Ларигама Раствор, ампулы, 10 шт, 2 мл, для внутримышечного введения

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мл"}}]},{"id":5,"name":"Описание","slug":"common_description","body":[{"type":"paragraph","data":{"text":"Прозрачная\nжидкость от розовато-красного до красного цвета со специфическим запахом."}}]},{"id":6,"name":"Фармакотерапевтическая группа","slug":"","body":[{"type":"paragraph","data":{"text":"Витамины группы В + прочие препараты."}}]},{"id":7,"name":"Фармакологические свойства","slug":"pharmacologic_effects","body":[{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакодинамика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"Комбинированный поливитаминный препарат. Действие препарата определяется\nсвойствами витаминов, входящими в его состав. Нейротропные витамины группы В оказывают\nблагоприятное воздействие на воспалительные и дегенеративные заболевания\nнервной системы и опорно-двигательного аппарата."}},{"type":"paragraph","data":{"text":"Тиамин (витамин В\u003csub\u003e1\u003c/sub\u003e) играет ключевую роль в процессах\nуглеводного обмена, имеющих решающее значение в обменных процессах нервной\nткани (участвует в проведении нервного импульса), а также в цикле Кребса с\nпоследующим участием в синтезе тиаминпирофосфата (ТПФ) и аденозинтрифосфата\n(АТФ)."}},{"type":"paragraph","data":{"text":"Пиридоксин (витамин В\u003csub\u003e6\u003c/sub\u003e) обладает жизненно важным влиянием на\nобмен белков, углеводов и жиров, необходим для нормального кроветворения,\nфункционирования центральной и периферической нервной системы. Обеспечивает\nсинаптическую передачу, процессы торможения в центральной нервной системе\n(ЦНС), участвует в транспорте сфингозина, входящего в состав оболочки нерва,\nучаствует в синтезе катехоламинов."}},{"type":"paragraph","data":{"text":"Физиологической функцией обоих витаминов (В\u003csub\u003e1\u003c/sub\u003e и В\u003csub\u003e6\u003c/sub\u003e)\nявляется потенцирование действия друг друга, проявляющееся в положительном\nвлиянии на нервную, нейромышечную и сердечно-сосудистую системы."}},{"type":"paragraph","data":{"text":"Цианокобаламин (витамин В\u003csub\u003e12\u003c/sub\u003e) участвует в синтезе нуклеотидов,\nявляется важным фактором роста, кроветворения и развития эпителиальных клеток;\nнеобходим для метаболизма фолиевой кислоты и синтеза миелина."}},{"type":"paragraph","data":{"text":"Лидокаин оказывает местноанестезирующее\nдействие в месте инъекции, расширяет сосуды, способствуя всасыванию витаминов.\nМестноанестезирующее действие лидокаина обусловлено блокадой потенциалзависимых\nнатриевых каналов, что препятствует генерации импульсов по нервным волокнам."}},{"type":"paragraph","data":{"text":"\u003cb\u003e\u003ci\u003eФармакокинетика\u003c/i\u003e\u003c/b\u003e"}},{"type":"paragraph","data":{"text":"\u003ci\u003eТиамин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"После внутримышечного введения\nтиамин быстро абсорбируется из места инъекции и поступает в кровь (484 нг/мл\nчерез 15 мин в первый день введения дозы в 50 мг) и неравномерно распределяется\nв организме при содержании его в лейкоцитах 15 %, эритроцитах 75 % и в плазме\nкрови 10 %. В связи с отсутствием значительных запасов витамина в организме, он\nдолжен поступать в организм ежедневно. Тиамин проникает через\nгематоэнцефалический и плацентарный барьеры и обнаруживается в грудном молоке.\nТиамин выводится с мочой в альфа-фазе через 0,15 часа, в бета-фазе – через 1\nчас, в конечной (терминальной) фазе – в течение 2 дней. Основными метаболитами являются:\nтиаминкарбоновая кислота, пирамин и некоторые неизвестные метаболиты. Из всех\nвитаминов тиамин сохраняется в организме в наименьших количествах. Организм\nвзрослого человека содержит около 30 мг тиамина в виде 80 % тиаминпирофосфата,\n10 % тиаминтрифосфата и остальное количество в виде тиаминмонофосфата."}},{"type":"paragraph","data":{"text":"\u003ci\u003eПиридоксин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"После внутримышечной инъекции\nпиридоксин быстро абсорбируется из места инъекции и распределяется в организме,\nвыполняя роль кофермента после фосфорилирования СН\u003csub\u003e2\u003c/sub\u003eОН-группы в 5-м\nположении. Около 80 % витамина связывается с белками плазмы крови. Пиридоксин\nраспределяется по всему организму, проникает через плаценту,  обнаруживается в грудном молоке. Накапливается\nв печени и окисляется до                                4-пиридоксиновой\nкислоты, которая выводится почками максимум через 2-5 часов после абсорбции. В\nорганизме человека содержится 40-150 мг витамина В\u003csub\u003e6\u003c/sub\u003e и его ежедневная\nскорость элиминации около 1,7-3,6 мг при скорости восполнения 2,2-2,4 %. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eЦианокобаламин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Цианокобаламин после внутримышечного\nвведения связывается с транскобаламинами I и II, переносится в различные ткани\nорганизма. Максимальная концентрация после внутримышечного введения достигается\nчерез 1 час. Связь с белками плазмы крови –       90 %. Проникает через плацентарный\nбарьер, обнаруживается в грудном молоке. Метаболизируется преимущественно в\nпечени с образованием аденозилкобаламина, являющегося активной формой цианокобаламина.\nДепонируется в печени, с желчью поступает в кишечник и вновь абсорбируется в\nкровь (феномен энтерогепатической рециркуляции). Период полувыведения\nдлительный, выводится преимущественно почками (7-10 %) и через кишечник (50 %).\nПри снижении функции почек выводится почками – 0-7 % и через кишечник – 70-100\n%. "}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛидокаин\u003csub\u003e\u003c/sub\u003e\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При\nвнутримышечном введении максимальная плазменная концентрация лидокаина\nотмечается спустя 5-15 минут после инъекции. В зависимости от дозы порядка\n60-80 % лидокаина связывается с белками плазмы. Быстро распределяется (в\nтечение 6-9 минут) в органах и тканях с хорошей перфузией, в т.ч. в сердце,\nлегких, печени, почках, затем в мышечной и жировой ткани. Проникает через\nгематоэнцефалический и плацентарный барьеры, обнаруживается в грудным молоке\n(до 40 % от концентрации в плазме крови  матери). Метаболизируется в печени при участии\nмикросомальных ферментов с образованием активных метаболитов –\nмоноэтилглицинксилидида и глицинксилидида, имеющих период полувыведения 2 ч и\n10 ч соответственно. Интенсивность метаболизма снижается при заболеваниях\nпечени. Экскретируется преимущественно в виде метаболитов почками и до 10 % в\nнеизменном виде."}}]},{"id":8,"name":"Показания к применению","slug":"indications","body":[{"type":"header","data":{"text":"В комплексной терапии:","level":4}},{"type":"paragraph","data":{"text":"-   моно-\nи полинейропатий различного генеза;"}},{"type":"paragraph","data":{"text":"-   дорсалгии;"}},{"type":"paragraph","data":{"text":"-   плексопатий;"}},{"type":"paragraph","data":{"text":"-   люмбоишиалгии;"}},{"type":"paragraph","data":{"text":"-   корешкового\nсиндрома, вызванного дегенеративными изменениями позвоночника."}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"-   повышенная\nчувствительность к компонентам препарата;"}},{"type":"paragraph","data":{"text":"-   острая\nсердечная недостаточность, хроническая сердечная недостаточность в стадии декомпенсации;"}},{"type":"paragraph","data":{"text":"-   детский\nвозраст до 18 лет (эффективность и безопасность не установлены);"}},{"type":"paragraph","data":{"text":"-   период\nбеременности и грудного вскармливания."}}]},{"id":11,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","body":[{"type":"paragraph","data":{"text":"Применение препарата противопоказано\nв период беременности и грудного вскармливания."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Инъекции выполняют глубоко\nвнутримышечно (см. раздел «Особые указания»)."}},{"type":"paragraph","data":{"text":"В случаях выраженного болевого\nсиндрома лечение целесообразно начинать с внутримышечного введения (глубоко) по\n2 мл ежедневно в течение 5-10 дней с переходом в дальнейшем либо на прием\nвнутрь, либо на более редкие инъекции (2-3 раза в неделю в течение 2-3 недель)\nс возможным продолжением терапии лекарственной формой для приема внутрь."}},{"type":"paragraph","data":{"text":"Необходим еженедельный контроль\nтерапии со стороны врача. Продолжительность лечения определяется врачом\nиндивидуально в зависимости от выраженности симптомов заболевания."}},{"type":"paragraph","data":{"text":"Переход на терапию лекарственной\nформой для приема внутрь рекомендуется осуществлять в наиболее возможный\nкороткий срок."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"По данным Всемирной организации\nздравоохранения нежелательные эффекты классифицированы в соответствии с их\nчастотой развития следующим образом: очень часто (≥ 10 % назначений); часто (≥\n1 % и < 10 %); нечасто (≥ 0,1 % и < 1 %); редко          (≥ 0,01 % и < 0,1 %); очень редко\n(< 0,01 %); частота неизвестна (недостаточно данных для оценки частоты\nразвития). "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны иммунной системы: редко –\u003c/i\u003e аллергические реакции (кожная сыпь, затрудненное дыхание,\nанафилактический шок, отек Квинке). "}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны нервной системы: частота неизвестна –\u003c/i\u003e головокружение, спутанность\nсознания."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны сердечно-сосудистой системы: очень редко –\u003c/i\u003e тахикардия; \u003ci\u003eчастота неизвестна – \u003c/i\u003eбрадикардия, аритмия."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны желудочно-кишечного тракта: частота неизвестна – \u003c/i\u003eрвота."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны кожи и подкожных тканей: очень редко – \u003c/i\u003eповышенное потоотделение, акне, зуд,\nкрапивница."}},{"type":"paragraph","data":{"text":"\u003ci\u003eСо стороны костно-мышечной и соединительной ткани: частота неизвестна – \u003c/i\u003eсудороги."}},{"type":"paragraph","data":{"text":"\u003ci\u003eОбщие расстройства и нарушения в месте введения: частота неизвестна –\u003c/i\u003e может возникнуть раздражение в месте\nвведения препарата; системные реакции возможны при быстром введении или при\nпередозировке."}},{"type":"paragraph","data":{"text":"При быстром введении (например,\nвследствие непреднамеренного внутрисосудистого введения или введения в ткани с\nбогатым кровоснабжением) или при превышении дозы могут развиваться системные\nреакции, включающие спутанность сознания, рвоту, брадикардию, аритмию,\nголовокружение и судороги."}},{"type":"paragraph","data":{"text":"Если любые из указанных в инструкции\nпобочных эффектов усугубляются, или Вы заметили любые другие побочные эффекты,\nне указанные в инструкции, \u003cb\u003eсообщите об\nэтом врачу\u003c/b\u003e."}}]},{"id":14,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eСимптомы:\u003c/i\u003e\nрвота, брадикардия, аритмия, возможны системные реакции, включающие\nголовокружение, спутанность сознания, судороги."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛечение:\u003c/i\u003e в\nслучае появления симптомов передозировки лечение препаратом следует отменить,\nпри необходимости назначить симптоматическую терапию. "}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"\u003ci\u003eВитамины группы В\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"Витамин В\u003csub\u003e1\u003c/sub\u003e (тиамин)\nполностью распадается в растворах, содержащих сульфиты. И как следствие,\nпродукты распада тиамина инактивируют действия других витаминов. Тиамин\nнесовместим с окисляющими и восстанавливающими соединениями, в том числе:\nхлоридом ртути, йодидом, карбонатом, ацетатом, таниновой кислотой,\nжелезо-аммоний цитратом, а также фенобарбиталом, рибофлавином,\nбензилпенициллином, декстрозой и метабисульфитом. Медь ускоряет разрушение\nтиамина; кроме того, тиамин утрачивает свою эффективность при увеличении\nзначений рН (более 3)."}},{"type":"paragraph","data":{"text":"Терапевтические дозы витамина В\u003csub\u003e6\u003c/sub\u003e\n(пиридоксин) ослабляют эффект леводопы (уменьшается ее противопаркинсоническое\nдействие) при одновременном применении. Также наблюдается взаимодействие с\nциклосерином, пеницилламином, изониазидом."}},{"type":"paragraph","data":{"text":"Витамин В\u003csub\u003e12\u003c/sub\u003e\n(цианокобаламин) несовместим с аскорбиновой кислотой, солями тяжелых металлов."}},{"type":"paragraph","data":{"text":"\u003ci\u003eЛидокаин\u003c/i\u003e"}},{"type":"paragraph","data":{"text":"При парентеральном применении\nлидокаина, в случае дополнительного использования норэпинефрина и эпинефрина,\nвозможно усиление нежелательных реакций на сердце. Также наблюдается\nвзаимодействие с сульфониламидами. В случае передозировки местноанестезирующих\nсредств нельзя дополнительно применять эпинефрин или норэпинефрин."}}]},{"id":16,"name":"Особые указания","slug":"","body":[{"type":"paragraph","data":{"text":"Препарат необходимо вводить только внутримышечно,\nне допуская его попадания в сосудистое русло. При случайном внутривенном\nвведении пациент должен находиться под наблюдением врача или быть\nгоспитализирован в зависимости от тяжести возникших симптомов."}},{"type":"paragraph","data":{"text":"Препарат может вызывать нейропатии при\nдлительности применения свыше 6 месяцев."}}]},{"id":17,"name":"Влияние на способность управлять автомобилем и движущимися механизмами","slug":"","body":[{"type":"paragraph","data":{"text":"Информация о влиянии препарата на\nспособность управлять транспортными средствами, а также на выполнение\nпотенциально опасных видов деятельности, требующих повышенной концентрации\nвнимания и быстроты психомоторных реакций, отсутствует. Однако рекомендуется\nсоблюдать осторожность, учитывая возможность развития нежелательных реакций\nпрепарата."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для внутримышечного введения."}},{"type":"paragraph","data":{"text":"По 2 мл в\nампулы из окрашенного стекла. "}},{"type":"paragraph","data":{"text":"По 5 или 10\nампул в контурной ячейковой упаковке из пленки\nполивинилхлоридной или\nполиэтилентерефталатной с пленкой полимерной\nили с фольгой алюминиевой лакированной, или без пленки полимерной и фольги\nалюминиевой лакированной, или в форме из картона с ячейками для укладки ампул. "}},{"type":"paragraph","data":{"text":"По 1 контурной ячейковой упаковке или форме из\nкартона с 5 или 10 ампулами, или по 2 или 5 контурных ячейковых упаковок или\nформ из картона с 5 ампулами вместе с\nинструкцией по применению и скарификатором ампульным, или без скарификатора\nампульного в пачке из картона."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Хранить при температуре\nот 2 до 8 °С."}},{"type":"paragraph","data":{"text":"Хранить в недоступном для детей\nместе. "}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"3 года. "}},{"type":"paragraph","data":{"text":"Не применять после окончания\nсрока годности!"}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"Отпускают по\nрецепту."}}]},{"id":22,"name":"Производитель","slug":"","body":[{"type":"paragraph","data":{"text":"ООО «Гротекс»"}},{"type":"paragraph","data":{"text":"Россия, 195279, Санкт-Петербург"}},{"type":"paragraph","data":{"text":"Индустриальный пр., д. 71, к. 2, лит. А"}},{"type":"paragraph","data":{"text":"Тел.: +7 812 385 47 87"}},{"type":"paragraph","data":{"text":"Факс: +7 812 385 47 88"}},{"type":"paragraph","data":{"text":"\u003ca href=\"http://www.solopharm.com\"\u003ewww.solopharm.com\u003c/a\u003e"}},{"type":"paragraph","data":{"text":"www.larigama.ru"}}]}],"source":null},"description_toggle":false,"short_description":"ФармакодинамикаКомбинированный поливитаминный препарат. Действие препарата определяется свойствами витаминов, входящими в его состав. Нейротропные витамины группы В оказывают благоприятное воздействие на воспалительные и дегенеративные заболевания нервной системы и опорно-двигательного аппарата. Тиамин (витамин В1) играет ключевую роль в процессах углеводного обмена, имеющих решающее значение в обменных процессах нервной ткани (участвует в проведении нервного импульса), а также в цикле Кребса с последующим участием в синтезе тиаминпирофосфата (ТПФ) и аденозинтрифосфата (АТФ). Пиридоксин (витамин В6) обладает жизненно важным влиянием на обмен белков, углеводов и жиров, необходим для нормального кроветворения, функционирования центральной и периферической нервной системы. Обеспечивает синаптическую передачу, процессы торможения в центральной нервной системе (ЦНС), участвует в транспорте сфингозина, входящего в состав оболочки нерва, участвует в синтезе катехоламинов. Физиологической функцией обоих витаминов (В1и В6) является потенцирование действия друг друга, проявляющееся в положительном влиянии на нервную, нейромышечную и сердечно-сосудистую системы. Цианокобаламин (витамин В12) участвует в синтезе нуклеотидов, является важным фактором роста, кроветворения и развития эпителиальных клеток; необходим для метаболизма фолиевой кислоты и синтеза миелина. Лидокаин оказывает местноанестезирующее действие в месте инъекции, расширяет сосуды, способствуя всасыванию витаминов. Местноанестезирующее действие лидокаина обусловлено блокадой потенциалзависимых натриевых каналов, что препятствует генерации импульсов по нервным волокнам.ФармакокинетикаТиаминПосле внутримышечного введения тиамин быстро абсорбируется из места инъекции и поступает в кровь (484 нг/мл через 15 мин в первый день введения дозы в 50 мг) и неравномерно распределяется в организме при содержании его в лейкоцитах 15 %, эритроцитах 75 % и в плазме крови 10 %. В связи с отсутствием значительных запасов витамина в организме, он должен поступать в организм ежедневно. Тиамин проникает через гематоэнцефалический и плацентарный барьеры и обнаруживается в грудном молоке. Тиамин выводится с мочой в альфа-фазе через 0,15 часа, в бета-фазе – через 1 час, в конечной (терминальной) фазе – в течение 2 дней. Основными метаболитами являются: тиаминкарбоновая кислота, пирамин и некоторые неизвестные метаболиты. Из всех витаминов тиамин сохраняется в организме в наименьших количествах. Организм взрослого человека содержит около 30 мг тиамина в виде 80 % тиаминпирофосфата, 10 % тиаминтрифосфата и остальное количество в виде тиаминмонофосфата.ПиридоксинПосле внутримышечной инъекции пиридоксин быстро абсорбируется из места инъекции и распределяется в организме, выполняя роль кофермента после фосфорилирования СН2ОН-группы в 5-м положении. Около 80 % витамина связывается с белками плазмы крови. Пиридоксин распределяется по всему организму, проникает через плаценту, обнаруживается в грудном молоке. Накапливается в печени и окисляется до 4-пиридоксиновой кислоты, которая выводится почками максимум через 2-5 часов после абсорбции. В организме человека содержится 40-150 мг витамина В6и его ежедневная скорость элиминации около 1,7-3,6 мг при скорости восполнения 2,2-2,4 %.ЦианокобаламинЦианокобаламин после внутримышечного введения связывается с транскобаламинами I и II, переносится в различные ткани организма. Максимальная концентрация после внутримышечного введения достигается через 1 час. Связь с белками плазмы крови – 90 %. Проникает через плацентарный барьер, обнаруживается в грудном молоке. Метаболизируется преимущественно в печени с образованием аденозилкобаламина, являющегося активной формой цианокобаламина. Депонируется в печени, с желчью поступает в кишечник и вновь абсорбируется в кровь (феномен энтерогепатической рециркуляции). 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