Imipramine

Chemical name

10,11-Дигидро-N,N-диметил- 5Н-дибенз[b,f]азепин-5-пр опанамин (mainly monogidrohlorid)

Gross

C19-H24-N2

Characteristics

The white crystalline powder. Easily soluble in water and alcohol.

Of drugs

Drugs, the antidepressant, psihostimulirutee, antidizuricescoe. Ingibiruet reverse takeover neiromediatornah monoaminov (norarenalina, dopamine, serotonin and others) presinapticakimi nerve endings neuronal increase in the level of synaptic junctions and increasing physiological activity. And m-holino- and альфа-адреноблокирую��им effect. Improves mood, reduces feelings of sadness, reduces motor block, improves mental and general tone Organizma.horosho absorbed from the digestive tract, bioavailability of 29-77%. C_max achieved in 1-2 h after administration of the interior and 30 to 60 minutes after the on / m introduction. T_1/2 ranges from 4 to 24 hours (20 hours). Associated with the plasma protein at 93-108%. Evenly distributed in tissues. Easily penetrates gistogematicalkie barriers, including GEB, and accumulate in the brain, kidney, liver. The liver is intense biotransformation. The ratio between desmetilimipraminom-metabolite with the expressed antidepressive activity imipraminom and in the blood of approximately 1,5:15. During the 24 hours up to 40% imipramina presented with urine in the form of active metabolites and unaltered (1-2%), about 20% of output from jelchew.

Indications

Depressive of different etiology : astenodepressivny syndrome, depression (endogenic, inwalutinaya, klimakterica, rocket, etc.), depressive state of Psychopathy and nervousness, functional enourez in children.

Contraindications

Hypersensitivity, renal and hepatic failure, ischemic heart disease, tachycardia, female heart failure, early postinfarknetary period, the propensity to cramps, schizophrenia, epilepsy, glaucoma, prostate adenoma cancer, atony bladder, pregnancy, age child (up to 2 years).

Side-Effects

Headache, dizziness, excessive sedation, parestesia, tremor, convulsions, dizartria violation of coordination, insomnia, excitation, hallucinations, dryness of mouth, constipation, hepatitis, tachycardia, incredible, ortostatical hypotension whose influence, violation ccomodation, leucocytosis or lakopenia, agranulozitos, ginekomastia, galactorea, reduced libido, impotence, increased body mass index, photosensitization, hair loss, fever, rash.

Patient interaction

Incompatible with alcohol, MAO inhibitors (Increased psihostimulirutego effect). Impact fenitoina effectiveness. Holinolitiki, fenotiazina and produced more sedativuyu and central holinoliticescuu imipramina activity.

Overdosing

Symptoms : dizziness, agitation ataxy, convulsions, stalemate, coma, midriaz, tachycardia, incredible, AV blockade collapse with a high venoznom pressure arterial gipotenzia, respiratory depression, zianoz, vomiting, Lichoradka.lechenie : washing stomach saline solution, inward-activated carbon, in / in the slow introduction fizostigmina salicilata, symptomatic treatment (anti-convulsants).

Precautions

During the initial period of therapy necessarily constant medical follow-up for patients with suicidal tendencies. During treatment are not allowed to drink alcoholic beverages and to the control of cellular peripheral blood and the liver. Nominations should be in 2 weeks (at the earliest) after the MAO inhibitors, starting with low doses of 25 mg / sut. In the application in patients with diabetes need a correction oral doses protivodiabeticakih drugs. It should be noted that the injection contains sulphites, which can cause or exacerbate reactions, such as arginine. During the initial period of therapy to abandon driving and the potentially hazardous work.

Dosing and Administration

Inside, in the 10 to 14 days dose gradually increased to 250 mg / day and after clinical effect gradually reduced to a supporting-50-150 mg. In shallow depression, 75-150 mg / day, supporting, 25-50 mg / sut. Children 3-6 years for 1 hour before sleep-5 mg; 7-12 years - 25 Mg.v / m to 25 mg three times a day in combination with oral receiving 25 mg daily dose may be increased to 25 mg. After 7 days starting dose reduction to support (25 mg / day) and the interior appoint 50 mg. From the 13th day only by oral-350 mg / day in 3 admission.

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