Panangin solution 10ml #5

Panangin solution user manual

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The composition of one ampoule

Active substances: Potassium asparaginate (in the form of potassium asparaginate hemihydrate) 452 mg (corresponds to 103.3 mg of potassium ions), magnesium asparaginate (in the form of magnesium asparaginate tetrahydrate) 400 mg (corresponds to 33.7 mg of magnesium ions);
Excipients: water for injection - up to 10 ml.
Description: Colorless or slightly greenish, transparent solution.
Pharmacotherapeutic group: potassium and magnesium drug.
ATH code: А12СХ

Pharmacological properties

Pharmacodynamics

Panangin is a source of important electrolytes: 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. Imbalance between intracellular and extracellular potassium leads to a decrease in cardiac contractility, arrhythmias, tachycardia and an increase in the toxicity of cardiac glycosides.
Magnesium is an important cofactor of more than 300 enzyme reactions, including energy metabolism and the synthesis of proteins and nucleic acids. In addition, magnesium plays an important role in the work of the heart: it improves contractility and heart rate, leading to a decrease in myocardial oxygen demand. Reduced contractility of smooth myocyte arterioles leads to vasodilation, including the coronary vessels, 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 the deficiency of potassium in the body is often accompanied by a deficiency of magnesium and requires the simultaneous correction of the levels of both ions. Further, with the simultaneous correction of the levels of these electrolytes, an additive effect is observed (a low level of potassium and / or magnesium has a pro-arrhythmic effect), in addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting the positive inotropic effect of the latter.

Pharmacokinetics

No data.

Indications for Panangin solution

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

Contraindications

Hypersensitivity to Panangin solution, acute and chronic renal failure; Addison's disease; atrioventricular block II, III degree; cardiogenic shock (blood pressure With caution
Atrioventricular block I degree, expressed impaired liver function; metabolic acidosis; the risk of edema; renal dysfunction in the event that regular monitoring of the content of magnesium in the blood serum is impossible (danger of accumulation, toxic content of magnesium); cardiogenic shock (systolic blood pressure less than 90 mm. Hg. Art.); hypophosphatemia; urolithiasis diathesis associated with metabolic calcium, magnesium and ammonium phosphate.

Pregnancy and lactation

No data on the harmful effects of Panangin solution during pregnancy.

Dosage and administration

Only for intravenous administration.
The contents of 1-2 ampoules of Panangin solution should be diluted in 50-100 ml of 5% dextrose solution (glucose) and injected intravenously in the form of a slow drip infusion (20 drops per minute). If necessary, you can repeat the dose after 4-6 hours.

Panangin solution is suitable for combination therapy.

Side effects of Panangin solution

With rapid intravenous possible development of hyperkalemia symptoms (fatigue, myasthenia gravis, paresthesias, confusion, abnormal heart rhythm (bradycardia, atrioventricular block, arrhythmia, heart failure) and hypermagnesemia (falling neuromuscular excitability, retching, vomiting, lethargy, lowering blood pressure The development of phlebitis, atrioventricular block and paradoxical reaction (increase in the number of extrasystoles) is also possible.

Overdose

To date, overdose cases have not been described. In case of overdose, the risk of symptoms of hyperkalemia and hypermagnemia increases.
Symptoms of hyperkalemia: fatigue, myasthenia gravis, paresthesia, confusion, heart rhythm disturbances (bradycardia, atrioventricular block, arrhythmias, cardiac arrest).
Symptoms of hypermagnesemia: a drop in neuromuscular excitability, retching, vomiting, lethargy, a decrease in blood pressure (BP). With a sharp increase in the content of magnesium ions in the blood - inhibition of deep tendon reflexes, respiratory paralysis, coma.
Treatment: In case of overdose symptoms, treatment with Panangin should be stopped and symptomatic therapy (intravenous administration of calcium chloride in a dose of 100 mg / min, if necessary, hemodialysis should be given).

Interaction with other drugs

Enhances the negative dromo-and bathmotropic action of antiarrhythmic drugs.
Eliminates hypokalemia caused by glucocorticoids.
Due to its magnesium content, it reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin. Cyclosporine, potassium-sparing diuretics, heparin, ACE inhibitors may increase the risk of developing hyperkalemia.
Anesthetics increase the inhibitory effect of magnesium on the central nervous system.
It can strengthen the neuromuscular blockade caused by depolarizing muscle relaxants (atracuria besylate, decametonium bromide, suxamethonia (chloride, bromide, iodide)).
Calcitriol increases the concentration of magnesium in the blood plasma, calcium preparations - reduce the effect of magnesium.
Beta-blockers, nonsteroidal anti-inflammatory drugs increase the risk of hyperkalemia, up to the development of arrhythmias and asystole.
Pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerability, reduces the undesirable effects of cardiac glycosides).

special instructions

With the rapid introduction may develop skin hyperemia.
Special care should be taken if there are diseases associated with hyperkalemia. In these cases, it is recommended to control the content of potassium ions in the blood.

The effect of the drug Panangin solution on the ability to drive vehicles and mechanisms

Not studied.

Release form

Concentrate for solution for infusion, 45.2 mg / ml + 40 mg / ml.
On 10 ml of a preparation in a colorless glass ampoule (1 hydrolytic class), 5 ampoules in the plastic pallet. 1 plastic pallet in a carton box with instructions for medical use.

Storage conditions

Store at a temperature of 15 to 30 ° C.
Keep out of the reach of children!
Shelf life - 3 years.
Do not use after expiration date.

Sales conditions

You can buy Panangin solution without a prescription.