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Product trade name: Luminal
Pharmaceutical active ingredients containing related brand and generic drugs, medications or other health care products: Luminal available forms, composition, doses: Luminal destination | category: Indications and usages, anatomical therapeutic chemical and diseases classification codes: Pharmaceutical companies, researchers, developers, manufacturers, distributors and suppliers: Online pharmacy, drugstores, pharma, health and beauty shops selling this or related pharmaceutical products: There is an additional general information about this medication active ingredient phenobarbital: Pharmacological action Luminal is an anticonvulsant, hypnotic, sedative drug. This medication is a long-acting barbiturate. It is believed that the effects of phenobarbital, like other barbiturates, due to the ability to increase and / or mimic the inhibitory effect of GABA on synaptic transmission. Sedative-hypnotic effect due to the suppression of sensory cortex, decrease motor activity, changes in the functional state of the brain. Although the mechanism of action is not fully installed, phenobarbital, like other barbiturates apparently is particularly active at the level of the thalamus, which suppresses the rising holding in the reticular formation, thereby preventing transmission of impulses in the cerebral cortex. Anticonvulsant effect is due to suppression of the monosynaptic and polysynaptic transmission in the CNS. Luminal causes a dose-dependent respiratory depression. Phenobarbital reduces the concentration of serum bilirubin. Like other barbiturates, this medicine contributes to the induction of microsomal liver enzymes, thereby enhancing or altering the metabolism of other drugs. Pharmacokinetics Distribution of phenobarbital is slower than other barbiturates because of the lower lipophilicity. The plasma protein binding is from low to moderate. Metabolized in the liver, mainly with the participation of microsomal enzymes. Why is Luminal prescribed? Epilepsy (treatment of generalized tonic-clonic and simple focal seizures); emergency treatment of acute attacks of convulsions (including associated with status epilepticus, eclampsia, meningitis, toxic reactions to strychnine); of tetanus (as adjunctive therapy). As a sedative (including as part of combination therapy and combination therapies) to reduce anxiety, tension, fear. Hyperbilirubinemia (prophylaxis and treatment). Dosage and administration The dosing regimen is individual, depending on the evidence, the age of the patient's clinical situation. For oral administration for adults the single dose is 10-200 mg, the multiplicity of the reception is 1-3 times / day; for children - 1-10 mg / kg 3 times / day. The single IV dose for adults is 100-1400 mg, IM - 10-200 mg; for children IV - 1-20 mg / kg, IM - 1.10 mg / kg. The frequency of administration is determined individually. After IV administration to achieve the maximum effect it may take up to 30 minutes. Maximum doses: for adults a single oral dose is 200 mg, the daily one is 500 mg. Luminal side effects, adverse reactions CNS: possible weakness, drowsiness, fatigue, ataxia, depression (especially in elderly or debilitated patients). Hematopoietic system: rarely - agranulocytosis, thrombocytopenia. Metabolism: rarely - calcium metabolism disorders. Allergic reactions: seldom - a skin rash, itching. Luminal contraindications Severe liver disease and / or kidney disease, acute intermittent or mixed porphyria, porphyria in history, hypersensitivity to phenobarbital. Using during pregnancy and breastfeeding According to some reports the use of phenobarbital as an anticonvulsant during pregnancy leads to disruption of blood clotting in a newborn and can cause bleeding in the early postpartum period (usually within the first 24 hours after birth). If barbiturates are used during childbirth there are encouraged to take delivery in intensive care availability. Barbiturates are excreted in breast milk. Receiving barbiturates by nursing mother may cause CNS depression in the infant. Luminal as an inducer of microsomal oxidation enzymes in the liver and increases its detoxifying function, reduces the concentration of bilirubin in serum. This property makes it appropriate use of phenobarbital in hemolytic disease of the newborn. Special instructions Used with caution in patients who abuse drugs or indications in the history of drug addiction; with hepatic dysfunction, acute or persistent pain, impaired renal function, respiratory diseases, accompanied by shortness of breath or respiratory obstruction, especially in status asthmaticus. With careful use of injection for heart disease, hypertension. With prolonged use it is possible liver damage. Patients who have increased sensitivity to one of the barbiturates may be sensitive to other barbiturates. Luminal should not be used concurrently with griseofulvin. Avoid alcohol during the period of treatment. During the period of treatment is observed slowing of psychomotor responses. It is necessary to take into account persons engaged in potentially hazardous activities that require attention and quickness of psychomotor reactions. Luminal drug interactions Luminal strengthens the metabolism of drugs biotransformed in the liver (due to the activation of microsomal enzyme oxidation) and reduces the effect of: indirect anticoagulants, including warfarin, acenocoumarol, phenindione and others (lowers the level of anticoagulant in the blood, while appointing need periodic monitoring of the prothrombin time to correct doses of anticoagulants), corticosteroids, digitalis drugs, chloramphenicol, metronidazole, doxycycline (reduces the T1/2 of doxycycline, the effect may persist for 2 weeks after discontinuation of the barbiturate), tricyclic antidepressants, estrogens, salicylates, paracetamol, etc. Luminal reduces the absorption of griseofulvin and its level in the blood. Valproic acid, sodium valproate increase the level of phenobarbital in the blood. Phenobarbital reduces plasma concentrations of carbamazepine, clonazepam. When this medication used with other central depressant drug (including sedatives, hypnotics, certain antihistamines, anxiolytics) and alcohol it is possible an additive inhibitory effect. MAO inhibitors prolong the effect of phenobarbital (probably due to inhibition of its metabolism). Luminal in case of emergency / overdose Symptoms of acute intoxication: nystagmus, unusual eye movements, ataxia, marked weakness, and drowsiness, severe confusion, slurred speech, agitation, dizziness, headache, respiratory depression, breathing Cheyne - Stokes, the weakening or absence of reflexes, pupillary (in severe poisoning paralytic shifting extension), oliguria, tachycardia, hypotension, hypothermia, cyanosis, weak pulse, cold and clammy skin, hemorrhages (in pixels pressure), coma. In severe poisoning may develop pulmonary edema, vascular collapse with a decrease in peripheral vascular tone, apnea, respiratory arrest and heart can be fatal. The overdose could be due to the development of complications such as pneumonia, arrhythmia, congestive heart failure, kidney failure. Treatment of acute overdose: accelerating excretion of phenobarbital and maintenance of vital functions. To reduce the absorption (if phenobarbital is not sucked completely from the gastrointestinal tract) - induction of emesis (unless the patient is conscious and has not lost the gag reflex), followed by the appointment of activated carbon, it is necessary to take measures to prevent aspiration of vomit. If the induction of vomiting is contraindicated, it is necessary to carry out gastric lavage. To speed up the elimination of the drug prescribed soaked saline laxatives, forced diuresis hold (while maintaining renal function), use alkaline solutions (for alkalinization of urine). Conduct monitoring of vital functions and water balance. Symptoms of chronic toxicity: constant irritability, weakening of the capacity for critical assessment, sleep disturbance, drowsiness, lethargy, weakness, impaired balance, tangled speech, dizziness, severe mental confusion. There are possible hallucinations, agitation, seizures, disruption of the gastrointestinal tract, cardiovascular system and kidneys. Treatment of chronic toxicity: a gradual reduction in dose (to avoid the development of withdrawal symptoms) to a complete withdrawal of the drug, symptomatic treatment and psychotherapy.
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