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Gliatilin - choline alfoscerate

21 Dec 2016

International Non-Proprietary Name (INN): choline alfostserat.

Pharmacological group: "nootropic agent"
ATC code: N07AH02

Product form:

Ampoules 1000mg / 4ml, 3 capsules per pack
Capsules 400mg, 14 capsules per pack.

Gliatilin in the Russian market since 1994. Included:

  • Gliatilin is in the list of vital and essential medicines.
  • The standards of specialized medical care for neurological diseases (cerebral infarction, spinal muscular atrophy).
  • The federal leadership on drug therapy (neurology, psychiatry).
  • Gliatilin is a donor of acetylcholine (a neurotransmitter of cholinergic structures of the central nervous system) and phosphatidylcholine (the main structural component of cell membranes and intracellular organelles).

Thus, gliatilin improves the transmission of signals from neuron to neuron, stabilizes the receptor field of neuronal membranes and prevents the destruction of brain tissue in critical situations, activates the recovery of neurons and neuronal synapses in the post-critical period. Clinically gliatilin provides a wake-up action (recovery of consciousness), improvement of cognitive, behavioral, emotional, motor functions.

Gliatilin unique feature is its ability to penetrate the blood-brain barrier at a high concentration (40.5% of the plasma concentration) and replenish endogenous acetylcholine deficiency even in critical situations (acute hypoxic-ischemic brain damage and toxicity) as choline, acetylcholine becomes through a biochemical reaction of acetylation. Thus, gliatilin has a strong central action and, in practice, has no peripheral (bradycardia, bronchospasm, salivation), characteristic of generic drugs.

Gliatilin is indicated for:

Stroke (ischemic and hemorrhagic in the acute and recovery period)
Traumatic brain injury of different severity
Cognitive disorders of various origins.

Gliatilin has a high level evidence base.


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Mexidol Overview

21 Dec 2016

(Emoxypine)

Main applications of Mexidol
Neurology: acute cerebrovascular accident, atherosclerotic lesions of vessels of the heart and brain; traumatic brain injury, epilepsy; circulatory, traumatic, and dysmetabolic posthypoxic encephalopathy; neurodegenerative diseases of the nervous system: Alzheimer's disease, Parkinson's disease, Gilles De La Tourette's, chorea Gentchintona; peripheral neuropathy (diabetic, toxic, traumatic, ischemic compression, sciatica-ischemic), autonomic dysfunction syndrome, para-somnic disorder cerebroasthenic syndrome. Surgery: acute purulent inflammation of the abdominal cavity processes (acute destructive pancreatitis, peritonitis). Psychiatry: relief of withdrawal symptoms with the presence in the clinical picture of neurosis and vegetative-vascular disorders, acute intoxication antipsychotics.

annotation

In recent years, more attention is paid to the processes of free radical oxidation in normal and pathological conditions. The most widely publicized their participation in the development of diseases such as atherosclerotic lesions of vessels of the heart and the brain, hypertension, cancers, neurodegenerative diseases, convulsive state, stress, neurosis, pain syndromes, osteoarthritis, amyloidosis, cholecystitis, pancreatitis, inflammatory processes, diseases of the blood , eyes (cataracts, etc..), skin, diabetes, kidney disease, liver and pulmonary, allergic and immune deficiencies and others. The main pathogenic process, accompanying the natural aging process is also a free-radical oxidation.

This was dictated by one of the most promising areas in the maintenance of adequate activity of endogenous antioxidant system - find a rational antioxidant therapy.

Creating synthetic antioxidants is an undoubted achievement of Russian Pharm Industry. A special place among these drugs takes Mexidol drug.

Mexidol (Mexidolum)

The international non-proprietary name - hydroxymethyl-ethyl pyridine-succinate.

Rational chemical name - 3-Hydroxy-6-methyl-2-ethylpyridine succinate.

Mexidol refers to heteroaromatic antioxidants - compounds analogues of vitamin B complex (Piridoxine). It has a wide spectrum of pharmacological activity: an inhibitor of free-radical processes, membrane-protector having anti-hypoxic stress-protective, neuroprotective, anticonvulsant and anxiolytic effects. The drug increases the body's resistance to the effects of various damaging factors, oxygen-dependent pathological conditions (shock, hypoxia and ischemia, cerebrovascular accident, alcohol intoxication and antipsychotic drugs (neuroleptics)).

The drug improves brain metabolism and blood flow to the brain, improves microcirculation and blood rheology, reduces platelet aggregation. It stabilizes the membrane structure of blood cells (erythrocytes and platelets) for hemolysis. It has hypolipidemic effect, reduces total cholesterol and low density lipoproteins. Reduces enzymatic toxemia and endogenous intoxication in acute pancreatitis.

The mechanism of Mexidol action
Determined to its antioxidant and membrane action, which are key links:
1. Mexidol inhibit free-radical oxidation of the lipid membrane, binds free radicals lipid peroxide.
2. Mexidol increases the activity of antioxidant enzymes responsible for the formation and consumption of reactive oxygen species, such as superoxide dismutase.
3. It inhibits the synthesis of prostaglandins, prostacyclins, and leukotrienes trombaksana A.
4. Performs hypolipidemic action, namely, reduces total cholesterol, LDL, reducing the ratio of cholesterol / phospholipid, the viscosity reducing lipid layer.
5. Improves energy metabolism cells, activates the energy-synthesizing mitochondrial function, affect the content of biogenic amines and improves synaptic transmission. Furthermore, succinate, part of mexidol itself is included in the respiratory chain, increasing its effectiveness.
6. Meksidol receptor complexes modulate brain membranes, in particular, benzodiazepine, GABA-ergic, acetylcholine receptors, enhancing their ability to bind.
7. The preparation stabilizes biological membranes, particularly membranes of erythrocytes and platelets.

Thus, due to its mechanism of action and a broad spectrum of pharmacological effects (cerebroprotective, antihypoxic, tranquilizing, anti-stress, nootropic, Wegetotropona, anticonvulsant, improvement and stabilization of brain metabolism and blood supply to the brain; the correction of disorders in the regulatory and microcirculation system, improving the rheological properties of blood, inhibition of platelet aggregation, activation of the immune system), mexidol affects the basic pathogenesis of various diseases associated with the processes of free radical oxidation. Moreover, this mechanism of action explains its extremely small side effects and the ability to potentiate the effect of other centrally active agents.

Its pharmacological effects mexidol implements, at least on two levels - neuronal and vascular. Therapeutic effects mexidol detected in the range of 10 to 300 mg / kg.

Meksidol increases resistance to the damaging effects of various extreme factors such as sleep disorders, conflict situations, stress, brain trauma, electric, exercise, hypoxia, ischemia, various intoxications, including ethanol.

Mexidol has a pronounced tranquilizing and anti-stress effect, the ability to eliminate the anxiety, fear, stress, anxiety, particularly in conflict situations. When parenteral administration it has a similar depth effect with diazepam (Seduxenum) and alprazolam (Xanax). Antistress effect of mexidol expressed in the normalization of post-stress behavior, somatic-vegetative parameters, restoring sleep-wake cycles and disturbed learning and memory processes, reduction of gastric ulcers, reduced dystrophic, morphological changes that occur after the stress in various structures of the brain and myocardium.

Mexidol has distinct anticonvulsant effect, affecting both primary generalized seizures caused primarily introduction of GABAergic agents, and the epileptiform activity in the brain with chronic epileptic focus.

Nootropic properties mexidol expressed in the ability to improve learning and memory, help to preserve the memory trace and counteract the fading process of transfer of skills and reflexes. The agent has a pronounced effect antiamnesic eliminating memory disorders caused by various influences (electric shock, brain injury, sleep deprivation, administration of scopolamine, ethanol, benzodiazepines and others.).

The agent has a distinct anti-hypoxic and anti-ischemic effect. According to the anti-hypoxic activity mexidol far exceeds Pyritinol and piracetam. In addition, the drug has a pronounced anti-hypoxic action on the myocardium. On the mechanism of implementation of these effects is mexidol antihypoxant direct energizing action, the effect of which is associated with the effect on endogenous mitochondrial respiration, activation energy-synthesizing mitochondrial function. Anti-hypoxic action mexidol due not only to its own properties, but also its member succinate, which in hypoxic conditions, doing the intracellular space, able to oxidize the respiratory chain.

Mexidol has a pronounced anti-alcoholic effect. It eliminates neurological and neurotoxic manifestations of acute alcohol intoxication, caused by a single administration of high doses of ethanol, and restores behavioral, autonomic, and emotional status, deterioration of cognitive functions, the processes of learning and memory caused by long-term (5 months) introduction of ethanol and its abolition, and prevents the accumulation of lipofuscin in the brain tissue.

Mexidol has expressed geroprotective effect, provides a clear corrective influence on impaired during aging processes of learning and memory, improving the fixing process, preservation and reproduction of information, it helps to restore emotional and vegetative status, reduces the symptoms of neurological deficit, reduces the level of brain and blood markers of aging - lipofuscin , malondialdehyde, cholesterol. The mechanism of action hero-protective mexidol linked to its antioxidant properties, the ability to inhibit lipid peroxidation processes with its membrane-direct action, the ability to restore the ultrastructural changes of the granular endoplasmic reticulum and mitochondria, modulating the receptor complexes work.

Mexidol has anti-atherogenic effect. The drug inhibits the humoral manifestations of athero-arteriosclerosis: reduce hyperlipidemia, prevents activation of lipid peroxidation, increases the activity of the antioxidant system, and has a protective effect on the local vascular mechanisms of atherogenesis, prevents the development of pathological changes in the vascular wall and reduce the degree of damage to the aorta.

Mexidol reduces the atherogenic lipoproteins and triglycerides, increases high density lipoproteins in serum, prevents deficiency of highly phospholipids.

Mexidol not only causes the regression of atherosclerotic changes in the arteries and restores lipid homeostasis, but also corrects violations of regulatory and microcirculatory system, which is reflected in the fact that there is no constriction of arterioles and precapillaries, and their diameter does not differ from the control, in venules observed only patchy units, as well as there is complete elimination of microvascular spasm bearing.

Furthermore, derivatives of 2-ethyl-6-methyl-3-hydroxypyridine, which include meksidol inhibit platelet aggregation induced by collagen, thrombin, ADP and arachidonic acid inhibits phosphodiesterase cyclic platelet nucleotides and protect blood cells after mechanical injury. In particular, there has been stabilization stability of erythrocyte membranes to hemolysis and accelerated the process of hematopoiesis (recovery amount of red blood cells) following acute hemorrhage or hemolysis chemical.

Hepatoprotective effect mexidol installed on three models of acute liver toxicity, in which hepatocyte cytolysis syndrome causes various hepatotoxins.

In the context of carbon tetrachloride liver injury mexidol reduce necrosis of the liver tissue and the amount of fatty degeneration of hepatocytes, normalize the energy balance of hepatocytes, has a protective effect on the nuclear and cytoplasmic pool of nucleic acids. In alcoholic liver disease mexidol effect is to reduce the number of cells with nuclei lysis and chromatin, accelerating the recovery of the total genome of hepatocytes and an increase in the content of nucleic acids in the liver tissue, and the nuclei of hepatocytes.

Mexidol has a pronounced ability to have a potentiating effect on the effects of other drugs neuropsychotropic. Influenced mexidol enhanced tranquilizing effect, antipsychotic, antidepressant, hypnotic, anticonvulsant and analgesic drugs that can reduce their dose and reduce side effects. In particular, in combination with mexidol anticonvulsant carbamazepine dose can be reduced by 2 times without reducing its therapeutic effect. Combined use of carbamazepine mexidol allows adequate pathogenetic therapy of partial epilepsy, to reduce the side effects of carbamazepine during prolonged use without reducing its therapeutic efficacy and thereby optimize the treatment of patients with epilepsy.

Indications for use:

1. Acute ischemic attacks, stroke subacute period, the early and late period of post-stroke rehabilitation.
2. Discirculatory encephalopathy - like on the background of atherosclerotic lesions of the brain vessels, and on the background of hypertensive disease (in the phase of decompensation, subcompensation and, as planned maintenance therapy in phase compensation).
3. posthypoxic, dysmetabolic and, above all, diabetic encephalopathy.
4. Vertebra-basilar insufficiency on the background of degenerative disc disease of the cervical spine.
5. The acute period of craniocerebral trauma, early recovery period after a traumatic brain injury, post-traumatic encephalopathy.
6. Epilepsy episyndrome.
7. Degenerative-dystrophic lesions of the nervous system (Alzheimer's disease, Parkinson's disease, vascular parkinsonism).
8. Syndrome autonomic dysfunction, neurotic and neurosis-like states.
9. Para-somnic disorder.
10. Polyneuropathy (dysmetabolic primarily diabetic compression-ischemic, traumatic, toxic, including alcohol).
11. exogenous-organic brain disease (as a result of the previously neuroinfections, radiation effects, traumatic brain injury).
12. With disorders of memory and Intelligent software failure in the elderly.
13. The periods of extreme stress, neurosis and neurotic disorders.
14. Intoxication neuroleptics.
15. Acute intoxication with ethanol and the relief of alcohol withdrawal syndrome.
16. Comprehensive treatment and rehabilitation of patients with opioid (heroin) addiction.
17. The use in combination therapy for the prevention of metabolic disorders postresuscitation.
18. Acute purulent inflammation of the abdominal cavity (acute destructive pancreatitis, peritonitis).
19. Combined therapy of liver failure.
20. Use for sedation of patients in dental clinical practice.

Dosing and Administration of Mexidol
Mexidol administered intravenously (bolus or infusion), intramuscularly and inside. For intravenous administration, the preparation method should be diluted with water for injection or physiological sodium chloride solution. For infusion administration should use physiological NaCL solution.

Chip mexidol administered 1.5-3.0 minutes, drip - at a rate of 80,120 drops per minute. The duration of treatment and the daily dose depends on the nosology of the disease and the severity of the patient's condition.

twice daily for the first 15 days of treatment for acute stroke meksidol intravenously administered 400 mg (8 ml) in isotonic sodium chloride solution (100-150 mL), and then:
or 400 mg (8 ml) intravenously at a physiological NaCL solution daily for 15 days;
or 200 mg (4 ml) intravenously isotonic sodium chloride solution (16 ml) and water for injection (same volumes) twice a day. Injection is performed within 1.5-3.0 minutes. The course of treatment 15 days.

Further mexidol recommended intramuscular administration of 200 mg (4 ml) one time per day for 10-15 days. In subsequent comprehensive medical therapy is expedient to include the tablet form of the drug at 0.25-0.5 g / day for 4-6 weeks. The daily dose is distributed into 2-3 doses during the day.

For the treatment of vascular encephalopathy (as on the background of atherosclerosis of brain vessels, and on the background of hypertensive disease):
In the phase of decompensation mexidol introduced:
- Either 400 mg (8 ml) was intravenously 100 ml isotonic NaCL daily for 10-15 days;
- Either 200 mg (4ml) intravenously to 16.0 ml of water for injection or isotonic sodium chloride solution (16.0 ml) twice a day for 10-15 days.

Then, the drug is administered intravenously at 100 mg (2 ml) 10.0 ml of isotonic sodium chloride solution, daily, a course of 10 days. Alternatively, 200 mg (4 ml) intramuscularly daily for 10 days. In the following recommended oral mexidol to 0,125 g three times a day for 4-6 weeks.
In phase subcompensation mexidol apply:
- Either 200 mg (4 ml) intravenously at 16.0 ml saline NaCL (or 16.0 mL of water for injection), daily for 10-15 days;
- Either 200 mg (4 ml) intramuscularly twice a day for 1015 days.

Then you can continue the treatment by introducing mexidol into 0,125 g three times a day, the course of 4-6 weeks.
For foreign exchange prevention vascular encephalopathy (phase compensation) mexidol should enter:
- Or 100 mg (2 ml) intravenously at 10.0 ml saline NaCL, daily, for 10 days;
- Either 200 mg (4 ml) intramuscularly daily, a course of 10 days. Subsequently expedient reception tablet form 0,125 g three times a day for 2-6 weeks (in both cases, - and by intravenous, intramuscular and mexydole);
- Or a term originally prevention can begin to use the tablet form to 0,125 g three times a day, for at least 4-6 weeks.

When vertebro-basilar insufficiency on the background of osteochondrosis of the cervical spine mexidol apply:
In the phase of decompensation:
- Either 400 mg (8 ml) intravenously, v100,0 ml saline NaCL, daily, 10 days;
- Either 200 mg (4 ml) intravenously izotonicheskokogo 16.0 ml of sodium chloride solution twice a day for 10 days;

Further mexidol recommended administration of 200 mg (4 ml) intramuscularly for 10-15 days. After intramuscular injection - the transition to oral medication to 0,125 mg three times a day, the course of 2-6 weeks.
In phase subcompensation:
- Either 200 mg (4 ml) is injected intravenously mexidol, 16.0 ml isotonic sodium chloride solution for 10 days;
- Either 200 mg (4 ml) intramuscularly twice a day for 10 days.

In the future, it is advisable appointment mexidol in tablet form in the above doses.

In the acute period of craniocerebral trauma designation mexidol pathogenetically justified because, apart from its Cerebroprotective properties it is of great importance its anticonvulsant activity and potentiation of the action of dehydration means.

Recommended dosage:
- In the acute phase - 200 mg (4 ml) intravenously, 16.0 ml of isotonic sodium chloride solution twice a day for 10-15 days;
- In the subacute period - 200 mg (4 ml) intravenously by 16.0 ml of isotonic sodium chloride solution, 10 days on a daily basis; or 200 mg (4 ml) intramuscularly twice a day for 10-15 days.

The period of rehabilitation recommended to take the tablet form mexidol to 0,125 g three times a day, 4-6 weeks.

Very effective in the treatment of introduction mexidol dismetabolic, and, above all, diabetic encephalopathy, polyneuropathy. Mexidol used in diabetes, improves the course of the disease, as well as improves the absorption of glucose into cells under conditions of insulin resistance. Recommended intravenous formulation of 200 mg (4 ml) intravenously, 16.0 ml of physiological NaCL solution twice a day for 10-15 days. Subsequently - injected intramuscularly with 100 mg (2 ml) daily for 15-30 days. After parenteral administration, tablets given meksidol - 0,125 g three times a day for at least 4-6 weeks.

Given the lack of a direct stimulatory effect on the cerebral cortex, and having pronounced anticonvulsant effect, mexidol advisable to use in the treatment of epilepsy. In addition, the drug increases the effects of anticonvulsants, which allows it to reduce the dose used in the appointment of anticonvulsants, as well as reduce their side effects. Meksidol recommended administered 100 mg (2 ml) intravenously at 18.0 ml isotonic sodium chloride solution (or the same amount of water for injection), twice a day for 15 days. Then the drug is administered intramuscularly, 100 mg (2 ml) daily for 15 days.

Degenerative-dystrophic lesions of the central nervous system

Mexidol has a pronounced positive effect in the treatment of chronic neuroleptic syndrome with symptoms of tardive dyskinesia and neuroleptic syndrome subacute. The drug reduces the severity of oral-lingual hyper-kinesis, reduces tremor of limbs, stiffness, gipomimiya and hypo-kinesis, improves motor function of patients. In addition, mexidol potentiates the action of anti-money that can reduce the dose used drugs and reduce their side effects.

For the treatment of degenerative lesions of the central nervous system, mexidol recommended 200 mg (4 ml) intravenously by 16.0 ml of isotonic sodium chloride solution, twice daily, for 10 days. Then the drug is administered intramuscularly, 200 mg (4 ml) daily for 15 days. In the next 4-6 weeks, the advisability of appointing a tablet form - to 0,125 g three times a day.

The syndrome of autonomic dysfunction, neurotic and neurosis-like states

Mexidol shown to be highly effective in vegetative-vascular dystonia, especially flowing through paroxysmal type. Mexidol has vegetative normalizing effect and a distinct tranquilizer with neurotic and neurosis-like states. Dosage and preparation: at 100200 mg (2-4 ml) is injected intravenously mexidol on 10,0-16,0 ml of isotonic sodium chloride solution, daily for 10 days. Perhaps intramuscular formulation of 200 mg (4 ml) daily for 15 days. After injection expedient purpose tablet form mexidol at 0.25-0.50 grams per day. The daily dose is distributed into 2-3 doses. The course of treatment - 2-6 weeks. Course therapy meksidolom end in this case is gradually decreasing for 2-3 days dose.

parasomnia disorder

The agent has a positive effect on sleep, restoring its duration and depth, helping with the restoration of the proper sleep rhythms. This is combined with the absence of sedation effects while taking the drug during the day. In this case, the drug is recommended to be administered intramuscularly, 100-200 mg (2-4 ml) daily for 15-20 days. Then given the drug in tablet form 0,125 g three times a day for 4-6 weeks. The dose of the drug before canceling reduce gradually over 2-3 days.

Memory disorders and intellectual impairment in the elderly

Mexidol is an effective drug for the revitalization of the elderly. The drug has a positive effect on gipomnezia, increased distractibility and difficulty focusing, improves the ability to concentrate and numeracy, improves short-term memory to current events and long-term memory of the past. The recommended dosing regime mexidol: 100-200 mg (2-4 ml) - depending on the degree of intellectual deficiency - are administered intramuscularly, for 10-15 days, then the drug is given orally at 0,125 g, three times daily, for at at least 4-6 weeks. Such courses are repeated every 5-6 months.

Periods of extreme loads

Mexidol has a pronounced ability to improve mental and physical performance, especially in extreme impacts. The advisability of appointing mexidol in such cases begin with the intravenous administration of 200 mg (4 ml) intravenously, 16.0 ml of isotonic sodium chloride solution, daily for 10-15 days. Then, the drug is administered by intramuscular injection of 200 mg. (4 ml) intravenously, 16.0 ml of isotonic sodium chloride solution, daily for 10-15 days. The preparation was then injected intramuscularly with 200 mg (4 ml) per day, 10 days, followed by a transition to the reception tablet form by 0.25-0.50 g per day; a course of treatment - 2-6 weeks. Possible transition to a tablet form immediately after intravenous administration mexidol.

Exogenous-organic brain disease

The reasons for exogenously-organic brain lesions are transferred earlier traumatic brain injuries, intoxication (excluding alcohol), neuroinfections, radiation exposure, as well as combinations of these factors.

Known poor tolerance of patients with exogenous-organic diseases of a number of drugs. Mexidol, as studies have shown, it does not belong to their number. When using it marked a clear positive impact on the existing neurological deficits in these patients. The recommended dosing regimen of medication: intravenous bolus of 200 mg (4 ml) mexidol 16.0 ml of isotonic sodium chloride solution, daily for 10-15 days; then the drug can be administered 100-200 mg intramuscularly (4.2 mL) per day for 10-15 days, or go to the tablet form 0,125 g three times a day, for 4-6 weeks.

Acute intoxication with ethanol

Given the anti-hypoxic, antioxidant, and hepatoprotective effects trvnkviliziruyuschy mexidol drug is recommended as part of combination therapy for the relief of acute intoxication with ethanol. In addition, mexidol prevents and reduces the toxic effect of alcohol. Dosage: 400 mg (8 ml) intravenously to 150.0 ml of isotonic sodium chloride solution twice a day - 3 days; Further 200 mg (4 ml) intravenously at 16.0 ml saline NaCL, twice a day for 7 days. If necessary, the treatment can continue using the tablet form of the drug - 0,125 g three times a day - 2-6 weeks.

Alcohol withdrawal syndrome

Mexidol effective as a means for the relief of alcohol withdrawal syndrome with somatic-neurological and psychiatric symptoms due to its strong antioxidant and tranquilizing effects. When comparing the speed mexidol cupping effect on certain symptoms of alcohol withdrawal syndrome with the effectiveness of traditional means of detoxification, it was found a significant advantage of this drug. Mexidol is an effective tool for the rapid relief of alcohol withdrawal syndrome with a wide range of exposure as his psychopathological components, and the vegetative-vascular manifestations. "Injection" mexidol, in contrast to the tablet form, is more effective against affective pathology, eliminating the trouble in significantly shorter time.

The recommended dosing regimen: 200 mg (4 ml) intravenously, 16.0 ml isotonic NaCL, daily for 10-15 days, then a transition to intramuscular administration at a dose of drug of 200 mg (4 ml) daily, for 10 days, followed by transfer to tablet form (0,125 g three times a day, 4-6 weeks).

In some cases, the combination drug only intramuscularly (in the described dosages) and tablet form.

Possible to use only mexidol release oral forms (tablets) in a dose of 500 mg / day - 2 tablets (0,125 g) twice a day during the period of alcohol withdrawal syndrome.

Treatment and rehabilitation of patients with opioid (heroin) addiction

- Acute drug withdrawal syndrome:

Turning mexidol in the complex treatment of acute drug withdrawal syndrome, reduces the intensity of autonomic disorders, can reduce the dosage of a number of drugs used for the relief of drug withdrawal syndrome, significantly mitigate the side effects of antipsychotics, to reduce the phenomenon of drug intoxication, accelerate the recovery of some of the vital functions ( sleep, appetite), as well as reduce the time of preparation of patients to conduct psychotherapeutic interventions. It was found that an intravenous bolus of the drug addicts in the initial phase of withdrawal symptoms and has a strong trankvilo-sedation.

Mexidol recommended dosing regimen for acute narcotic withdrawal syndrome - 400-600 mg / day (8-12 ml) intravenously (bolus or infusion) for 5-7 days.

- The post-withdrawal period and stage of rehabilitation:

Cerebroprotecion, antiamnestic properties, as well as the ability mexidol eliminate the side effects of antipsychotics, defined its purpose drug addicts in post-withdrawal period and on the stages of rehabilitation. It was found that the daily administration of the drug prevents or eliminates extrapyramidal disorders in the appointment of neuroleptics.

Combined therapy of acute purulent inflammation of the abdominal cavity

In acute destructive pancreatitis, peritonitis mexidol administered on the first day, both in the preoperative and postoperative period. The dosage administered depends on the type and severity of the disease, the prevalence of process variants of clinical course. Cancel the drug should be made gradually, only after sustained positive clinical and laboratory effect.
- In acute edematous (interstitial) pancreatitis mexidol appoint 100 mg (2 mL) three times a day by intravenous drip, for isotonic sodium chloride solution.
- Mild necrotizing pancreatitis - 100-200 mg (2-4 ml) three times a day by intravenous drip (NaCL solution isotonic).
- Severe necrotizing pancreatitis - mexidol introduced into the pulse dosage - 800 mg (16 ml) in the first day, with double injection mode; Further, 300 mg (6 ml) twice per day with gradual decrease in the daily dose.
- It is hard for - in an initial dose of 800 mg / day (16 ml) to the relief of persistent manifestations pancreatogenic shock to stabilize the condition of 300-400 mg (6-8 ml) two times a day intravenously (in isotonic sodium chloride solution) with gradual reduction of the daily dosage.

Use in dental medical practice

Properties and mechanism of action mexidol clearly reveal its advantages over the known drugs and determine the prospects of using it for sedation of patients in dental clinical practice. Mexidol has an advantage, both to classical tranquilizers, and to non-narcotic analgesics, which is the complexity of the action of this drug has both tranquilizing and analgesic effects without side effects.

For the purpose of sedation on an outpatient dental patients receiving recommended administration of 100-200 mg (2-4 ml) of 5% solution mexidol on 10,0-16,0 ml of isotonic sodium chloride solution for 20-30 minutes before the upcoming dental treatment.

Interaction with other drugs

The drug combined with anticoagulants, antiplatelet, antihypertensive agents, antidiabetic agents; all drugs used to treat diseases of the cardiovascular system.

Mexidol potentiates the action of anticonvulsants, tranquilizers, antiparkinsonian agents, analgesics. The drug reduces the toxic effects of ethanol.


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Mexidol Russian drug of a new generation

21 Dec 2016

(Emoxypine)

The original Russian antihypoxant and antioxidant of direct action, optimizing the energy supply of cells and increases the reserve capacity of the organism.

Mexidol - the main field of application

Neurology:
Acute and chronic cerebrovascular accident (stroke); traumatic brain injury; circulatory and post-traumatic encephalopathy; neurodegenerative diseases of the nervous system.

Surgery:
Acute purulent inflammation of the abdominal cavity processes (acute destructive pancreatitis, peritonitis), cholecystitis.

Psychiatry:
Anxiety disorders in neurological and neurotic-like states; mild cognitive disorders of atherosclerotic; acute intoxication antipsychotic drugs (neuroleptics).

Narcology:
Abstinence syndrome in alcoholism.


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Piracetam + Thiotriazoline - Interactions with other Active Compounds

21 Dec 2016

Piracetam + Thiotriazoline + Medicinal products with the properties of weak acids

The combination of piracetam + thiotriazoline should not be used simultaneously with drugs that have acidic pH.

Piracetam + Thiotriazoline + antianginal drugs

The combined application with piracetam (consisting of a combination of piracetam + thiotriazoline) amplifies the effect of antianginal drugs.

Piracetam + Thiotriazoline + Thyroid hormones

With simultaneous use of a combination of piracetam + thiotriazoline with thyroid hormones can be confusion, irritability and sleep disturbances.

Piracetam + Thiotriazoline + The substrates of cytochrome P450

Piracetam (consisting of a combination of piracetam + thiotriazoline) does not inhibit cytochrome P450 isozymes. Metabolic interactions with other drugs are unlikely.


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Tetramethyltetraazabicyclooctandione - Active Substances

21 Dec 2016

The Latin name of the substance Tetramethyltetraazabicyclooctandionum (genus. Tetramethyltetraazabicyclooctandioni).

chemical name 2,4,6,8-Tetramethyl-2,4,6,8-tetraazabicyclo [3.3.0] octane-3,7-dione
formula - C8H14N4O2

Therapeutic agents of Tetramethyltetraazabicyclooctandione: anxiolytics

The nosological classification (ICD-10)
F10.2 alcohol dependence syndrome
F17.2 Nicotine addiction
F28 Other non-organic psychotic disorders
F30.0 Hypomania
F48 Other neurotic disorders
F48.0 Neurasthenia
R45.0 Nervousness
R45.1 Restlessness and agitation
R45.4 Irritability and anger

Pharmacology
Mode of action - anxiolytic.

Adjusts to sleep at night. It has anticonvulsant activity. It shows no central or peripheral anticholinergic properties. It has no direct muscle relaxant and sedative effect. Do not violate the coordination of movements.
Excreted by the kidneys within 24 hours.

Application of the substance Tetramethyltetraazabicyclooctandione

Neuroses and neurosis-like states, accompanied by irritability, emotional lability, anxiety, fear (including alcoholic patients in remission); hypomanic easy and anxiety-delirium without serious behavioral disorders and psychomotor agitation (including anxiety and paranoid syndrome in schizophrenia, with vascular and involutional psychosis); residual condition after acute psychosis with symptoms of affective instability and productive residual symptoms; chronic verbal hallucinosis organic origin; nicotine abstinence (in the complex therapy).

Contraindications
Hypersensitivity, pregnancy (I term).
Pregnancy and breast-feeding
Contraindicated in pregnancy (I term).

Side effects of substance Tetramethyltetraazabicyclooctandionum
Hypotension, weakness, dizziness, hypothermia (in 1-1,5 ° C), dyspepsia, allergic reactions (skin itch).

Interaction

It enhances the effect of hypnotics.
Dosing and Administration

Inside, regardless of meals, for 0,3-0,6-0,9 g 2-3 times a day. The maximum single dose of 3 grams daily - 10 g course of treatment from a few days to 2-3 months, with mental illness - up to 6 months, with nicotine withdrawal - 5-6 weeks.


Precautions Tetramethyltetraazabicyclooctandionum substance

Should not be used during the drivers of vehicles and people skills relate to the high concentration of attention.

Trading names of drugs with working substance Tetramethyltetraazabicyclooctandione
Trade Name

  • Adaptol
  • Mebicar
  • Mebicar tablets
  • Mebix 


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Active Substances - Alprazolam

21 Dec 2016

Name: Alprazolam

The Latin name of the substance Alprazolam (genus. Alprazolam).

chemical name 8-Chloro-1-methyl-6-phenyl-4H- [1,2,4] triazolo [4,3-a] [1,4] benzodiazepine
Formula - C17H13ClN4

Therapeutic agents of Alprazolam: anxiolytics

The nosological classification (ICD-10)
F06 Other mental disorders due to brain damage and dysfunction and to physical disease
F06.4 Organic anxiety disorder
F10.2 alcohol dependence syndrome
F10.3 abstinence
F11 Mental and behavioral disorders due to use of opioids
F25 Schizoaffective disorders
Inorganic psychosis F29 Unspecified
F32 Depressive episode
F34.0 Cyclothymia
F34.1 Dysthymia
F40.0 Agoraphobia
F40.1 Social phobias
F41.0 Panic disorder [episodic paroxysmal anxiety]
F41.1 Generalized anxiety disorder
F42 Obsessive-compulsive disorder
F43.0 Acute stress reaction
F43.1 Post-traumatic stress disorder
F43.2 Disorder adaptive reactions
F44 Dissociative [conversion] disorders
F45 Somatoform disorders
F79 Mental retardation, unspecified
G93.4 Encephalopathy, unspecified

Characteristics substance Alprazolam

Anxiolytic, benzodiazepine derivative. White or white with blue polka crystalline powder. Insoluble in water and slightly soluble in alcohol.

Pharmacology
Mode of action - anxiolytic, sedative, muscle relaxant, central.

By binding to benzodiazepine and GABAergic receptors causes inhibition of the limbic system, thalamus, hypothalamus, polysynaptic spinal reflexes.

After intake of rapidly absorbed from the gastrointestinal tract. Cmax achieved within 1-2 h. Plasma protein binding is 80%. It passes through GEB and placental barrier, enters the breast milk. It is metabolized in the liver. T1 / 2 -. 16 hours is derived mainly kidneys. Re-appointment with an interval of at least 8-12 hours can lead to accumulation.

Application of the substance Alprazolam
Neurosis and psychopathy, accompanied by fear, anxiety, concern; Reactive depression (including on the background of systemic diseases), panic disorder, withdrawal syndrome in patients with alcoholism and drug addiction.

Contraindications
Hypersensitivity, severe respiratory failure, glaucoma (acute onset), acute liver disease and kidney disease, myasthenia gravis, pregnancy (especially I trimester), breast-feeding, age and 18 years of age.

Restrictions applyOpen-angle glaucoma, sleep apnea, chronic renal and / or hepatic insufficiency, alcoholic liver disease.


Pregnancy and breast-feeding
Category effects on the fetus by FDA - D.

Side effects of substance Alprazolam
Drowsiness, fatigue, dizziness, unsteadiness of gait, slowing of mental and motor reactions, decreased concentration, nausea, constipation, dysmenorrhea, loss of libido, pruritus, paradoxical reactions (aggression, agitation, irritability, anxiety, hallucinations), addiction, drug addiction, withdrawal.
Interaction

Enhances the effect of alcohol, neuroleptics and hypnotics, narcotic analgesics, central muscle relaxants. Increases concentration of imipramine in the serum.

Overdose
Symptoms: oppression CNS varying degrees of symptoms (from somnolence to coma) - drowsiness, confusion; in more severe cases (especially in patients receiving other drugs which depress the central nervous system, or alcohol) - ataxia, decreased reflexes, hypotension, coma.

Treatment: induction of vomiting, gastric lavage, symptomatic therapy, monitoring vital functions. In severe hypotension - introduction of norepinephrine. The specific antidote - benzodiazepine antagonist flumazenil receptors (introduction only in a hospital).

Dosing and Administration
Inside. The mode set individually depending on the disease, tolerability and al. Treatment should start with the lowest effective dose. Typically, the initial dose for adults - 0.25-0.5 mg 3 times a day, if tolerated (if necessary) may increase the dose every 3-4 days. The maximum daily dose - 3-4 mg.

Precautions - Alprazolam substance
Keep in mind that anxiety or tension associated with everyday stress usually does not require treatment with an anxiolytic.

At occurrence of paradoxical reactions need to stop taking the drug. In the period of treatment is unacceptable consumption of alcoholic beverages. Be wary of during the drivers of vehicles and people skills relate to the high concentration of attention.

Trading names of drugs with working substance Aprazolam
Trade Name

Alzolam
Alprazolam
Alprox
Zolomax
Kassadan
Kassadan
Xanax
Xanax retard
Neurol
Neurol
Frontin
Helex
Helex


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Semax stimulant for mental performance

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If days off were successful and work / study hard to concentrate. Or suppose a complex project and need to increase the concentration.

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Amino acids responsible for Semax effects Met-Glu-His-Phe (methionine, glutamine, histidine, phenylalanine).

To do this, "Semax 0,1%" drip 3 drops in each nostril 2 times in the morning with an interval of 15 minutes, additionally desirable 3rd day of taking the drug, for example, in the afternoon.


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For amino acids responsible Semax effects Met-Glu-His-Phe (methionine, glutamine, histidine, phenylalanine).

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Can Semax replace coffee during intelligent work?

The main effect of Semax - improving mental performance.

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A single dose for a single performance increase is possible.
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TBI

Concussion due to a sharp shock is the most common head injury.

Upon impact, the human brain inside the skull beating on the walls of the cranial bones, causing a temporary disorder of nerves.

If the kick is not strong, and do not penetrate the brain injury itself does not occur, and for 1-2 days after symptoms disappear completely shake.

Usually, a concussion brings instant character, the kick must be strong and sudden, as if hit head on the ground, head injury in an accident, or a strong blow on the head with a heavy object, or with his fist during a fight or a soccer ball. You can buy online Semax.

Concussion called mild damage, not burdened by brain injury or penetrating head injuries.

Typical symptoms of concussion (requiring a doctor's advice):

  • short-term memory loss;
  • loss of consciousness;
  • vomiting, and dizziness;
  • irritability and lethargy.
The doctor draws attention to the patient's orientation in space, the mental state, motor function of the patient, recognition of loved ones. To eliminate the serious internal injuries, the doctor sends the patient to a CT scan. treatment method sets only after studying the patient's history.

The precautions in the event of deterioration, the family and friends give the memo.

mEMO

There are symptoms that require urgent intervention of rescue and subsequent hospitalization under the supervision (danger signs):

  • severe headaches;
  • convulsive state;
  • vision hallucinations;
  • severe sleepiness;
  • reel while driving;
  • shifty eyes;
  • behavioral change;
  • turbidity of consciousness.


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