Adonis-Brom

General characteristics. Structure:

Active ingredients: 69,07 mg of the adonis of extract of dense, 250 mg of Kalii bromidum in 1 tablet.

Excipients: magnesium a carbonate the main, potato starch, talc, calcium stearate, Advantiya Prefed (contains: to a gipromelloz, кополивидон, polyethyleneglycol, caprylic capric триглецирид, to polydextrosum (Е 1200), titanium dioxide (Е 171), ferrous oxide yellow (Е 172)).

Medicine of a plant origin, has sedative and cardiotonic effect.

Pharmacological properties:

Pharmacodynamics. Action is caused being a part of extract of the adonis (an adonis spring) polar glycosides of a tsimarin (1-10% of total quantity of glycosides) and an adonitoksin (3-20% of total quantity of glycosides), and also bromide ions. Bromide ions is stabilized GAMKA-retseptory abroach, after interaction with γ-aminobutyric acid acid, providing receipt bromide - both chloride ions in a cell and decrease of the activity of neuron. Tsimarin vzamodeystvut with the neurosteroid distinguishing site GAMKA-retseptory and increases its sensitivity to effect of γ-aminobutyric acid of acid. In a membrane of neuron and a myocardium цимарин blocks Na+/K+-Atfaza's work that interferes with removal of ions of sodium from a cell. Increase in intracellular sodium breaks process of removal of calcium of a cell and increases sokratitelny activity of a myocardium.

Adonis bromine has weak cardiotonic effect, mainly, at the expense of a systolic component: increases force of cordial reductions (a positive inotropic effect), excitability of a myocardium (positive bathmotropic effect). Diastolic action is expressed much more weakly and is characterized by decrease in heart rate (negative chronotropic effect) and carrying out impulses on a myocardium (negative dromotropic effect). Against the background of Adonis bromine use force of cordial reductions slightly increases, the period of a systole is shortened and time of a diastole is extended, ChSS decreases.

Adonis bromine concentrates and strengthens processes of braking in a cerebral cortex. Recovers balance between processes of excitement and braking in TsNS.

Pharmacokinetics. After intake active components are soaked up quickly and rather fully. The maximum concentration of a tsimarin (the adonis's glycoside) and bromide ions is reached in 1-2 hours after reception. Bioavailability makes 47% for a tsimarin and about 96% for bromide ions. In blood about 51 - 59% of a tsimarin circulate in the state connected with proteins of plasma. Bromide ions practically do not contact proteins of plasma.

In an organism цимарин and bromide ions are distributed evenly, generally in extracellular liquid. In cerebrospinal fluid of concentration bromide ion and a tsimarina make 37% of their concentration in plasma. Bromide ions are not exposed to metabolism, цимарин it biotransformirutsya partially in a liver and a wall of intestines. Elimination bromide ions and a tsimarin is carried out generally by kidneys.

Bromide ions is removed by glomerular filtering, but in the subsequent are exposed to a canalicular reabsorption, competing about chloride ions. The semi-elimination period bromide ions averages 11,9± 1,4 days and depends on level of consumption of salt (it is shortened at increase in consumption of sodium of chloride). Additional ways of elimination bromide ions are intestines, sweat and mammary glands.

Tsimarin eliminirutsya in the form of metabolites and not changed substance (about 21% of the entered dose). The coefficient of daily elimination makes 50%. Semi-elimination period about 13-23 h.

Indications to use:

Apply at initial stages of chronic heart failure, irritability.

Route of administration and doses:

Appoint inside on 1 tablet 3 times a day.

At a renal failure with decrease in clearance of creatinine more than it is recommended to reduce a single dose by 50% of normal indicators twice or to increase an interval between medicine receptions till 12 o'clock.

Features of use:

It is necessary to keep to a hyposalt diet (to limit sodium chloride consumption) during treatment Adonis bromine. During treatment for prevention of undesirable action bromide ions on skin and mucous membranes is recommended regular bowel emptying, rinsing of a mouth and respect for hygiene of skin (reception of a bathtub, shower).

Pregnancy and lactation. Bromide ions easily get through a placenta and are allocated in milk of the lactating woman. Use Adonis bromine during pregnancy is possible only if the expected advantage exceeds possible risk for a fruit. In need of appointment Adonis bromine in the period of a lactation it is necessary to separate the child from a breast for the entire period of treatment and within 1 month after its termination.

Use in pediatrics. Safety and efficiency of use of medicine for children is not established. Experience of its use for patients of this age group is limited.

Influence on ability to driving of motor transport and control of mechanisms. Reception Adonis bromine breaks ability of the patient to control of the vehicle or other operator activity therefore during treatment it is necessary to be careful during the driving of motor transport and occupation other potentially dangerous types of activity demanding the increased concentration of attention and speed of psychomotor reactions.

Side effects:

From cardiovascular system: bradycardia, arrhythmia (premature ventricular contraction as a bigeminal pulse).

From the central nervous system: a headache, concern, sleeplessness, the depressive phenomena, vision disorders, slackness, block, weakness, drowsiness, a hypophrasia, in hard cases – bromism symptoms (at drug overdose);

From digestive tract: nausea, vomiting (the emetic effect is partly caused by the reflexes arising at excitement of receptors of heart), a gastralgia (it is connected with direct influence of cardiac glycosides on the emetic center and hemochuvstvitelny receptor zones, and also with the reflexes caused by irritant action on a mucous membrane of a stomach); at high doses the loss of appetite, diarrhea are possible.

Allergic reactions.

Interaction with other medicines:

At simultaneous use strengthening of toxic effect of other cardiac glycosides (drugs of a foxglove, Strophanthus and lily of the valley) is possible.

At simultaneous use strengthens effect and toxic action of antiarrhythmic means of the class IA (quinidine, procaineamide, Disopyramidum), drugs of calcium, purgatives and glucocorticosteroids.

Strengthens the oppressing impact on TsNS of derivatives of benzodiazepine, anticonvulsant and sedative and hypnotic means, neuroleptics and alcohol.

Galotanovy anesthesia increases level bromide ions in an organism at the patients accepting Adonis bromine and strengthens its effect and toxic action.

Reception of salty food leads to increase in excretion of bromides with urine and weakens effect of drug.

Contraindications:

- hypersensitivity to the adonis, bromides;

- depression;

- respiratory insufficiency;

- chronic congestive heart failure of high gradation (the III-IV class on NYHA);

- severe forms of a liver and renal failure;

- erosion, stomach ulcer and duodenum;

- reception of cardiac glycosides;

- digitalis intoxication;

- hypercalcemia, hypopotassemia;

- bradycardia, atiroventrikulyarny blockade or ventricular form of arrhythmia.

Overdose:

Symptoms: the expressed bradycardia, polytopic premature ventricular contraction, a bigeminal pulse or a trigeminy, delay of atrioventricular conductivity; in hard cases – trembling of ventricles, a cardiac standstill.

Treatment: at intoxication connected with overdose by cardiac glycosides do a break in medicine use, if necessary appoint drugs of potassium and antiarrhytmic drugs.

Use of diuretics for creation of an artificial diuresis and acceleration of removal bromide ions contraindicated since at the same time the risk of toxic action of glycosides of the adonis increases.

Storage conditions:

In the place protected from moisture, at a temperature not over 25 ºС. To store in the place, unavailable to children. A period of validity - 2 years. Not to use medicine after the termination of a period of validity.

Issue conditions:

According to the recipe

Packaging:

On 10 tablets in a blister strip packaging or on 25 tablets in bank. Each can or on 3 planimetric packagings with a leaf insert in a pack.