Ascorbic acid

General characteristics. Structure:

Active ingredient: 50 mg or 100 mg of ascorbic acid.

Excipients: Natrii hydrocarbonas, sodium metabisulphite, the water for an injection saturated with carbon dioxide.

Vitamin means which is not formed in a human body and arrives only with food. Participates in regulation of oxidation-reduction processes, carbohydrate metabolism, coagulability of blood, a regenerayotion of fabrics; in synthesis of steroid hormones.

Pharmacological properties:

Pharmacodynamics. Ascorbic acid - vitamin means which is not formed in a human body and arrives only with food. Participates in regulation of oxidation-reduction processes, carbohydrate metabolism, coagulability of blood, a regenerayotion of fabrics; in synthesis of steroid hormones; increases resistance of an organism to infections, reduces a vascular pronitsayeyomost, reduces the need for Bl vitamins, B2, A, E, folic acid, pantothenic acid. Has the expressed antioxidant properties. Regulates hydrogen transport in many biochemical reactions, improves use of glucose in a cycle of tricarboxylic acids, participates in formation of tetrahydrofolic acid and an angenesis, synthesis of steroid hormones, collagen, procollagen.

Maintains colloidal state of intercellular substance and normal permeability of capillaries (oppresses hyaluronidase). Activates proteolytic enzymes, participates in exchange of aromatic amino acids, pigments and cholesterol, promotes accumulation in a glycogen liver. Due to activation of respiratory enzymes in a liver strengthens its detoksikatsionny and belkovoobrazovatelny functions, increases synthesis of a prothrombin.

Improves bile secretion, recovers vneshnesekretorny function of a pancreas and incretory - thyroid Regulates immunologichesyoky reactions (activates synthesis of antibodies, the SZ-component of a complement, interferon), promotes phagocytosis, raises an organism soproyotivlyaemost to infections. Slows down release and accelerates degradation of a histamine, formation of prostaglandins (Pg) and other mediators of an inflammation and allergic reactions oppresses.

The pharmacokinetics Is metabolized preferential in a liver in dezoksiaskorbinovy and further in oxalacetic and diketogulonic kisyolota. It is removed by kidneys, through intestines, with then, breast milk in the form of not changed ascorbate and metabolites.

At purpose of high doses removal speed sharply amplifies. Smoking and the use of ethanol accelerate destruction of ascorbic acid (transformation into inactive metabolites), sharply reducing stocks in an organism. It is removed at a hemodialysis.

Indications to use:

Apply in the medical purposes in all clinical situations connected with need of additional administration of asyokorbinovy acid. Drug is appointed:

- at avitaminosis With (scurvy);

- as a part of complex therapy at bleedings (pulmonary, uterine, caused by a radial illness);

- at various intoxications and infectious diseases, alcoholic and infectious deliriums;

- Addison's diseases, at overdose of anticoagulants, vyalozazhivayushchy wounds, various dystrophies.

Route of administration and doses:

Apply on doctor's orders. The drug is administered intravenously and intramusculary. Medical doses for adults - on 1-3 ml of solution of 50 mg/ml, at poisonings enter up to 60 ml/days.

Medical doses for children - on 1-2 ml 50 mg/ml of solution (or on 1 ml 100 mg/ml of solution). Duration of treatment depends on character and the course of a disease.

Features of use:

In connection with a promoting effect of ascorbic acid on synthesis of corticosteroid hormones it is necessary to monitor function of adrenal glands and the arterial pressure (AP). At prolonged use of high doses oppression of function of the insulyarny device of a pancreas therefore in the course of its treatment it is regularly necessary to control is possible. At patients with the increased content of iron in an organism it is necessary to apply ascorbic acid in the minimum doses.

Nazyonacheniye of ascorbic acid to patients with quickly proliferating and intensively metastasizing tumors can usuyogubit the course of process. Ascorbic acid as a reducer, can distort results of various laboratory tests (content in blood of glucose, bilirubin, activity of "hepatic" transaminases, laktatdagidrogenaza).

Use at pregnancy and a lactation. Ascorbic acid gets through a placenta. Studying of a reproduction on animals revealed adverse action on a fruit, but adequate and strictly controlled researches at the person were not conducted therefore at parenteral administration of high doses of ascorbic acid it is necessary to correlate advantage for mother and risk for a fruit. Ascorbic acid gets into breast milk therefore at parenteral administration of high doses of an ascorbic kisyolota it is necessary to resolve an issue of the breastfeeding termination.

Side effects:

From the central nervous system (CNS): at bystry intravenous administration - dizziness, feeling of fatigue: at prolonged use of high doses - increase in excitability of TsNS, a sleep disorder.

So sides of the digestive tract (DT): nausea, vomiting, diarrhea, stomach spasms.

From endocrine system: oppression of function of the insulyarny device of a pancreas (hyperglycemia, glucosuria).

From an urinary system: at use in high doses - a hyperoxaluria and education uric turn into stone from calcium oxalate, damage of the glomerular device of kidneys.

From cardiovascular system (CCC): decrease in permeability of capillaries and deterioration in a trophicity of fabrics, тром­боз, at use in high doses - increase in arterial pressure, development of mikroangiopatiya, a myocardial dystrophy.

Allergic reactions: skin rash, it is rare - an acute anaphylaxis.

Laboratory indicators: thrombocytosis, giperprotrombinemiya, erythropenia, neutrophylic leukocytosis, hypopotassemia.

Others: a hypervitaminosis, disbolism, feeling of heat, at prolonged use of high doses - a delay of sodium and liquid, disturbance of exchange of zinc, copper.

Interaction with other medicines:

Ascorbic acid increases concentration in blood of benzylpenicillin and tetracyclines, in a dose of 1 g/days increases bioavailability of ethinylestradiol (as a part of contraceptives for intake).

Reduces efficiency of heparin, indirect coagulants, antibiotics.

At simultaneous use with acetylsalicylic acid there is an increase a vyvedeyoniya to urine of ascorbic acid and reduction of excretion of acetylsalicylic acid.

Ascorbic acid increases risk of development of a crystalluria at treatment by salicylates and streptocides of short action, slows down removal of a pochkayoma of acids, increases removal of the drugs having alkali reaction (including alkaloids), reduces concentration in blood of oral contraceptives.

Increases the general clearance of ethanol which, in turn, reduces concentration of ascorbic acid in an organism.

Drugs of a quinolinic row, Calcii chloridum, salicylates, glucocorticosteroids at prolonged use exhaust reserves of ascorbic acid.

At simultaneous use reduces chronotropic action of an izoprenalin. At prolonged use or use in high doses can break interaction дисульфирамэтанол.

In high doses raises renal excretion of a meksiletin.

Barbiturates and Primidonum raise vyvedeyony ascorbic acid with urine. Reduces therapeutic action of neuroleptics (derivatives of a fenotiazin), a canalicular reabsorption of amphetamine and tricyclic antidepressants.

Contraindications:

Hypersensitivity to drug components. Introduction of high doses - hypercoagulation, thrombophlebitis, a sklonyonost to fibrinferments, a diabetes mellitus, a nephrolithiasis, deficit glyukozo-6-fosfatdegidrogenazy.

Overdose:

Symptoms. At intravenous administration in high doses - threat of abortion (owing to an estrogenemia), hemolysis of erityorotsit. At emergence of one of the symptoms which are listed below use of drug should be stopped. At prolonged use of high doses (more than 1 g) symptoms: headache; increase in excitability of the central nervous system: sleeplessness; nausea; vomiting; diarrhea; hyperacid gastritis; ultseration of a mucous membrane of digestive tract; oppression of function of the insulyarny device of a pancreas (hyperglycemia, glucosuria); hyperoxaluria; a nephrolithiasis (from oxalate calcium): damage of the glomerular device of kidneys; a moderate pollakiuria (at reception of a dose more than 600 mg/days), decrease in permeability of capillaries (deterioration in a trophicity of fabrics, increase in arterial pressure, hypercoagulation, development of mikroangiopatiya is possible.

Treatment: symptomatic.

Storage conditions:

In the place protected from light at a temperature not above 25 °C. In the place, unavailable to children. Period of validity: for 50 mg/ml - 1 year, for 100 mg/ml - 1,6 year. Not to use after the expiry date specified on packaging.

Issue conditions:

According to the recipe

Packaging:

Solution for intravenous and intramuscular administration of 50 mg/ml and 100 mg/ml. 2 ml in ampoules of neutral glass. 5 ampoules in a blister strip packaging. 2 planimetric cell upayokovka in a pack from a cardboard. 10 ampoules in a pack from a cardboard with partitions or lattices, or a separator from a cardboard for a retail container or paper bag. 10 ampoules in a box from a cardboard. Put the application instruction, a knife in each box or a pack ampoule or the scarificator ampoule. When using ampoules with notches, break rings, break points, the knife ampoule or the scarificator ampoule is not put.