Hexobarbital

Chemical name

5-(1-Циклогексен-1-ил)-1,5- диметил-2,4,6(1H,3H,5H)-пири��идинтрион (and the form of sodium salt)

Gross

C12-H16-N2-O3

Characteristics

White penoobraznaya mass. Gigroskopicna, under the influence of carbon dioxide pollution degrades. Very rastvorima easily in water, alcohol (preferably in the 95%) is not very dietilovom broadcast and chloroform. An aqueous solution fragile, easily hydrolyses, situated at the time of sterilization.

Of drugs

The drugs-publeanestezirutee, sedative, sleeping, protivosudorozhnoe. Potenziruet braking effect of GABA : interacts with barbituratnam " ("пикротоксининзависи мым") site �АМК_А-бензодиазепин-б арбитуратного Complex and increases affinity for the GABA postsinapticski Gamk_a-retseptoram, prolong the period of disclosure membrane channels for chlorine ions and increases their entry into neurons. Reversible oppressing CNS : sinapticescuu blocks of the institution, in the upstream activator retikuliarna formations barrel brain talamuse and to a lesser extent, spinal cord (weak miorelaksiruty effect). Oppressing breathing center, weakened its sensitivity to uglekislote and hydrogen ions, but does not diminish the response to the incentives associated with irritation hemoretseptorov karotidnyi and aortalnah clubockov. Increases tone wandering nerve, produces wagusnye reactions : gipersalivacia, cough, laringospazm, aetiology, etc. stops sosudodwigatelny centre blocks Evoked ganglia. Provides cardiodepressivne Effects (inotropony negative effect, reducing HR), increased peripheral vessels, reduces venous blood return to miocardu, BCC, lodging volume, cardiac ejection (at the time of deep narcosis 30%), AD. In high doses reducyruet coronary flow and reduces blood diseases. Motoriku stops in Kishechnika.posle / or in a rectal consistently growing indifference (eliminates anxiety, fear, anxiety, tension), drowsiness, and the initiation of short-term (up to 1-2 minutes), sleep and loss of consciousness (with increased glotocnogo and gortang reflex), surgical Narkoz.pri surface anaesthesia disappears engine response to the pain, breathing becomes shallow and rises. Light anaesthesia is oppression breathing disappearance zraczkowah rogovichnykh and reflexes. At the stage of deep narcosis violations by breathing and there was a trend towards a progressive cardiovascular violations, including collapse. Clinical signs of sustainable narcosis are : the central position of the eye of apples failure, a small gipotenzia (at the weakened patients might be significant respiratory depression). There has analgeziruta activity (even in deep anaesthesia). The on / in a anaesthesia is a half minutes and lasts up to 20 minutes (awakening through 20-30 minutes). Under anaesthesia awakening usually goes in the secondary sleep, long hours 6-12 While Burn injuries increased activity, the duration of the. Increases threshold excitability and lengthens the period refrakternosti neuronal prevented and the convulsant momentum in the brain. Suppress convulsions regardless of the causal factors and symptoms, particularly in children. After the on / in the albuminami associated plasma at 65-70%. The human protein exchange and gipoproteinemii in doses 0,005-0,015 mg / kg is very deep anaesthesia. An increase in the speed of the decline was linked to the plasma proteins. Alkaloz albuminopekshiyu increases, and acidosis - Oslablet.bystro becomes a plasma neionizirovannuu lipofilnuu form. Easily permeates through gisto-gematicalkie barriers, including GEB, placental barrier. During the first 40 seconds of the brain is 1 / 10 dose (corresponding to a period of sleep). After the on / in the concentration in the brain reaches its maximum after 1-2 min, reduced to 50% of C_max after four minutes and, after 10 minutes does not exceed 10% of the maximum concentration. The young children, as a result of greater permeability GEB and sensitivity of brain tissue CNS oppression of the lower doses, but the removal of vegetative spinal reflexes achieved only with high doses. Biotransformiroetsa in the liver by oxidation with the formation of oxides, keto- carboxibarbiturovh compounds (see news in a free form or in the form of kongugatov), toluene or destruction barbitu

Indications

Neingalaii anaesthesia : induction (in combination with dinitrogen oxide, galotanom, ether ether, etc. general anaesthetics), and short-term (duration 15-20 min) vnepolostnykh surgical and diagnostic procedures : endoscopy, broncho-painful dressings, etc. (mononarkoz or in combination with local anaesthetics); Sudorozhny syndrome (tetanus, eclampsia, anaphylaxis, overdose antiholinesteraznah funds, etc.) acute mental institution, including in Puerto psychosis.

Restrictions on the use of

Gipotenzia, hypertension, anemia, severe metabolic disorders expressed obesity or depletion, and the elderly aged age pregnancy.

Pregnancy and lactation

When pregnancy is possible if the expected benefits for a mother than the potential risk to the fetus. Not recommended for analgesics in kesarevom section (can cause asphyxia fruit).

Contraindications

Hypersensitivity, the violation of the kidneys and the liver, heart failure; Violations coronary and general hemodynamics, including collapse; nasopharyngeal diseases of the respiratory system, including bronchial asthma; occlusion bowel shock, gipoksicskie, septic and feverish state, Adisson disease, diabetes mellitus, expressed depletion; a young child.

Side-Effects

From the respiratory system : respiratory depression (especially with the rapid introduction), low ventilation lung gipercapnia, black lungs, Bronhospazm.so the circulatory system (blood, gemostaz) : aetiology, compensatory tachycardia, arterial gipotenzia, collapse, oppression sokratimosti infarction, cardiac arrest (with a change in miocarde and coronary vessels). From the nervous system and sensory organs : headache, dwigatelnoe and mental arousal to elicit tremor, convulsions; retrogradnaya amnesia Sonlivosti.prochie : wagusnye reaction (gipersalivacia, laringospazm etc.), allergic reaction (urticaria, etc.), nausea and vomiting (in raising), violations detoksiciruta liver, pigmentny, protein and hydrocarbons exchange diureza decrease; Local : with the / in a throm; paravenoznom-inflammatory infiltration, necrosis; randomly in / and is a strong pain in the fingers of limbs, gangrene.

Specific guidance

Solutions are at izotonicescom solution of sodium chloride or sterile (bidistilled), water for injection, in aseptic conditions immediately preceding the imposition; Store no more than 1 hour; Using only totally transparent.

Patient interaction

Potenziruut narkoznoe the neiroleptiki, tranquilizers, analgesics, hypnotics means Tricyclic antidepressants, alcohol and MAO inhibitors (down mikrosomaiona enzymes). Tireoidnye hormones increase the activity and toxicity. Analeptiki, vitamins and PP B_1, ATF reduce the length poslenarkoznogo sleep. Protivosudorozhny effect weaken rezerpin and products containing it. Do gipotenziveh effect of local anaesthetics funds oppressive central nervous system. Changes (increased or reduced), the indirect anti-hastens excretion of vitamin C; Weakens active glucocorticoids; Incompatible with the central nervous system stimulant. Farmatsevticeski compatible (it is not possible to confuse one sprite) with suksametoniem.

Overdosing

Symptoms : respiratory depression until ventricle, and a cardiodepression until cardiac arrest; Gipotenzia, collapsed Koma.lechenie : a specific antagonist - bemegrida (in / in slow adult-5-10 ml 0.5% solution to the insufficient or no effect on repeat). It should be borne in mind that the effect is bemegrida only if imposed gexobarbitala dose does not exceed 2 g, and the length of the coma no more than 12 hours; Symptomatic therapy : in the event of respiratory-IVL, oxygen 100%, with a development hypotension-introduction vazopressorov, calcium chloride (adults up to 10 ml of 10% solution in / w).

Precautions

In the running of the oral cavity and pharynx are only after reaching the level of narcosis (possible kashlevaya sharp reaction laringospazm, bronhospazm, aetiology). In order to prevent side effects associated with the commencement of wandering nerve during Then someone introduced atropine or metoqinia iodide. It should be borne in mind that a depressed respiration and blood circulation depends on the dose and speed / in the introduction. Be wary used as a means protivosudorozhnogo poisoning strichninom because gexobarbitala injection may provoke sudorozhny attack.

Dosing and Administration

In / in, in / m rektalno. For narcosis, adults in / in struino slowly 1-2% solution (in some cases 2.5-5% solution); First introduced test-dozu : 1-2 ml at the rate of 1 ml / min (maximum); In the absence of side effects in the 30 to 40 - with the same speed ingeziruut rest of the dose needed to achieve the desired effect; total dose of 700 mg, usually 8-10 mg / kg, depending on the nature of the procedure, condition, age and body mass index patient. The weakened patients and children with heart disease using 1% solution. For a long (more than 20 minutes) narcosis give / drip in 2% solution of izotonicescom solution of sodium chloride at a speed of 20 or 0.5-1% solution. In ischemic 1-2% solution (at the dose of 400 to 600 mg) in / in struino within 2-3 min. Severe mental institution in / in struino 2-10 ml 5-10% solution; The маниакально-депресси��ном psychosis possibly / m (0.5-1 ml of 10% solution) or rektalnoe introduction (in klizmah to 0.5 grams per 20 ml water). In acute sudorozhnom syndrome : adult-0.5-1 ml of 10% solution in / m or 0.5 grams per 20 ml water rektalno; Children rektalno (10% solution) or / m (5% solution) at the rate of 0.5 ml / kg : either / in struino slowly in the form of 1% solution in the dose does not exceed 15 mg / kg Higher time and the highest daily intake for adults with the on / in a one-and

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