Phytomenadione

Chemical name

[R-[R*,R*-(E)]]-2-Метил-3-(3,7,11,1 5-тетраметил-2-гексаде��енил)-1,4-нафталендион

Gross

C31-H46-O2

Characteristics

Yellow or oranjevo-jeltaya transparent viscous with weak smell. Virtually nerastvorim water, little soluble in alcohol, slightly soluble in vegetable oils. Decomposes under the influence of UV rays and alkalis.

Of drugs

The drugs-gemostaticescoe. It stimulates the biosynthesis of protrombinovogo compound in the liver : protrombina (factor II), prokonvertina (VII factor), the plasma component tromboplastinovogo (IX or Christmass-factor) Stewart factor-Prauer (X factor). Is ko-factorom mikrosomaionah enzymes andoplazmaticescoy of hepatocytes, promoter posttranslatine гамма-карбоксилирова��ие prokoagulyantov predecessors, II, VII, IX, X factors, and protein C (coagulation inhibitor), as well as proteins that bind calcium in the blood plasma and tissues, including patients. After гамма-карбоксилирова��ия glutaminova acid functionally inactive predecessors antigemorragicakie acquire properties and secretiruyutza gepatocitami in Crovi.ucastvet in biosynthese ATF and kreatinfosfata tissue activation Atfaza, kreatinkinaza some aminotransferaz, enzymes pancreas (amilazy, lipase), the bowel (enterokinaza, alkaline �осфатазы).Всасываетс�� in a thin leg (only in the presence of bile), and falls into lymphatic and then in the blood. There are in the blood at 0.5 h after administration of inwards and much faster with the / m introduction. C_max achieved through 2-8 hours Fully metabolised (first activated, then destroyed). Products of the show and jelchew Mochoe.pri ingestion effect manifests itself after 6-10 h (in / m in a period of 1 h), and is 3-6 hours In healthy people are not active, but in the face of Vitamin K_1 regulate metabolism and increases the coagulation of blood.

Indications

Lower blood coagulability (haemorrhagic syndrome) associated with vitamin K_1 (treatment and prevention), or violation of its intake (with Hepatitis, cirrhosis of the liver, mechanical jelthe, spru, yazvennom kolite, zeliakii, Resection bowel kistosnom fibrosis pancreas, enterite, chronic diarrhea, cystic fibrosis), overdose anti indirect actions (John and indandionovogo number), salicilatov, sulfanilamidov, broad-spectrum antibiotics, tranquilizers; hemorrhagic disease of the newborn (treatment and prevention), the prevention of bleeding in heavy operations.

Restrictions on the use of

Pregnancy, breast-feeding (for the period of treatment needed to stop breastfeeding), children's age (for oral administration).

Contraindications

Hypersensitivity, increased coagulation of blood, tromboembolia.

Side-Effects

The sense of heat and redness of skin, changes in taste, weakness, tachycardia, profuznoe sweating, short gipotenzia, despnoe, zianoz, allergic reactions (local-skin rashes, itching, generally, or anaphylactic shock anaphylactoidnyi); Pain and swelling at the site of; At the time Injecting a-infiltration, itching, skin lesions characteristic of sclerodermia, giperbilirubinemia (children).

Specific guidance

Benzyl alcohol used as a preservative for injectable may cause toxic effects in newborns. The children enter any gemorragiami : determine their cause is the application, and the loss of time to diagnosis can lead to death.

Patient interaction

Does the anti proximity. Holestiramin reduces absorption in the digestive tract.

Precautions

In / in the typing only slowly, not more than 1 mg / min-likely heavy allergic reactions, including anaphylacticski shock. When violations education or a kidney shows no oral application. Before and during the treatment, it was necessary to monitor the gemokoagulyatsii (protrombinovy index koagulogramma, tolerance to blood geparino, the number of platelets). It should be borne in mind that phytomenadione does not eliminate bleeding in hemophilia and disease Verlgofa due geparinom deficit protrombina with inadequate protein exchange.

Dosing and Administration

Inside (through 30 minutes after eating), in / m, / in (sverhtonkie emulsion), and p / K.novorozdennym : to prevent haemorrhagic disease : one of 0.5-1 mg in / m in the first hours after birth, for the treatment of 1 mg p / to or / m once a day for 3-4 days (in larger doses in the case of anti proximity to the mother); for the prevention of early forms of hemorrhagic disease of newborns pregnant women suffering from tuberculosis or epilepsy and receiving products of gipoprotrombinemia, inside in the last two months of pregnancy, 10 mg or in the last two weeks of pregnancy-20 Mg.vesroslam to treat gipoprotrombinemii caused by the anti-admission, ranging from 2.5 mg to 25 mg (in a few cases -- 50 mg) three times a day (if necessary, to 6 times a day). The usual course for 2-5 days, often up to 10 days. Doses and length of treatment depend on the performance gemokoagulyatsii; Gipoprotrombinemia diseases of liver and digestive tract : 2,5-25 mg (sometimes 50 mg) three times a day for 1-4 weeks. The objective of applying to 30 mg / day for 3-4 days before the operation. If any secretions, and the allocation of the intestine endogenous bile is needed (in the appointment of the interior) combined with drugs biliary acids.

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