Panangin injections 10ml #5

Instruction for Panangin injections

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Pharmachologic effect

Panangin injections are a source of potassium and magnesium ions.
One of the most important functions of potassium ions is to maintain the membrane potential of neurons, myocytes, and excitable structures of myocardial tissue. An imbalance between the intracellular and extracellular potassium content leads to a decrease in cardiac contractility, arrhythmias, tachycardia and increased toxicity of cardiac glycosides.
Magnesium is an important cofactor in over 300 enzymatic reactions, including energy metabolism and synthesis of proteins and nucleic acids. In addition, magnesium plays an important role in the work of the heart: it reduces contractility and heart rate, leading to a decrease in myocardial oxygen demand. Decreased contractility of smooth muscle myocytes of the walls of arterioles, incl. coronary, leads to vasodilation and to increased coronary blood flow. Magnesium has an anti-ischemic effect on myocardial tissue.
The combination of potassium and magnesium ions in one preparation is based on the fact that potassium deficiency in the body is often accompanied by magnesium deficiency and requires simultaneous correction of the content of both ions in the body. Further, with the simultaneous correction of the levels of these electrolytes, an additive effect is observed (low levels of potassium and / or magnesium have a proarrhythmogenic effect), in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting their positive inotropic effect.

Indications for Panangin injections

To eliminate the deficiency of potassium and magnesium as an adjuvant:
    with various manifestations of ischemic heart disease, including acute myocardial infarction;
    with chronic heart failure;
    in case of cardiac arrhythmias (including arrhythmias caused by an overdose of cardiac glycosides).

Method of application, course and dosage

Panangin injections are intended for intravenous administration only.
The contents of 1-2 ampoules should be diluted in 50-100 ml of 5% dextrose (glucose) solution and administered intravenously as a slow drip infusion (20 drops / min). If necessary, re-introduction is possible after 4-6 hours.
Panangin injections can be used as part of a combination therapy.

Overdose

To date, overdose cases with the Panangin injections have not been described. In case of an overdose, the risk of developing hyperkalemia and hypermagnesemia increases.
Symptoms of hyperkalemia: fatigue, myasthenia gravis, paresthesia, confusion, heart rhythm disturbances (bradycardia, AV block, arrhythmias, cardiac arrest).
Symptoms of hypermagnesemia: decreased neuromuscular excitability, urge to vomit, vomiting, lethargy, decreased blood pressure. With a sharp increase in the content of magnesium ions in the blood - suppression of tendon reflexes, respiratory paralysis, coma.
Treatment: drug withdrawal, symptomatic therapy (intravenous injection of 100 mg / min calcium chloride solution), if necessary, the appointment of hemodialysis.

Drug interactions

Strengthens the negative dromo- and batmotropic effect of antiarrhythmic drugs.
Eliminates hypokalemia caused by GCS.
Due to the magnesium content, it reduces the effectiveness of neomycin, polymyxin B, tetracycline and streptomycin.
Cyclosporine, potassium-sparing diuretics, heparin, ACE inhibitors may increase the risk of hyperkalemia.
Anesthetics increase the inhibitory effect of magnesium on the central nervous system.
May increase neuromuscular blockade caused by depolarizing muscle relaxants (atracuria besylate, dexamethonium bromide, suxamethonium chloride / bromide / iodide).
Calcitriol increases the concentration of magnesium in the blood plasma, calcium preparations reduce the effect of magnesium preparations.
Beta-blockers, NSAIDs increase the risk of hyperkalemia up to the development of arrhythmia and asystole.
Pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerance, reduces the undesirable effects of cardiac glycosides.

Application Panangin injections during pregnancy and lactation

There are no data on the negative effect of the drug during pregnancy and lactation (breastfeeding).
Intravenous administration of the drug during pregnancy and lactation is contraindicated.

Side effect of Panangin injections

With rapid intravenous administration, symptoms of hyperkalemia may develop (fatigue, myasthenia gravis, paresthesia, confusion, heart rhythm disturbances / bradycardia, AV blockade, arrhythmias, cardiac arrest /) and hypermagnesemia (decreased neuromuscular excitability, vomiting, vomiting, lethargy , decrease in blood pressure). It is also possible to develop phlebitis, AV blockade and a paradoxical reaction (an increase in the number of extrasystoles).

Contraindications for use

    hypersensitivity to drug components;
    acute and chronic renal failure;
    Addison's disease;
    AV block II-III degree;
    cardiogenic shock (blood pressure <90 mm Hg);
    hyperkalemia;
    hypermagnesemia;
    insufficiency of the adrenal cortex;
    severe myasthenia gravis;
    dehydration;
    pregnancy;
    breastfeeding period;
    age up to 18 years (efficacy and safety have not been established).
With caution: grade I AV block, severe liver dysfunction, metabolic acidosis, with a risk of edema, impaired renal function if regular monitoring of the magnesium content in the blood serum is impossible (risk of cumulation, toxic magnesium content) ; hypophosphatemia, urolithiasis diathesis associated with impaired metabolism of calcium, magnesium and ammonium phosphate.

Special instructions for Panangin injections

With rapid intravenous administration of Panangin injections, skin hyperemia may develop.
Special care should be taken in the presence of diseases accompanied by hyperkalemia. In these cases, it is recommended to control the content of potassium ions in the blood plasma.

Application for impaired renal function

Acute and chronic renal failure, oliguria, anuria.

Terms of sell

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