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მეთილერგობრევინი / METHYLERGOBREVIN | მედიკამენტები | vidal.ge
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მეთილერგობრევინი / METHYLERGOBREVIN
შემადგენლობა 

პრეპარატის შემადგენლობა:1მლ ხსნარი შეიცავს: აქტიური ნივთიერება: მეთილერგომეტრინის მალეატი 0,2მგ; დამხმარე ნივთიერებები: მალეინის მჟავა, გლიცინი, ნატრიუმის ქლორიდი, თიოკარბამიდი, საინექციო წყალი.
აღწერა
უფერო გამჭვირვალე სითხე.
გამოშვების ფორმა
1მლ, I ჰიდროლიზური კლასის უფერო მინის ამპულებში. ამპულაზე დატანილია: ყავისფერი საღებავით პირველი რგოლი, ყვითელი საღებავით მეორე რგოლი და წერტილი. 5 ამპულა კონტურულ უჯრედოვან პვქ შეფუთვაში ალუმინის საფარით. 10 კონტურული უჯრედოვანი შეფუთვა გამოყენების ინსტრუქციასთან ერთად მუყაოს კოლოფში.

ფარმაკოლოგიური თვისებები
ფარმაკოდინამიკა
სპორინიის ბუნებრივი ალკალოიდის (ერგომეტრინის) ნახევრადსინთეზური წარმოებული. ზრდის მიომეტრიუმის ტონუსს და კუმშვად აქტივობას. სუსტ ზემოქმედებას ახდენს პერიფერიულ სისხლძარღვებზე, პრაქტიკულად არ ზრდის არტერიულ წნევას.

ფარმაკოკინეტიკა
თერაპიულ მოქმედება ინტრავენური შეყვანის შემდეგ ვლინდება 30-60 წამში, კუნთში შეყვანის შემდეგ 2-5 წუთში. პრეპარტის მოქმედება გრძელდება 3 და მეტი საათი კუნთში შეყვანიდან და 2 სათამდე ვენაში შეყვანიდან.
პრეპარატის კავშირი პლაზმის ცილებთან შეადგენს 35%-ს. განაწილების მოცულობა შეადგენს 39,1-73,1ლ-ს, კლირენსი - 9,9-18,9 ლ/სთ. პრეპარატი სწრაფად ნაწილდება ორგანიზმის ქსოვილებში, ნახევარგამოყოფის პერიოდი ინტრავენური შეყვანის შემდეგ 1-3წთ. აღწევს რძეში. მეტაბოლიზდება ღვიძლში, გამოიყოფა უმეტესად განავალთან ერთად, ნაწილობრივ - თირკმელებით.

ჩვენებები
მშობიარობის მეორე პერიოდის შესამცირებლად, ნაყოფის მხრის წინა ნაწილის გამოჩენის შემდეგ. მშობიარობა (II პერიოდი, მხრის წინა ნაწილის გამოჩენის შემდეგ), მეტრორაგია (მათ შორის ატონიური), ჰიპოტონური სისხლდენა ადრეულ მშობიარობის შემდგომ პერიოდში (პროფილაქტიკა და მკურნალობა), პოსტოპერაციული (საკეისრო კვეთა, მიომის მოცილება), პოსტაბორტული.

მიღების წესები და დოზები
მეთილერგობრევინის დოზები ისაზღვრება ჩვენების შესაბამისად.
საშვილოსნოს ატონიური სისხლდენები. ინიშნება 0,1 მგ (0,5მლ) ი/ვ ან 0,2მგ (1მლ) ი/მ, აუცილებლობისას ინექცია შეიძლება გაიმეორონ 2 საათიანი ინტერვალის შემდეგ. 
მეტრორაგიები. ინიშნება 0,1-0,2 მგ ი/მ ან 0,1მგ ი/ვ.
საკეისრო კვეთა. პრეპარტი შეყავთ ნაყოფის ამოყვანის შემდეგ: ი/ვ 0,05-0,1 მგ ან ი/მ 0,2მგ. 
აბორტი. ინიშნება საშვილოსნოს ყელის არხის გაფართოების შემდეგ ი/ვ 0,1-0,2მგ. სპონტანური აბორტებისას ნაჩვენებია ი/ვ შეყვანა 0,05-0,1მგ.
მშობიარობა. მეანის კონტროლის ქვეშ მშობიარობის მეორე პერიოდის შესამცირებლად შეყავთ ი/ვ 0.1-0.2 მგ მეთილერგობრევინი მხოლოდ ნაყოფის თავის ან მხრის წინა ნაწილის გამოჩენის შემდეგ. ზოგადი გაუტკივარებით მიმდინარე მშობიარობის შემთხვევაში რეკომენდებულია შეყვანა 0,2მგ მეთილერგობრევინისა, თუ ი/ვ შეყვანა შეუძლებელია, პრეპარატი შეყავთ ი/მ 0,2-0,4 მგ დოზით.

გვერდითი მოვლენები
აბდომინური ტკივილი, გულისრევა, ღებინება, მომატებული ოფლიანობა, თავბრუსხვევა, თავის ტკივილი, ხმაური ყურებში, ბრადიკარდია, არტერიული წნევის ტრანზიტორული მომატება, პერიფერიული ვაზოსპაზმი, ტკივილი გულმკერდის მიდამოში, დისპნოე, ინსულტი, მიოკარდიუმის ინფარქტი, ფილტვების შეშუპება, ალერგიული რეაქციები კანის გამონაყარის სახით, უკიდურესად იშვიათად - ანაფილაქსიური შოკი, რძის სეკრეციის დაქვეითება

უკუჩვენება
ორსულობა, მშობიარობის პირველი პერიოდი, მეორე პერიოდი ნაყოფის თავის გამოჩენამდე, არტერიული ჰიპერტენზიის მძიმე ფორმები, პერიფრიული სისხლძარღვების ოკლუზიური დაავადება, სპორინის პრეპარატების მიმართ მომატებული მგრძნობელობა, სეფსისი.
სიფრთხილით: ღვიძლის ან თირკმლის უკმარისობა, გულ-სისხლძარღთა დაავადებები, პლაცენტის ხელით მოცილების აუცილებლობა.

ორსულობა და ლაქტაცია
ორსულობისა და ძუძუთი კვებისას მიღება უკუნაჩვენებია.

განსაკუთრებული მითითებები
პრეპარატის მიღება საჭიროა მხოლოდ სპეციალიზებულ სტაციონარში, არტერიული წნევის, გულის შეკუმშვათა სიხშირის, საშვილოსნოს შეკუმშვის აქტივობის ექიმის კონტროლით. ბავშვის დაბადების შემდეგ უცბად მიღებისას (თუ პლაცენტა იმყოფება საშვილოსნოს ღრუში) შეიძლება წინააღმდეგობა შეექმნას მომყოლის მოცილებას.

ჭარბი დოზირება
ჭარბი დოზირების სიმპტომებს წარმოადგენს: გულისრევა, ღებინება, აბდომინალური ტკივილი, კიდურების დაბუჟებისა და ჩხვლეტის შეგრძნება, არტერიული ჰიპერტენზია, მძიმე შემთხვევებში სუნთქვის დათრგუნვით, ჰიპოთერმიით, კრუნჩხვებითა და კომით.
ჭარბი დოზირებისას ტარდება სიმპტომური მკურნალობა გულ-სისხლძარღვთა და სასუნთქ სისტემაზე დაკვირვებით.

სხვა წამლებთან ურთიერთქმედება
საშვილოსნოდან ატონიური სისხლდენების მკურნალობისა და პროფილაქტიკისთვის ეფექტურია მეთილერგობრევინის კომბინაცია ოქსიტოცინთან. მეთილერგობრევინმა შეიძლება გააძლიეროს სიმპათომიმეტიკების და ერგოტამინის ვაზოპრესული ეფექტები. დოფამინთან შეთანხმება უკუნაჩვენებია, რადგან შესაძლებელია კიდურების განგრენის განვითარება. ფთოროტანი აქვეითებს საშვილოსნოს მგრძნობელობას და ამცირებს მეთილერგომეტრინის აქტიურობას.

შენახვის პირობები და ვადები
8-15oC ტემპერატურაზე, სინათლისგან დაცულ, ბავშვებისთვის მიუწვდომელ ადგილას.
ვარგისობის ვადა 2 წელი. გამოყენება არ შეიძლება შეფუთვაზე მითითებული ვადის გასვლის შემდეგ.

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