Ноотропный препарат. Оказывает действие на ЦНС различными пу... Инструкция
Показания к применению
Симптоматическое лечение интеллектуально-мнестических нарушений при отсутствии установленного диагноза деменции; с целью уменьшения проявлений кортикальной миоклонии у чувствительных к пирацетаму пациентов, как в качестве монотерапии, так и в составе комплексной терапии (для определения чувствительности к пирацетаму в конкретном случае может быть проведен ...
Геморрагический инсульт.- Терминальная стадия почечной недостаточности (при клиренсе креатинина менее 20 мл/мин).- Детский возраст до 1 года.- Беременность.- Лактация.- Повышенная чувствительность к пирацетаму или производным пирролидона, а также другихкомпонентам препарата.
Ноотропный препарат. Оказывает действие на ЦНС различными путями: модифицирует нейротрансмиссию в головном мозге, улучшает условия, способствующие нейрональной пластичности, улучшает микроциркуляцию, воздействуя на реологические характеристики крови и не вызывая вазодилатацию. Применение пирацетама у пациентов с церебральной дисфункцией повышает концентрацию внимания и улучшает когнитивные функции, что проявляется значительными изменениями на ЭЭГ (повышением α и β активности, снижение δ активности). Способствует восстановлению когнитивных функций вследствие различных нарушений, таких как гипоксия, интоксикация или электросудорожная терапия. Уменьшает продолжительность вестибулярного нейронита. Пирацетам ингибирует повышенную агрегацию активированных тромбоцитов и, в случае патологической ригидности эритроцитов, улучшает их деформируемость и способность к фильтрации.
Показания к применению
Симптоматическое лечение интеллектуально-мнестических нарушений при отсутствии установленного диагноза деменции; с целью уменьшения проявлений кортикальной миоклонии у чувствительных к пирацетаму пациентов, как в качестве монотерапии, так и в составе комплексной терапии (для определения чувствительности к пирацетаму в конкретном случае может быть проведен пробный курс лечения).
Противопоказания
Геморрагический инсульт.- Терминальная стадия почечной недостаточности (при клиренсе креатинина менее 20 мл/мин).- Детский возраст до 1 года.- Беременность.- Лактация.- Повышенная чувствительность к пирацетаму или производным пирролидона, а также другихкомпонентам препарата.
Применение при беременности и в период грудного вскармливания
Адекватных и строго контролируемых клинических исследований по безопасности применения препарата при беременности не проводилось, поэтому Луцетам не следует применять при беременности. Пирацетам проникает через плацентарный барьер, выделяется с грудным молоком. При необходимости применения препарата в период лактации грудное вскармливание следует прекратить.
Способ применения и дозы
Внутрь препарат назначают в суточной дозе 30-160 мг/кг, кратность приема - 2-4 раза/сут. Таблетки Луцетама принимают во время приема пищи или натощак, запивая жидкостью (вода, сок). При симптоматическом лечении хронического психоорганического синдрома в зависимости отвыраженности симптомов назначают 1.2-2.4 г/сут, а в течение первой недели - 4.8 г/сут. При лечении последствий инсульта назначают 4.8 г/сут. При алкогольном абстинентном синдроме - 12 г/сут. Поддерживающая доза - 2.4 г/сут. Для лечения головокружения и связанных с ним расстройств равновесия назначают 2.4-4.8 г/сут. При кортикальной миоклонии лечение начинаются с дозы 7.2 г/сут, каждые 3-4 дня дозу повышают на 4.8г/сут до достижения максимальной дозы 24 г/сут. Лечение продолжают на протяжении всего периодаболезни. Каждые 6 мес следует предпринять попытку уменьшить дозу или отменить препарат, постепенносокращая дозу на 1.2 г каждые 2 дня с целью предотвращения приступа. При отсутствии эффекта илинезначительного терапевтического эффекта лечение прекращают. Детям для коррекции пониженной обучаемости назначают внутрь в дозе 3.2 г/сут. Лечение продолжаетсяв течение всего учебного года. У пациентов с нарушениями функции печени коррекции режима дозирования не требуется. У пациентов с нарушениями функции почек требуется коррекция режима дозирования в зависимости отклиренса креатинина (КК). Степень почечной недостаточности КК (мл/мин) Доза Норма > 80 Обычная дозаЛегкая 50-79 2/3 обычной дозы в 2 - 3 приема Средняя 30-49 1/3 обычной дозы в 2 приема Тяжелая < 30 1/6обычной дозы, однократно Терминальная стадия - противопоказаноУ пациентов пожилого возраста дозу корригируют при наличии почечной недостаточности и придлительной терапии необходим контроль функционального состояния почек.
Побочное действие
Со стороны ЦНС: гиперкинезы, раздражительность, сонливость, депрессия, астения, головная боль, головокружение, бессонница, психическое возбуждение, беспокойство, нарушения равновесия, тремор, атаксия, обострение течения эпилепсии, тревога, галлюцинации, спутанность сознания, повышение либидо. Со стороны органов чувств: головокружение (вертиго). Со стороны сердечно-сосудистой системы: снижение или повышение АД. Со стороны пищеварительной системы: тошнота, рвота, диарея, абдоминальная боль, эпигастральная боль. Со стороны обмена веществ и питания: увеличение массы тела. Со стороны кожных покровов: дерматит, зуд, крапивница. Со стороны иммунной системы: гиперчувствительность, анафилактические реакции, ангионевротический отек.
Передозировка
Пирацетам не токсичен даже в высоких дозах. Зарегистрирован единичный случай развития диспептических явлений в виде диареи с кровью и болями внизу живота при приеме препарата в лекарственной форме раствор для приема внутрь в суточной дозе 75 г. Лечение: индукция рвоты, промывание желудка, симптоматическая терапия, гемодиализ (эффективность 50-60%). Специфического антидота нет.
Особые указания
В связи с влиянием пирацетама на агрегацию тромбоцитов с осторожностью следует назначать препарат пациентам с геморрагическими нарушениями, риском кровотечения (например, при язвенной болезни желудка), нарушением гемостаза, у пациентов, принимающих антикоагулянты и антиагреганты, в т.ч. ацетилсалициловую кислоту в низких дозах. При лечении кортикальной миоклонии следует избегать резкого прерывания лечения, т.к. это может вызвать возобновление приступов. При длительной терапии пациентам пожилого возраста рекомендуется регулярный контроль показателей функции почек, при необходимости проводят коррекцию дозы в зависимости от результатов исследования КК. Проникает через фильтрующие мембраны аппаратов для гемодиализа. Влияние на способность к вождению автотранспорта и работе с механизмамиВ период лечения необходимо соблюдать осторожность при управлении транспортными средствами и занятии другими потенциально опасными видами деятельности, требующими повышенной концентрации внимания и быстроты психомоторных реакций.
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