Propanorm

Description overdue on 01.04.2012

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Antiarrhythmics . The main component acts propafenone . On cardiomyocytes membranostabiliziruyusche medicament acts. The active ingredient decreases the rate of depolarization of phase zero, inhibits automatism, reduces the speed of the pulse Purkinje fibers . Electrophysiological action of of a medicament longer is directed to ischemic myocardium, rather than a healthy. Propanorm has local anesthetic effects, has a slight beta-adrenoceptor blocking action. Available in tablet form.

Indications:

Propanorm prescribed for fatal ventricular arrhythmias resistant Ventricular tachycardia , Atrial flutter, WPW syndrome , Supraventricular tachycardia, atrial fibrillation .

Contraindications:

Propanorm not prescribed for AV block grade 2-3 at bifastsikulyarnoy intraventricular blockade intolerance propafenone, breastfeeding, chronic heart failure, sinus bradycardia , Cardiogenic shock. In myasthenia gravis, hypokalemia, asthma, hepatic cholestasis, hypotension , Hyperkalemia, patients with a pacemaker (temporary, permanent), pregnancy, renal disease, hepatic failure, the system used with caution, after consultation of experts.

Side effect:

Cardiovascular system: angina , AV block, supraventricular tachyarrhythmia , Orthostatic hypotension, bradycardia, heart failure worsening course, a violation of intraventricular conduction, SA blockade. The digestive tract:   chair violations, violations of the liver, loss of appetite, taste perversion of perception, cholestatic jaundice , Dryness in a mouth. Nervous system : diplopia , Seizures, dizziness, headaches, blurred vision. In laboratory parameters observed inhibition of bone marrow hematopoiesis, electrolyte disorders, the appearance of antinuclear antibodies, prolonged bleeding,   thrombocytopenia . Perhaps the development of exanthema, of skin itch, oligospermia . hives , Reduced potency, hemorrhagic rash, bronchospasm, weakness, arthralgia.

Overdose:

Extrapyramidal disorder , Drop in blood pressure, convulsions, coma, asystole, ventricular tachyarrhythmia, drowsiness, bradycardia, sputannosti of consciousness. Defibrillation is required, gastric lavage, administration of diazepam, dobutamine. In some cases chest compressions, ventilation. Hemodialysis is recognized as ineffective.

Mode of application:

Before treatment should be abolished all anti-arrhythmic drugs. Propanorm appointed interior, 150 mg every eight hours. Every three days, the dosage was increased to 300 mg three times a day. Increasing daily dosing is possible only under strict observation of cardiology. Tablets propanorm taken after meals. In order to prevent cardiac arrhythmias drug is administered in a dose of 300 mg once a day T2-3. In renal disease, liver dosage is reduced to 20-30% of a standard dose of the drug. Patients weighing less than 70 kg, elderly patients antiarrhythmic therapy is carried out in small doses.

Special instructions:

Initial treatment with Propanorm performed only in a hospital because of the high risk arrhythmogenic action . Antiarrhythmic therapy is conducted under the supervision of electrolyte balance , Level of antinuclear antibodies, of hepatic enzymes. In identifying induced arrhythmias conducted electrophysiological, intraatrial investigation a week after the start of treatment. With ventricular ekstasistolii   reduce the number of premature beats 70% of the initial level of Holter ambulatory monitoring. Propanorm affects the speed of psychomotor reactions, driving vehicles.

Drug Interactions:

Propanorm increases the concentration of of digoxin, propranolol . metoprolol , Cyclosporine, anticoagulants   in blood plasma. The drug blocks the metabolism of warfarin, increasing its effects. Simultaneous treatment with tricyclic antidepressants, beta-blockers increases antiarrhythmic effect. The simultaneous use of local anesthetics increases the risk of damage to the nervous system. When assigning quinidine, cimetidine metabolism slows Propanorm increased drug levels in the blood plasma by 20%. Antibiotic rifampicin   reduces the concentration of propafenone. Risk   mielosupression   increases in the appointment of drugs that inhibit the operation of the bone marrow.