— эндотрахеальная интубация и релаксация скелетной мускулатуры в ходе проведения общей анестезии при оперативных вмешательствах, требующих более чем 20-30-минутной миорелаксации и в условиях ИВЛ.
Лиофилизат для приготовления раствора для в/в введения белого или почти белого цвета . приложенный растворитель - бесцветный и прозрачный. 1 фл. пипекурония бромид 4 мг Вспомогательные вещества: маннитол. Растворитель: р-р натрия хлорида 0.9% - 2 мл.
Фармакологические свойства
Недеполяризующий периферический миорелаксант длительного действия. За счет конкурентного связывания с н-холинорецепторами, расположенными в моторных окончаниях поперечно-полосатых мышечных волокон, блокирует передачу сигнала от нервных окончаний к мышечным волокнам. Не вызывает мышечную фасцикуляцию, не оказывает гормонального действия. Даже в дозах, в несколько раз превосходящих его эффективную дозу, необходимую для 90% снижения мышечной сократимости (ED90), не оказывает ганглиоблокирующей, м-холиноблокирующей и симпатомиметической активности. По данным исследований, при сбалансированной анестезии дозы ED50 и ED90 пипекурония бромида составляют 30-50 мкг/кг массы тела соответственно. Доза, равная 50 мкг/кг массы тела, обеспечивает 40-50-минутную миорелаксацию во время оперативного вмешательства. Максимальное действие пипекурония бромида зависит от дозы и развивается через 1.5-5 мин, быстрее всего эффект наступает при дозах, равных 70-80 мкг/кг. Дальнейшее увеличение дозы препарата сокращает время, необходимое для проявления миорелаксирующего действия, и существенно увеличивает его продолжительность.
Показания к применению
— эндотрахеальная интубация и релаксация скелетной мускулатуры в ходе проведения общей анестезии при оперативных вмешательствах, требующих более чем 20-30-минутной миорелаксации и в условиях ИВЛ.
Применение при беременности и в период грудного вскармливания
Клинических исследований для доказательства безопасности применения Ардуана при беременности для организма матери и плода недостаточно. Применение препарата при беременности не рекомендуется. Клинических данных по безопасности применения Ардуана в период лактации недостаточно. Применение препарата во время грудного вскармливания не рекомендуется.
Побочное действие
Со стороны ЦНС и периферической нервной системы: редко ( меньше 1%) - угнетение ЦНС, сонливость, гипестезия, паралич скелетной мускулатуры. Со стороны костно-мышечной системы: редко ( меньше 1%) - слабость скелетной мускулатуры после прекращения миорелаксации, мышечная атрофия. Со стороны дыхательной системы: редко ( меньше 1%) - апноэ, ателектаз легкого, угнетение дыхания, ларингоспазм в результате аллергической реакции, бронхоспазм, кашель. Со стороны сердечно-сосудистой системы: редко ( меньше 1%) - ишемия миокарда (вплоть до инфаркта миокарда) и мозга, фибрилляция предсердий, желудочковая экстрасистолия, аритмии, тахикардия, брадикардия, снижение или повышение АД. Со стороны свертывающей системы крови: редко ( меньше 1%) - тромбоз, уменьшение АЧТВ и протромбинового времени. Со стороны мочевыделительной системы: редко ( меньше 1%) - гиперкреатининемия, анурия. Со стороны обмена веществ: редко ( меньше 1%) - гипергликемия, гипокалиемия, гипомагниемия, гипокальциемия. Со стороны органа зрения: блефарит, птоз. Аллергические реакции: редко ( меньше 1%) - кожная сыпь, реакции гиперчувствительности, отек Квинке.
Особые указания
Со стороны ЦНС и периферической нервной системы: редко ( меньше 1%) - угнетение ЦНС, сонливость, гипестезия, паралич скелетной мускулатуры. Со стороны костно-мышечной системы: редко ( меньше 1%) - слабость скелетной мускулатуры после прекращения миорелаксации, мышечная атрофия. Со стороны дыхательной системы: редко ( меньше 1%) - апноэ, ателектаз легкого, угнетение дыхания, ларингоспазм в результате аллергической реакции, бронхоспазм, кашель. Со стороны сердечно-сосудистой системы: редко ( меньше 1%) - ишемия миокарда (вплоть до инфаркта миокарда) и мозга, фибрилляция предсердий, желудочковая экстрасистолия, аритмии, тахикардия, брадикардия, снижение или повышение АД. Со стороны свертывающей системы крови: редко ( меньше 1%) - тромбоз, уменьшение АЧТВ и протромбинового времени. Со стороны мочевыделительной системы: редко ( меньше 1%) - гиперкреатининемия, анурия. Со стороны обмена веществ: редко ( меньше 1%) - гипергликемия, гипокалиемия, гипомагниемия, гипокальциемия. Со стороны органа зрения: блефарит, птоз. Аллергические реакции: редко ( меньше 1%) - кожная сыпь, реакции гиперчувствительности, отек Квинке.
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