Теопэк (Теофиллин) относится к ингибиторам фосфодиэстеразы.; Теофиллин увеличивает накопление в тканях ц-АМФ, что уменьшает сократительную активность гладкой мускулатуры.; Теофиллин расширяет бронхи, кровеносные сосуды (главным образом сосуды мозга, кожи и почек).; Уменьшает легочное сосудистое сопротивление, понижает давление в малом круге кровообращения.; Увеличивает почечный кровоток.; Обладает умеренно выраженным диуретическим эффектом.; Угнетает агрегацию тромбоцитов.; Оказывает стимулирующее действие на дыхательный центр, повышает частоту и силу сердечных сокращений.; Замедленное высвобождение действующего вещества из таблетки обеспечивает достижение терапевтического уровня теофиллина в крови через 3-5 часов после приема Теопэка и сохраняется в течение 10-12 часов.; Двухразовый прием препарата позволяет получить эффективные концентрации теофиллина в крови в течение суток.; В связи с действием препарата одним из важных показателей к применению является предупреждение ночных и предутренних явлений бронхоспазма.
Показания к применению
Лечение и профилактика бронхообструктивного синдрома при: - Бронхиальной астме.
Хроническом обструктивном бронхите.
Эмфиземе легких.
Дерматореспираторном синдроме.
Других заболеваниях органов дыхания.
Противопоказания
Гиперчувствительность (в т.ч. к другим производным ксантина - кофеину, пентоксифиллину, теобромину ).
Острый инфаркт миокарда.
Тяжелая артериальная гипер - или гипотензия.
Распространенный атеросклероз сосудов.
Серьезные нарушения сердечного ритма (тяжелые тахиаритмии, экстрасистолия ).
Гиперфункция щитовидной железы.
Язвенная болезнь желудка и двенадцатиперстной кишки в стадии обострения.
Гастрит с повышенной кислотностью.
Кровотечение из желудочно-кишечного тракта.
Эпилепсия.
Повышенная судорожная активность.
Геморрагический инсульт.
Кровоизлияние в сетчатку глаза.
Беременность.
Детский возраст до 3-х лет.
С осторожностью применять при: - Тяжелой стенокардии.
Сердечной недостаточности.
Гипертрофической кардиомиопатии.
Выраженных нарушениях функции печени и почек.
Язвенной болезни желудка и двенадцатиперстной кишки (в анамнезе).
Кровотечение из желудочно-кишечного тракта в недавнем анамнезе.
Длительная гипертермия.
Гастроэзофагеальный рефлюкс.
Гипертрофия предстательной железы.
Применение при беременности и в период грудного вскармливания
Теофиллин проникает через плацентарный барьер, выделяется с грудным молоком.; При беременности теофиллин применяют только в том случае, если предполагаемая польза для матери превышает возможный риск для плода.; При необходимости применения в период лактации следует учитывать, что теофиллин выделяется с грудным молоком.
Способ применения и дозы
Теопэк применяют внутрь после еды, запивая водой. Таблетку не измельчают, не разжевывают и не растворяют в воде.; Суточная доза делится на 2 приема с интервалом 12 часов.; Оптимальную дозу подбирают индивидуально, в зависимости от характера заболевания, возраста и веса больного.; Препарат назначают 2 раза в день: - Взрослым и детям старше 14 лет по 300 мг.;- Детям от 7 до 12 лет - по 200 мг.;- Детям от 3 до 7 лет - по 100 мг.; В первый день лечение начинают с половины суточной дозы в 2 приема.; При отсутствии побочных реакций переходят на полную суточную дозу.; Длительность применения препарата зависит от особенностей течения заболевания и оказываемого терапевтического эффекта.; В среднем курс лечения может длиться от 2-х недель до 2-х месяцев.
Передозировка
Симптомы: снижение аппетита, гастралгия, диарея, тошнота, рвота (в т.ч. с кровью), желудочно-кишечное кровотечение, тахипноэ, гиперемия кожи лица, тахикардия, желудочковые аритмии, бессонница, двигательное возбуждение, тревожность, светобоязнь, тремор, судороги. При тяжелом отравлении могут развиться эпилептоидные припадки, гипоксия, метаболический ацидоз, гипергликемия, гипокалиемия, снижение артериального давления, спутанность сознания, почечная недостаточность с миоглобинурией.; Лечение: отмена препарата, промывание желудка, назначение активированного угля, слабительных ЛС, промывание кишечника комбинацией полиэтиленгликоля и электролитов, форсированный диурез, гемосорбция, плазмосорбция, гемодиализ (эффективность не высока, перитонеальный диализ не эффективен), симптоматическая терапия (в т.ч. метоклопрамид и ондансетрон - при рвоте). При возникновении судорог поддерживать проходимость дыхательных путей и проводить оксигенотерапию. Для купирования припадка - в/в диазепам, 0,1-0,3 мг/кг (но не более 10 мг). При сильной тошноте и рвоте - метоклопрамид или ондансетрон (в/в).
Особые указания
При тяжелых заболеваниях сердечно-сосудистой системы, печени, вирусных инфекциях, а также у больных пожилого возраста дозу препарата следует уменьшить.; Эффективность действия теофиллина может уменьшаться у курящих.; Так как бронхолитическое действие Теопэка развивается постепенно через 3-6 часов после приема, препарат не назначается для купирования неотложных состояний.; Соблюдать осторожность при употреблении больших количеств кофеинсодержащих продуктов или напитков в период лечения.
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