Ephedrine

Description overdue on 20.10.2012

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Sympathomimetic . The main ingredient - ephedrine hydrochloride. The active component stimulates the adrenoretseptory of beta and alpha. Under the influence of the drug is released norepinephrine   into the lumen of the synaptic cleft. The drug affects the varicose bulges in the adrenergic, efferent fibers. Ephedrine is able to provide a weakly expressed stimulating effect on the adrenergic receptors. The drug causes a psychostimulant, bronchodilatory and vasoconstrictor effects. The drug improves atrioventricular conduction Increases in heart rate, the IOC, the strength of heart contractions, increase the level of systemic blood pressure and systemic vascular resistance, inhibits intestinal peristalsis, increases the level of sugar in the blood, increases the tone of the skeletal muscles. Ephedrine dilates the pupil, without affecting the intraocular pressure, and accommodation of . According to the effects of psychoactive medication close to fenaminu. The medicinal drug is able to to brake Activity of catecholamines-0-methyltransferase, monoamine oxidase. The medicament stimulates alpha-adrainoretseptora in blood vessels integuments, narrowing expanded vessels that conducts to decrease their increased permeability. This mechanism explains the reduction in the severity of edema hives . When receiving ephedrine inwardly therapeutic effect develops in 15-60 minutes, lasts about 5 hours. In intramuscular effect is registered in 10-20 minutes and lasts about an hour. The pressor effects   the drug with repeated administration of 10-30 minutes decreases rapidly evolving tachyphylaxis caused by a decrease in inventories of norepinephrine in the varicose bulges. Ephedrine is available in tablet dosage form, in solution, nasal drops. Separately produced children's form of the drug.

Indications:

Ephedrine is prescribed for hay fever, rhinitis, catarrh, sinusitis, vasomotor rhinitis, with hypotension   (spinal anesthesia, surgery, shock, collapse, an overdose of antihypertensive medications, blockers, drugs ganglioblokiruyuschimi, bacteremia, blood loss, trauma). The drug is prescribed for depression, narcolepsy, asthma, sleeping pills poisoning, serum sickness , Rash, bleeding from the pulp of a tooth and gums, with drug poisoning, with the aim of diagnostic ophthalmic practice (mydriasis).

Contraindications:

Ephedrine is not indicated for insomnia, intolerance to the main component, pheochromocytoma GOKMP, tachycardia, uncontrolled hypertension during at fibriddyatsii ventricles. When hypoxia, hypercapnia, metabolic acidosis , Hypovolemia, pulmonary hypertension, the form-closure glaucoma, atrial fibrillation, Buerger's disease, atherosclerosis, arterial embolism, occlusive vascular lesions in the history of the patient with myocardial infarction, Raynaud's disease , Diabetic endarteritis, frostbite, thyrotoxicosis, diabetes, benign prostatic hyperplasia, ventricular fibrillation, tachyarrhythmia, angina pectoris, hypertension, coronary heart disease and other diseases of the cardiovascular system Ephedrine used with caution.

Side effect:

Nervous system: restlessness , Nervousness, weakness, sleep disturbances, headache, tremor of limbs, muscle spasms , Cramps, dizziness, mood and mental changes, hallucinations, excessive sleepiness, numbness in hands   and Foot . Cardiovascular system:   discomfort and chest pain, ventricular arrhythmias , Drop in blood pressure, palpitations, tachycardia   or bradycardia, angina, flushing of the skin, unusual bleeding. The digestive tract: heartburn , Violations of of appetite, irritation and dryness of the pharynx and the oral cavity, vomiting, nausea. Urinary: painful and difficult urination. The injection site may burning pain. It is also noted peripheral vasoconstriction, pale skin, sweating, shortness of breath, blurred vision, allergic reactions, dilated pupils, hyperthermia , Chills, shortness of breath.

Overdose:

Manifested rashes on the skin, excessive sweating, vomiting, loss of appetite, excessive increase in blood pressure levels, urinary retention , Insomnia, agitation, severe weakness. It is recommended that administration of an alpha-blockers short-acting.

Mode of application:

Ephedrine taken orally, intravenously, subcutaneously, intramuscularly, .  In allergic diseases, asthma drug in 10-15 days taken orally 2-3 times a day by 25-50 mg, or a cycle of three days and a three-day break .  As a CNS stimulant and bronchodilator drug prescribed to children means subcutaneously, intravenously at 3 mg / kg (doses 4-6) .  Before spinal anesthesia, while bacteremia intramuscularly and subcutaneously administered on 20-50 mg 2-3 times a day .  Higher dosages for subcutaneous administration, oral administration: daily - 150 mg, single - 50 mg .  If hypotension Ephedrine is administered intravenously slowly subcutaneously with 20-50 mg saline .  Re-introduction of is held under the the control of level of arterial pressure .  When vasomotor rhinitis 2-3% solution used in ophthalmic practice prescribed 1-5% solution .  As children vasoconstrictor is administered intravenously or subcutaneously to 750 mg / kg under the control response of the patient .

Special instructions:

At carrying out of infusion is necessary to use a special device, equipped with measuring scale to regulate the speed infusion. Infusion is preferably carried out in a large vein, preferably the central. During treatment requires monitoring of ECG changes, urine volume, blood pressure, pressure, pulmonary capillary wedge pressure in the pulmonary artery, central venous pressure . For the prevention of violations night of sleep Ephedrine appoint before bedtime either at the end of the day. Care should be taken that the drug did not get to perivascular tissue, which causes the formation of necrosis. Excessive amounts of the drug in myocardial infarction can cause amplification and progression ischemia   because of the increased need for myocardial tissue oxygen .  Prior to therapy, the correction of hypovolemia .  Introduction ephedrine is not a substitute salt solutions, blood fluids, plasma, blood, .  It is unacceptable long-term treatment of ephedrine .  During spinal anesthesia drug can cause heart palpitations in the fetus .  The drug can cause resistant hypertension during combination therapy with medications, reinforcing generic activities, adding local anesthetics during delivery .  The drug addicts can be used because of the stimulating effect on the central nervous system .  Never use an opaque solution .  Remains of the solution after the infusion were destroyed .  Earlier Ephedrine taken orally for the treatment of myasthenia gravis, enuresis .  When sharing a monoamine oxidase inhibitors marked increase in the pressor effect of sympathomimetic, which causes vomiting, headaches, arrhythmia, increased risk hypertensive crisis .

Drug Interactions:

Ephedrine is able to weaken the action sleeping pills , Narcotic analgesics. Medicines that was made alkaline urine (citrate, antacids, sodium bicarbonate, carbonic anhydrase inhibitors) increase the half-life of ephedrine, increasing the risk of intoxication. Simultaneous with the appointment hinidine, cardiac glycosides , Dopamine, tricyclic antidepressants, drugs for inhalation anesthesia (methoxyflurane, isoflurane, halothane, enflurane, chloroform, trichlorethylene) more likely to develop severe ventricular arrhythmias. Combination with antihypertensive agents , Rauwolfia alkaloids, diuretics, sympatholytic causes a decrease in the hypotensive effects. Increased severity of side effects of the cardiovascular system is registered, while the use of sympathomimetic drugs. With simultaneous use of adrenergic bronchodilator medicines more marked, excessive stimulation of the central nervous system, which manifests itself by insomnia, increased irritability, excitability, seizures, arrhythmias. Monoamine oxidase inhibitors , Reserpine, selegiline, procarbazine, furazolidone in combination with ephedrine causes a pronounced rise in blood pressure, arrhythmia, headaches, vomiting, hypertensive crises. Appointment of non-selective beta-blockers, nitrates, lead to a decrease in the effectiveness of ephedrine. Phenoxybenzamine increases the severity of tachycardia, the hypotensive effect. Ergotamine, ergometrine, Oxytocin , Metilergometrin increase the risk of gangrene, ischemia, increase the vasoconstrictor effect, hypertension may intracranial hemorrhage. Methylphenidate, trimetafan, mecamylamine, mazindol, methyldopa, doxapram, guanethidine, guanadrel increase the severity of the pressor effect. Application levodopa   It may cause arrhythmias, reduce the dosage required sympathomimetic. Ephedrine enhances stimulus methylphenidate mazindol on the central nervous system. Admission is ritodrin mutual reinforcement effects, including side.