1 мл раствора для внутримышечного и внутривенного введения содержит: действующее вещество: хлоропирамина гидрохлорид 20 мг. Вспомогательное вещество: вода для инъекций.
Фармакологические свойства
Хлоропирамин является блокатором Н1-гистаминовых рецепторов. По химическому строению относится к производным этилендиамина. Хлоропирамин селективно блокирует Н1-гистаминовые рецепторы и уменьшает проницаемость капилляров. Предупреждает развитие и облегчает течение аллергических реакций. Оказывает седативное, антигистаминное, м-холиноблокирующее и выраженное противозудное действие. Обладает умеренной спазмолитической активностью и противорвотным действием. Равномерно распределяется в организме, включая центральную нервную систему. Проникает через гематоэнцефалический барьер. Связь хлоропирамина с белками плазмы крови составляет 7,9%. Пик связывания отмечен при pH 6,8-7,4. Терапевтическая концентрация сохраняется 4-6 ч. Интенсивно метаболизируется в печени. Выводится преимущественно через почки с мочой в виде метаболитов. Выведение хлоропирамина у детей может происходить быстрее, чем у взрослых.
Показания к применению
Аллергические заболевания, в том числе:
крапивница,
ринит,
конъюнктивит,
поллиноз (сенная лихорадка),
ангионевротический отек,
сывороточная болезнь,
лекарственная аллергия,
кожные заболевания, в том числе:
экзема,
контактный дерматит,
кожный зуд,
нейродермит,
токсикодермия.
Противопоказания
Индивидуальная повышенная чувствительность к препарату или его компонентам;
острый приступ бронхиальной астмы;
одновременное применение ингибиторов моноаминоксидазы;
новорожденные дети (до 1 мес.);
беременность и период лактации;
язвенная болезнь желудка в стадии обострения;
гиперплазия предстательной железы;
выраженная дыхательная недостаточность.
С осторожностью
Препарат следует назначать с осторожностью пациентам пожилого возраста, при недостаточности функции печени и/или заболеваниях сердца, при язвенной болезни желудка и/или 12-перстной кишки, при приеме лекарственных средств, угнетающих центральную нервную систему (ЦНС), задержке мочи, закрытоугольной глаукоме.
Способ применения и дозы
Внутримышечно или внутривенно. Взрослым назначают 20-40 мг в сутки (содержимое 1-2 ампул). Лечение у детей начинают с дозы 5 мг (0,25 мл). В дальнейшем повышение дозы лимитируется преимущественно появлением побочных эффектов. Детям в возрасте 1-12 месяцев - 5 мг (0,25 мл). Детям в возрасте 2-6 лет -10 мг (0,5 мл). Детям в возрасте 7-14 лет-10-20 мг (0,5-1 мл). Суточная доза не должна превышать 2 мг/кг массы тела. При тяжелом течении аллергии лечение следует начинать с инъекционной формы хлоропирамина. Сначала его вводят внутривенно медленно, затем переходят на внутримышечное введение и в заключительной фазе лечения переходят на прием таблеток внутрь.
Побочное действие
Со стороны ЦНС: вялость, слабость, сонливость, головокружение, головная боль, эйфория, ощущение усталости, раздражительность, тремор, судороги, нарушение координации движений, нарушение зрения; у детей возможно некоторое стимулирующее действие на WYC, проявляющееся беспокойством, повышенной раздражимостью, бессонницей. Со стороны органов пищеварения: сухость во рту, тошнота, рвота, гастралгия, диарея/запор, потеря или повышение аппетита. Со стороны мочеиспускательной системы: затруднение мочеиспускания. Со стороны сердечно-сосудистой системы: снижение АД (чаще у пожилых пациентов), тахикардия, аритмия. Со стороны системы кроветворения: очень редко — лейкопения, агранулоцитоз. Со стороны органов зрения: повышение внутриглазного давления. Прочие: фотосенсибилизация, мышечная слабость. Аллергические реакции к препарату.
Передозировка
Симптомы: у детей - возбуждение, тревожность, галлюцинации, атетоз, атаксия, судороги, мидриаз, неподвижность зрачков, гиперемия кожи лица, гипертермия; затем - коллапс, кома. У взрослых - угнетение (заторможенность, депрессия) или возбуждение центральной нервной системы (психомоторное возбуждение), очень редко -галлюцинации, расстройство координации, расширение зрачков и отсутствие их реакции на свет, сухость во рту, гипертермия и гиперемия кожных покровов, судороги, в тяжелых случаях - коматозное состояние. Лечение: симптоматическая терапия (включая назначение противоэпилептических средств, кофеина, фенамина), реанимационные мероприятия, искусственная вентиляция легких - по показаниям. Специфического антидота нет.
Взаимодействие с другими лекарственными средствами
Усиливает действие лекарственных средств для общей анестезии, снотворных, седативных лекарственных средств, транквилизаторов, м-холиноблокаторов, опиоидных анальгетиков, местных анестетиков. Трициклические антидепрессанты и ингибиторы МАО усиливают м-холиноблокирующее и угнетающее действие на ЦНС. Кофеин и фенамин уменьшают угнетающее действие на ЦНС. Одновременное применение с этанолом не рекомендуется (риск тяжелого угнетения ЦНС).
Особые указания
Во время лечения недопустимо употребление алкогольных напитков. Прием препарата на ночь может усилить симптомы рефлюкс-эзофагита. Если во время длительного приема препарата наблюдается беспричинное повышение температуры тела, ларингит, бледность кожных покровов, желтуха, образование язв слизистой оболочки полости рта, появление гематом, необычные и трудноостанавливаемые кровотечения, необходимо обратиться к врачу, так как пролонгированная терапия антигистаминными препаратами может привести к нарушениям гемопоэза. Антигистаминные средства могут искажать проявление реакции при постановке кожных аллергологических проб, поэтому за несколько дней до планируемого проведения теста применение препарата следует прекратить. При сочетании с ототоксичными препаратами хлоропирамин может маскировать ранние проявления ототоксичности.
Влияние на способность управлять автомобилем и движущимися механизмами
Больным, применяющим хлоропирамин, рекомендуется воздерживаться от вождения транспортных средств, работы с механизмами, а также от других видов деятельности, требующих повышенной концентрации внимания и быстроты психомоторных реакций.
Форма выпуска
Раствор для внутримышечного и внутривенного введения.
Условия хранения
В защищенном от света месте, при температуре не выше 25 °C.
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Информация предоставляется в справочных целях. Не занимайтесь самолечением. При первых признаках заболевания обратитесь к врачу.
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Со стороны органов зрения: повышение внутриглазного давления. Прочие: фотосенсибилизация, мышечная слабость. Аллергические реакции к препарату."}}]},{"id":16,"name":"Передозировка","slug":"overdose","body":[{"type":"paragraph","data":{"text":"Симптомы: у детей - возбуждение, тревожность, галлюцинации, атетоз, атаксия, судороги, мидриаз, неподвижность зрачков, гиперемия кожи лица, гипертермия; затем - коллапс, кома. У взрослых - угнетение (заторможенность, депрессия) или возбуждение центральной нервной системы (психомоторное возбуждение), очень редко -галлюцинации, расстройство координации, расширение зрачков и отсутствие их реакции на свет, сухость во рту, гипертермия и гиперемия кожных покровов, судороги, в тяжелых случаях - коматозное состояние. Лечение: симптоматическая терапия (включая назначение противоэпилептических средств, кофеина, фенамина), реанимационные мероприятия, искусственная вентиляция легких - по показаниям. 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