Penicillamine

Chemical name

3-mercapto-d-valin

Gross

C5-H11-N-O2-S

Characteristics

Produced hydrolysis Penitsillina.bely or almost white crystalline powder. Easily soluble in water, very soluble in alcohol nerastvorim and on the airwaves, acetone, benzene, carbon tetrachloride.

Of drugs

The drugs-compleksoobrazutee, desintoksikatine, immunodepressivne. Links ions of copper, mercury, lead, iron and calcium. Effective in gepatolentikuliarna degeneration (Wilson disease-Konovalova), as increased excretion of urine excess copper normalize its content in tissues. Oppressing some enzymes involved in the reactions сульфгидрильно-дисул��фидного exchange. In contact with tsisplatinom becoming penitsillamin-tisteina disulphide, which because of the high solubility easily excreted in the urine; This effect is a reduction of tisteinovykh kidney stones in zisteinurii. T-helpernuu oppressing the cells inhibits chemotaxis Klebsiella, and the lysosomal enzymes increased macrofagalnuu activity suppresses the synthesis of collagen and normalizes the relationship between the soluble and insoluble fractions helping suppress sclerosing process in the tissues. Impact of pathological macroglobulinov, incl. rheumatoid factor. Quickly, though partially (40-70%) of the skin glands. C_max achieved after 1-3 hours The liver is biotransformation. Place in the form of metabolites kidneys.

Indications

More Wilson-Konovalova, rheumatoid arthritis (incl. uvenilny), primary biliary cirrhosis, chronic hepatitis, sklerodermia, zistinurija, zistinoz, poisoning by heavy metals (copper, cobalt, gold, mercury, lead, zinc).

Contraindications

Hypersensitivity violation gemopoaiza, agranulozitos, male, Nephropathy, kidney failure, Shegrena syndrome.

Side-Effects

Arthralgia, limfoadenopatia, volchanochnopodobnyy syndrome, alopecia, tireoidit, a antiadernah antibodies, lakopenia, thrombocytopenia, male gravis, peripheral neiropatia, polimiozit, dermatomiozit fever, principally syndrome, gematuria, legern-pochecna syndrome hereditary deficiency (Gudpascera) throm, diarrhoea disorders, nausea, vomiting, pain in epigastralna area; Allergic reactions.

Patient interaction

Antimalarial and antineoplastic means fenilbutazon, gold drugs increase the risk of side effects. Incompatible with antibiotics.

Precautions

It continuously monitor blood and urine (an analysis to determine the level of alkaline phosphatase, transaminaz etc.).

Dosing and Administration

Inside, erh (should not take food for 1.5 h before and after admission). Rheumatoid arthritis, hepatitis, sklerodermia : 1-4 weeks-1 caps. (150 mg) per day (up to 250 mg); 5-8 weeks-1 капс. (250 mg) per day (up to 450 mg); Weeks 9-13-1 caps. (150 mg) twice a day (600 mg); increase the dose to 150 mg per day with 4-12-nedelnami intervals up to 750 mg in Deny.uvenilny rheumatoid arthritis : the body mass index of less than 20 kg-1 caps. (50 mg) a day, more than 20 kg to 1 caps. (50 mg) twice a day; increase the dose to 50 mg with 2-4-nedelnam intervals up to 15 to 20 mg / kg or 600 mg in Deny.bolezni Wilson-Konovalova : adults c steady increase with the dose of 250 mg to 2 g per day, the children - from 150 mg to 750 mg in Deny.zistinurija : 1000 mg / m ^ 2 surface Tela.otravljenia : 0,9-1,8 g per day or 2-4 caps. (150 mg) three times.

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