Nimbeks

Roman name

Nimbex

The composition and the form of

Solution intravenous-1 mltsistrakuriya besilat-2 or 5 megawatts 182,000,000 2.5; 5, or 10 ml (2 mg) or in vials to 30 ml (5 mg) in the box five vials or 1 bottle.

Characteristics

Nedepoliarizuti benzilhinolinovi miorelaxant average duration of action.

Pharmacokinetics

The body in physiological pH and temperature of the body is off yesterday with the formation of laudanozine моночетвертичного and binders. The hydrolysis is the non esterazami plasma education monochetverticnogo alcohol. Metabolites show liver and kidneys miorelaksirutmi properties is not a Obladaut.pri drug adult patients in the dose to 0.4 mg / kg farmakokinetika it is not dependent on dose (8hed_95). Pharmacokinetic parameters Nimbexa dose in excess of 0.1 and 0.2 mg / kg for adult surgical patients are presented in Table 1.O older patients has been a modest increase in distribution (17%) and T_1/2 (4 min) Preparata.kliniceski meaningful difference in farmakokinetike tsistrakuriya besilata in patients with end stage renal failure, the healthy volunteers not Nabludaetsa.pri liver failure is a slight difference in the amount of distribution (21%) and klirense (16%) tsistrakuriya besilata but T_1/2 and breeding withdrawal Izmenautxia.pri infuzionnom establishment or bolusnom a klirens average is 6.9 ml / kg / min, and T_1/2-28 min. Return drug does not depend on the duration of infusions.

Clinical pharmacology

At doses up to 8 times higher than ED_95 (average dose required for 95% suppression reaction draining muscle thumb in response to stimulation elbow nerve), it is dependent on the dose release Gistamina.ed_95 tsistrakuriya besilata during opioid anesthesia (тиопентал/фентанил/м��дазолам) of 0.05 mg / kg; children during anaesthesia galotanova - 0.04 mg / Kg.tsistrakuriya besilat paralysis of the respiratory and skeletal muscles but does not affect the mind, and the threshold of pain �увствительности.Имею тся sporadic reports of the convulsing from patients in intensive care units that have received атракурия бесилат in combination with other drugs (introduction animals laudanozine - метаболита цисатракурия бесилата and атракурия бесилата high doses associated with транзиторной suffer and, in some cases, the symptoms brought cortex brain). Since they typically suffered one or more diseases predraspolagatmi in a convulsing (such as brain damage, gipoksica encephalopathy, brain swelling, viral encephalitis, uremia), the causal swazirazvitia convulsing with ldaudanosinem not installed. Furthermore, it should be borne in mind that laudanozine concentration in plasma with a Nimbexa 3 times lower than those Infusion atrakuriya besilata.

Indications

Maintenance relax skeletal muscles and mouth traheivo time operations and IVL offices in intensive care.

Pregnancy and lactation

When pregnancy and breastfeeding applied with caution, only if the expected benefits of therapy outweighs the potential risk to the fetus. Tsistrakuriya besilat no undesirable actions on the development of the fruit. The impact on the reproductive not investigated. It is not known whether the move product in breast milk.

Contraindications

Гиперчувствительност ь цисатракурия to бесилату, атракурия бесилату, бензолсульфоновой acid). A caution : the acid-base equilibrium and elektrolitnogo graphical; kartsinomatos neurotransmission, or diseases (including infants and miasteniceski syndrome), or other conditions that could lead to prolonged neuromuscular blockade; burns; gemiparez or paraparez; pregnancy; lactation period.

Side-Effects

The frequency of adverse events possibly associated with the introduction of Nimbexa is less than 0.5%. These include redness, or skin rashes, bradycardia, tissues and rarely Bronhospazm.oceny critically anaphylacticskie reaction (when applied in combination with one or more anaesthetics) In some cases, the development of muscle weakness and / or myo after long term use of seriously ill patients, in most cases, the combined application with korticosteroidami (relationship with Nimbexa unknown).

Specific guidance

Nimbeks must appoint anaesthetists and other specialists who have experience with miorelaksantov. Tsistrakuriya besilat paralysis of the respiratory and skeletal muscles but does not affect the mind, and the threshold of pain sensitivity. In appointing миорелаксантов, including Нимбекса, it is necessary to monitor the conductivity nervous to pick the individual dose препарата.Нимбекс must appoint anaesthetists and other specialists who have experience with миорелаксантов. In appointing miorelaksantov, incl. Nimbexa, it is necessary to monitor the conductivity nervous to pick the individual dose Preparata.sleduet used only when mouth and trachea Ivl.tsistrakuriya besilat has expressed wagoliticakimi or ganglioblokirutmi qualities, it Nimbeks has no clinically meaningful effect on the frequency of heart and does not affect the bradycardia, caused many means to anaesthesia or stimulation wandering nerve during Operation.u patients with myasthenia and other forms of neurotransmission diseases greatly enhanced sensitivity to nedepoliarizutm miorelaxantham. The recommended initial dose Nimbexa of such patients should not exceed 0.02 mg / Cg.vrajenne of acid-base equilibrium and / or elektrolitnogo exchange may increase or decrease sensitivity to the patients миорелаксантам.Влиян��е tsistrakuriya besilata for patients with malignant gipertermiei in history and with burns was not investigated. However, the appointment of such patients Nimbexa, like other nedepoliarizuth miorelaksantov, it is necessary to have the largest doses and shorter of the product is Nih.nimbeks gipotoniceski solution, and should not be imposed infuzionnuu system through which blood transfusions.

Patient interaction

Funds for anaesthesia (anfluran, izofluran and alothane, ketamine), the other nedepoliarizute relaxants, antibiotics (including aminoglikozida, polimiksin, spectinomycin, tetratziklin, linkomicin and clindamycin), antiaritmicescie means (including propranolol, calcium antagonists, lidocaine, procainamide and quinidine), dioretiki (including furosemide, possibly tiazida, mannit, acetazolamide), magnesium salt, salt lithium ganglioblokirute funds (trimetafan, gexametoni) added effect �иорелаксантов.Предше ствующее longstanding use fenitoina or carbamazepina effect weakens �иорелаксантов.Сочета нное with the suksametoniem could lead to a long and difficult siege, which can be difficult to remove through antiholinesteraznah Sredstv.v some cases, drugs are antibiotics, blockers �ета-адренорецепторов ( propranolol, oxprenolol), antiaritmicescie funds (procainamide, quinidine), protivorevmaticalkie funds (chloroquine, D-penitsillamin) trimetafan, chlorpromazine, steroids, phenytoin and lithium-could degrade over or attract latent gravis, as well as a miasteniceski syndrome, which may be accompanied by a heightened sensitivity to nedepoliarizutm miorelaxantham. With the conditions that simulate infuzionnuu system U-obraznam catheter Nimbeks compatible with the following drugs commonly used during surgery : droperidol, fentanyl citrate, midazolama Gidrohlorid.ne compatible with ketorolakom, trometamolom or drug propofola emulsion.

Precautions

In view of the possibility of cross-reactions between miorelaxanthami special caution should be exercised when the Nimbexa patients who experienced reactions гиперчувствительност и other muscle relaxants. In order to maintain adequate miorelaxation in hypothermia (for heart surgery) can be a significant decrease in speed infusions.

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