Dinoprostone

Chemical name

(5Z,11альфа,13Е,15S)-11,15-Диг��дрокси-9-оксопроста-5,1 3-диен-1-овая acid

Gross

C20-H32-O5

Characteristics

The white crystalline powder. Rat in alcohol, in ethanol solutions, it is difficult soluble in water.

Of drugs

The drugs-uterotonizirutee. Provides a stimulating effect on the activity Oxytocics and tone Oxytocics, modulating response to internal organs of the various hormonal effects, it is automatically reduce the pregnant uterus at any stage of pregnancy (sensitivity in the last trimester of pregnancy). The local application reduces the smooth musculature of the uterus and increases the blood supply, contributes razmagcheniu, and better disclosure of the cervix and stimulates smooth reduction in Musculatura.t_1/2 in / with the introduction of less than 1 minute for each of the primary metabolites-8 min. The timing of C_max intrawaginalnogo after the 0.5-mg 30-45 minutes, followed by a rapid return to the original level. Metabolised in the liver metabolites derived, mainly kidneys.

Indications

Enlisting the birth donoshenna pregnancy induction birth donoshenna or nearly donoshenna pregnancy induction exile fruit in the case of foetal death medikamentosny abortion, missed abortion, puzarnyi shipping.

Restrictions on the use of

Bronchial asthma, glaucoma, arterial hypertension, cardiovascular disease, epilepsy, human liver or renal function.

Contraindications

Hypersensitivity; At the time of appointment for induction birth donoshenna pregnancy in the history of the section kesarevom or large surgical interventions on the uterus, difficult and / or injuries birth pelvioperitonite, 6 or more mature pregnancies; A high degree of imbalance between the pelvis and the head of the fruit; Distress before the fruit of abnormal fetus. An induction to delivery vaginal gel-nemakushechne predlejania fruit infection lower divisions sexual tract, krovanistye separated from the genital tract of fuel during pregnancy, fetal vskrformisa bubble. In appointing the medical abortion, pelvic infection, in the event that it is not an adequate prior therapy zerwitzit or vaginal infections (counter ekstraamnioticescoe introduction).

Side-Effects

The tone uterus, tetanicescie reduction; Nausea, vomiting, diarrhoea, headache, dizziness, irritation tissues, erythema at the site in / with the introduction tides, chemical, temperature increases, leucocytosis; In the fruit, of a heart rhythm, asphyxia.

Specific guidance

Are solutions with a concentration of 1.5 µ g / mL, 5 µ g / J Solutions for on / in the application can be stored no more days. Before applying for induction delivery should be carefully evaluated the size of the pelvis and the head of the fruit; During childbirth must be carefully monitor uterine activity over the process of maturation and the disclosure of the cervix, the state of the fruit. With a history PNDS or tetaniceskih Tuesday reductions control cancer activity and the status of the foetus for the duration of induced childbirth. If patients are vsokotonicona reduction should take into account the possibility of a rupture in the uterus.

Patient interaction

Do oxytocin effect.

Overdosing

Symptoms : significant strengthening and increasing reductions Matki.lechenie : in / in a beta-adrainomimetikov; Inefficiencies in the fast Rodorazreshenie.pri overdose gel : The drug should be removed from the vagina, patientku put in the position semireclining sideways; Demonstrated the application of oxygen.

Precautions

We do not recommend a long (more than two days) application.

Dosing and Administration

For induction birth donoshenna pregnancy dose filled, in accordance with the sensitivity and patient support at as low a level as possible to assure a sufficient response uterus and the normal progressive Cheicki.vnutri disclosure in the first dose of 0.5 mg, in a subsequent 0.5 mg every hour. If activity uterus inadequate dose increase to 1 mg / h, the activity of the uterus does not increase. Not recommended dose greater than 1.5 mg / h. If progressive expansion cervix may reduce the dose to 0.5 mg / h. For in / with the introduction of drug use solution with a concentration of 1.5 µ g / J Initial speed Infusion, which has been supported in the first 30 minutes, is 0.25 µ g / min. If the desired effect is achieved, the speed of the increase to 0.5 µ g / min. In some cases, allow a gradual increase in speed of up to 1 or 2 µ g / min. In the event of a gipertonusa uterus or foetus distressa infuziu out to a normalization of the patient and the fetus, then infuziu can resume at a speed of 50% of the latter, and then gradually increase Skorosti.dl induction childbirth may also use vaginal gel in a dose of 1 mg. Gehl give back set vagina. If necessary, in 6900, you can enter the second dose of the gel-1-2 mg (2 mg appoint a complete lack of effect of the first, 1 mg used to reinforce what has already been achieved effect). For induction exile fruit in the case of foetal deaths in / in cefuroxim from a speed of 0.5 µ g / min, with a further increase in the speed at intervals of no less than 1 hour Do not exceed speed limits Infusion 4 µ g / Min.dla medical abortion, the abortion failed and puzarnom knifing in / in cefuroxim solution with a concentration of 5 g / J Recommended initial speed for the first 30 minutes and 2.5 µ g / min; If the effect is not possible, the rate of increase to 5 µ g / min. When the 6700 Infusion the necessary level sokratimosti uterus is not achieved, the pace Infusion increase to 10 µ g / min. If you have side effects reduce by 50% the speed of infusions or terminate it.

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