Atropin

Atropinum A03B A01, S01F A01

Specialiti: Sulfat de atropin.
Proprieti
Alcaloid izolat din Atropa belladonna L. Se mai conine n Ho!camu! ni"er L., #atura
!tramonium L. $.a. !ub form de l%&io!ciamin. 'n proce!ul izolrii l%&io!ciamina !e
tran!form n d,l% &io!ciamin (atropin). Bloc&eaz m%colinoreceptorii tuturor or"anelor
mpiedec*nd acce!ul acetilcolinei la ace$ti receptori n mod competiti+. ,educe !ecreia
"landelor lacrimale, !ali+are, bron$ice, di"e!ti+e, !udoripare. Scade tonu!ul mu$c&ilor
netezi ai -./, cilor $i +ezicii biliare. 0ic$oreaz tonu!ul +ezicii urinare n! pro+oac
!pa!mul !fincterului $i retenie urinar. #ilat pupila, pro+oac ciclople"ie, cre$te
pre!iunea intraocular.
Indicaii
Spa!mele mu!culaturii netezi a or"anelor interne1 -./, cilor biliare, bron&iilor. 2lcerul
"a!tric $i duodenal, pancreatita acut, &iper!ali+aia (par3in!oni!m, into4icaia cu
metale "rele). 0edicaia preoperatorie. Blocul A%5. /nto4icaia cu m%colinomimetice $i
anticoline!terazice (re+er!ibile $i ire+er!ibile). 6ercetarea fundului oc&iului, pentru
paralizia acomodrii, tratamentul iriditelor, iridociclitelor, c&orioiditelor, 3eratitelor,
emboliilor $i !pa!melor arterei centrale a retinei $i unor traume oculare.
Contraindicaii
.laucomul !au po!ibilitatea "laucomului, adenomul de pro!tat cu retenie urinar,
&iper!en!ibilitatea la atropin.
Posologie
6*te 0,17%1 m" !.c., i.m. !au i.+. de 1%8 ori pe zi. 'n oftalmolo"ie colir 19 c*te 1%8
picturi n oc&iul bolna+ (pentru copii concentraii mai mici) de 3 ori pe zi.
Supradozare
A"itaie p!i&omotorie, &alucinaii, delir, com, depre!ie re!piratorie, u!cciunea
mucoa!elor $i a pielii, &ipertermie. -ratament1 La+a: "a!tric cu !oluie ;9 de acid tanic.
'n a"itaia p!i&omotorie !e recomand barbiturice !au diazepam n doze moderate
deoarece n fazele tardi+e atropina in&ib centrul re!pirator. Analepticele nu !unt
recomandate. Hipertermia poate fi redu! cu cear$afuri umede (alcool, ap). <c&ii
trebuie!c umectai ncontinuu cu ap !au !er fiziolo"ic. ,e!piraie cu o4i"en.
6ateterizarea +ezicii urinare.
Efecte adverse
=ero!tomie, ta&icardie, con!tipaie, miciune dificil, midriaz, fotofobie, paralizia
acomodrii.
Interaciuni
,educe aciunea colinomimeticelor $i anticoline!terazicelor.
Precauii
>acienii cu afeciuni cardio+a!culare !e+ere. #up in!tilarea !oluiilor de atropin n
!acul con:uncti+al !e +a ap!a ductul lacrimal pentru a !e e+ita trecerea !oluiei n
orofarin"e $i ab!orbia (1 pictur !oluie 19 conine 0,7 m" atropin).
Sulfat de atropin (Farmaco, 0oldo+a). >icturi oftalmice 19%7 ml n flacoane.
(Scopolaminum).
?@AB@CDE, FCEGHIBJDKFL MNGFOG F BOHCPDQCN M AHBFBMAG, RG@GQG, ESHNBQG,
FACPC@DD.
THDNGQLUO M MDEG FACPC@BNDQB VDEHCRHCNDEB (SFCHClBmini &drobromidum).
WDQCQDNX1 Scopolaminum &drobromicum, Ho!cini &drobromidum.
YGZ[MGOQXG PHCZHB\QXG AHDFOB@@X D@D RG@XK AHDFOB@@D\GFADK PCHC]CA. ^GVAC
HBFOMCHDN M MCEG (113), HBFOMCHDN M FPDHOG (111_). W [G@`U FOBRD@DZB[DD
HBFOMCHCM E@L DQaGA[DK PHDRBM@LUO HBFOMCH b@CHDFOCMCECHCEQCK ADF@COX EC pH
8, c % 3, 0. WOGHD@DZSUO PHD d 100 W 30 NDQ.
eDND\GFAD FACPC@BNDQ R@DZCA A BOHCPDQS1 LM@LGOFL F@CIQXN fgDHCN FACPDQB D
OHCPCMCK ADF@COX. Y@DZCA A BOHCPDQS PC M@DLQDU QB PGHDgGHD\GFADG
bC@DQCHGBAODMQXG FDFOGNX. TCECRQC BOHCPDQS MXZXMBGO HBF]DHGQDG ZHB\ACM,
PBHB@D\ BAACNCEB[DD, S\BJGQDG FGHEG\QXb FCAHBJGQDK, HBFF@BR@GQDG V@BEADb
NX][ SNGQ`]GQDG FGAHG[DD PDJGMBHDOG@`QXb D PCOCMXb IG@GZ.
hABZXMBGO OBAIG [GQOHB@`QCG bC@DQC@DOD\GFACG EGKFOMDG. hRX\QC MXZXMBGO
FGEBODMQXK fggGAO1 SNGQ`]BGO EMDVBOG@`QSU BAODMQCFO`, NCIGO CABZBO`
FQCOMCHQCG EGKFOMDG. eBHBAOGHQXN FMCKFOMCN FACPC@BNDQB LM@LGOFL
MXZXMBGNBL DN BNQGZDL.
WACPC@BNDQ PHDNGQLUO DQCVEB M PFDbDBOHD\GFACK PHBAODAG M AB\GFOMG
SFPCABDMBJGVC FHGEFOMB, M QGMHC@CVD\GFACK % E@L @G\GQDL PBHADQFCQDZNB, M
bDHSHVD\GFACK PHBAODAG MNGFOG F BQB@`VGODABND (NCHgDQ, PHCNGEC@) % E@L
PCEVCOCMAD A QBHACZS, DQCVEB ABA PHCODMCHMCOQCG D SFPCABDMBUJGG FHGEFOMC PHD
NCHFACK D MCZES]QCK RC@GZQD (\BJG E@L fOCK [G@D QBZQB\BUO OBR@GOAD i?fHCQi),
B OBAIG PHD DHDOBb, DHDEC[DA@DOBb D F EDBVQCFOD\GFACK [G@`U E@L HBF]DDHGQDL
ZHB\AB MNGFOC BOHCPDQB.
THCODMCPCABZBQDL OG IG, \OC PHD QBZQB\GQDD BOHCPDQB. jGCRbCEDNC S\DOXMBO`
MGF`NB ]DHCACG HBZ@D\DG M DQEDMDESB@`QCK \SMFOMDOG@`QCFOD A FACPC@BNDQS1
COQCFDOG@`QC \BFOC CRX\QXG ECZX MXZXMBUO QG SFPCACGQDG, B MCZRSIEGQDG,
VB@@U[DQB[DD D EHSVDG PCRC\QXG LM@GQDL.
jBZQB\BUO FACPC@BNDQ MQSOH` (CRX\QC M HBFOMCHBb D PCE ACIS M HBZCMXb ECZBb
0, 00087 % 0, 0007 V (0, 87 % 0, 7 NV) D@D 0, 7 % 1 N@ 0, 07 9 HBFOMCHB. k V@BZQCK
PHBAODAG (E@L HBF]DHGQDL ZHB\AB D PBHB@D\B BAACNCEB[DD) PHDNGQLUO 87 9
MCEQXK HBFOMCH (PC 1 % 8 ABP@D M V@BZB 8 HBZB M EGQ`) D@D 0, 87 9 NBZ`
k X F ] D G E C Z X E@L MZHCF@Xb MQSOH` D PCE ACIS1 HBZCMBL 0, 0007 V, FSOC\QBL
0, 0017 V.
lCHNX MXPSFAB1 PCHC]CAm 0, 07 9 HBFOMCH M BNPS@Bb PC 1 N@.
k CgOB@`NC@CVD\GFACK PHBAODAG QBHLES F 0, 87 9 MCEQXN HBFOMCHCN
PHDNGQLGOFL PHC@CQVDHCMBQQXK PHGPBHBO % HBFOMCH FACPC@BNDQB VDEHCRHCNDEB 0,
87 9 F NGOD@[G@@U@CZCK (Solutio SFCHClamini &idrobromidi 0, 87 9 cum
nGt&lcellulo!o). YGF[MGOQBL PHCZHB\QBL D@D F@GVAB CPB@GF[DHSUJBL IDEACFO`
(Hj ;, 7 % o, 7) MC g@BACQBb PC 7 D 10 N@.
eHBQGQDG1 FPDFCA ?. k bCHC]C SASPCHGQQCK OBHG M ZBJDJGQQCN CO FMGOB NGFOG.
,H.1 SCl. ScCHolamini &drobromidi 0, 07 9 1 ml
#.t.d. p. o in ampull.
#.S. TC h, 7 % 1 N@ PCE ACIS
,p.1 Scopolamini &drocarbomidi 0, 0087
qrCmGdoli h, 1
rp&Gdrini &droc&loridi 0, 187 ml
?s. HrC in:ect. 7 ml
n. Steril.t
#.S. TC 1 N@ PCE ACIS D@D MQSOHDNX]G\QC ABA CRGZ RC@DMBUJGG PHD OHBMNBbm
E@L MMCEQCVC QBHACZB
,p.1 Sol. Scopolamini &drobromidi 0, 87 9 10 ml
#.S. u@BZQXG ABP@D. TC 1 % 8 ABP@D 3 % ; HBZB M EGQ` (PHD DHDEC[DA@DOG)
T H D N G \ B Q D G. jG ECPSFABGOFL PHDGN HBFOMCHB OBACK ACQ[GQOHB[DD MQSOH` D
MMGEGQDG GVC PCE ACIS.
vBR@GOAD i?fHCQi (vBbulettae i?erCnum). WCFOBM1 FACPC@BNDQB ABNgCHQCADF@CVC
0, 0001 V D VDCF[DBNDQB ABNgCHQCADF@CVC 0, 000; V.
wGKFOMDG OBR@GOCA FMLZBQC F CFCRGQQCFOLND gBHNBACEDQBNDAD FACPC@BNDQB D
VDCF[DBNDQB.
vBR@GOAD i?fHCQi PHDNGQLUO E@L PHCgD@BAODAD D @G\GQDL NCHFACK D MCZES]QCK
RC@GZQD, B OBAIG E@L PHGECOMHBJGQDL D ASPDHCMBQDL PHDFOSPCM RC@GZQD nGQ`GHB
xFN. OBAIG wDNGQVDEpBO (wGEB@CQ)y. zQCVEB Db DFPC@`ZSUO E@L SNGQ`]GQDL F@DZG%
D F@UQCCOEG@GQDL PHD P@BFOD\GFADb CPGHB[DLb QB @D[G D PHD CPGHB[DLb QB
MGHbQDb EXbBOG@`QXb PSOLb. THD MCZES]QCK D NCHFACK RC@GZQD OBR@GOAD
QBZQB\BUO MQSOH`1 PHCgD@BAOD\GFAD ZB 30 % o0 NDQ EC COaGZEB PHDQDNBUO 1 % 8
OBR@GOAD, B M EB@`QGK]GN, GF@D QGCRbCEDNC, \GHGZ o \ % GJG CEQS OBR@GOAS. rF@D
BfHCQ PHCgD@BAOD\GFAD QG PHDNGQL@D, OC PHD PGHMXb PHDZQBABb RC@GZQD
(OC]QCOB, VC@CMCAHSIGQDG, VC@CMQBL RC@`) PHDQDNBUO 1 % 8 OBR@GOAD, M
EB@`QGK]GN EBUO PC CEQCK OBR@GOAG 8 HBZB M EGQ`.
k X F ] D G E C Z X E@L MZHCF@Xb1 HBZCMBL 8 OBR@GOAD, FSOC\QBL ; OBR@GOAD.
k HGEADb F@S\BLb PHD SPCHQCK HMCOG MNGFOC BfHCQB NCVSO QBZQB\BO`FL FMG\D,
FCEGHIBJDG FOC@`AC ABNgCHQCADF@CVC FACPC@BNDQB D VDCF[DBNDQB, FAC@`AC Db
FCEGHIDOFL M CEQCK OBR@GOAG BfHCQB.
THD RC@GZQD nGQ`GHB QBZQB\BUO PC 1 OBR@GOAG 8 % 3 HBZB M EGQ`. THD
bDHSHVD\GFADb MNG]BOG@`FOMBb QB @D[G ZB 80 % 30 NDQ EC CPGHB[DD QBZQB\BUO
FHBZS 8 OBR@GOAD D PCF@G CPGHB[DD PC 1 OBR@GOAG 8 HBZB M EGQ` M PGHMXG 8 FSOCA.
THD PHDNGQGQDD BfHCQB MCZNCIQX IBIEB, FSbCFO` MC HOS D VCH@G. w@L
CR@GV\GQDL fOCVC FCFOCLQDL QBZQB\BUO PDO`G D ACgGDQ. vBR@GOAD QG@`ZL
QBZQB\BO` RC@`QXN V@BSACNCK.
lCHNB MXPSFAB1 OBR@GOAD PC 0, 0007 V M SPBACMAG PC 10 ]OSA.
eHBQGQDG1 FPDFCA Y.
Platifilin
>latp&llinum A03
Specialiti: >latifilin &idrotartrat.
Proprieti
Alcaloid izolat din Senecio platp&llu! #.6. $i Senecio r&ombofoliu! {illd., deri+at de
pirolizidin. Bloc&eaz m%colinoreceptorii dup tipul atropinei, n! !e deo!ebe$te de
acea!ta $i printr%o aciune mu!culotrop de tip papa+erinic.
Indicaii
6olicile inte!tinale, &epatice $i renale, ulcerul "a!tric $i duodenal, a!tmul bron$icm
&iperten!iunea arterial, !pa!mul +a!elor cerebrale $i coronare. >entru obinerea
midriazei pentru un timp !curt.
Contraindicaii
.laucomul, in!uficiena &epatic $i renal, &ipertrofia de pro!tat..
Posologie
'n colicile inte!tinale, &epatice, renale, durerile acute pro+ocate de ulcerul "a!tric c*te
1%8 ml !oluie 0,89 !.c. >entru tratamentul mai ndelun"at !e recomand formele
perorale, cli!mele terapeutice !au !upozitoarele. 'n oftalmolo"ie % colir 19 (!copuri
dia"no!tice) !au 89 (!copuri terapeutice). 6opii c*te 0,8%3 m" de 8%3 ori pe zi nainte
de me!e.
Supradozare
=ero!tomie, ta&icardie, midriaz, e4citaie ner+oa!. -ratament !imptomatic.
Efecte adverse
=ero!tomie, midriaz, ciclople"ie (tulburri +izuale), fotofobie, palpitaii, an&idroz $i
cre$terea po!ibil a temperaturii corporale n perioada cald a anului, con!tipaie $i
retenie urinar la pacienii +*r!tnici.
Interaciuni
,educe efectele colinomimeticelor $i anticoline!terazicelor.
Precauii
>er!oanele pe!te ;0 ani $i +*r!tnicii, pacienii cu &ipertrofie de pro!tat. >er!oanele
predi!pu!e la "laucom.
Platifilin hidrotartrat (Farmaco, 0oldo+a). Soluie in:ectabil 0,89%1 ml n fiole.
(kGnzo&e4onium). 1, o%YDF%(p%OHDNGOD@BNNCQDK)%VGAFBQB
EDRGQZC@FS@`gCQBO.
WDQCQDNX: exconu , examethonii Benzosulfonis.
YG@XK D@D RG@XK F AHGNCMBOXN COOGQACN NG@ACAHDFOB@@D\GFADK PCHC]CA FC
F@BRXN FMCGCRHBZQXN ZBPBbCN. ^GVAC HBFOMCHDN M MCEG, NB@C % M FPDHOG.
qBFOMCHX FOGHD@DZSUO PHD d 100 |W M OG\GQDG 30 NDD.
kNGFOC EDRGQZC@FS@`gCQBOB NCVSO PHDNGQLO`FL D EHSVDG FC@D 1, o%RDF%
(pOHDNGOD@BNNCQDK)%VGAFBQB. wDKCEDE MXPSFAB@FL PCE QBZMBQDGN iuGAFCQDKi.
wDKCEDEX D EDRHCNDEX MXPSFABUOFL ZB HSRGICN PCE QBZMBQDLND1 Bi!trium,
.an"lio!tat, jGbBmet&onium, jGbBmGton, jGbBnium, jGbBt&ide, jiC&e4,
nGt&obromin, nGt&onium, 5e"ol!en D EH.
YGQZCVGAFCQDK LM@LGOFL FDNNGOHD\QXN RDF\GOMGHOD\QXN BNNCQDGMXN
FCGEDQGQDGN, CR@BEBUJDN MGF`NB FD@`QCK VBQV@DCR@CADHSUJGK BAODMQCFO`U.
THDNGQLUO PHD FPBZNBb PGHDgGHD\GFADb FCFSECM (fQEBHOGHDDO,
PGHGNGIBUJBLFL bHCNCOB D EH.), E@L ASPDHCMBQDL VDPGHOCQD\GFADb AHDZCM, PHD
LZMGQQCK RC@GZQD IG@SEAB D EMGQBE[BODPGHFOQCK AD]AD, PHD RHCQbDC@CFPBZNBb,
E@L SPHBM@LGNCK VDPCOGQZDD. (w@L fOCK [G@D PHGEPC\ODOG@`QC PC@`ZCMBO`FL
ACHCOACEGKFOMSUJDND VBQV@DCR@CABOCHBND (FN. zNGbDQ)).
kMCELO RGQZCVGAFCQDK PCE ACIS, MQSOHDNX]G\QC D MQSOH`, E@L ACQOHC@DHSGNCK
VDPCOGQZDD PHGPBHBO MMCELO MQSOHDMGQQC. wCZX QGCRbCEDNC
DQEDMDESB@DZDHCMBO`, S\DOXMBL RC@`]SU MBHDBRG@`QCFO` HGBA[DD HBZQXb
RC@`QXb PC COQC]GQDU A PHGPBHBOS (OBA IG, ABA D PC COQC]GQDU A EHSVDN
VBQV@DCR@CADHSUJDN MGJGFOMBN).
THD PCMOCHQCN PHDNGQGQDD PHGPBHBOB HGBA[DL QB QGVC PCFOGPGQQC
SNGQ`]BGOFL, \OC OHGRSGO SMG@D\GQDL ECZX. qGACNGQESGOFL PCfOCNS QB\DQBO`
@G\GQDG F QBDNGQ`]Db ECZ, EBUJDb QGCRbCEDNXK fggGAO, D ZBOGN PCFOGPGQQC
SMG@D\DMBO` ECZS.
^G\GQDG FPBZNCM PGHDgGHD\GFADb FCFSECM, LZMGQQCK RC@GZQD D O. P.
HGACNGQESGOFL QB\DQBO` F QBZQB\GQDL PHGPBHBOB MQSOH` (EC GEX) M ECZG h, 1 V 3 o
HBZ M FSOAD. THD QGECFOBOC\QCK fggGAODMQCFOD ECZS SMG@D\DMBUO EC 0, 8 V QB
PHDGN D@D PGHGbCELO QB PCEACIQCG D@D MQSOHDNX]G\QCG MMGEGQDG.
w@L PBHGQOGHB@`QCVC MMGEGQDL PHDNGQLUO 8, 7 9 HBFOMCH. WHGEQLL ECZB PHD
PCEACIQCN D@D MQSOHDNX]G\QCN MMGEGQDD E@L MZHCF@CVC 0, 087 Vm MMCELO M 1 % 8
PHDGNB (PC 0, 7 % 1 N@ 8, 7 9 HBFOMCHB). THD LZMGQQCK RC@GZQD IG@SEAB D
EMGQBE[BODPGHFOQCK AD]AD HGACNGQESGOFL MMCEDO` PC 0, 87 N@ 8, 7 9 HBFOMCHB ZB
1 \ EC GEX ; HBZB M EGQ`.
w@L ASPDHCMBQDL VDPGHOCQD\GFADb AHDZCM MMCELO MQSOHDNX]G\QC D@D PCEACIQC
PC 18, 7 % 87 NV (0, 7 % 1 N@ 8, 7 9 HBFOMCHB).
THD QGCRbCEDNCFOD RGQZCVGAFCQDK NCIQC MMCEDO` PCMOCHQC (3 % ; DQaGA[DD M
EGQ`).
w@L @G\GQDL VDPGHOCQD\GFACK RC@GZQD RGQZCVGAFCQDGN (ABA D EHSVDND
VBQV@DCR@CABOCHBND) M QBFOCLJGG MHGNL PC@`ZSUOFL HGEAC. hEQBAC M F@S\BG GVC
PHDNGQGQDL E@L fOCK [G@D GVC ACNRDQDHSUO CRX\QC F FB@SHGODABND, BPHGFFDQCN
D@D EHSVDND BQODVDPGHOGQZDMQXND PHGPBHBOBND.
w@L ACQOHC@DHSGNCK VDPCOGQZDD MMCELO NGE@GQQC MQSOHDMGQQC (M OG\GQDG 8
NDQ) 1 % 1, 7 N@ 8, 7 9 HBFOMCHBm fggGAO HBZMDMBGOFL \GHGZ 18 % 17 NDQm PHD
QGCRbCEDNCFOD MMCELO ECPC@QDOG@`QXG AC@D\GFOMB PHGPBHBOB.
k X F ] D G E C Z X E@L MZHCF@Xb MQSOH`1 HBZCMBL 0, 3 V, FSOC\QBL 0, } Vm PCE
ACIS1 HBZCMBL 0, 0_7 V, FSOC\QBL 0, 3 V.
^G\GQDG RGQZCVGAFCQDGN PHCMCELO CRX\QC ASHFBND PC 8 % ; % o QGE F
PGHGHXMBND NGIES QDND 1 % 3 QGE.
kCZNCIQXG PCRC\QXG LM@GQDL1 CRJBL F@BRCFO`, VC@CMCAHSIGQDG, S\BJGQDG
PS@`FB, FSbCFO` MC HOS, NDEHDBZ, DQaGA[DL FCFSECM FA@GH. THCODMCPCABZBQDL1
CFOHBL FOBEDL DQgBHAOB NDCABHEB, MXHBIGQQBL VDPCOGQZDL, HBZMDM]DKFL ]CA,
PCHBIGQDL PC\GA D PG\GQD, OHCNRCZX, EGVGQGHBODMQXG DZNGQGQDL ~jW.
hFOCHCIQCFO` QSIQB PHD QBZQB\GQDD @D[BN PCID@CVC MCZHBFOB.
lCHNX MXPSFAB1 OBR@GOAD PC h, 1 V D 0, 87 Vm 8, 7 9 HBFOMCH M BNPS@Bb PC 1 N@.
eHBQGQDG1 FPDFCA Y. k bCHC]C SASPCHGQQCK OBHG.
,H.1 vBb. kGnzo&e4onii h, 1 p. 80
#.S. TC 1 OBR@GOAG 3 HBZB M EGQ`
,H.1 SCl. kGnzo&e4onii 8, 7 9 1 ml
#.t.d. p. o in Bmpull.
S. TC 1 N@ PCE ACIS 1 HBZ M EGQ`
P (jS"ronium). %wDNGOD@BNDQCfOD@CMCVC fgDHB p%NGOD@%
%PDHHC@DEDQABHRCQCMCK ADF@COX EDKCENGOD@BO.
WDQCQDN1 Trepirium iodide.
YG@XK D@D RG@XK FC F@GVAB IG@OCMBOXN COOGQACN AHDFOB@@D\GFADK PCHC]CA.
h\GQ` @GVAC HBFOMCHDN M MCEG. k MCEQXb HBFOMCHBb QGSFOCK\DM.
hOQCFDOFL A RDF\GOMGHOD\QXN BNNCQDGMXN FCGEDQGQDLN, PC FOHCGQDU DNGGO
FbCEFOMC F EDNGAC@DQCN.
hABZXMBGO AHBOACMHGNGQQCG VBQV@DCR@CADHSUJGG EGKFOMDG, M FMLZD F \GN
SECRGQ E@L PHDNGQGQDL M BQGFOGZDC@CVD\GFACK PHBAODAG E@L SPHBM@LGNCK
VDPCOGQZDD.
THDNGQLUO MQSOHDMGQQC ABPG@`QC M MDEG h, 1 9 HBFOMCHB M DZCOCQD\GFACN (0, }
9) HBFOMCHG QBOHDL b@CHDEB. jB\DQBUO F _0 % 1hh ABPG@` M NDQSOS D PCF@G
ECFODIGQDL QGCRbCEDNCVC VDPCOGQZDMQCVC fggGAOB SNGQ`]BUO AC@D\GFOMC ABPG@`
EC 30 % ;0 M NDQSOS. wGKcOMDG QBFOSPBGO \GHGZ 8 % 3 NDQ, B DFbCEQCG ?w
MCFFOBQBM@DMBGOFL \GHGZ 10 % 17 NDQ PCF@G PHGAHBJGQDL M@DMBQDL. THD
CEQCNCNGQOQCN D@D EHCRQCN MMGEGQDD (;0 % c0 NV M 3 % 7 N@ DZCOCQD\GFACVC
HBFOMCHB QBOHDL b@CHDEB) VDPCOGQZDMQXK fggGAO PHCEC@IBGOFL 10 % 17 NDQ. k
F@S\BLb \HGZNGHQCVC PCQDIGQDL ?w PHDNGQLUO QCHBEHGQB@DQ D@D NGZBOCQ.
uDVHCQDK, ABA D EHSVDG VBQV@DCR@CABOCHX, NCIGO PHDNGQLO`FL M BAS]GHFACK
PHBAODAG PHD QGgHCPBODD S RGHGNGQQXb, fA@BNPFDD. zNGUOFL EBQQXG CR
SFPG]QCN PHDNGQGQDD PHGPBHBOB E@L ASPDHCMBQDL VDPGHOCQD\GFQDb AHDZCM (;0 %
c0 NV M 17 % 80 N@ DZCOCQD\GFACVC HBFOMCHB QBOHDL b@CHDEB MQSOHDMGQQC NGE@GQQC
% M OG\GQDG _ % 10 NDQ).
lCHNB MXPSFAB1 MC g@BACQBb D@D BNPS@Bb MNGFODNCFO`U 10 N@, FCEGHIBJDb PC
0, 1 V VDVHCQDL. qBFOMCHLUO PHGPBHBO QGPCFHGEFOMGQQC PGHGE PHDNGQGQDGN.
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Suxametoniu
Su4amet&onium 003A B01
Specialiti: L!t&enon.
Proprieti
0iorela4ant depolarizant. Acioneaz ca acetilcolina, n! depolarizarea e!te de durat
(cca. 10 min) $i di!pare odat cu mic$orarea concentraiei lui n fanta !inaptic neuro%
mu!cular. Se inacti+eaz de!tul de rapid de ctre coline!terazele !erice
(p!eudocoline!teraz). >aralizia pro+ocat de !u4ametoniu ncepe cu fa!ciculaii.
4cit "an"lionii para!impatici $i m%colinoreceptorii pro+oc*nd bradicardie $i n unele
cazuri !top cardiac. 6re$te pre!iunea intraocular $i cea intracranian imediat dup
in:ecie.
Indicaii
/ntubaia intratra&eal, bron&o!copia, miorela4area total n operaiile "inecolo"ice,
abdominale, toracale. ,epoziia oa!elor n fracturi $i lu4aii. >rofila4ia con+ul!iilor n
terapia electro%impul!i+. -etano!ul. /nto4icaia cu !tricnin.
Contraindicaii
/n!uficiena &epatic acut, mia!tenia, "laucomul acut, traumele penetrante oculare,
anemia !e+er, combu!tiile $i traumele e4tin!e, deficitul p!eudocoline!terazei,
&iper!en!ibilitatea la preparat.
Posologie
0,1%1 m"3" i.+. n dependen de !ituaia clinic. Se admini!treaz de !peciali!t cu
e4perien n domeniu.
Supradozare
Atonie mu!cular, de!cre$terea rezer+ei re!piratorii, +olum tidal mic !au apnee.
-ratament1 0eninerea re!piraiei $i a permeabilitii cilor re!piratorii p*n la
re!tabilirea re!piraiei !pontane.
Efecte adverse
-ulburri ale e4citabilitii $i conductibilitii miocardului, $oc cardio"en, dureri
mu!culare, preponderent n re"iunile toracal $i abdominal, cre$terea ten!iunii
intraoculare, tulburri ale funciei &epatice, &iper3aliemie, $oc anafilactic a!ociat cu
bron&o!pa!m.
Interaciuni
>romazina, o4itocina, aprotinina, antibioticele non%penicilinice, c&inidina, beta%
blocantele, procainamida, lidocaina, trimetafanul, !rurile de litiu, c&inina, cloroc&ina,
eterul dietilic, i!ofluranul, metoclopramidul $i terbutalina cre!c efectul !u4ametoniului.
6re!c efectele lui $i preparatele care in&ib acti+itatea coline!terazei ca contracepti+ele
orale, "lucocorticoizii, /0A<, anticoline!terazele re+er!ibile $i ire+er!ibile.
Precauii
A nu !e admini!tra concomitent cu !*n"e $i deri+ai.
Lystenon (pcomed Au!tria, Au!tria). Soluie in:ectabil 100 m"7 ml n fiole p 7.
T (nGllictinum).
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Pirenzepin
>irenzepinum A08B =03
Specialiti: .a!trozem, .a!trozepin.
Proprieti
Blocant !electi+ al colinoreceptorilor 0
1
al celulelor bazale $i parietale din mucoa!a
!tomacului. /n&ib !ecreia acidului clor&idric $i pep!inei fr a dere"la funciile
fiziolo"ice ale tractului ./. Se ab!oarbe puin $i nu pro+oac !imptome centrale.
Indicaii
Formele cronice $i acute ale ulcerului "a!tric $i duodenal, "a!trita, !tomacul iritat
&iperacid, afeciunile !tomacului pro+ocate de medicamente, !indromul ollin"er%
lli!on.
Contraindicaii
>rimul trime!tru al !arcinii, &iper!en!ibilitatea la preparat..
Posologie
6*te 8 comprimate de 8 ori pe zi cu 30 min nainte de m*ncare timp de ; !ptm*ni.
Supradozare
6azuri de !upradoza: nu au fo!t !emnalate. 'n caz de into4icaie tratamentul poate fi
!uporti+.
Efecte adverse
2!ccinea "urii, u$oare tulburri de acomodare (n doze ridicate, n debutul
tratamentului).
Interaciuni
Antiacidele cre!c efectul pirenzepinei. 'n !indromul ollin"er%lli!on !e a!ociaz cu
anti&i!taminice H
8
. ,educe efectele ad+er!e ale A/pS.
Precauii
.laucomul, &ipertrofia de pro!tat.
Gastrozem (Al3aloid, 0acedonia). 6omprimate 87 m" p 80 $i p o0.
Gastrozepin (Boe&rin"er /n"el&eim, .ermania). 6omprimate 87 m" $i 70 m" p 70.
Gastrozepin (Boe&rin"er /n"el&eim, .ermania) >ulbere parenteral 10 m"8 ml n fiole
p 7.
TYYPP -XP (-ubocurarini c&loridum). d%vSRCASHBHDQB b@CHDE.
unonumm : m e lizol, uradetensin, urarin, Delacurarine, yo statine,
y ricin, T ubadil, T ubaril, T ubarine, T ubocuran, ypapun -acma , nmoxcompun u
p .
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Ipratropium bromid
/pratropii bromidum ,03B B01
Specialiti: Atro+ent, /trop.
Prezentare
Aero!ol (!pra) dozator 0,08 m"doz, 6omprimate filmate 10 m", Fiole 0,7 m"1 ml.
Proprieti
/pratropiul e!te un compu! !intetic de amoniu cuaternar cu proprieti anticoliner"ice
bron&odilatatoare. /n&ib refle4ele +a"ale la ni+elul bron&iilor prin blocarea m%
colinoreceptorilor $i reducerea concentraiei "uano!in%monofo!fatului ciclic (.0>
c
)
mu$c&ilor netezi. Admini!trat prin in&alare acioneaz predominant local, n bron&ii. <
parte din doz !e n"&ite cu !ali+a n! nu !e ab!oarbe $i nu are efecte !i!temice.
Admini!trat !i!temic poate produce $i unele efecte atropinice.
Indicaii
>rofila4ia $i tratamentul crizelor de a!tm bron$ic, bron$ita cronic cu !au fr emfizem.
Bradicardia !inu!al +a"al, bradiaritmia cu bloc !ino%atrial, blocul A%5 de "radul // !au
/// (tip {enc3enbac&) $i fibrilaia auricular.
Contraindicaii
Hiper!en!ibilitatea la anticoliner"ice, "laucomul, &ipertrofia de pro!tat, dificultile de
miciune, !tenoza mecanic a tractului "a!trointe!tinal, ta&icardia, me"acolonul.
Posologie
>rofila4ia crizelor de a!tm 1%8 puffuri de 3 ori pe zi. -ratamentul crizelor acute de a!tm
1%8 puffuri. La nece!itate pe!te 7 min !e poate admini!tra o a doua doz, n cazuri
e4cepionale, pe!te alte 7 minute !e admini!treaz a treia doz. Formele parenterale %
iniierea tratamentului % o !in"ur admini!trare i.+. !ub controlul .6... 0ai departe !e
prelun"e$te cu comprimate p.o. 1%118 6omprimate de 8%3 ori pe zi.
Supradozare
2!cciunea "urii $i farin"elui. -ratament1 >ro+ocarea +omei cu ap !rat (1 lin"ur de
!are de buctrie la 1 pa&ar de ap) !au la+a: "a!tric. Fizo!ti"mina e!te con!iderat
antidot de elecie. 'n lip!a ei % peo!ti"min i.m. !au i.+.
Efecte adverse
=ero!tomie, iritaie a "*tului, reacii aler"ice, tu!e, bron&ocon!tricie parado4al.
/napeten, flatulen, con!tipaie. La pacienii cu con!tipaie cronic !au in!uficien
cardiac tratai cu "licozide cardiace poate !ur+eni ileu! paralitic ire+er!ibil. -ulburri de
acomodaie, miciuni dificile, crize "laucomatoa!e, &ipertermie (rezultatul in&ibiiei
per!piraiei), e4tra!itole !upra+entriculare $i +entriculare, ta&icardie, fibrilaie
+entricular.
Interaciuni
Beta%adrener"icele $i 4antinele inten!ific efectul bron&odilatator. Antipar3in!onienele,
clonidina $i antidepre!i+ele triciclice inten!ific efectele anticoliner"ice ale /pratropiului.
Precauii
.laucomul cu un"&i nc&i!, &ipertrofia pro!tatei. Sarcina (n !pecial primul trime!tru)
numai n cazuri e4cepionale. 6onducerea +e&iculelor (tulburri de acomodaie). 6opiii
(datele clinice n pri+ina copiilor lip!e!c).
Atrovent (Boe&rin"er /n"el&eim, .ermania). Aero!ol (!pra) dozat 0,0879 80ml n
flacoane.
Itrop (Boe&rin"er /n"el&eim, .ermania). 6omprimate 10 m" p 70.
Trihexifenidil
-ri&e4p&enidlum p0;A A01
Specialiti: >ar3opan, ,omparc&in.
Proprieti
/n&ib !i!temul para!impatic (efect colinoblocant central $i periferic). ,ela4eaz
mu!culatura neted n mod direct ca $i atropina n!, !pre deo!ebire de acea!ta,
pro+oac efecte ad+er!e mai !labe.
Indicaii
>ar3in!oni!mul de orice etiolo"ie (idiopatic, po!tencefalitic, atero!clerotic) ca ad:u+ant
la le+odopa. Afeciunile e4trapiramidale pro+ocate de neuroleptice cu &ipertonu! $i
&iper3inezii.
Contraindicaii
Hiper!en!ibilitatea la preparat, tratamentul cu antidepre!i+e, perioada de recuperare
dup infarctul miocardic.
Posologie
/niial 1 m"zi. #oza de ntreinere1 doza iniial !e mre$te "radual, la inter+ale de 3%7
zile, cu 8 m" p*na la doza optim, de obicei o%10 m"zi (n unele cazuri 10%17 m"zi).
Supradozare
2!cciunea "urii, a mucoa!elor $i pielii, cre$terea temperaturii corporale (ca urmare a
!uprimrii per!piraiei), retenie urinar, e4citaie, &alucinaii. -ratament1 Lini$tirea
bolna+ului cu un neurolepticantip!i&otic (clorpromazin) i.m., cateterizarea +ezicii
urinare (la nece!itate). -erapie !imptomatic (umectarea oc&ilor etc.).
Efecte adverse
.rea, tulburri ale acomodaiei, u!cciunea "urii, ira!cibilitate, +erti:. >arotidit
!upurati+ (ca con!ecin a u!cciunii "urii), &alucinaii, paranoia. 4citaie neobi$nuit
(n doze mari).
Interaciuni
6re$te eficacitatea le+odopei, n! admini!trarea lor concomitent nu !e recomand
bolna+ilor cu antecedente p!i&otice.
Precauii
/n!uficiena renal, &epatic !au cardiac, "laucomul, &ipertrofia de pro!tat. >re!iunea
intraocular !e +a controla la perioade re"ulate.
Parkopan 2/5 (He4al >&arma, .ermania). 6omprimate 8 m" $i 7 m" p 00.
Romparcin (Armedica, ,om*nia). 6omprimate 8 m" p 70.
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