Description overdue on 03.04.2012

Calcium channel blocker slow . The active ingredient is derived difenilalkilamina. The drug has a hypotensive, antriaritmicheskim, antianginal effects. Direct impact on peripheral hemodynamics   myocardium and provides antinaginalnoe impact. The drug has a negative chronotropic, inotropic and vasodilatory effects. Verapamil decreases atriventrikulyarnuyu conductivity It suppresses automaticity sinus node Moderately lengthens refractory, relaxing tone of myocardial wall, extends the period of relaxation of the left ventricle during diastole. In some cases, Verapamil prescribed for the prevention of headaches of vascular origin (drug predovtraschaet jet expansion of the lumen of blood vessels, prevents them from narrowing). With the participation of cytochrome P450 drug inhibits the metabolism. Antianginal effect is dose-dependent. Verapamil is available in the form of Friendly, solution, capsules, a tablet form.

Indications:

Verapamil prescribed for sinus tachycardia , Atrial arrhythmia, supraventricular tachycardia . angina   (stable vasospastic form stablnaya without vasoconstriction, stress), and WPW syndrome , Atrial flutter. When hypertensive crisis drug is administered intravenously.

Contraindications:

Verapamil is not indicated in the SA block, atriventrikulyarnoy blockade, severe course of hypertension, intolerance, Lown-Ganong syndrome-Levine , Breastfeeding. In severe aortic stenosis , Bradycardia, atrioventricular block first degree, myocardial infarction, renal disease, hepatic failure system in pediatric appointed after consultation with experts addressing the issue of destination. Verapamil prescribed during pregnancy in emergency situations.

Side effect:

Influence on Cardiovascular system : Tachycardia, marked drop in blood pressure, bradycardia, arrhythmia, collapse, asystole, atriventrikulyarnaya blockade of the third degree with the rapid intravenous injection. Nervous system:   tremor of the extremities, extrapyramidal disorder , Depression, asthenia, fatigue, fainting, headache, dizziness, ataxia. Digestive system:   increased appetite, increased levels of liver enzymes, gingival hyperplasia, diarrhea, constipation . Perhaps the development of allergic reactions, agranulocytosis, pulmonary edema, the formation of peripheral edema, arthritis, gynecomastia, galactorrhea, hyperprolactinemia .

Overdose:

Manifested SA block, bradycardia, shock, drop in blood pressure, artrioventrikulyarnoy blockade, shock, heart failure. Requires recovery rate, gastric lavage. Enter intravenous atropine   norepinephrine Isoprenaline, calcium gluconate. To raise the blood pressure is administered phenylephrine, alpha adrenostimulyatorov. Hemodialysis is not proven effective.

Mode of application:

Verapamil take three times a day by 40-80 mg inside in the supraventricular tachycardia, angina. In patients with hypertension take medication twice a day. Babies with supraventricular arrhythmias give 2-3 times a day to 20 mg, when hypertension was calculated by circuit 10 mg / kg per day. Initial dosage if necessary slow decrease in blood pressure is 120 mg per day. Long-term treatment is not recommended to increase the daily dose up to 480 mg. The increase in dosage is allowed only in cases of emergency for a short time, under the supervision of a doctor. In the pathology of renal daily dosage should not exceed 120 mg. Verapamil prescribed during pregnancy for the scheme.

Special instructions:

Before the appointment of Verapamil is a mandatory procedure compensate Heart Failure . During therapy, estimate the amount of urine, respiratory system, the cardiovascular system, blood sugar levels. In infants, newborns are registered heavy hemodynamic disturbances . Invalid abrupt discontinuation of treatment.

Drug Interactions:

Verapamil causes an increase in the concentration of quinidine, miorlaksantov, carbamazepine , Cyclosporine, prazosin, theophylline, digoxin, valproic acid   in the blood due to the inhibition of metabolism involving the enzyme cytochrome P450. Verapamil bioavailability is increased by 40% while the body is cimetidine. The effectiveness of drug formulations affect calcium. By accelerating the metabolism of nicotine in the hepatic system, barbiturates, rifampicin reduce the concentration of drug in the blood, reducing the quality of antiarrhythmic, antihypertensive and antianginal effects . The likelihood of developing heart failure, atriventrikulyarnoy blockade, bradycardia increases significantly in the appointment of inhaled anesthetics. The hypotensive effect   decreases in the appointment sympathomimetic. Verapamil increases the concentration in the blood cardiac glycosides . Estrogen causes fluid retention in the body, reducing the hypotensive effect. Verapamil increases the impact Peripheral muscle relaxants.