В составе комплексной терапии сердечной недостаточности , инфаркта миокарда, нарушений сердечного ритма (преимущественно желудочковых аритмий ). Для улучшения переносимости сердечных гликозидов.
Противопоказания
Острая и хроническая почечная недостаточность. Олигурия, анурия. Болезнь Аддисона.AV-блокада II и III степени. Кардиогенный шок (АД < 90 мм. рт.ст.). Гиперкалиемия. Гипермагниемия. Повышенная чувствительность к компонентам препарата.
Калия аспарагината (в форме гемигидрата) 45.2 мг 452 мг, что соответствует содержанию к+ 10.33 мг 103.3 мгмагния аспарагинат (в форме тетрагидрата) 40 мг 400 мг, что соответствует содержанию mg2+ 3.37 мг 33.7 мгвспомогательные вещества: вода д/и - до 10 мл.
Фармакологические свойства
Препарат, влияющий на метаболические процессы. Источник ионов калия и магния. Калий и магний - внутриклеточные катионы, которые играют основную роль в функционировании многих ферментов, взаимодействии макромолекул и внутриклеточных структур и в механизме мышечной сократимости. Внутри- и внеклеточное соотношение ионов калия, магния, кальция и натрия оказывает влияние на сократительную способность миокарда. Низкий уровень ионов калия и/или магния во внутренней среде способен оказывать проаритмогенное действие, предрасполагает к развитию артериальной гипертензии , атеросклероза коронарных артерий и возникновению метаболических изменений в миокарде. Одной из наиболее важных физиологических функций калия является поддержание мембранного потенциала нейронов, миоцитов и других возбудимых структур ткани миокарда. Нарушение баланса между внутри- и внеклеточным содержанием калия приводит к снижению сократимости миокарда, возникновению аритмии , тахикардии и повышению токсичности сердечных гликозидов. Магний является кофактором > 300 ферментативных реакций энергетического метаболизма и синтеза белков и нуклеиновых кислот. Магний снижает напряжение сокращения и ЧСС, приводя к снижению потребности миокарда в кислороде. Магний оказывает противоишемическое действие на ткани миокарда. Снижение сократимости миоцитов гладких мышц стенок артериол, в т.ч. коронарных, приводит к вазодилатации и к усилению коронарного кровотока. Сочетание ионов калия и магния в одном препарате обосновано тем, что дефицит калия в организме часто сопровождается дефицитом магния и требует одновременной коррекции содержания в организме обоих ионов. При одновременной коррекции уровней этих электролитов наблюдается аддитивный эффект, кроме того, калий и магний снижают токсичность сердечных гликозидов, не оказывая влияния на их положительный инотропный эффект. Эндогенный аспартат (аспарагинат) благодаря незначительной диссоциации действует в качестве проводника ионов внутрь клеток в виде комплексных соединений. Калия аспарагинат и магния аспарагинат улучшают метаболизм миокарда.
Показания к применению
В составе комплексной терапии сердечной недостаточности , инфаркта миокарда, нарушений сердечного ритма (преимущественно желудочковых аритмий ). Для улучшения переносимости сердечных гликозидов.
Противопоказания
Острая и хроническая почечная недостаточность. Олигурия, анурия. Болезнь Аддисона.AV-блокада II и III степени. Кардиогенный шок (АД < 90 мм. рт.ст.). Гиперкалиемия. Гипермагниемия. Повышенная чувствительность к компонентам препарата.
Применение при беременности и в период грудного вскармливания
Данные о негативном влиянии препарата в форме раствора для в/в введения при беременности и в период лактации (грудного вскармливания) отсутствуют.
Способ применения и дозы
Препарат назначают в/в капельно, в виде медленной инфузии. Разовая доза - 1-2 ампулы, в случае необходимости возможно повторное введение через 4-6 ч. Для приготовления раствора для в/в инфузии содержимое 1-2 амп. растворяют в 50-100 мл 5% раствора глюкозы.
Побочное действие
При быстром в/в введении: возможно развитие симптомов гиперкалиемии и/или гипермагниемии.
Передозировка
Симптомы: при в/в введении - гиперкалиемия, гипермагниемия. Лечение: отмена препарата, проведение симптоматической терапии (в/в введение 100 мг/мин раствора кальция хлорида ), в случае необходимости - гемодиализ и перитонеальный диализ.
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