Cyanocobalamin

Chemical name

альфа-(5,6-диметилбензи мидазолил)кобамид cyanide

Gross

C63-H88-Co-N14-O14-P

Characteristics

Vitamin B_12. Gigroskopicny crystalline powder dark colors, odourless. It is soluble in water, brines are red (or pink) color. Long avtoclavirovnie, oxidizing or reinstating substance (ascorbic acid), heavy metal salts are otherwise; Quickly destroyed germline, and the solutions should remain in aseptic conditions.

Of drugs

The drugs-gemopoeticescoe, eritropoeticescoe, protivoanemicescoe, metabolicescoe. It has high biological activity and participates in uglevonom, belkovom, lipidnom exchange. Increases tissue regeneration, normalizes blood, liver and nervous system, activates svertawatuyu the blood, lowers cholesterol in the blood (in cattle). Inside the (predominantly in the liver) becomes a cofactor - kobamid which is a component of many enzymes, including of the inhibitors, reconstructive folic acid in tetragidrofolievu. Kobamid involved in the transfer of methyl etc. odnouglerodistah fragments and the need for education and dezoksiribozy DNA creatinine, methionine - methyl donor groups in the synthesis of lipotroponogo factors - choline, to make methyl acid in glass as part of the attack and for the recycling of propionic acid. Has accumulate in erythrocytes compounds containing sulfgidrile group, which accounts for an increase in the tolerance to Gemolizu.vsasavanie happening throughout thin bowel (partly in the colon). In the face of atherosclerosis connected with a special internal factor and is out of the reach of micro ulcers; Complex in the face of small bowel passes zianokobalamin the receptor, which transports it in the box (receptor activity depends on the structure and function of membranes supported folic acid as well as on the availability of calcium ions and pH environment). The blood vitamin B_12 contact transkbalaminami I and II, which transported it to the fabric. The deposit occurs mainly in the liver, the liver appears to jelchew in intestine and then absorbed. Eliminations are mostly kidneys.

Indications

Chronic anaemia, running with a deficit of vitamin B_12 (Addison-Biermer nutritional macrocitarnaya) in the treatment of anaemia, iron, postgemorragicaka, religion caused by the toxic substances and drugs, mieloz traumatic injuries and inflammation of the peripheral nerves (injured radikulonevrit, rapid, nevralgia, kauzalgia, phantom pains), the lateral sclerosis amiotroficski, encephalomyelitis, multiple sclerosis, diabetic neiropatia, infant cerebral palsy, a disease syndrome, skin diseases (psoriasis, fotodermatos, gerpetiformny dermatitis, neirodermit) traumatic injuries bones and post-surgery oporno-dwigatelnom apparatus during deceleration bone consolidation, acute and chronic hepatitis, cirrhosis, Radiation sickness. The objective, in a biguanidov, paraaminosalicilova acid, high doses of vitamin C and pathology stomach and intestines, preventing the normal absorption of vitamin (resection of the stomach, small bowel, ulcerative disease, gluten, spru).

Restrictions on the use of

With caution and smaller doses to appoint stroke, benign and malignant tumors (used only in cases involving megaloblastna anaemia and vitamin B_12).

Contraindications

Hypersensitivity, giperkoagulyatsia (including the acutely trombozah) eritremia, eritrotsitoz.

Side-Effects

Headache, dizziness, causing pain in the heart, tachycardia, allergic reactions (urticaria).

Specific guidance

The treatment should be regularly monitored picture and blood coagulation.

Patient interaction

Farmatsevticeski (one sprite) is not compatible with solutions of vitamins, and B_1 B_6 (cobalt ion to the destruction of vitamins etc.). Do likelihood allergic reactions caused by vitamin B_1.

Dosing and Administration

Inside, c / a, in / m, in / in and intralumbalno. When anemia Addison-Biermer on 100-200 micrograms a day; With anemia Addison-Biermer events funikulyarnogo mieloza and macrocitarnah anemiah human nervous system-500 µ g or more on injection (in the first week of daily, and then at intervals between wvedeniami to 5-7 days). At the same time, appoint folic acid. During remission in the absence of events funikulyarnogo mieloza impose a maintenance therapy to 100 µ g twice a month and the availability of neurological events for 200-400 g 2-4 times a month. When transmitted and postgemorragicakih anemiah on 30-100 µ g 2-3 times a week. When al anemiah (especially in children), 100 µ g before клинико-гематологиче��кого improvement. In nutritional anaemia in children at an early age and the weight-to 30 micrograms per day for 15 days; In the central nervous system diseases and neurological diseases with a sore syndrome give increasing doses of 200 to 500 µ g / injection, and the improvement in the-100 micrograms per day; course until two weeks; with traumatic lesions peripheral nerves on 200-400 micrograms a day within 40 to 45 days. In hepatitis and liver zirrozah for 30-60 micrograms per day or 100 micrograms a day for 25-40 days; In distrofiah in infants, disease and Down's cerebral palsy, for 15-30 micrograms a day; In spru, radiation sickness, diabetic neuropathy appoint 60-100 µ g daily for 20 days. In funikulyarnom mieloze, side amiotroficescom EMG, EMG spread misleading sometimes spinal canal to 15-30 g (gradually increasing the dose of 200 to 250 µ g).

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