DITILIN (Dithylinum). b-Dimetilaminoetilovogo amber acid ester diyodmetilat.

     Synonyms : Suxamethonii iodidum, Suxamethonium iodide.

     Similar dihloridy and dibromidy issued under the title : Listenon [name drug (suksametoniya chloride) firm Hafslund Nycomed Pharma AG] Miorelaksin, A nectin e revidil In Moscow, locaine Se, Se locurin, hlorsuccilin S, S ura with holin, uracit S, S uralest, Diacetylcholine, L er tosuccin (YU )), Lysthenon, M y o-Relaxin, Ra ntolax, Quelicin with hloride, Scoline, Succinylcholini with hloridum, Sucostrin, Su ha methonii with hloridum, Suxinyl, Syncuror and others.

     White melkokristallichesky powder. The easily soluble in water, very little of alcohol.

     On chemical structure of molecules can ditilina rassmatrivatsya as renewed molecule acetylcholine [diatsetilholin). He is the representative depolyarizuyuschih muscle. When intravenously violates a neuro-muscular stimulation and causes skeletal muscle relaxation.

     Ditilin psevdoholinesterazoy collapses and falls into choline and amber acid. The drug has a quick and short term action; The cumulative effect is not. For a long muscle to the reintroduction of the drug. Quick offensive impact and subsequent rapid restoration of muscle tone allows a controlled and managed by the relaxation of muscles.

     The main indication for use ditilina (listenona) are tracheal intubations, endoscopic procedures (bronchial and ezofagoskopiya, tsistoskopiya etc.), short-term transactions (overlay seams at the abdominal wall, lumbar fractures, etc.). With appropriate dose and the re-introduction ditilin (listenon) can be used for longer operations, but for a long relaxing muscles normally apply antidepolyarizuyuschie muscle, which give prior tracheal intubations in the face ditilina. The drug can also be used to remove convulsing with tetanus.

     Enter ditilin intravenously. For heavy and full relaxation skeletal and respiratory muscles during an operation to impose drug dose of 1, 5, 2 mg / kg. For a long muscles relax during the entire operation can be administered medication fraktsionno after 5 to 7 minutes on the 0.5-1 mg / kg. Repeated dose ditilina operate more continuously.

     Complications in the application ditilina usually no. However, it should be borne in mind that in some cases there may be increased sensitivity to ditilinu the long oppression of breath, which may be related to genetically caused violations education cholinesterase. The reason for acting drug may also gipokaliemiya.

     Ditilin can be applied to different types of narcosis (ether, nitrous oxide, Halothane, barbiturates). In all cases, the introduction ditilina in high doses is permitted only after the patient for artificial respiration (controlled). When using low doses can be maintained independently breath. However, in those cases you have all devices tank.

     Neostigmine and other anticholinesterase substances are not antagonists against depolyarizuyuschego of ditilina Conversely, inhibiting cholinesterase activity, they lengthened and strengthened it.

     When complications arising from the use ditilina (prolonged respiratory depression) have resorted to artificial respiration, and blood transfusions if necessary, thereby contained in cholinesterase.

     It should be borne in mind that in high doses can cause ditilin "double block" after depolyarizuyuschego of developing antidepolyarizuyuschy effect. So, if after the last injection ditilina muscle relaxation of long-term (over 25-30 min) and respiration is not fully restored resort with intravenous prozerina or galantamina (see), after the introduction of atropine (0.5 -0.7 ml 0.1% solution).

     One possible complication in the application ditilina are muscular pain caused by 10 to 12 h after injection of preparation. Introduction of 1 min before ditilina 3 - 4 mg d-tubokurarina 10 or 15 mg diplatsina almost completely prevents fibrillyarnye car and the subsequent muscle pain.

     Ditilin contraindications infants and glaucoma (possibly boost inner pressure).

     With caution should be used when heavy ditilin liver diseases, anemia, cachexia, pregnancy (product passes through the placental barrier).

     Pharmacological properties ditilina to use it in patients with myasthenia.

     Solutions should not be confused with solutions ditilina barbiturates (sludge), and blood (hydrolysis occurs).

     Method of issuance : 2% solution in ampoules for 5 or 10 ml pack of 10 vials.

     Listenon issued on 5 ml ampoules containing 0.1 g suksametoniya hydrochloride.

     Storage : List A. In the dark spot (in the refrigerator) at a temperature of +2' C to 8 C (point is not permitted).

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