Но-шпа Раствор, ампулы, 25 шт, 2 мл, 20 мг/мл, для внутривенного и внутримышечного введения

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Поэтому эффективность дротаверина зависит от концентраций ФДЭ-4 в\nтканях, содержание которой в разных тканях различается. ФДЭ-4 наиболее важна для\nподавления сократительной активности гладкой мускулатуры, в связи с чем селективное\nингибирование ФДЭ-4 может быть полезным для лечения гиперкинетических дискинезий\nи различных заболеваний, сопровождающихся спастическим состоянием желудочнокишечного тракта.\nГидролиз ц-АМФ в миокарде и гладкой мускулатуре сосудов происходит главным\nобразом с помощью изоэнзима ФДЭ-3, чем объясняется тот факт, что при высокой\nспазмолитической активности у дротаверина отсутствуют серьезные побочные эффекты\nсо стороны сердца и сосудов и выраженные эффекты в отношении сердечно-сосудистой\nсистемы.\u003cbr /\u003e\nДротаверин эффективен при спазмах гладкой мускулатуры как нейрогенного, так и\nмышечного происхождения. Независимо от типа вегетативной иннервации, дротаверин\nрасслабляюще действует на гладкую мускулатуру желудочно-кишечного тракта,\nжелчевыводящих путей, мочеполовой системы."}}]},{"id":4,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"_спазмы гладкой мускулатуры, связанные с заболеваниями желчевыводящих путей:\nхолецистолитиаз, холангиолитиаз, холецистит, перихолецистит, холангит,\nпапиллит.\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["спазмы гладкой мускулатуры мочевыводящих путей: нефролитиаз, уретролитиаз,"]}},{"type":"paragraph","data":{"text":"пиелит, цистит, тенезмы мочевого пузыря.\u003cbr /\u003e\nВ качестве вспомогательной терапии (когда форма таблеток не может быть\nприменена):\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["при спазмах гладкой мускулатуры желудочно-кишечного происхождения: язвенная"]}},{"type":"paragraph","data":{"text":"болезнь желудка и двенадцатиперстной кишки, гастрит, спазмы кардии и\nпривратника, энтерит, колит\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["при гинекологических заболеваниях: дисменорея."]}}]},{"id":5,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к действующему веществу или к любому из вспомогательных\nвеществ препарата.\u003cbr /\u003e\nГиперчувствительность к натрия дисульфиту (смотри раздел «Особые указания»).\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Тяжелая печеночная или почечная недостаточность.\u003cbr /\u003e","Тяжелая хроническая сердечная недостаточность.\u003cbr /\u003e","Детский возраст (применение дротаверина у детей в клинических исследованиях не"]}},{"type":"paragraph","data":{"text":"изучалось).\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["Период кормления грудью.\u003cbr /\u003e"]}},{"type":"paragraph","data":{"text":"С осторожностью:\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["При артериальной гипотензии (опасность коллапса, смотри раздел «Особые"]}},{"type":"paragraph","data":{"text":"указания»);\u003cbr /\u003e"}},{"type":"list","data":{"style":"unordered","items":["У беременных женщин (смотри раздел «Беременность и период лактации»)"]}}]},{"id":6,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Как показали исследования по репродуктивной токсичности у животных и\nретроспективные исследования клинических данных, применение дротаверина в\nпериод беременности не оказывало ни тератогенного, ни эмбриотоксического\nдействия. Несмотря на это при назначении дротаверина беременным женщинам\nследует соблюдать осторожность и применять его только в тех случаях, когда\nпотенциальная польза для матери превышает потенциальный риск для плода,\nпри этом следует избегать назначения инъекционной лекарственной формы\nпрепарата Но-шпа® у беременных женщин.\u003cbr /\u003e\nПрепарат не следует применять во время родов (потенциальный риск развития послеродовых\nатонических кровотечений).\u003cbr /\u003e\nВ связи с отсутствием необходимых клинических данных в период лактации назначать препарат\nне рекомендуется."}}]},{"id":7,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Взрослые:\u003cbr /\u003e\nСуточная средняя доза составляет 40-240 мг дротаверина гидрохлорида (разделенная на 1-3\nдозы в сутки) внутримышечно.\u003cbr /\u003e\nПри острых коликах (почечной или желчно-каменной) - 40-80 мг внутривенно-медленно\n(продолжительность введения приблизительно 30 секунд)."}}]},{"id":8,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Ниже представлены неблагоприятные реакции, наблюдавшиеся в клинических\nисследованиях, разделенные по системам органов с указанием частоты их возникновения\nв соответствии со следующими градациями: очень частые (≥10%), частые (≥1% и \u003c10%);\nнечастые (≥0,1 и \u003c1%); редкие (≥0,01% и \u003c0,1%) и очень редкие, включая отдельные\nсообщения (\u003c0,01%), неизвестная частота (по имеющимся данным частоту определить\nнельзя).\u003cbr /\u003e\nСо стороны сердечно-сосудистой системы\u003cbr /\u003e\nРедкие – учащение сердцебиения, снижение артериального давления.\u003cbr /\u003e\nСо стороны нервной системы\u003cbr /\u003e\nРедкие – головная боль, головокружение, бессонница.\u003cbr /\u003e\nСо стороны желудочно-кишечного тракта\u003cbr /\u003e\nРедко - тошнота, запор.\u003cbr /\u003e\nСо стороны иммунной системы\u003cbr /\u003e\nРедкие – аллергические реакции (ангионевротический отек, крапивница, сыпь, зуд)\n(смотри раздел «Противопоказания»).\u003cbr /\u003e\nНеизвестная частота\u003cbr /\u003e\nПри применении препарата сообщалось о развития анафилактического шока со\nсмертельным исходом и без смертельного исхода.\u003cbr /\u003e\nМестные реакции\u003cbr /\u003e\nРедкие - реакции в месте введения.\u003cbr /\u003e"}}]},{"id":9,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Передозировка дротаверина ассоциировалась с нарушениями сердечного ритма и\nпроводимости, включая полную блокаду ножек пучка Гиса и остановку сердца, которая\nможет быть фатальной.\u003cbr /\u003e\nВ случае передозировки пациенты должны находиться под тщательным медицинским\nнаблюдением и им следует проводить симптоматическую терапию и лечение,\nнаправленное на поддержание основных функций организма."}}]},{"id":10,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"С леводопа\u003cbr /\u003e\nИнгибиторы фосфодиэстеразы, подобные папаверину, ослабляют\nпротивопаркинсонический эффект леводопы. При назначении дротаверина одновременно\nс леводопа возможно усиление ригидности и тремора.\u003cbr /\u003e\nС папаверином, бендазолом и другими спазмолитиками (в том числе и м-холинолитиками)\nДротаверин усиливает спазмолитическое действие папаверина, бендазола и других\nспазмолитиков, включая м-холиногблокаторы.\u003cbr /\u003e\nС трициклическими антидепрессантами, хинидином и прокаинамидом\nУсиливает гипотензию, вызываемую трициклическими антидепрессантами, хинидином и\nпрокаинамидом.\u003cbr /\u003e\nС морфином\u003cbr /\u003e\nСнижает спазмогенную активность морфина.\u003cbr /\u003e\nС фенобарбиталом\u003cbr /\u003e\nФенобарбитал усиливает спазмолитическое действие дротаверина."}}]},{"id":11,"name":"Особые указания","slug":"cautions","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Препарат содержит дисульфит, который может вызывать реакции аллергического типа,\nвключая анафилактические симптомы и бронхоспазм у чувствительных лиц, особенно у\nлиц с астмой или аллергическими заболеваниями в анамнезе. В случае повышенной\nчувствительности к дисульфиту парентерального применения препарата следует избегать\n(смотри раздел «Противопоказания»).\u003cbr /\u003e\nПри внутривенном введении дротаверина у пациентов с пониженным артериальным\nдавлением больной должен находиться в горизонтальном положении в связи с риском\nразвития коллапса."}}]},{"id":12,"name":"Условия хранения","slug":"storage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"5 лет.\u003cbr /\u003e\nНе применять после истечения срока годности, указанного на упаковке."}}]},{"id":13,"name":"Срок годности","slug":"expiry_date","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Хранить в защищенном от света месте при температуре 15-25С.\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":"Дротаверин представляет собой производное изохинолина, которое проявляет мощное спазмолитическое действие на гладкую мускулатуру за счет ингибирования фермента фосфодиэстеразы (ФДЭ). Фермент фосфодиэстераза необходим для гидролиза ц-АМФ до АМФ. Ингибирование фермента фосфодиэстеразы приводит к повышению концентрации ц-АМФ, которое запускает следующую каскадную реакцию: высокие концентрации цАМФ активируют ц-АМФ зависимое фосфорилирование киназы легких цепей миозина (КЛЦМ). Фосфорилирование КЛЦМ приводит к снижению ее аффинности к кальций (Ca2+)-кальмодулиновому комплексу, в результате чего инактивированная форма КЛЦМ поддерживает мышечное расслабление. ц-АМФ кроме этого влияет на цитозольную концентацию Ca2+, благодаря стимулированию транспорта Ca2+ в экстрацеллюлярное пространство и саркоплазматический ретикулум. Этот понижающий концентрацию C2+ эффект дротаверина через ц-АМФ объясняет антагонистический эффект дротаверина по отношению к Ca2+. In vitro дротаверин ингибирует изофермент ФДЭ-4, без ингибирования изоферментов ФДЭ-3 и ФДЭ-5. Поэтому эффективность дротаверина зависит от концентраций ФДЭ-4 в тканях, содержание которой в разных тканях различается. ФДЭ-4 наиболее важна для подавления сократительной активности гладкой мускулатуры, в связи с чем селективное ингибирование ФДЭ-4 может быть полезным для лечения гиперкинетических дискинезий и различных заболеваний, сопровождающихся спастическим состоянием желудочнокишечного тракта. Гидролиз ц-АМФ в миокарде и гладкой мускулатуре сосудов происходит главным образом с помощью изоэнзима ФДЭ-3, чем объясняется тот факт, что при высокой спазмолитической активности у дротаверина отсутствуют серьезные побочные эффекты со стороны сердца и сосудов и выраженные эффекты в отношении сердечно-сосудистой системы. Дротаверин эффективен при спазмах гладкой мускулатуры как нейрогенного, так и мышечного происхождения. Независимо от типа вегетативной иннервации, дротаверин расслабляюще действует на гладкую мускулатуру желудочно-кишечного тракта, желчевыводящих путей, мочеполовой системы.","substance":[{"id":135,"title":"Дротаверин","title_latin":"Drotaverinum","slug":"drotaverin_135"}],"branding":null,"valid_for_quick_buy":true,"is_available_to_delivery":false,"comments":null,"image_alt":"Но-шпа - фото упаковки","image_share":{"isTouch":{"default":"https://vseapteki.ru/cropping/thumbnails/101/7536/share_default/"},"isFromTablet":{"default":"https://vseapteki.ru/cropping/thumbnails/101/7536/share_default/"}},"diseases":[{"id":"756","title":"Другие цереброваскулярные болезни","slug":"756-drugie_tserebrovaskulyarnye_bolezni"},{"id":"765","title":"Болезнь периферических сосудов неуточненная (перемежающаяся хромота)","slug":"765-bolezn_perifericheskih_sosudov_neutochnennaya_peremezhayuschayasya_hromota"},{"id":"860","title":"Язва желудка","slug":"860-yazva_zheludka"},{"id":"862","title":"Язва 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колика)","slug":"900-zhelchnokamennaya_bolezn_holelitiaz_v_tch_pechenochnaya_kolika"},{"id":"902","title":"Холецистит","slug":"902-holetsistit"},{"id":"903","title":"Острый холецистит","slug":"903-ostryy_holetsistit"},{"id":"904","title":"Хронический холецистит","slug":"904-hronicheskiy_holetsistit"},{"id":"906","title":"Другие уточненные болезни желчного пузыря и пузырного протока (в т.ч. дискинезия)","slug":"906-drugie_utochnennye_bolezni_zhelchnogo_puzyrya_i_puzyrnogo_protoka_v_tch_diskineziya"},{"id":"908","title":"Холангит","slug":"908-holangit"},{"id":"1086","title":"Острый тубулоинстерстициальный нефрит (острый пиелонефрит)","slug":"1086-ostryy_tubuloinsterstitsialnyy_nefrit_ostryy_pielonefrit"},{"id":"1087","title":"Хронический тубулоинтерстициальный нефрит (хронический пиелонефрит)","slug":"1087-hronicheskiy_tubulointerstitsialnyy_nefrit_hronicheskiy_pielonefrit"},{"id":"1094","title":"Камни почки и 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