Aspinat cardio

General characteristics. Structure:

Active agent: acetylsalicylic acid of 100 mg

Excipients: MKTs; starch 1500; aerosil (silicon dioxide colloid); stearic acid 
 
Cover: AKRIL-IZ (copolymer of methacrylic acid with ethyl acrylate 1:1; titanium dioxide; talc; triethyl citrate; silicon oxide colloid anhydrous; Natrii hydrocarbonas; sodium lauryl sulfate); коповидон; hydroxypropyl cellulose (Klutsel).

Pharmacological properties:

Pharmacodynamics. Irreversible inhibition of TsOG-1 therefore synthesis of A2 thromboxane is blocked is the cornerstone of the mechanism of effect of acetylsalicylic acid (ASK) and aggregation of thrombocytes is suppressed.
It is considered that ASK has also other mechanisms of suppression of aggregation of thrombocytes that broadens area of its use at various vascular diseases. ASK has also antiinflammatory, anesthetizing, febrifugal effect.

Pharmacokinetics. After intake acetylsalicylic acid is soaked up in an upper part of a small intestine. Cmax in a blood plasma is noted on average in 3 h after administration of drug inside.
Acetylsalicylic acid is exposed to partial metabolism in a liver with formation of less active metabolites. It is removed by kidneys, as in not changed type, and a type of metabolites. T1/2 for acetylsalicylic acid makes about 15 min., for metabolites — about 3 h.

Indications to use:

- prevention of an acute myocardial infarction with risk factors (for example a diabetes mellitus, a lipidemia, arterial hypertension, obesity, smoking, advanced age) and a repeated myocardial infarction;
- unstable stenocardia;
- prevention of a stroke (including at patients with passing disturbance of cerebral circulation);
- prevention of passing disturbance of cerebral circulation;
- prevention of a thromboembolism after operations and invasive interventions on vessels (for example aortocoronary shunting, endarterectomy of carotid arteries, arteriovenous shunting, angioplasty of carotid arteries);
- prevention of a deep vein thrombosis and thromboembolism of a pulmonary artery and its branches (for example at a long immobilization as a result of big surgical intervention).

Route of administration and doses:

Inside, before food, washing down with a large amount of liquid.

Drug is intended for prolonged use. Duration of therapy is defined by the attending physician.

Prevention at suspicion of an acute myocardial infarction — 100–200 mg/days (the first tablet needs to be chewed for more bystry absorption).

Prevention for the first time the arisen acute myocardial infarction with risk factors — 100 mg/days.

Prevention of a repeated myocardial infarction, unstable stenocardia, prevention of a stroke and passing disturbance of cerebral circulation, prevention of tromboembolic episodes after surgeries or invasive researches — 100 mg/days.

Prevention of a deep vein thrombosis and thromboembolism of a pulmonary artery and its branches — 100–200 mg/days.

Features of use:

- Drug should be used only after appointment of the doctor.
- ASK can provoke a bronchospasm, and also cause attacks of bronchial asthma and other reactions of hypersensitivity. Risk factors are existence of bronchial asthma in the anamnesis, hay fever, the polypose of a nose, chronic diseases of respiratory system, and also allergic reactions to other drugs (for example skin reactions, an itch, urticaria).
- ASK can cause bleedings of various degree of manifestation in time and after surgical interventions.
- ASK combination to anticoagulants, trombolitika and antithrombocytic drugs is followed by the increased risk of development of bleedings.
- ASK in low doses can provoke development of gout in the predisposed persons (having reduced excretion of uric acid).
- ASK combination to a methotrexate is followed by the increased frequency of development of side effects from bodies of a hemopoiesis.
- High doses of ASK render hypoglycemic effect that patients need to mean at appointment it with the diabetes mellitus receiving hypoglycemic drugs.
- At the combined purpose of GKS and salicylates it is necessary to remember that during treatment the level of salicylates in blood is reduced, and after cancellation of GKS the overdose of salicylates is possible.
- ASK combination to an ibuprofen as the last worsens beneficial effect of Aspinata®kardio on life expectancy is not recommended.
- Exceeding of a dose of ASK is accompanied by risk of gastrointestinal bleeding.
- The overdose is especially dangerous at patients of advanced age.
- At ASK combination to alcohol the risk of injury of a mucous membrane of a GIT and lengthening of a bleeding time is increased.

Influence on ability to manage cars/mechanisms. It is not observed.

Side effects:

- Allergic reactions: small tortoiseshell, Quincke's edema.
- From immune system: anaphylactic reactions.
- From a GIT: nausea, heartburn, vomiting, pain in a stomach, ulcers of a mucous membrane of a stomach and a duodenum, including perforative, gastrointestinal bleedings, increase in activity of liver enzymes.
- From respiratory system: bronchospasm.
- From system of a hemopoiesis: the raised bleeding, anemia (seldom).
- From TsNS: dizziness, sonitus.

Interaction with other medicines:

At simultaneous use of ASK strengthens action of the following HP:
- a methotrexate — due to decrease in renal clearance and its replacement from communication with proteins;
- heparin and indirect anticoagulants — due to dysfunction of thrombocytes and replacement of indirect anticoagulants from communication with proteins;
- thrombolytic and antithrombocytic (тиклопидин) drugs;
- digoxin — owing to decrease in its renal excretion;
- hypoglycemic means (insulin and derivatives of sulphonylurea) — due to hypoglycemic properties of the ASK in high doses and replacement of derivatives of sulphonylurea from communication with proteins;
- valproic acid — due to its replacement from communication with proteins.

The additive effect is observed at a concomitant use of ASK with alcohol.

ASK weakens effect of uricosuric drugs (benzbromaron) owing to competitive tubular elimination of uric acid.

Strengthening elimination of salicylates, system GKS weaken their action.

Contraindications:

- hypersensitivity to ASK, excipients of drug and other NPVS;
- GIT erosive cankers, gastrointestinal bleeding;
- hemorrhagic diathesis;
- the bronchial asthma induced by reception of salicylates and NPVS, Fernán-Vidal's triad (a combination of bronchial asthma, the nose recuring a polypose, okolonosovy bosoms and intolerance of ASK);
- the combined use with a methotrexate in a dose of 15 mg in week and more;
- renal liver failure;
- pregnancy (I and III trimester);
- lactation period;
- age up to 18 years.

With care:
- gout;
- hyperuricemia;
- existence in the anamnesis of cankers of a GIT or gastrointestinal bleedings, renal and liver failure, bronchial asthma, chronic diseases of a respiratory organs, hay fever, polypose of a nose, allergic reactions to other drugs;
- II trimester of pregnancy;
- a combination to a methotrexate in a dose less than 15 mg in week;
- deficit of vitamin K and glyukozo-6-phosphate-dehydrogenase.

Use at pregnancy and feeding by a breast
Use of high doses of salicylates in the I trimester of pregnancy is associated with the increased frequency of defects of fetation (the split sky, heart diseases).
In the II trimester of pregnancy it is possible to appoint salicylates only taking into account strict assessment of risk and advantage.
In the last trimester of pregnancy salicylates in a high dose (more than 300 mg/days) cause braking of patrimonial activity, premature closing of an arterial channel in a fruit, the raised bleeding in mother and a fruit, and appointment just before childbirth can cause intracraneal hemorrhages, especially in premature children.
Purpose of salicylates in the last trimester of pregnancy is contraindicated.

Use in the period of a lactation. Salicylates and their metabolites in small amounts get into breast milk.
Accidental reception of salicylates in the period of a lactation is not followed by development of side reactions in the child and does not demand the breastfeeding termination. However at prolonged use of drug or appointment it in a high dose feeding by a breast should be stopped immediately.

Overdose:

Symptoms of overdose of moderate severity: nausea, vomiting, sonitus, deterioration in hearing, dizziness, confusion of consciousness.

Treatment: drug dose decline.

Symptoms of overdose of heavy degree: fever, a hyperventilation, ketoacidosis, a respiratory alkalosis, a coma, cardiovascular and respiratory insufficiency, the expressed hypoglycemia.

Treatment: immediate hospitalization in specialized department for performing the emergency therapy — gastric lavage, determination of acid-base balance, the alkaline and forced alkaline diuresis, a hemodialysis, administration of solutions, purpose of absorbent carbon, symptomatic therapy.

When carrying out an alkaline diuresis it is necessary to achieve values рН between 7,5 and 8. The forced alkaline diuresis should be carried out when concentration of salicylates in plasma makes more than 500 mg/l (3,6 mmol/l) at adults and 300 mg/l (2,2 mmol/l) — at children.

Storage conditions:

In the dry, protected from light place, at a temperature not above 25 °C.
To store in the place, unavailable to children.

Issue conditions:

Without recipe

Packaging:

In packaging of planimetric cell 10 pieces; in polymeric banks 1, 2, 3, 5 or 10 of packagings.