Description overdue on 12/18/2014

• Composition
• Product form
• Pharmacological action
• Pharmacodynamics and pharmacokinetics
• Indications
• Contraindications
• Side effects
• Promedol, instructions for use
• Overdose
• Cooperation
• Terms of sale
• Storage conditions
• Shelf life
• Cautions
• Babies
• With alcohol
• During pregnancy (and lactation)
• Reviews
• Price, where to buy

Composition

1 tablet contains 25 mg trimeperidine .

1 ml injection solution contains 10 mg or 20 mg trimeperidine .

Product form

Promedol The drug is available in tablets of 10 or 20 pieces in a package, as well as a 1% or 2% injectable solution in ampoule of 5, 10, 100, 150, 200, 250 or 500 pieces per pack.

Pharmacological action

Analgesic, antishock, antispasmodic, uterotoniziruyuschee, sleeping.

Pharmacodynamics and pharmacokinetics

Promedol The drug belongs to the pharmacological group Narcotic   ( opioid ) analgesics With primary analgesic. The active substance promedol classification INN - trimeperidine Exhibits agonistic effect on opioid receptors . It activates the endogenous analgesic   ( antinocyceptiv ) system Thus violating, at different levels CNS , Transportation pain impulses between neurons . Trimeperidine also it has an impact on the higher parts brain Modifying emotional   pain .

The pharmacological effects similar to the effects promedol M Orfin and expressed increasing pain threshold   the symptoms of pain of various origins, braking conditioned reflexes And faint hypnotic influence .Podavlenie respiratory center When used promedol, it is less pronounced as compared to Morphine . The drug is less likely to lead to symptoms such as a nausea and vomiting Somewhat strengthens contractile function   and the tone of the myometrium It has spasmolytic moderate efficiency with respect to ureters and bronchi, as well as spazmogennoe yielding action Morphine , towards intestines and biliary ways .

Development promedol analgesic effect, when administered parenterally, is observed after 10-20 min, rapidly increases and reaches a maximum after 40 minutes. High analgesic effects last for 2-4 hours, during epidural anesthesia   - More than 8 hours.

Oral administration of the drug provides an analgesic effect which is at 1, 5-2 times less than when administered parenterally.

With any method of delivery trimeperidine organism, it is quite rapid absorption. TCmax while taking orally is observed after 60-120 minutes. When administered intravenously, the contents trimeperidine plasma decreases rapidly and after 2 hours it detected only trace concentrations.

The plasma protein trimeperidine It binds 40%. The main metabolism passes in liver through the process of hydrolysis with separation normeperidinovoy and meperidinic acids   and further conjugation. T1 / 2 takes from 2 to 4 to 4 hours, kidney failure   increases slightly.

Excreted kidney in smaller amounts, including unchanged at 5%.

Indications

Cupping pain   moderate to severe intensity at:

• After a pain surgery ;
• pain at cancer patients;
• myocardial infarction ;
• unstable angina ;
• exfoliating aortic aneurysm ;
• renal artery thrombosis ;
• Acute pericarditis ;
• thromboembolism pulmonary arteries and arteries;
• Air embolism ;
• acute pleurisy ;
• heart attack light ;
• Spontaneous pneumothorax ;
• perforation of the esophagus;
• peptic ulcer ;
• chronic pancreatitis ;
• paranephritis ;
• acute dysuria ;
• renal and hepatic colic ;
• paraphimosis ;
• acute attack Glaucoma ;
• priapism ;
• Acute prostatitis ;
• lumbosacral radiculitis ;
• causalgia ;
• Acute vesiculitis ;
• thalamic syndrome;
• acute neuritis ;
• injuries and burns;
• protrusion intervertebral disc;
• foreign bodies in the urethra, rectum, urinary bladder.

Promedol appoint obstetric practice   with the aim of labor analgesia   and as a light stimulator labor.

AT surgical practice   the drug is indicated for premedication and composition general anesthesia As analgesic component (e.g., holding neuroleptanalgesia   in combination with neuroleptics ).

Pulmonary edema , Acute left ventricular failure   and cardiogenic shock Also are among the indications for use promedol.

Contraindications

Absolute contraindications to receiving promedol are:

• hypersensitivity   patient to trimeperidine ;
• age up to 2 years;
• a painful condition in which there is respiratory depression ;
• pursued in parallel therapy with MAO inhibitors And the time to 21 days after their withdrawal.

There are also a number of relative contraindications, in which the use promedol possible only with extreme caution, it is:

• respiratory failure ;
• renal failure   and / or liver;
• chronic heart failure ;
• adrenal insufficiency ;
• traumatic brain injury;
• CNS depression ;
• intracranial hypertension ;
• hypothyroidism ;
• myxedema ;
• BPH ;
• urethral stricture ;
• Surgical manipulation of the urinary system or the digestive tract;
• bronchial asthma ;
• convulsions ;
• obstructive pulmonary disease , Chronic course;
• hypotension ;
• arrhythmia ;
• emotional lability;
• suicidal ;
• cachexia ;
• alcoholism ;
• old age;
• debilitated patients;
• bowel disease   inflammatory disorders;
• drug addiction   (including history).

Side effects

CNS:

• blurring of vision;
• dizziness ;
• diplopia ;
• headache ;
• tremor ;
• convulsions ;
• involuntary muscle contractions;
• drowsiness ;
• weakness;
• disorientation ;
• confusion ;
• euphoria ;
• hallucinations ;
• unusual or nightmares;
• depression ;
• anxiety;
• paradoxical excitement;
• muscle stiffness (especially respiratory);
• retardation of psychomotor reactions ;
• ringing in the ears.

Bodies of the digestive tract:

• constipation ;
• dryness of the mouth;
• nausea ;
• anorexia ;
• vomiting ;
• spasm of biliary tract;
• toxic megacolon , Paralytic ileus . jaundice (inflammatory bowel disease in the nature).

Respiratory system:

• the suppression of the respiratory center .

Cardiovascular system:

• arrhythmia ;
• changes in blood pressure   (in either direction).

Urinary system:

• urinary retention ;
• a decrease in urine output .

Allergic symptoms:

• laryngism ;
• bronchospasm ;
• angioedema ;
• swelling of the face;
• rash and itch skin.

Local reactions:

• feeling burning at the injection site;
• edema ;
• hyperemia .

Others:

• increased sweating;
• development Drug Dependence . addiction .

Promedol, instructions for use

Application Instruction promedol assumes its delivery to the patient via intramuscular (i / m), subcutaneous (s / c) and in emergency situations, the intravenous (w / w) solution in the form of injections and internal (oral) administration in the form of tablets.

For relief   pain   Tablets recommend taking orally to adults in doses ranging from 25 mg to 50 mg. The maximum daily dose is equal promedol tablets - 50 mg.

Adults / m and s / c typically administered from 10 mg to 40 mg of Promedol (from the first vial to a 1% solution of 2 ampoules of 2% solution).

During the anesthesia recommend to / in a divided doses, depending on the situation, 3-10 mg.

With pain syndrome Provoked by smooth muscle spasm ( E. . renal . hepatic colic ), Prescribed in combination with Promedol   antispasmodic   and atropine drugs Under the close supervision of the patient's condition.

With the aim of premedication And 30-40 minutes before surgery, is administered i / m and s / c of 20-30 mg in combination with 0, 5 mg A tropine .

Promedol at birth   to appoint anesthesia and stimulate labor . The injection is carried out in / m or s / c in doses of 20-40 mg, with a positive assessment of the state of the fetus and the cervical dilatation of 3-4 cm. Promedol helps cervical muscle relaxation Thereby speeding up the process of its disclosure. Last injection should be done 30-60 minutes before the intended delivery In order to avoid negative consequences of childbirth-related suppression of fetal breathing .

The maximum dose of parenteral administration to adult patients is 40 mg and the maximum daily 160 mg.

Children older than 2 years old, the dose promedol is 0, 1 and 0, 5 mg / kg, n / a, / m, and rarely on / in the introduction. Repeated injections in order to relieve the pain, can be carried out in 4-6 hours.

During the general anesthesia As a component thereof, Promedol introduced in / for 0, 5 2, 0 mg / kg / hr. The maximum dose for the duration of the operations It should be no more than 2 mg / kg / hr.

Recommend infusion administered 10-50 mg / kg / h.

Epidural anesthesia   carried out at a dose of 0, 1 0, 15 mg / kg, prediluted promedol 2-4 ml of sodium chloride solution for injection. Getting there is the effect of the procedure after 15-20 minutes, peak action occurs after about 40 minutes, with a gradual decrease in efficiency over 8 hours or more.

Overdose

In overdose promedol, the main negative effect is depression of consciousness   and respiratory depression , up to coma . Also, there may be a variety of adverse events reinforced. A characteristic feature of diagnosing overdose can be miosis (pupillary constriction).

Recommended holding pulmonary ventilation   and its continued support, as well as in / in the introduction antidote - Naloxone and subsequent symptomatic therapy.

Cooperation

During a parallel application with promedol hypnotics   and sedatives , Anxiolytics, neuroleptics . muscle relaxants , Ethanol, means General anesthesia   and other narcotic analgesics Amplified the suppression of the central nervous system and respiratory .

The systematic admission barbiturates , especially Phenobarbital Observed decrease in analgesic action trimeperidine .

Promedol can increase efficiency antihypertensive drugs   ( diuretics . ganglioblokatorov etc.).

Antidiarrhoeal and anticholinergics means could lead to urinary retention , Heavy constipation . bowel obstruction .

Trimeperidine enhances the effects of drugs with anticoagulant activity in connection than at their joint use requires monitoring plasma prothrombin .

Treatment with Buprenorphine , Is there currently or previously pursued lowers promedol action.

Combined treatment with MAO inhibitors   It can cause severe consequences associated with braking or overexcitation of the central nervous system   and lead to the development antihypertensive or hypertensive crises .

Effects Metoclopramide fall when co-administered with promedol.

Naloxone It is antidote trimeperidine , It eliminates the side effects: suppression of breath , Analgesia, CNS depression . With drug dependence   accelerates the development of symptoms " withdrawal ".

Naltrexone also affects the acceleration of symptoms " withdrawal "When narcotic addiction . After administration of the drug-resistant and difficult to avoidable symptoms fairly quickly, sometimes within 5 minutes and observed for 2 days.

Terms of sale

To buy this drug requires a prescription promedol correctly filled in Latin, on the letterhead of the established rules, with all the accompanying details and seals.

Storage conditions

As an injection, tablets and promedol refer to the list A. The storage temperature of the drug 8-15 ° C.

Shelf life

For tablets and solution - 5 years.

Cautions

During therapy promedol better to refrain from delicate and dangerous work, as well as driving a car.

The systematic use of promedol may develop such drug dependence .

Babies

Assign children after 2 years, strictly on the testimony, in exactly the recommended doses, with extreme caution and under medical supervision.

With alcohol

Treatment promedol can not be combined with alcohol intake.

During pregnancy (and lactation)

In periods pregnancy (except for the onset of labor in which the drug is indicated as an analgesic and stimulant) and also during breast-feeding   Promedol prescribed with caution, taking into account all the possible negative effects of the therapy for the mother, the fetus or newborn.

Reviews

Reviews Promedol doctors use in their practice, as well as reviews of patients using this drug for the purpose of a strong relief pain In 99% of cases positive. The drug does possess   powerful analgesic   for pain of different origin, showing significant effectiveness as antispasmodic and even part of some kits as antishock agent .

But at the same time as any potent drug, a serious side effects : respiratory depression . oppression CNS . addictive . Therefore, when selecting drug anesthetic, you must first understand what it is, how to take it and what consequences it may bring. You should not rely on the information on the preparation Promedol Wikipedia, trust dubious Internet resources and the advice of friends. The decision to use promedol, and similar drugs may decide by a qualified medical specialist, as well as explain all the positive and negative aspects of therapy.

Price promedol where to buy

Promedol approximate price in Russia is: in the form of a 1% injectable solution №10 - 400 rubles in the form of a 2% injectable solution №10 - 500 rubles.

Buy 10 pills of the drug can be at a price of about - 200 rubles.