Nitroglycerin spray podyaz.dozir. 0.4mg / dose 200doz 10ml vials. with crucified. Medisorb

$2.10

Nitroglycerin spray podyaz.dozir. 0.4mg / dose 200doz 10ml vials. with crucified. Medisorb

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Description

Composition
Active substance:
1 dose contains nitroglycerin (as a 1% alcohol solution in 96% ethanol) 0.4 mg.
Description:
Transparent colorless liquid.
Product form:
Spray sublingual dosage of 0.4 mg / dose.
200 doses (10 mL / 8 g) in polymer bottles, provided with dispensing nozzles, nebulizers and protective caps.
The vial together with instructions for use placed in a pile of cardboard boxed.
Contraindications
Hypersensitivity to nitrates, shock, collapse, age 18, simultaneous reception of phosphodiesterase 5 inhibitors (including sildenafil, vardenafil, tadalafil), severe anemia, intracranial hypertension.
Precautions prescribed to patients with: hemorrhagic stroke; acute myocardial infarction with low filling pressure of the left ventricle (LV) (risk of lowering blood pressure (BP) and tachycardia which can enhance ischemia); chronic heart failure (CHF) with a low pressure filling of LV; angle-closure glaucoma (risk of increased intraocular pressure); thyrotoxicosis; hypotension with a low systolic blood pressure (.. below 90 mm Hg) (may exacerbate the condition, causing paradoxical bradycardia and angina); Hypertrophic obstructive cardiomyopathy (possibly increased frequency of angina attacks); severe renal insufficiency; hepatic insufficiency (risk of methemoglobinemia); pregnancy; lactation; recently transferred head trauma; conditions involving reduction in left ventricular filling pressure – isolated mitral stenosis; constrictive pericarditis; cardiac tamponade; alcoholism; epilepsy; migraine.
Dosage
0.4 mg / dose
Indications
Cupping strokes, transient prevention of angina attacks before exercise or emotional stress.
Interaction with other drugs
Intensity of lowering blood pressure is enhanced by the simultaneous application of nitroglycerin to: – other vasodilators; – antihypertensive drugs (ACE-inhibitors, beta-blockers, blockers “slow” calcium channel); – tricyclic antidepressants; – monoamine oxidase inhibitors; – diuretics; – neuroleptics; – ethanol.
Simultaneous administration of nitroglycerin with sildenafil and also with other phosphodiesterase inhibitors can lead to a sharp decrease in blood pressure.
With simultaneous application of nitroglycerin with quinidine and procainamide Orthostatic hypotension may occur, procainamide enhances expression of lowering blood pressure.
Simultaneous application of nitroglycerin with dihydroergotamine may increase the content of the latter in the blood and an increase in blood pressure (increased bioavailability dihydroergotamine).
When concomitant administration of nitroglycerin and heparin, reduced the effectiveness of the latter (after drug withdrawal possible a substantial reduction of blood clotting, which may require dose reduction heparin).
The simultaneous use of acetylsalicylic acid increases the maximum concentration of nitroglycerin and AUC (area under the curve “concentration-time”).
Overdose
Symptoms: lowering blood pressure (below 90 mm Hg..) To the orthostatic dysregulation, reflex tachycardia, headache; may develop fatigue, dizziness, drowsiness, fever, nausea, vomiting; when used in high doses (20 mg / kg) – collapse, cyanosis, methemoglobinemia, dyspnea and tachypnea.
Treatment: with the appearance of symptoms of overdose immediately put the patient, lift the legs. Seek medical advice immediately.
pharmachologic effect
Pharmacological group:
Vasodilating agent, a nitrate.
Pharmacodynamics:
Venodilatiruyuschee agent from the group of nitrates. Nitrates are capable of releasing from the molecule nitric oxide, which is a natural endothelium-derived relaxing factor – mediated direct activation of soluble guanylate cyclase. Increasing concentrations tsikloguanozinmonofosfata causes relaxation of smooth muscle fibers (mostly venules and veins). It has antianginal and antispasmodic action, relaxing the smooth muscles of the vascular walls, bronchi, gastrointestinal (GI) tract, biliary tract, ureter.
Reduces blood flow to the right atrium, thereby reducing the pressure in the “small” circulation symptoms and regression of lung edema decreases afterload, myocardial oxygen demand (due to reduction of preload, afterload, and the voltage of the ventricles due to the reduced volume of the heart). Promotes redistribution of coronary blood flow in the area of ​​reduced blood circulation.
It has central inhibitory effect on sympathetic vascular tone, inhibiting the formation of vascular component of pain. It causes dilation of cerebral blood vessels, which explains the headache if it is applied.
Effect of the drug begins quickly, the effect develops within 1-1.5 minutes and lasts for about 30 minutes.
Pharmacokinetics:
Suction. Quickly and completely absorbed from mucosal surfaces. Therapeutic plasma concentration reached within a few minutes.
When reception is eliminated sublingual first pass effect through the liver – nitroglycerin immediately enters the systemic circulation.
Distribution. The bioavailability is approximately 100%. It has a very large volume of distribution. Communication with plasma proteins – 60%.
Withdrawal. Is rapidly metabolized with the participation of nitrate to form di- and mononitrate (only active isosorbide-5-mononitrate), the final metabolite – glycerol. The total clearance is 25-30 l / min. The half-life after oral administration is 4 hours with sublingual application – 20 minutes, after on / in the 1- 4 min.. Excreted mainly by the kidneys in the form of metabolites.
Pregnancy and breast-feeding
The drug is contraindicated during pregnancy and lactation.
Conditions of supply of pharmacies
Leave without a prescription.
side effects
Cardio-vascular system: tachycardia, fever, decreased blood pressure, orthostatic collapse, cyanosis.
From the digestive system: dryness of the oral mucosa, nausea, vomiting, abdominal pain.
Central nervous system: dizziness, headache, anxiety, psychotic reactions, lethargy, disorientation.
Allergic reactions: seldom – skin rash, itching.
Local reactions: burning under the tongue.
Other: blurred vision, weakness, hypothermia, methemoglobinemia.
special instructions
In acute myocardial infarction or acute heart failure (HF) should be used only with careful observation of the patient.
To prevent the increased frequency of angina attacks should avoid abrupt withdrawal.
Patients undergoing treatment previously organic nitrates (isosorbide dinitrate, isosorbide mononitrate), a higher dose may be required to obtain the desired hemodynamic effect.
While taking nitroglycerin may be a significant decrease in blood pressure and the occurrence of vertigo with a sharp transition to the vertical position of the “lying” or “sitting” in the use of ethanol, physical exercises and hot weather and increased angina with a sharp decrease in blood pressure, ischemia, up to myocardial infarction and sudden death (paradoxical nitrate reaction).
With frequent admission without the application of free slots may develop addictive requiring increasing dosage.
Severity of headache in patients receiving nitroglycerin can be reduced by reduction of the dose and / or simultaneous reception mentolsoderzhaschih PM.
If blurred vision or dryness of the oral mucosa or expressed strongly retained, the treatment should be discontinued.
During the period of treatment must be careful when driving and other lesson. Potentially hazardous activities that require high concentration and psychomotor speed reactions.
Nitroglycerin increases the excretion of catecholamines and vanillylmandelic acid by the kidneys.
Storage conditions
In the dark place, away from the fire, at a temperature of 8 to 20 ° C.
Dosing and Administration
Spray sprayed sublingually.
At first use or after long periods of non-use is recommended before actually using one dose reset in air for filling aerosol chamber.
For relief of angina – 0.4-0.8 mg (1-2 doses) by pressing on the metering valve, preferably a position “sitting”, breath-hold at intervals of 30 seconds; then you should close your mouth for a few seconds. If necessary, the drug is administered repeatedly with 5 minute intervals, but not more than 1.2 mg (3 doses) for 15 min. If the angina attack is not cropped, should consult a doctor.
To prevent the development of attack – 0.4 mg (one dose) for 5-10 minutes before the expected load or stress.
The maximum single dose – 1.6 g (4 doses), the maximum daily dose – 6.4 g (16 doses).
The drug should not be inhaled.
Information
Appearance may differ from that depicted in the picture. There are contraindications. You need to read the manual or consult with a specialist

Additional information

Weight0.100 kg
Manufacturer

Medisorb

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