Miwakron

Roman name

Mivacron

Characteristics

Высокоселективный недеполяризующий миорелаксант short steps.

Pharmacokinetics

It is a mixture of three stereoisomers. Trans-trans and tsis-trans stereoisomers of 92-96% of the drug and little different in the ability of a neuromuscular blockade. Effectiveness of tsis-tsis stereoizomera 10 times less than two стереоизомеров.Основ��ым by metabolism is fermentativei hydrolysis with plasma cholinesterase education metabolites - Quaternary alcohol and Quaternary modimifira with no meaningful action at the neuromuscular conductivity and cardiovascular system. Perhaps there are other ways расщепления/выведени�� mivakuriya chloride (eg. hydrolysis by the action esterz liver, rendering the jelchew, renal excretion).

Clinical pharmacology

In appointing in the recommended dose range Miwakron not blocking wandering nerve and brain ganglia, has no substantial influence on the frequency of heart rhythm and prevents bradycardia caused by the anaesthetics or stimulation wandering nerve during the operation.

Indications

The general anesthesia for relaxation skeletal muscles in the mouth and trachea IVL during surgery.

Pregnancy and lactation

Perhaps if the effect of therapy outweighs the potential risk to Ploda.dl of neuromuscular blockade at the time of caesarean sections require dose adjustment and the speed of the product (during pregnancy reduces cholinesterase plasma). Speed of a patient who until caesarean sections appointed Magnesium sulphate (magnesium ions make the drug). Currently, we do not know is whether Miwakron with breast milk.

Contraindications

Hypersensitivity, gomozigotnosti on gene SARS Holinesterzy.s caution : kidney and / or liver failure, cirrhosis, nervno-myshechne disease, bronchial asthma, cardiovascular, bronhogennaya carcinoma, or other malignant neoplasms expressed violations elektrolitnogo balance, dehydration, gipokaliemia, burns, cachexia, severe anemia, a decline of cholinesterase (severe liver failure, geterozigotnosti gene for cholinesterase, fungicidal effect, antiholinesteraznah drugs, MAO inhibitors, pankuronia, organic phosphate), the impact of neurotoxic insecticides, hypothermia, obesity, respiratory distress, respiratory depression, pregnancy, lactation period, up to 2 months.

Specific guidance

As with the application suksametonia / suktinilholina, patients gomozigotnye on SARS gene plasma cholinesterase, it is susceptible to mivakuriya action. The three adult patients a small dose Miwakrona 0.03 mg / kg (approximately equal to ED10-20 genotipiceski healthy patients) produced complete neuromuscular blockade during 26-128 Min.pri signs of spontaneous recovery nervous conductivity a standard dose neostigmina fully kupirovalo Blokadu.s caution should appoint patients with a heightened sensitivity to gistaminu (such as asthma) and ready to lower AD (eg, gipovolemii). duration of these patients must be at least 60 S.u adults, with the rapid introduction bolusnom Miwakrona dose of 0.2 mg / kg (greater than or equal to 3hed_95) had the symptoms associated with the release of gistamina. However, the slow introduction Мивакрона in the same dose or SQLquery introduction to the dose of 0.25 mg / kg (see "Dosing and Administration") significantly reduces the adverse reactions of the cardiovascular system. Children bolusnoe rapid introduction Miwakrona dose of 0.2 mg / kg did not affect the cardiovascular Sistemu.kak and in the application of other nedepoliarizuth miorelaksantov, Hypersensitivity to miwakuriyu may occur in patients with myasthenia or other nervno-myshecnami diseases and Kahexiei.patientam burns with a first test dose Miwakrona 0,015-0,02 mg / kg, then introduces a suitable dose controlled stimulation flaccid Nerva.net data on the use of Miwakrona in patients in the long IVL offices intensive Terapi b13a i.obratimosti neuromuscular blockade : signs of spontaneous recovery nervous conductivity after Miwakrona should occur prior to the election preparations, its rebuilding (eg neostigmina). In order to assess the degree of recovery conductivity before and after the appointment of these drugs should be used stimulants peripheral nerve.

Patient interaction

If you are applying to mivakuriya anfluranom, izofluranom, sevofluranom and galotanom growing nervno-myshecnaya Blokada.antibiotiki (aminoglikozida, polimiksin, spectinomitina, tetratziklin, linkomicin and clindamycin), antiaritmicescie funds (propranolol, BAC, lidocaine, procainamide and quinidine), dioretiki (furosemide, tiazidove (possibly), mannit, acetazolamide), magnesium salt, ketamine, salt lithium ganglioblokatora (trimetafan, gexametoni) can add value and / or the duration of neuromuscular blockade conductivity caused by nedepoliarizutmi miorelaxanthami, incl. Miwakronom.preparata and of the slowdown plasma cholinesterase (fungi, antiholinesteraznae drugs, MAO inhibitors, pancuronium, organic phosphate), may extend the duration of neuromuscular blockade induced Miwakronom.v rare cases, antibiotics, beta-blokatora (propranolol, oxprenolol), antiaritmicescie (procainamide, quinidine) and antirevmaticalkie funds (chloroquine, D-penitsillamin) trimetafan, chlorpromazine, steroids, phenytoin and lithium exacerbate gravis, development miasteniceski syndrome, and have a latent miasteniu, followed by an increased sensitivity to the Miwakronu.socetannoe depoliarizuth neuromuscular blocking conductivity and Miwakrona can cause more severe blockade than expected from the introduction of one Miwakrona equivalent total dose. Expressiveness synergies varies depending on the combination Lekarstv.pri with suksametonia chloride may elongation neuromuscular blockade, which was difficult to pain through antiholinesteraznah drugs.

Precautions

It should be used only in the offices, where there is equipment for transporting voice and IVL qualified Anesteziologami.ne should combine with depoliarizutmi miorelaxanthami and confused in one sprite or designate at the same time through one machine with a highly alkaline solution (barbiturates). If necessary, the one the same needle or sampling, or needle sampling to wash saline solution after each Preparata.sovmestim with many acid solutions, which are normally used during operations, such as fentanyl, alfentanilom, sufentanil, droperidolom and midazolam.

Storage conditions

Schedule A. In the dark place at a temperature of no higher than 25 ° C. (not freezing)

Shelf life

1.5 years

The registration

015247/01

The drug forms

Transparent liquid and contains little or none of inclusions.

Directory → Wegetotropona funds → Holinoliticaskie funds → N-holinolitiki (ganglioblokatora) → Miwakron