Celanidum

Celanidum – drug, относящийсяк to group of cardiotonic means, cardiac glycoside. It is released only according to the recipe. Celanidum contains active ingredient – lanatosidum Ts. Preparat is issued in the form of solution for injection use, tablets, solution for oral administration.

The mechanism of action of Celanidum consists in blocking of Na+/K+-ATF-azy. As a result concentration of ions of Na in cardiomyocytes increases, allocation of ions of Sa from a sarcoplasmic reticulum accelerates, as a result - the troponinovy complex rendering the oppressing effect on interaction of a myosin and actin is inhibited. Drug increases indicators of force and speed of reduction of a myocardium on a way, other than Frank-Starlinga mechanism (does not depend on the level of preliminary stretching of a myocardium). The period of a systole becomes shorter and economic. Celanidum increases contractility of a myocardium, UOK and IOC. At the same time KSO and KDO decreases that against the background of increase in a tone of a myocardium leads to essential reduction of its sizes and decrease in oxygen requirement. Drug has negative dromotropic effect that is shown in increase in a refrakternost of an AV node. As a result of the direct and mediated influence on processes of regulation of a cordial rhythm drug causes urezheny ChSS. Celanidum renders direct vasopressor effect. At the patients having chronic heart failure also mediated vazodilatiruyushchy influence of drug, decrease in venous pressure, increase in a diuresis, reduction of hypostases, asthmas is shown. The positive bathmotropic effect is shown when using subtoxic and toxic dosages.

At intravenous administration action of Celanidum begins in 10 minutes, the maximum is reached in 2 hours.

Indications to use of Celanidum

According to the instruction to Celanidum, this drug is shown at:

• ciliary tachyarrhythmia;

• an atrial flutter (for decrease in ChSS or transfer of trembling in fibrillation with the controlled carrying out impulses through an atrioventricular node);

• Bouveret's supraventricular disease;

• chronic heart failure;

• acute left ventricular failure;

• chronic pulmonary heart.

Contraindications to use of Celanidum

In the instruction to Celanidum such contraindications to use are noted:

• hypersensitivity;

• intoxication cardiac glycosides.

With care it is necessary to apply Celanidum at:

• bradycardia;

• To AV blockade;

• SSSU without pacemaker;

• GKMP;

• Bouveret's ventricular disease;

• the isolated mitral stenosis;

• acute myocardial infarction;

• WPW syndrome;

• unstable stenocardia;

• chronic heart failure with the broken diastolic function (an amyloidosis, restrictive KMP, a cardiac tamponade, chronic cardial compression);

• premature ventricular contraction;

• to cardiac asthma at a mitral stenosis (in case of lack of a takhisistolichesky ciliary arrhythmia);

• the expressed dilatation of cardial cavities;

• electrolytic disturbances: hypopotassemias, hypomagnesiemia, hypernatremias, hypercalcemias;

• hypothyroidism;

• alkalosis;

• arteriovenous shunt;

• advanced age.

Side effects

At use of Celanidum the following side effects are registered:

• from a GIT: vomiting, nausea, loss of appetite, diarrhea;

• from CCC: AV blockade, arrhythmias;

• from NANOSECOND: delirious psychosis, drowsiness, sleep disorder, dizziness, headache, confusion of consciousness;

• from the hemopoietic system: Werlhof's disease, thrombocytopenia;

• allergic reactions: small tortoiseshell, Quincke's disease;

• others: nasal bleedings, decrease in visual acuity, gynecomastia, petechias.

Overdose

At overdose of Celanidum there are symptoms of digitalis intoxication: Bouveret's ventricular disease, nodal premature ventricular contraction, ventricular premature ventricular contraction, blinking, atrial flutter, SA-blockade, AV blockade, vomiting, abdominal pain, diarrhea, change of visual perception, neuritis, paresthesias.

Overdose treatment: cancellation of this drug, introduction of specific antidotes (EDTA, Unithiolum), antiarrhytmic drugs, symptomatic treatment. At full AV blockade with Morganyi-Adams-Stokes' episodes use temporary electrocardiostimulation.

Route of administration of Celanidum and dosage

Celanidum is intended for parenteral and oral administration. The dosage in each clinical case is defined by the doctor. In need of achievement of bystry effect Celanidum is entered intravenously in a dosage 0,2-0,4mg, frequency rate of introduction – 1-2 times a day. The initial dosage for oral administration makes 0,25-0,5mg or 10-25 drops 3-4 times a day. The supporting dosage – 0,4-0,2mg (at intravenous administration), 0,5-0,25mg or 40-10 drops (at oral administration). Maximum dosages: daily – 1 mg, one-time – 0,5mg at oral administration; daily – 1 mg, one-time – 0,8mg at intravenous use.

Before use of drug it is necessary to study the instruction to Celanidum, and also the instructions of the attending physician noted in the recipe on Celanidum.

Special instructions

At GOKMP Celanidum causes increase in obstruction. At a mitral stenosis Celanidum is appointed in case of accession of right ventricular insufficiency or a mitral tachyarrhythmia. Use of Celanidum at AV blockade can aggravate its expressiveness and lead to emergence of attacks of Morganyi-Adams-Stokes. At a WPW syndrome Celanidum promotes carrying out cordial impulses in additional ways, thereby provoking development of a Bouveret's disease. For control of level of a digitalization definition of plasma concentration of drug can be used.

Interaction of Celanidum with other drugs

Antacids, холестирамин, Sulfasalazinum reduce absorption of Celanidum. Verapamil and beta adrenoblockers aggravate decrease in atrioventricular conductivity. Methyldopum, quinidine, spironolakty, verapamil, Amiodaronum increase concentration of Celanidum in blood as a result of competitive decrease in secretion in proximal tubules of kidneys. Diuretics, glucocorticoids increase probability of development of electrolytic disturbances. Calcium drugs, thiazide diuretics increase risk of development of a hypercalcemia. Calcium drugs, catecholamines, diuretics at a concomitant use with Celanidum increase risk of glikozidny intoxication.

Storage conditions

The drug Celanidum should be stored at the room temperature.

This medicine belongs to the list A. Celanidum according to the recipe is released.

Celanidum analogs

There are following analogs of Celanidum: Isolanidum, Tsedizanol, Lanatosidum With, Tsedistabil, Celadigal, Cedilanidum, Tseglunat, Digilanidum With, Cristalanatum With, Lanakroist, Page Lanatigenum.

The drug Celanidum can be used exclusively on doctor's orders.