска","slug":"release_condition","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"По рецепту."}}]}],"source":null},"description_toggle":false,"short_description":"Добавление фосфокреатина в кардиоплегические растворы в концентрации 10 ммоль/л улучшает кардиопротективный эффект: • снижается риск развития ишемии миокарда при кардиопульмональном обходном шунтировании; • снижается риск развития реперфузионной аритмии при инфузионном введении до развития экспериментальной регионарной ишемии в результате наложения лигатуры на переднюю нисходящую ветвь левой коронарной артерии на 15 мин; • снижает деградацию АТФ и фосфокреатина в клетках миокарда, сохраняет структуру митохондрий и сарколеммы, улучшает процесс функционального восстановления миокарда после остановки сердца, вызванной введением большой дозы калия, и снижает частоту реперфузионной аритмии. 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