Pananginum

Pananginum – the drug influencing metabolic processes, filling shortage of potassium and magnesium in an organism.

Form of release and structure

• Tablets, film coated: a round form, convex from two parties, almost white or white color, with uneven and a little brilliant surface, almost inodorous (on 50 таб. in polypropylene bottles, in a pack a cardboard 1 bottle);
• Solution for intravenous administration: transparent, slightly greenish or colourless, without visible impurity (on 10 ml in glass colourless ampoules, on 5 ampoules in plastic pallets, in a pack the cardboard 1 pallet).

Active agents as a part of 1 tablet:

• Asparaginate potassium гемигидрат – 166,3 mg that corresponds to 158 mg of potassium of asparaginate;
• Asparaginate magnesium tetrahydrate – 175 mg that corresponds to 140 mg of magnesium of asparaginate.

Active agents as a part of solution (1 ml / 1 an ampoule):

• Potassium asparaginate (in the form of a gemigidrat) – 45,2 mg / 452 mg that 10,33 mg and 103,3 mg of potassium correspond respectively;
• Magnesium asparaginate (in the form of tetrahydrate) – 40 mg / 400 mg that 3,37 mg and 33,7 mg of magnesium correspond respectively.

Additional components of coated tablets:

• Excipients: corn starch, magnesium stearate, povidone, silicon dioxide colloid, talc, potato starch;
• Structure of a film cover: titanium dioxide (E171), macrogoal 6000, talc, methacrylic copolymer of acid (Е 100%).

Auxiliary component of solution for intravenous injections is injection water.

Indications to use

• Completion of a lack of magnesium and potassium at the lowered receipt of these elements with food (for tablets);
• Complex therapy of disturbances of a cordial rhythm (especially ventricular arrhythmias and arrhythmias caused by overdose of cardiac glycosides), heart failure and an acute myocardial infarction;
• Improvement of portability of cardiac glycosides.

Contraindications

For intravenous administration:

• Dehydration;
• Gipermagniyemiya;
• Hyperpotassemia;
• Insufficiency of bark of adrenal glands;
• Heavy myasthenia;
• Cardiogenic shock (arterial pressure is less than 90 mm hg);
• Acute and chronic renal failure;
• Atrioventricular block of the II-III degree;
• Addison's disease;
• Age up to 18 years;
• Pregnancy;
• Lactation;
• Hypersensitivity to drug components.

With care:

• Atrioventricular block of the I degree;
• Metabolic acidosis;
• Decrease in level of phosphates in blood;
• Risk of development of hypostases;
• The expressed abnormal liver functions owing to disturbance of exchange of magnesium, calcium and ammonium of phosphate;
• Urolithic diathesis;
• Renal failure if there is no opportunity constantly to control concentration of magnesium in blood serum.

For intake:

• Hemolysis;
• Disturbance of exchange of amino acids;
• Organism dehydration;
• Acute metabolic acidosis;
• Gipermagniyemiya;
• Hyperpotassemia;
• Acute and chronic renal failure;
• Heavy myasthenia;
• Addison's disease;
• Cardiogenic shock (arterial pressure is less than 90 mm hg);
• Atrioventricular block of the I-III degree.

With care: pregnancy (especially I trimester) and lactation.

Route of administration and dosage

Solution for intravenous (in/in) introductions
Pananginum is entered in/in kapelno (in the form of slow infusion with a speed of 20 thaws a minute). If necessary in 4-6 hours enter one more dose.

For preparation of infusion solution contents of 1-2 ampoules are diluted by 50-100 ml of 5% of solution of a dextrose (glucose).

Tablets, film coated
In the tableted Pananginum form it is necessary to accept inside after food.

Depending on indications appoint 1-2 tablets 3 times a day. In some cases the doctor can increase a single dose to 3 tablets.

The doctor determines duration of treatment and need of carrying out repeated therapeutic courses individually.

Side effects

At bystry intravenous administration development of the following side effects is possible: a dermahemia, phlebitis, paradoxical reaction (increase in quantity of extrasystoles), a hyperpotassemia (paresthesia, a myasthenia, fatigue, confusion of consciousness, disturbance of a heart rhythm, arrhythmia, bradycardia, an atrioventricular block, a cardiac standstill), a gipermagniyemiya (desires on vomiting, vomiting, a lowering of arterial pressure, decrease in neuromuscular irritability, a lethargy).

At intake the following side effects are possible:

• From water and electrolytic balance: a hyperpotassemia (it is shown by diarrhea, nausea, vomiting, paresthesias), a gipermagniyemiya (it is shown by feeling of thirst, face reddening, a hyporeflexia, a lowering of arterial pressure, respiratory depression, spasms);
• From cardiovascular system: paradoxical reaction (increase in number of extrasystoles), atrioventricular block;
• From the alimentary system: diarrhea, nausea, vomiting; at patients with anacid gastritis and cholecystitis – a burning sensation or feeling of discomfort in pancreatic area.

Special instructions

At patients with the increased risk of development of a hyperpotassemia during treatment it is necessary to control constantly potassium concentration in a blood plasma.

Pananginum does not exert a negative impact on occupations the types of activity demanding high concentration of attention and speed of reactions.

Medicinal interaction

The potassium which is a part of Pananginum:

• Eliminates the hypopotassemia caused by glucocorticosteroids;
• Reduces side effects of cardiac glycosides;
• Strengthens negative dromo-and bathmotropic effect of antiarrhytmic medicines.

At simultaneous use of cyclosporine, heparin, non-steroidal anti-inflammatory drugs, kaliysberegayushchy diuretics, beta adrenoblockers or inhibitors of an angiotensin-converting enzyme the risk of development of a hyperpotassemia increases, up to premature ventricular contraction.

The enveloping and knitting drugs reduce absorption of Pananginum in digestive tract therefore between their receptions it is necessary to observe at least a 3-hour interval.

Drugs of calcium reduce effect of magnesium.

Anesthetics strengthen the oppressing effect of magnesium on the central nervous system.

Magnesium reduces efficiency of tetracycline, polymyxin B, streptomycin, Neomycinum.

Calcitriol increases magnesium level in a blood plasma.

At simultaneous use a deksametoniya, an atrakuriya, succinylcholine strengthening of neuromuscular blockade is possible.

Solution for in/in introductions Pananginum is compatible to solutions of cardiac glycosides (improves their portability, reduces the undesirable effects caused by them).

Terms and storage conditions

To store in the place, unavailable to children, with observance of temperature condition 15-30 ºС.

Solution period of validity – 3 years, tablets – 5 years.