VERAPAMIL (Verapamilum) *. 5-[(3, 4-Dimetoksifenetil) - metilamino] -2 - (3, 4-acid) 2-izopropilvaleronitrila hydrochloride.

     Synonyms : Verpamil, Izoptin, Falikard, Fenoptin, Calan, Cardilax, Dilacoran, Falicard, Finoptin, Ikacor, Iproveratril, Isopine, Isoptin, Manidon, Vasolan, Vepamil, Verapamilhydrochlorid, Verapamil and others.

     On chemical structure of molecules verapamil can be seen as a complex version fenilalkilaminov molecules (see Senzit).

     The drug has antiadrenergicheskoy activity. Previously thought that his therapeutic effect by the weakening sympathetic impulses coming to the circulatory vessels, the heart and other organs. Now it lies within the ions of calcium antagonists, and he is one of the main products of the group.

     Isoptin increasing coronary vessels and increases coronary blood flow; Reduces need heart of oxygen. For ischaemic heart medication processes to reduce the imbalance between demand and supply oxygen to the heart by increasing blood circulation, and better utilization and more economical expenditure delivered oxygen.

     The drug reduces sokratimost attack, but the increased peripheral vascular resistance and decreased vascular, cardiac ejection does not change drastically. The drug suppresses the aggregation of platelets.

     Isoptin wire system affects the heart and oppressing sinoatrialnuyu atrioventrikulyarnuyu conductivity. Has antiaritmicheskoe effect; Complications related to IV drugs (see Antiaritmicheskie drugs).

     Moreover, having some natriyureticheskoe and diureticheskoe effect by reducing kanaltsevoy reabsorption.

     In mechanism antianginalnogo of verapamil, along with antagonism towards calcium ions, the role also increased the content of potassium ions in cells attack.

     Isoptin well absorbed by ingestion. The peak concentration in plasma is found in 1 to 3 hours However, there were significant individual differences in the pharmacokinetics of the drug. The half ranges from 2, 5 to 7, 5 h after a single injection of 4 and 5 until 12 hours after re-admission. Standing therapeutic concentration in the blood is usually through four days of the early re-admission into. The drug is metabolized in the liver intensive. In violation of liver function, the time for preparation much longer. In unaltered for around 5% of the preparation.

     Verapamil inside and applied by injection.

     Inside are in chronic IBS to prevent strokes voltage, especially when combined with arrythmia predserdnoy and prone to tachycardia.

     As antiaritmicheskogo funds designated mainly predserdnyh notice : when supraventrikulyarny tachycardia, arrythmia. In zheludochkovyh adults, including ventricular arrythmia; Drug ineffectual.

     It is also recommended to hypertension, but as antihypertensive agents for treating severe hypertension more efficient Nifedipine (see).

     Intravenous use in acute strokes, stroke supraventrikulyarnoy paroxysmal tachycardia and PNDS crises.

     Inside are 30 minutes before eating. Dose, especially given the volatility, pharmacokinetics, picked individually. In milder forms of strokes appoint 0,04 - 0,08 g (40-80 mg), 3 to 4 times a day. If necessary, add a single dose of 0.12 to 0.16 g - (120-160 mg). Usually a daily dose of 0,24 - 0,48 g (240-480 mg). Supportive therapy (less individually tailored dose) for the long-term. It has been observed that the application of tolerance verapamil (as opposed to organic nitrates and nifedipina) is not progressing. Instead, antiishemichesky effect with regular admission verapamil increases.

     Intravenously for edema hysteria supraventrikulyarnoy tachycardia impose adult slow 2 - 4 ml 0.25% solution (5 to 10 mg). Re maintenance therapy to introduce one every day drip at speeds 0,005 mg / kg per minute, not earlier than 30 minutes after the introduction of an inkjet. Solution verapamil are breeding 2 ml of 0.25% solution of the drug (1 vials) in the 100-150 ml isotonic sodium chloride solution, or 5% glucose solution.

     Children designate drug in smaller doses : up to 4 years are usually inside of 0.02 g (20 mg) 2 - 3 times a day; Until 14 years - 0.04 (40 mg) 2 - 3 times a day. Intravenous impose aged 1 to 5 years of 0,002 - 0,003 grams (2 to 3 mg), from 6 to 14 years - 0,025 0.05 g (2, 5, 5 mg).

     Isoptin usually well. However, there is nausea, vomiting, dizziness, increased fatigue, the development of peripheral oedema, allergic reactions, relatively often (especially with a long reception) is constipation flaccid nature. Large doses can cause arterial hypotension, atrioventrikulyarnuyu blockade.

     Contraindications : cardiac shock expressed hypotension, acute myocardial infarction with atrioventrikulyarnoy blockade; The first 3 months of pregnancy and lactation period.

     Care should be taken while applying verapamil and b-adrenoblokatorov (about the possible impact on summatsiey conductivity and sokratimost heart).

     Isoptin injected under the control of hemodynamic variables.

     The forms of pills to 0.04 g (40 mg); 0.08 g (80 mg) and 0.12 g (120 mg) in a package of 30 and 100 pieces; 0.25% solution in ampoules of 2 ml (5 mg) in a package of five vials; pill acting on 0.2 g (200 mg) and 0.24 g (240 mg).

     Storage : List B. In the dark spot.

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