Piracetam

Chemical name

2-Оксо-1-пирролидинаце��амид

Gross

C6-H10-N2-O2

Characteristics

White or almost white crystalline powder. Easily soluble in water, soluble in alcohol.

Of drugs

Drugs - the properties. Activates associative processes in the brain, improves memory, mood and mentality of healthy and sick people. Increases integrativuyu brainwaves and intellectual activity, stimulates learning processes, restore, and stabilizes the broken brain. Normalizes ratio ATF and the ADF (activates adenilatziklazu and ingibiruet nukleotidfosfatazu) increases the activity fosfolipaza A plastic promotes atherosclerosis and processes in the nervous tissue accelerates mezhneironne contacts and exchange neiromediatorov. Increases resistance brain tissue to hypoxia and toxic effects of increased synthesis of nuclear RNA in the brain. It improves microcirculation (without the pressure), blocks agregatia platelets, optimizes conformational properties eritrocitarna membrane and the ability of cells to undergo invasive mikrososuda. In patients with brain as a result of repeated violations of cerebral circulation improves local capture oxygen and glucose brain tissues, and in patients with functional disorders CNS enhances wakefulness. In connection with the operation of antihypoxic effective in treatment of myocardial infarction. Impact severity vestibular Nistagma.bystro and almost completely absorbed by ingestion. Bioavailability is 100%. Thirty minutes after the dose of 2 g (inside) in the plasma is C_max amounting to 40-60 µ g / J The plasma protein is not associated. The maximum concentration in a likwore through 2-8 hours Penetrates in all organs and tissues, a placental barrier. Selectively stored in the cortex, for the most part, in leading, and temennykh spine shares, the cerebellum and bazalnah gangliah. There is metabolized. T_1/2 plasma is 4-5 hours; Liquor 6-8 hours After 30 hours more than 95% of display memory. In patients with renal insufficiency T_1/2 longer. Pronounced clinical effects develop after day reception.

Indications

Psihoorganiceskie vascular disorders, and traumatic toxic genesis (komatosnye of, the acute phase of traumatic brain injuries, etc.), psihoorganiceskie syndromes dominated by fear, reducing attention and mental abilities (cerebral arteriosclerosis, intoxication, alcoholism, etc.), alcohol cravings and mild drink deliria, acute morphine and barbituratami, psychoses and the astenodepressivee (complex therapy), valoapaticalkie defective state of schizophrenia, depressive moods resistant to antidepressants; in Gerontology : impaired memory, dizziness, facial features cards, Alzheimer's disease, aterosklerotical discirkulatornaya encephalopathy, postinsultne mental and physical defects; in pediatrics, the prevention and treatment of birth asphyxia, birth trauma and its consequences, the convalescence after meningitis, encephalitis, a brain trauma, mental retardation, learning difficulty, memory disorders and intellectual deficiency; Correction side effects and complications of therapy psychotropic substances (fear, adinamii, neirolepticakih krizov with giperkinezami) korticalnaya mioclonia, sickle cell anaemia (complex therapy), viral CNS (to minimize phenomena hypoxia and the brain Ischemia).

Contraindications

Hypersensitivity, incl. derivatives pirrolidona; haemorrhagic stroke expressed by the human kidney (Cl creatinine less than 20 ml / min), pregnancy, breast-feeding (at the end of treatment), breast up to 1 year.

Side-Effects

Dizziness, tremor, nervousness, the institution including sexual (in a few cases), irritability, anxiety, insomnia, weakness, drowsiness, nausea, vomiting, diarrhoea, pain in the abdomen, frequent attacks of coronary insufficiency.

Specific guidance

Penetrates through membrane filtration devices for dialysis.

Patient interaction

In elderly patients increases the antianginalnah products reduces the need for nitroglycerine. Increases efficiency antidepressants.

Precautions

Caution is needed in the appointment of people in violation of hemostasis during big surgery, or patients with symptoms of heavy bleeding. When treating patients BGs mioclauniei should avoid abrupt cessation of treatment (risk of the resumption of attacks). It should be borne in mind that the development of side effects is most common among patients with mental disorders, worsening coronary insufficiency more frequently in older patients; In these cases, it is necessary to reduce the dose or stop the therapy. If you have sleep disturbance to cancel evening receptions by increasing daily. Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention.

Dosing and Administration

Inside, in / in, in / m. When treating heavy states should enter struino or Infuzii.vesroslam : inwards 800-1,200 mg / day (up to 1,6-2,4 g), 3 admission; In / in struino or infusions of 3-4 g (up to 12 grams) a day. In stroke-12 grams per day for two weeks, supporting dose is 4.8 grams per day; In the long-term therapy Psycho syndrome in older patients, it is 4.8 grams per day for a few weeks, then 1,2-2,4 g per day. In chronic alcoholism-12 grams daily during demonstrations withdrawal syndrome supporting dose of 2.4 and the BGs mioclonii are starting from 7.2 grams per day, increasing the dose of 4.8 g every 3-4 days until the 24 grams a day. In sickle cell disease-160 mg / kg / day 4 Priema.detam : 3-7 years inside, starting with 400 mg, the average therapeutic dose of 800 mg, the maximum 1 g; Children 7-12 years, 400 mg, 0.8-1.2 g factor g, respectively; 12-16 years - 800 mg, 1,2-1,6 g, 2.4 g, respectively. The correction reduced learning in children is 3.3 grams per day, representing 8 ml of 20% solution of 2 times daily (before breakfast and dinner), therapy continues throughout the school year. Using in patients with creatinine Cl 60-40 ml / min (creatinine concentration in the serum of 1.25 ml sales to 1.7 blend ml) dose reduced twice, and Cl creatinine 40-20 ml / min were created. Length course in psychiatry 4-6 weeks. Courses to repeat 2-3 times as curative as well as preventive purpose.

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