Слабительный препарат. Лактулоза под воздействием кишечной м... Инструкция
Показания к применению
запор (в т.ч. хронический); - необходимость размягчения стула в медицинских целях (при геморрое, необходимости хирургической операции на толстой кишке и/или анальном отверстии, болевой синдром после удаления геморроидальных узлов, послеоперационный период); - дисбактериоз кишечника; - печеночная энцефалопатия; - печеночная прекома и кома (лечение и профилактика); - гипераммониемия; - энтерит, вызванный сальмонеллами, шигеллами, сальмонеллоносительство; - синдром гнилостной диспепсии (у детей раннего возраста в результате острых пищевых отравлений).
Противопоказания
Гиперчувствительность к лактулозе или другим компонентам препарата, галактоземия, непроходимость кишечника, ректальные кровотечения (причиной которых не является геморрой), коло-, илеостома, подозрение на аппендицит.
100 мл сиропа содержат 66,7 г лактулозы концентрата. ; Вспомогательные вещества: вода очищенная.
Фармакологические свойства
Слабительный препарат. Лактулоза под воздействием кишечной микрофлоры распадается в толстой кишке на низкомолекулярные органические кислоты. Образование кислот приводит к снижению pH содержимого кишечника и активизации его перистальтики. Наряду с этим увеличивается объем и происходит размягчение каловых масс. Под воздействием препарата также уменьшается образование азотсодержащих токсических веществ в проксимальном отделе толстой кишки и их абсорбция в системный кровоток. Кроме того, усиливается перемещение ионов аммония из крови в кишечник. ; Действие препарата наступает через 24-48 ч после приема внутрь.
Показания к применению
запор (в т.ч. хронический); - необходимость размягчения стула в медицинских целях (при геморрое, необходимости хирургической операции на толстой кишке и/или анальном отверстии, болевой синдром после удаления геморроидальных узлов, послеоперационный период); - дисбактериоз кишечника; - печеночная энцефалопатия; - печеночная прекома и кома (лечение и профилактика); - гипераммониемия; - энтерит, вызванный сальмонеллами, шигеллами, сальмонеллоносительство; - синдром гнилостной диспепсии (у детей раннего возраста в результате острых пищевых отравлений).
Противопоказания
Гиперчувствительность к лактулозе или другим компонентам препарата, галактоземия, непроходимость кишечника, ректальные кровотечения (причиной которых не является геморрой), коло-, илеостома, подозрение на аппендицит.
Применение при беременности и в период грудного вскармливания
Данные о безопасности применения препарата при беременности и в период лактации (грудного вскармливания) отсутствуют.
Способ применения и дозы
Дозу препарата подбирают индивидуально. ; При лечении запоров и для размягчения стула: начальная доза (три дня) ; продолжение лечения ; Дети до 1 года ; 5 мл сиропа ;(1 чайная ложка) ; 5 мл сиропа ;(1 чайная ложка) ; дети от 1 года до 6 лет ; 5-10 мл сиропа ;(1-2 чайные ложки) ; ; 5-10 мл сиропа ;(1-2 чайные ложки) ; дети от 7 до 14 лет ; 15 мл сиропа ;(1 столовая ложка) ; 10 мл сиропа ;(2 чайные ложки) ; взрослые ; 15-45 мл сиропа ;(1 -3 столовые ложки) ; 15-30 мл сиропа ;(1-2 столовые ложки) ; Препарат лучше принимать утром во время или после еды, однократно или разделяя на два приема. Препарат можно запивать водой или другой жидкостью. Пациент может подбирать и изменять дозу и время приема препарата по потребности. Слабительный эффект препарата развивается в течение первых двух дней приема. ; Продолжительность лечения при запорах составляет от 4 недель до 3-4 месяцев. ; При лечении печеночной (портальной) энцефалопатии, печеночной комы и прекомы: 30-50 мл сиропа (2-3 столовые ложки) три раза в день. ; В начальной фазе лечения могут назначаться дозы 30-45 мл сиропа каждые 1-2 часа для достижения быстрого эффекта (первого опорожнения кишечника). Затем переходят на поддерживающую дозу, подбирая ее индивидуально, чтобы получать мягкий стул 2-3 раза в день. ; При лечении дисбактериоза и для нормализации микрофлоры кишечника: Препарат назначают во время или после еды, 2-4 раза в сутки. ; ; Разовая доза ; Дети до 1 года ; ; 1,5-3 мл сиропа ; Дети от 1 года до 3 лет ; ; 3 мл сиропа ; Дети от 3 до 7 лет ; ; 5 мл сиропа (1 чайная ложка) ; Взрослые и дети старше 7 лет ; ; 5-10 мл сиропа (1-2 чайные ложки) ; Продолжительность лечения составляет 10-14 дней, повторные курсы назначаются с недельными перерывами.
Побочное действие
Побочные эффекты носят, как правило, слабовыраженный и обратимый характер и являются следствием превышения дозы. ; Со стороны пищеварительной системы: спазмы, ощущение дискомфорта и боли в животе, диарея (могут быть устранены снижением дозы); в начале лечения - метеоризм (проходит через несколько дней). Приторный вкус препарата у некоторых пациентов может вызвать тошноту и рвоту. ; Со стороны обмена веществ: при длительной терапии в высоких дозах возможно нарушение водно-электролитного баланса. ; Прочие: кожная сыпь. ;
Передозировка
Симптомы: прием препарата в чрезмерных дозах может вызвать диарею с потерей жидкости и электролитов, в более тяжелых случаях - гипернатриемию и гипокалиемию. ; Лечение: в легких случаях достаточно отменить препарат. При необходимости проводят симптоматическую терапию. Специфического антидота нет. Гипокалиемия может ухудшить состояние при печеночной коме и даже спровоцировать ее развитие. В этом случае необходимо введение калия хлорида. ;
Особые указания
В связи с присутствием в препарате незначительного количества сахаров (15 мл сиропа содержат до 1.7 г галактозы и до 1 г лактозы) необходимо соблюдать меры предосторожности при назначении препарата больным сахарным диабетом. ; С осторожностью следует назначать препарат пациентам с гастрокардиальным синдромом. В этом случае лечение начинают с низких доз и повышают их постепенно, чтобы избежать возникновения метеоризма. ; Не следует назначать препарат на фоне болей в животе, тошноты, рвоты. ; При лечении печеночной энцефалопатии, особенно в начальной фазе терапии, не следует применять другие слабительные средства. Усиленное опорожнение кишечника может привести к ошибочному заключению о том, что достигнута адекватная доза для терапии энцефалопатии. ; Пациент должен быть предупрежден, что если запор сохраняется в течение нескольких дней приема препарата или если состояние вновь ухудшится после прекращения приема препарата, необходимо обратиться к врачу. ; Влияние на способность к управлению автотранспортом и работе с механизмами ; В рекомендованных дозах Порталак не оказывает влияния на способность к управлению транспортными средствами и работе с механизмами. ;
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Лактулоза под воздействием кишечной микрофлоры распадается в толстой кишке на низкомолекулярные органические кислоты. Образование кислот приводит к снижению pH содержимого кишечника и активизации его перистальтики. Наряду с этим увеличивается объем и происходит размягчение каловых масс. Под воздействием препарата также уменьшается образование азотсодержащих токсических веществ в проксимальном отделе толстой кишки и их абсорбция в системный кровоток. Кроме того, усиливается перемещение ионов аммония из крови в кишечник. ; Действие препарата наступает через 24-48 ч после приема внутрь."}}]},{"id":3,"name":"Показания к применению","slug":"indications","displayInMenu":true,"body":[{"type":"list","data":{"style":"unordered","items":["запор (в т.ч. хронический); - необходимость размягчения стула в медицинских целях (при геморрое, необходимости хирургической операции на толстой кишке и/или анальном отверстии, болевой синдром после удаления геморроидальных узлов, послеоперационный период); - дисбактериоз кишечника; - печеночная энцефалопатия; - печеночная прекома и кома (лечение и профилактика); - гипераммониемия; - энтерит, вызванный сальмонеллами, шигеллами, сальмонеллоносительство; - синдром гнилостной диспепсии (у детей раннего возраста в результате острых пищевых отравлений)."]}}]},{"id":4,"name":"Противопоказания","slug":"contraindications","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Гиперчувствительность к лактулозе или другим компонентам препарата, галактоземия, непроходимость кишечника, ректальные кровотечения (причиной которых не является геморрой), коло-, илеостома, подозрение на аппендицит."}}]},{"id":5,"name":"Применение при беременности и в период грудного вскармливания","slug":"pregnancy_warnings","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Данные о безопасности применения препарата при беременности и в период лактации (грудного вскармливания) отсутствуют."}}]},{"id":6,"name":"Способ применения и дозы","slug":"dosage","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Дозу препарата подбирают индивидуально. ; При лечении запоров и для размягчения стула: начальная доза (три дня) ; продолжение лечения ; Дети до 1 года ; 5 мл сиропа ;(1 чайная ложка) ; 5 мл сиропа ;(1 чайная ложка) ; дети от 1 года до 6 лет ; 5-10 мл сиропа ;(1-2 чайные ложки) ; ; 5-10 мл сиропа ;(1-2 чайные ложки) ; дети от 7 до 14 лет ; 15 мл сиропа ;(1 столовая ложка) ; 10 мл сиропа ;(2 чайные ложки) ; взрослые ; 15-45 мл сиропа ;(1 -3 столовые ложки) ; 15-30 мл сиропа ;(1-2 столовые ложки) ; Препарат лучше принимать утром во время или после еды, однократно или разделяя на два приема. Препарат можно запивать водой или другой жидкостью. Пациент может подбирать и изменять дозу и время приема препарата по потребности. Слабительный эффект препарата развивается в течение первых двух дней приема. ; Продолжительность лечения при запорах составляет от 4 недель до 3-4 месяцев. ; При лечении печеночной (портальной) энцефалопатии, печеночной комы и прекомы: 30-50 мл сиропа (2-3 столовые ложки) три раза в день. ; В начальной фазе лечения могут назначаться дозы 30-45 мл сиропа каждые 1-2 часа для достижения быстрого эффекта (первого опорожнения кишечника). Затем переходят на поддерживающую дозу, подбирая ее индивидуально, чтобы получать мягкий стул 2-3 раза в день. ; При лечении дисбактериоза и для нормализации микрофлоры кишечника: Препарат назначают во время или после еды, 2-4 раза в сутки. ; ; Разовая доза ; Дети до 1 года ; ; 1,5-3 мл сиропа ; Дети от 1 года до 3 лет ; ; 3 мл сиропа ; Дети от 3 до 7 лет ; ; 5 мл сиропа (1 чайная ложка) ; Взрослые и дети старше 7 лет ; ; 5-10 мл сиропа (1-2 чайные ложки) ; Продолжительность лечения составляет 10-14 дней, повторные курсы назначаются с недельными перерывами."}}]},{"id":7,"name":"Побочное действие","slug":"side_effects","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Побочные эффекты носят, как правило, слабовыраженный и обратимый характер и являются следствием превышения дозы. ; Со стороны пищеварительной системы: спазмы, ощущение дискомфорта и боли в животе, диарея (могут быть устранены снижением дозы); в начале лечения - метеоризм (проходит через несколько дней). Приторный вкус препарата у некоторых пациентов может вызвать тошноту и рвоту. ; Со стороны обмена веществ: при длительной терапии в высоких дозах возможно нарушение водно-электролитного баланса. ; Прочие: кожная сыпь. ;"}}]},{"id":8,"name":"Передозировка","slug":"overdose","displayInMenu":true,"body":[{"type":"paragraph","data":{"text":"Симптомы: прием препарата в чрезмерных дозах может вызвать диарею с потерей жидкости и электролитов, в более тяжелых случаях - гипернатриемию и гипокалиемию. ; Лечение: в легких случаях достаточно отменить препарат. При необходимости проводят симптоматическую терапию. Специфического антидота нет. Гипокалиемия может ухудшить состояние при печеночной коме и даже спровоцировать ее развитие. 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