Передозировка опиоидных анальгетиков, бензодиазепинов, барбитуратов. Кома при остром алкогольном отравлении. В анестезиологии: для ускорения выхода из наркоза, из нейролептанальгезии . угнетение дыхательного центра, вызванное галотаном или кетамином . при операциях по поводу фокальной эпилепсии . перед окончанием управляемого дыхания. Шок (в составе ...
Раствор для инъекций 1 мл налоксона гидрохлорид (в форме налоксона гидрохлорида дигидрата) 400 мкг. Вспомогательные вещества: L-метионин - 0.447 мг, натрия сульфат безводный - 1.704 мг, натрия дигидрофосфата моногидрат - 0.414 мг, маннитол - 9 мг, полоксамер 188 - 0.03 мг, кислота хлористоводородная разбавленная или раствор натрия гидроксида (q.s. до pH 6.2), вода д/и.
Фармакологические свойства
Конкурентный антагонист опиоидных рецепторов. Блокирует преимущественно μ .-рецепторы и в меньшей степени влияет на другие опиоидные рецепторы. Устраняет центральное и периферическое действие опиоидов (включая эндогенные эндорфины), в т.ч. угнетение дыхания и артериальную гипотензию.
Показания к применению
Передозировка опиоидных анальгетиков, бензодиазепинов, барбитуратов. Кома при остром алкогольном отравлении. В анестезиологии: для ускорения выхода из наркоза, из нейролептанальгезии . угнетение дыхательного центра, вызванное галотаном или кетамином . при операциях по поводу фокальной эпилепсии . перед окончанием управляемого дыхания. Шок (в составе комбинированной терапии). В качестве диагностического средства у больных с подозрением на лекарственную зависимость.
Противопоказания
Повышенная чувствительность к налоксону.
Применение при беременности и в период грудного вскармливания
С осторожностью применяют при беременности. Налоксон проникает через плацентарный барьер. Неизвестно, выделяется ли налоксон с грудным молоком. Применение у кормящей матери в период лактации возможно по абсолютным показаниям.
Способ применения и дозы
При передозировке опиоидных анальгетиков налоксон вводят взрослым в/в, в/м или п/к в дозе 400 мкг, детям - 10 мкг/кг. При недостаточном эффекте через 2-3 мин введение повторяют в той же дозе. В анестезиологии применяют у взрослых в дозе 100-200 мкг (1.5-3 мкг/кг) в/в . в случае необходимости при каждом последующем введении с интервалом 2-3 мин эта доза может быть увеличена на 100 мкг. Затем в течение 1-2 ч налоксон можно вводить в/м.
Побочное действие
Со стороны сердечно-сосудистой системы: при быстром введении - тахикардия . после введения высоких доз (особенно в послеоперационном периоде у больных с сердечно-сосудистыми заболеваниями) возможны артериальная гипотензия или гипертензия, желудочковая тахикардия, фибрилляция желудочков, отек легких. Со стороны ЖКТ: при быстром введении - тошнота, рвота. Аллергические реакции: возможны кожная сыпь, зуд. Прочие: при быстром введении - дрожь, усиление потоотделения.
Особые указания
Со стороны сердечно-сосудистой системы: при быстром введении - тахикардия . после введения высоких доз (особенно в послеоперационном периоде у больных с сердечно-сосудистыми заболеваниями) возможны артериальная гипотензия или гипертензия, желудочковая тахикардия, фибрилляция желудочков, отек легких. Со стороны ЖКТ: при быстром введении - тошнота, рвота. Аллергические реакции: возможны кожная сыпь, зуд. Прочие: при быстром введении - дрожь, усиление потоотделения.
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