В составе комплексной терапии мышечной дистрофии и атрофии; для купирования пароксизмов наджелудочковой тахикардии; при спазмах периферических сосудов (перемежающаяся хромота, болезнь Рейно, облитерирующий тромбангиит).
При центральных, периферических и смешанных формах наследственной пигментной дегенерации сетчатки.
Противопоказания
Индивидуальная повышенная чувствительность к препарату,
1 мл раствора для внутривенного введения содержит:
действующее вещество:
аденозинтрифосфорной кислоты 10 мг.
вспомогательные вещества:
раствор натрия гидроксида 2 М (до рН 7,0-7,3),
вода для инъекций.
Фармакологические свойства
Натрия аденозинтрифасфат (АТФ) - метаболическое средство, обладает антиаритмическим эффектом, оказывает также гипотензивное действие, расширяет коронарные и мозговые артерии. Является естественным макроэргическим соединением. Образуется в организме в результате окислительных реакций и в процессе гликолитического расщепления углеводов. Содержится во многих органах и тканях, но более всего - в скелетной мускулатуре. Улучшает метаболизм и энергообеспечение тканей.
Благодаря своему расщеплению на АДФ и неорганический фосфат, АТФ высвобождает большое количество энергии, используемой для сокращения мышц, синтеза белка, мочевины, промежуточных продуктов обмена и др.
Под влиянием АТФ происходит снижение артериального давления и расслабление гладкой мускулатуры, улучшается проведение нервных импульсов в вегетативных ганглиях и передача возбуждения с блуждающего нерва на сердце, повышается сократимость миокарда. После парентерального введения проникает в клетки органов, где расщепляется на аденозин и неорганический фосфат с высвобождением энергии.
В дальнейшем продукты расщепления включаются в ресинтез АТФ. Антиаритмическое действие обусловлено образующимся при распаде АТФ аденозином, подавляющим автоматизм синусно-предсердного узла и волокон Пуркинье (блокада кальциевых каналов и увеличение проницаемости для ионов калия).
Показания к применению
В составе комплексной терапии мышечной дистрофии и атрофии; для купирования пароксизмов наджелудочковой тахикардии; при спазмах периферических сосудов (перемежающаяся хромота, болезнь Рейно, облитерирующий тромбангиит).
При центральных, периферических и смешанных формах наследственной пигментной дегенерации сетчатки.
Противопоказания
Индивидуальная повышенная чувствительность к препарату,
хронические обструктивные заболевания легких (например, бронхиальная астма);
беременность,
период кормления грудью,
детский возраст.
Способ применения и дозы
Натрия аденозинтрифосфат вводят внутримышечно или внутривенно.
Для лечения мышечных дистрофий, нарушений периферического кровообращения в первые 2-3 дня назначают по 1 мл внутримышечно 1 раз в день, в последующие дни – по 1 мл 2 раза в день или сразу 2 мл 1 раз в день. Курс лечения – 30-40 дней. При необходимости курс повторяют через 1-2 месяца.
При наследственной пигментной дегенерации сетчатки вводят по 5 мл внутримышечно 2 раза в день, с интервалом 6-8 часов, ежедневно в течение 15 дней. При необходимости курсы могут быть повторены с интервалом 8-12 месяцев.
Для купирования наджелудочковых тахиаритмий вводят внутривенно 1-2 мл в течение 5-10 секунд (эффект наблюдается через 20-40 секунд). При необходимости повторно вводят ту же дозу через 2-3 минуты.
Побочное действие
Со стороны центральной нервной системы: головная боль, головокружение, кратковременная потеря сознания, ощущение сжатия в голове, фобии.
Со стороны органа зрения: нечеткость зрения.
Со стороны желудочно-кишечного тракта: тошнота, металлический привкус во рту, усиление моторики желудочно-кишечного тракта (при внутривенном введении).
Со стороны сердечно-сосудистой системы: ощущение сердцебиения, ощущение дискомфорта в грудной клетке, тахикардия или брадикардия, артериальная гипотензия, аритмия, нарушение AV-проводимости (атриовентрикулярная блокада), асистолия.
Со стороны опорно-двигательного аппарата: боль в руках, спине, шее.
Со стороны мочевыделительной системы: усиление диуреза.
Со стороны дыхательной системы: одышка, бронхоспазм.
Изменения со стороны кожи и подкожной клетчатки: гиперемия лица, зуд, сыпь на коже.
Нарушения в месте введения: ощущение покалывания.
Аллергические реакции: реакции гиперчувствительности, аллергический дерматит, крапивница, анафилактический шок.
Симптомы: головокружение, артериальная гипотензия, кратковременная потеря сознания, аритмия, атриовентрикулярная блокада II и III степени, асистолия, бронхоспазм, желудочковые нарушения, синусовая брадикардия и тахикардия. Также возможно развитие аллергических реакций.
Лечение. Введение препарата немедленно прекращают и назначают кардиотонические средства. Терапия симптоматическая. Конкурентными антагонистами аденозина являются ксантины (эуфиллин, теофиллин).
Взаимодействие с другими лекарственными средствами
При совместном применении с дипиридамолом усиливается действие дипиридамола, в частности сосудорасширяющих эффект.
Проявляется некоторый антагонизм при совместном применении препарата с производными пурина (кофеин и теофиллин).
Нельзя вводить одновременно с сердечными гликозидами в больших дозах, поскольку усиливается риск развития побочных реакций со стороны сердечно-сосудистой системы.
При одновременном применении с ксантинола никотинатом снижается эффект натрия аденозинтрифосфата.
Карбамазепин может усиливать эффекты аденозина, привести к развитию блокады.
Особые указания
Внутривенное введение препарата, как правило, необходимо проводить в условиях стационара, под медицинским наблюдением, при контроле функции сердца, медленно, после чего желательно измерить артериальное давление.
Условия хранения
В защищенном от света месте, при температуре (5±2)°С.
Хранить в недоступном для детей месте.
Срок годности
2 года.
Условия отпуска
По рецепту.
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После парентерального введения проникает в клетки органов, где расщепляется на аденозин и неорганический фосфат с высвобождением энергии."}},{"type":"paragraph","data":{"text":"В дальнейшем продукты расщепления включаются в ресинтез АТФ. 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