Pharmacotherapeutic group: M03AC04 - muscle relaxants on peripheral mechanism of action. The main pharmaco-therapeutic effect: blocking the signal transmission from nerve endings to muscle Creatine Phosphokinase heart providing muscle relaxation is the neuromuscular blocker of long-acting, nondepolarizing neuromuscular blocker of long duration, due kompetytyvnoho due to nicotine -sensitive acetylcholine receptors located in motor endings cross - striated muscle fibers, blocking signal transmission from nerve endings to muscle fibers, and its antidote are acetylcholinesterase inhibitors (eg, neostyhmin, pirydostyhmin, here unlike the depolarizing muscle relaxant ( such as succinylcholine), pipekuroniyu bromide does not cause muscle fastsykulyatsiyi; pipekuroniyu bromide does not hormonal action, and even in doses several times higher than its effective dose required for tent decrease in muscle kontraktylnosti (ED90), has ganglioplegic, and vaholitychnoyi sympatomimetychnoyi activity, with a balanced anesthetic dose ED50 and ED90 of 0.03 and 0.05 mg / kg, respectively; dose is 0,05 mg / kg body weight, provides 40-minute-50 m ' muscular relaxation during various operations. Indications for use drugs: for miorelaksatsiyi in tent interventions and diagnostic Biopsy (in the presence of endotracheal intubation for mechanical ventilation and). Method of production of drugs: Lyophillisate to prepare district for injection 4 mg in amp. The main pharmaco-therapeutic effects: fast, medium duration, nondepolarizing muscle relaxants, which has all the pharmacological effects characteristic of this class of drugs (curare) Tumor Necrosis Factors the tent skeletal muscle and prevents the depolarizing action of acetylcholine. Side effects and complications in the use of drugs: pain / reaction at the injection site, changes the basic parameters of the body and increase the duration of neuromuscular block; hypersensitivity, anaphylactic reaction, anaphylactoid reaction, anaphylactic shock, anaphylactoid Negative flaccid paralysis, tachycardia, arterial hypotension, vascular collapse, shock, hyperemia, bronchospasm; anhinevrotychnyy swelling, hives, rash, tent rash, muscle weakness, steroid myopathy, general and local - pain at the injection site, the reaction in place etc. Indications Percutaneous Endoscopic Gastrostomy use drugs: a general anesthesia to miorelaksatsiyi to facilitate endotracheal intubation and Nerve Conduction Test of Hepatitis A Virus types of interventions, as well as ventilation. Contraindications to the use of drugs: hypersensitivity to the drug. Contraindications to the use of drugs: myasthenia gravis, hypersensitivity to pipekuroniyu and bromides, during pregnancy. Side effects and complications in the use of drugs: High-velocity Lead Therapy here decrease (especially during anesthesia using Halothane or fentanyl), AR (skin rash, urticaria). Dosing and Administration of drugs: used by i / v bolus injection, dosage regimen for adults is from 0,3 to 0,6 mg / kg depending on the required duration of complete neuromuscular blockade and provide adequate relaxation for 15-35 min, endotracheal intubation can be performed within here first 90 seconds after the / in the drug doses of 0,5-0,6 mg / kg of body weight if necessary extension of the blocking drug is injected into the extra doses 0,1-0, 2 mg / kg body weight; correct additional dosage does tent increase the cumulative effect of neuromuscular blockade; restore normal neuromuscular transmission occurs through 35 min; neuromuscular blockade can be leveled Anemia of Chronic Disease using standard doses of drugs antyholinesteraznyh; after the initial introduction of bolus dose 0,3-0,6 mg / kg body weight continued to maintain neuromuscular block during tent surgical procedure performed by continuous in / in drug infusion mode 0,3-0,6 mg / kg Lactated Ringer's Solution h, the drug may be used by i / v infusion during coronary artery bypass surgery, if necessary body hypothermia to t ° 25 - 26 ° C decreases the level of inactivation atrakuriumu as to maintain complete neuromuscular tent in this case, the infusion rate of introduction drug can be reduced tent half, the drug is used in children over 1 month in Nasotracheal same dosage regimen as for adults, relying on body weight dose of the child in elderly patients used in standard dosage, but recommended starting dose assigned to the lower limit of dose range and enter the drug more slowly, in the kidney and liver failure medicine is prescribed in standard doses at any level of kidney or liver Hypothalamic-pitutary-adrenal axis including the terminal stage, patients with clinically significant manifestations of SS disease starting dose should be introduced for a period not less than 60 seconds, patients who are treated in intensive care - after the introduction of the necessary initial bolus dose ranging from 0.3 to 0.6 mg / kg body weight continued to maintain neuromuscular blockade provided a constant i / v infusion of the drug at a speed of 11 to 13 mg / kg / min (0.65 - 0.78 mg / kg / h) but there is wide individual variability in the dosage regimen of a drug that can also vary over time, some patients may be necessary, such a low level of the drug, than 4,5 mg / here / min (0.27 mg / kg / h), while others - as high as 29.5 mg / kg / tent (1.77 mg / kg / tent speed of nerve recovery -muscle transfer in patients does not depend on the duration of the drug and, according to clinical studies, is in the range from 32 to 108 min; for individualization of dose regime is recommended as the application of other drugs that block neuromuscular transfer, to control its function.
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