Description
Release form
Solution for intravenous administration.
Packing
10 pcs.
Pharmacological action
Purified preparation from the leaves of May lily of the valley and its varieties. Cardiac glycoside, has a positive inotropic effect. This is due to the direct inhibitory effect of Na + / K + ATPase on the membranes of cardiomyocytes, which leads to an increase in the intracellular content of sodium ions and, accordingly, a decrease in potassium ions. An increased content of sodium ions causes activation of sodium / calcium metabolism, an increase in the content of calcium ions, as a result of which the strength of myocardial contraction increases.
As a result of increased myocardial contractility, the stroke volume of the blood increases, the final systolic and final diastolic volumes of the heart decrease, which, along with an increase in the tone of the myocardium, leads to a reduction in its size and, thus, to reduce myocardial oxygen demand.
Has a negative chronotropic effect, reduces excessive sympathetic activity by increasing the sensitivity of cardiopulmonary baroreceptors. Due to the increased activity of the vagus nerve, it has an antiarrhythmic effect, due to a decrease in the speed of impulses through the atrioventricular node and lengthening of the effective refractory period. This effect is enhanced by a direct effect on the atrioventricular node and sympatholytic effect.
A negative dromotropic effect is manifested in an increase in refractoriness of the atrioventricular (AV) node.
With atrial tachyarrhythmia, cardiac glycosides help slow down ventricular contractions, lengthen diastole, and improve intracardiac and systemic hemodynamics. The positive batmotropic effect is manifested in subtoxic and toxic doses. It has a direct vasoconstrictor effect, which is most clearly manifested in the absence of congestive peripheral edema. At the same time, an indirect vasodilating effect (in response to an increase in minute blood volume and a decrease in excessive sympathetic stimulation of vascular tone) usually prevails over direct vasoconstrictor action, resulting in a decrease in total peripheral vascular resistance (OPSS).
When administered intravenously, the action begins in 3-5 minutes and reaches a maximum in 25-30 minutes.
Indications
As part of the complex therapy of chronic heart failure of the II-IV functional class (in the presence of clinical manifestations), the tachysystolic form of atrial fibrillation and flutter of paroxysmal and chronic course (especially in combination with chronic heart failure).
Contraindications
Sharp organic changes in the heart and blood vessels, acute myocarditis, endocarditis, severe cardiosclerosis. Caution is required for thyrotoxicosis and atrial extrasystole due to the possibility of its transition to atrial fibrillation.
Special instructions
The likelihood of intoxication increases with hypokalemia, hypomagnesemia, hypercalcemia, hypernatremia, hypothyroidism, severe dilatation of the heart cavities, pulmonary heart, myocarditis, obesity, old age. With severe mitral stenosis and normo- or bradycardia, heart failure develops as a result of a decrease in diastolic filling of the left ventricle. Strofantin, increasing the contractility of the myocardium of the right ventricle, causes a further increase in pressure in the pulmonary artery system, which can provoke pulmonary edema or aggravate left ventricular failure. For patients with mitral stenosis, cardiac glycosides are prescribed with the addition of right ventricular failure, or in the presence of atrial tachyarrhythmia. Korglikon with WPW syndrome, reducing AV conduction, promotes the conduction of impulses through additional paths – bypassing the AV node, causing the development of paroxysmal tachycardia. As one of the methods for monitoring the level of digitalization in the appointment of cardiac glycosides, monitoring of their plasma concentration is used.
Composition
1 ml of solution contains:
Active ingredient: korglikona – 0.60 mg
Excipients: chlorobutanol hydrate, water for injection.
Dosage and administration of
I / O slowly (over 4-5 minutes), 0.5-1 ml of a 0.06% solution, 2 times a day (children 2-5 years old – 0.2-0, 5 ml, 6-12 years – 0.5-0.75 ml) before use, diluted in 10 ml or 20 40% dextrose solution or 0.9% NaCl solution. The highest single dose for iv administration is 1 ml, daily – 2 ml.
Side effects
Side effects of Korglikard are associated with increased patient sensitivity to cardiac glycosides or overdose. From the cardiovascular system: arrhythmia, AV block.
From the central nervous system and sensory organs: drowsiness, confusion, sleep disturbances, headache, dizziness, delirious psychosis, decreased visual acuity.
From the hemopoietic organs: thrombocytopenia, thrombocytopenic purpura, nosebleeds.
From the digestive system: anorexia.
Other: allergic reactions.
Drug Interactions
Adrenomimetics. The combined use of ephedrine hydrochloride, epinephrine hydrochloride or norepinephrine hydrotartrate, and selective beta-adrenergic agonists with cardiac glycosides can contribute to the occurrence of cardiac arrhythmias.
Aminazine and other phenothiazine derivatives. The action of cardiac glycosides is reduced.
Anticholinesterase drugs. With the simultaneous use of anticholinesterase drugs with cardiac glycosides, bradycardia is enhanced. If necessary, it can be eliminated or weakened by the administration of atropine sulfate.
Glucocorticosteroids. If hypokalemia occurs as a result of prolonged treatment with glucocorticosteroids, an increase in the undesirable effect of cardiac glycosides is possible.
Diuretics. When combining diuretic drugs (cause hypokalemia and hypomagnesemia, but increase the concentration of calcium ions in the blood) with cardiac glycosides, the effect of the latter is enhanced. With their simultaneous use, it is necessary to adhere to the optimal dosage. You can periodically prescribe potassium-sparing diuretics (spironolactone, triamteren), which eliminate hypokalemia. However, hyponatremia may develop.
Potassium preparations. Under the influence of potassium preparations, the undesirable effects of cardiac glycosides are reduced.
Calcium preparations. In the treatment of cardiac glycosides, parenteral administration of calcium preparations is dangerous, since cardiotoxic effects (cardiac arrhythmias, etc.) are enhanced.
Acids of ethylenediaminetetraacetic disodium salt. There is a decrease in the effectiveness and toxicity of cardiac glycosides.
Corticotropin preparations. The action of cardiac glycosides under the influence of corticotropin can be enhanced.
Xanthine derivatives. Caffeine or theophylline preparations sometimes contribute to cardiac arrhythmias.
Sodium adenosine triphosphate. Sodium adenosine triphosphate should not be given concurrently with cardiac glycosides.
Ergocalciferol. With hypervitaminosis caused by ergocalciferol, an increase in the action of cardiac glycosides is possible, due to the development of hypercalcemia.
Narcotic analgesics. The combination of fentanyl and cardiac glycosides can cause hypotension.
naproxen. In healthy people, the combined use of cardiac glycosides with naproxen does not affect the results of psychological testing.
Paracetamol. The clinical significance of this interaction has not been sufficiently studied, but there is evidence of a decrease in the release of cardiac glycosides by the kidneys under the influence of paracetamol.
Storage conditions
In a dark place and out of the reach of children, at a temperature not exceeding 25 ° C.
The Expiration of
is 3 years.
Deystvuyuschee substances
Land sha lystev glikozid
Dosage form
solution for infusions
Pilot Plant GNCLS, Russia
