Korglykonum

Korglykonum – cardiotonic drug, cardiac glycoside.

Form of release and structure

Dosage form – solution for intravenous (in/in) introductions (on 1 ml in ampoules, in cardboard packs on 10 pieces or on 10 pieces in a blister strip packaging, in a cardboard pack 1 packaging).

Active ingredient – Korglykonum (a glycoside of leaves of a lily of the valley May), in 1 ml – 0,6 mg.

Indications to use

• Clinical displays of chronic heart failure of the II-IV functional class, as a part of complex therapy;
• Paroxysmal and chronic current of an atrial flutter at a takhisistolichesky form of blinking (especially against the background of chronic heart failure).

Contraindications

• Period of pregnancy and breastfeeding;
• Glikozidny intoxication;
• WPW-syndrome;
• Atrioventricular (AV) blockade of the II degree;
• The alternating total block;
• Hypersensitivity to Korglykonum.

With extra care, comparing estimated advantage and possible risk, it is necessary to appoint Korglykonum to patients: with a sick sinus syndrome in the absence of a pacemaker, unstable stenocardia, an atrioventricular block of the I degree, the acute myocardial infarction, the instruction in the anamnesis on Morganyi-Adams-Stokes's attacks isolated by a mitral stenosis with the rare heart rate, a hypertrophic subaortal stenosis, the arteriovenous shunt, a hypoxia, heart failure with disturbance of diastolic function (chronic cardial compression, a heart amyloidosis, a cardiac tamponade, a restrictive cardiomyopathy); at risk of unstable carrying out on an atrioventricular node, premature ventricular contraction, cardiac asthma against the background of a mitral stenosis (at patients without takhisistolichesky form of a ciliary arrhythmia), "pulmonary" heart, the expressed dilatation of cardial cavities, a hypothyroidism, myocarditis, an alkalosis, obesity, a renal and/or liver failure; to patients of advanced age.

Besides, it is recommended to use under control of the doctor drug at patients with disturbance of level of electrolytes in a blood plasma (a hypomagnesiemia, a hypopotassemia, a hyponatremia, a hypercalcemia).

Route of administration and dosage

Solution is intended for intravenous slow (within 5-6 minutes) introductions.

Injections of Korglykonum are recommended to be carried out to combinations from 10-20 ml of solution of a dextrose, or glucose (20% or 40%).

The recommended one-time dosing has age restrictions:

• Adults: on 0,5-1 ml;
• Children: from 2 to 5 years – on 0,2-0,5 ml, from 6 to 12 years – on 0,5-0,75 ml.

Use of drug is shown 1-2 times a day, at 2-times appointment it is necessary to observe an interval between drug use at 8-10 o'clock.

The maximum single dose for adults should not exceed 1 ml.

Side effects

Use of Korglykonum can cause side effects in patients in case of overdose or hypersensitivity to cardiac glycosides:

• From bodies of a hemopoiesis: nasal bleedings, Werlhof's disease, thrombocytopenia;
• From cardiovascular system: AV blockade, arrhythmia;
• From the alimentary system: anorexia;
• From a nervous system and sense bodys: headache, confusion of consciousness, drowsiness, sleep disorders, delirious psychosis, dizziness, decrease in visual acuity;
• Others: allergic reactions.

Special instructions

Increase in risk of developing of intoxication can be promoted by a hypothyroidism, a hypopotassemia, a hypercalcemia, a hypomagnesiemia, a hypernatremia, the expressed dilatation of cardial cavities, myocarditis, "pulmonary" heart, obesity, and also advanced age of the patient.

At expressed bradi-or a normokardiya and a mitral stenosis, development of heart failure is caused by decrease in diastolic filling of a left ventricle. Strophanthin, increasing contractility of a myocardium of a right ventricle, promotes further increase in pressure in system of a pulmonary artery that can cause aggravation of a left ventricular failure or a fluid lungs.

Use of drug is shown to patients with a mitral stenosis at right ventricular insufficiency or a ciliary tachyarrhythmia.

For control of level of a digitalization of cardiac glycosides it is necessary to carry out monitoring of level of their concentration in a blood plasma.

Medicinal interaction

Combined use of cardiac glycosides from sodium adenozinotrifosfaty is not recommended.

At simultaneous use of Korglykonum:

• Ephedrine a hydrochloride, noradrenaline hydrotartrate, Adrenalinum hydrochloricum, the selection beta-adrenergic agonists, and also xanthine derivatives (including drugs of theophylline and caffeine) can promote development of arrhythmia of heart;
• Drugs of corticotropin promote increase in action of Korglykonum;
• Aminazine and other derivatives of a fenotiazin reduce clinical effect of cardiac glycosides;
• Calcium drugs for parenteral use – strengthen arrhythmia of heart and other cardiotoxic effects;
• Glucocorticosteroids against the background of the hypopotassemia which resulted from their prolonged use can cause increase in side effects of Korglykonum;
• Disodium salt of ethylene diamine tetraacetic acid reduces toxicity and therapeutic effect of cardiac glycosides;
• Antikholinesterazny means strengthen bradycardia, in case of need uses of Korglykonum, in addition appoint introduction of Atropini sulfas;
• Narcotic analgetics, in particular fentanyl, can cause hypotension;
• Drugs of potassium reduce side effects of cardiac glycosides;
• Naproxenum does not exert impact on results of psychological testing at healthy people;
• Paracetamol reduces allocation by Korglykonum kidneys;
• Diuretic means increase effect of drug, in need of this combination it is necessary to observe optimum dosing of each of drugs;
• Ergocalciferol, in case of a hypervitaminosis against the background of prolonged use, can promote strengthening of effect of the drug caused by development of a hypercalcemia.

Terms and storage conditions

To store in the place protected from light at a temperature of 8-15 °C. To protect from children.

Period of validity – 2 years.