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კალიუმ-ნორმინი / KALIUM-NORMIN | მედიკამენტები | vidal.ge
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იხილეთ აფთიაქების ჩამონათვალი

კალიუმ-ნორმინი / KALIUM-NORMIN
შემადგენლობა

სამკურნალწამლო ფორმა: პროლონგირებული მოქმედების ტაბლეტები 1000 მგ 
შემადგენლობა
1 ტაბლეტი შეიცავს:
აქტიურ ნივთიერებას
კალიუმის ქლორიდი 1000,00 (რაც შეესაბამება K+524,44 მგ (13,3 მმოლი))
დამხმარე ნივთიერებებს
სილიციუმის კოლოიდური 
უწყლო დიოქსიდი
(აეროსილი 200 ) 10,00
პოლივინილბუტირალი
(მოვიტალი B 30 T) 57,50
ცეტილური სპირტი 17,00
მაგნიუმის სტეარატი 1,00
ტალკი 8,00

აღწერილობა ორივე მხრიდან ოდნავ ამობურცული დისკის ფორმის თეთრი ფერის 
მარმარილოსმაგვარი ნახატით ტაბლეტები, მომწარო გემოთი, სუნის გარეშე. ტაბლეტის ჭრილის ფერი - თეთრი

ფარმაკოლოგიური თვისებები
ფარმაკოდინამიკა
კალიუმის მიკროელემენტის შემცველი პრეპარატი ავსებს კალიუმის ნაკლებობას. კალიუმი ამცირებს აგზნებადობასა და გამტარობას მიოკარდში, ასუსტებს გულის გლიკოზიდების ტოქსიკურ მოქმედებას, არ მოქმედებს მათ დადებით ინოტროპულ ეფექტზე.
მცირე დოზებში K+ აფართოებს კორონალურ სისხლძარღვებს, ხოლო მაღალში ავიწროებს. მონაწილეობს ნერვული იმპულსების გატარების პროცესში. ააქტიურებს ბევრ ციტოპლაზმურ ფერმენტს, არეგულირებს შიდა უჯრედოვან ოსმოსურ წნევას, ცილის სინთეზს, ამინომჟავათა ტრანსპორტს. აუმჯობესებს კუნთების შეკუმშვას მათი დისტროფიის და მიასთენიის დროს.

ფარმაკოკინეტიკა
შიგნით მიღებისას ადვილად და თითქმის ნებისმიერი რაოდენობით პასიურად აბსორბირდება (აბსორბცია – 70%), რადგან მისი კონცენტრაცია (როგორც საკვებისა, ასევე სამკურნალო ფორმიდან გათავისუფლებულის) უფრო მაღალია წვრილი ნაწლავის სანათურში, ვიდრე სისხლში. რეტარდი ტაბლეტებიდან თანდათანობით და ნელა თავისუფლდება მთლიანად კნტის სიგრძეზე. თეძოსა და მსხვილ ნაწლავში K+ გამოიყოფა ნაწლავის სანათურ-ში Na +-თან დაკავშირებული ცვლის პრინციპით და გამოიყოფა ნაღველთან (10%) ერთად. K+-ის განაწილება ორგანიზმში გრძელდება მიღების მომენტიდან დაახლოებით 8 საათს: აბსორბციის ფაზაში ნახევრადგამოყოფის პერიოდი - 1,31 სთ; რეტარდ ტაბლეტებიდან გამონთავისუფლების დრო - 6 სთ.

ჩვენებები
სხვადასხვა გენეზის ჰიპოკალიემიის პროფილაქტიკა და მკურნალობა, მათ შორის 
- გამოწვეული სხვადასხვა მდგომარეობითა და ავადმყოფობით (გულისრევა, დიარეა) 
- მედიკამენტოზური მკურნალობით გამოწვეული (დიურეზული, გლუკოკორტიკოსტეროიდები, საგულე გლიკოზიდები)

მიღების წესები და დოზები
პრეპარატის დოზას ადგენენ ინდივიდუალურად, დაავადებისა და სისხლის პლაზმაში კალიუმის კონცენტრაციის მიხედვით. უნიშნავენ 1-2 გ/დღეღამეში (კალიუმის ქლორიდზე გაანგარიშებით), აუცილებლობის შემთხვევაში დოზას ზრდიან 6 გ/დღეღამე-მდე.

გვერდითი მოვლენები
კნტ-ის მხრივ: გულისრევა, ღებინება, დიარეა, მეტეორიზმი, აბდომინალური ტკივილები, კნტ-ის ლორწოვანი გარსის დაწყლულება, კუჭ-ნაწლავიდან სისხლდენა, პერფორაცია და ნაწლავთა გაუვალობა. 
ნერვული სისტემის მხრივ: პარესთეზიები, კუნთების მოდუნება, ცნობიერების დარღვევა. 
გულ-სისხლძარღვთა სისტემის მხრივ: არტერიული წნევის დაქვეითება არითმიები, გულის ბლოკადა, გულის გაჩერება.

უკუჩვენება
მაღალი მგრძნობელობა პრეპარატისადმი, ჰიპერკალიემია, AV სრული ბლოკადა, თირკმელზედა ჯირკვლის უკმარისობა, თირკმლების ქრონიკული უკმარისობა, თანმხლები თერაპია კალიუმშემნახველი დიურეზულებით, მეტაბოლური დარღვევები (აციდოზი, ჰიპოვოლემია ჰიპონატრიემიასთან ერთად), კნტ-ის ეროზიულ-წყლულოვანი დაზიანებები, ორსულობა, ლაქტაციის პერიოდი, ასაკი 18 წლამდე.

განსაკუთრებული მითითებები
მკურნალობის პერიოდში აუცილებელია გაკონტროლდეს სისხლის შრატში K+-ის შემცველობა, ეკგ, ჰიპოკალიემიის მკურნალობისას - მჟავა-ტუტე წონასწორობა. კალიუმის ქლორიდის გამოყენების უსაფრთხოება და ეფექტურობა ბავშვებში არ არის დადგენილი. ორსულობისას მისი გამოყენების აუცილებლობის შემთხვევაში საჭიროა დედისათვის მოსალოდნელი სარგებლობისა და ნაყოფისათვის პოტენციური რისკის შედარება. ლაქტაციის პერიოდში ძუძუთი კვების საკითხი უნდა იყოს გადაჭრილი. ნატრიუმის ქლორიდის მაღალი შემცველობის დიეტა აძლიერებს ორგანიზმიდან K+-ის გამოყოფას. უნდა იყოს გათვალისწინებული, რომ ჰიპერკალიემია, რომელიც იწვევს სიკვდილს, შეიძლება სწრაფად და უსიმპტომოდ განვითარდეს.

ჭარბი დოზირება
სიმპტომები: ჰიპერკალიემია (კუნთების ჰიპოტონია, პარესთეზიები, AV-ს გამტარობის შენელება, არითმიები, გულის გაჩერება). ჰიპერკალიემიის ადრეული კლინიკური ნიშნები ვლინდება შრატში K+-ის 6 მეკვ/ლ-ზე მეტი კონცეტრაციის დროს: T კბილის გამახვილება, QRS კომპლექსის გაფართოება.
ჰიპერკალიემიის უფრო მძიმე სიმპტომები - კუნთების დამბლა და გულის გაჩერება - ვითარდება K+ 9-10 მექვ/ლ-ის კონცენტრაციის დროს. 
მკურნალობა: შიგნით ან ვენაში - ნატრიუმის ქლორიდის ხსნარი, საჭიროებისამებრ ჰემოდიალიზი და პერიტონეალური დიალიზი.

სხვა წამლებთან ურთიერთქმედება
კალიუმშემნახველი დიურეზულები, კალიუმის პრეპარატები, ამფ ინჰიბიტორები, ასას საშუალებები ამაღლებენ ჰიპერკალიემიის განვითარების რისკს, ამცირებენ გულის გლიკოზიდების გვერდით მოქმედებას. ისინი აძლიერებენ ქინიდინის, დიზოპირამიდის გვერდით მოქმედებას.

შენახვის პირობები და ვადები
მშრალ და ბავშვებისთვის მიუწვდომელ ადგილას, 15-300C ტემპერატურაზე. შენახვის ვადა 3 წელი. არ გამოიყენება შეფუთვაზე მითითებული ვადის ამოწურვის შემდეგ.

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