Комбинированный препарат, улучшающий мозговое кровообращение и обмен веществ. Этамиван за счет активации ретикулярной формации нормализует функциональное состояние нейронных комплексов коры и подкорково-стволовых структур. Гексобендин повышает утилизацию глюкозы и кислорода за счет активации анаэробного гликолиза и пентозных циклов. Возможности такой активации реализуются только в условиях ишемии и гипоксии, когда нарушается цикл аэробного окислительного фосфорилирования. Стимуляция анаэробного окисления дает энергетический субстрат для синтеза и обмена медиаторов и восстановления синаптической передачи, депрессия которой, наряду с деструкцией мембран нейронов, является ведущим патогенетическим механизмом расстройств сознания и неврологических нарушений при гипоксии и ишемии мозга. Гексобендин также стабилизирует физиологические механизмы ауторегуляции церебрального и кардиального кровотока, что связано с воздействием лактата и пирувата (продуктов анаэробного гликолиза) на рецепторный аппарат интракраниальных артериол и капилляров. Этофиллин активирует метаболизм миокарда с увеличением минутного объема сердца, что способствует повышению перфузионного давления в сосудах краевой зоны ишемии. При этом не меняется системное АД. Возбуждающее действие на нервную систему проявляется также в стимуляции подкорковых образований, среднего мозга и стволовых центров и ядер (дыхательного, сосудодвигательного, центров вегетативной регуляции, а также ядер ЧМН, прежде всего блуждающего нерва). При применении Инстенона в случаях ишемического инсульта, закрытой черепно-мозговой травмы отмечается восстановление нарушенного сознания пациента, регрессия неврологических нарушений, активация вегетативной сферы.
Показания к применению
заболевания мозга сосудистого генеза и связанные с возрастными изменениями; - последствия недостаточности кровоснабжения мозга; - постинсультные состояния; - головокружения, вызванные функциональными расстройствами мозга.
Противопоказания
состояние сильного возбуждения; - судорожный синдром; - эпилепсия; - симптомы повышенного внутричерепного давления (длительная головная боль, рвота, нарушение зрения); - кровоизлияние в мозг; - повышенная чувствительность к компонентам препарата.
Применение при беременности и в период грудного вскармливания
При беременности и в период лактации Инстенон применяют только по строгим показаниям.
Способ применения и дозы
В зависимости от тяжести течения заболевания препарат вводят в/м или в/в (медленно) по 1 ампуле 1-2 раза/сут или в виде в/в капельной инфузии по 1 ампуле 1-2 раза/сут вместе с 250 мл 5% раствора левулезы. В ряде случаев при быстром введении возможно снижение АД, поэтому продолжительность введения одной ампулы должна составлять не менее 3 мин. По мере улучшения состояния лечение может быть продолжено препаратом в форме таблеток, покрытых оболочкой. Внутрь назначают по 1-2 таб. 3 раза/сут или по 1 таб. форте 3 раза/сут (максимально 5 таб.) в течение 6 недель.
Побочное действие
В отдельных случаях: при применении в высоких дозах - головная боль, гиперемия лица, снижение АД.
Передозировка
Симптомы: возможны головные боли, тахикардия, гиперемия лица. Лечение: рекомендуется отмена препарата с последующим возобновлением приема в меньшей дозе.
Особые указания
В ряде случаев при быстром в/в введении может понизиться АД, поэтому продолжительность введения одной ампулы должна составлять не менее 3 мин. Влияние на способность к вождению автотранспорта и управлению механизмамиВ период лечения необходимо соблюдать осторожность при занятиях потенциально опасными видами деятельности, требующими повышенного внимания и быстроты психомоторных реакций
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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