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Gynipral injection - relaxes the muscles of the uterus, reduces the frequency and intensity of contractions, suppresses spontaneous and oxytocin-induced labor contractions.
Selective beta2-adrenomimetic, reduces the tone and contractile activity of the myometrium. Reduces the frequency and intensity of uterine contractions, suppresses spontaneous as well as birth-related labor caused by oxytocin. During childbirth normalizes excessively strong or irregular contractions.
Under the action of the drug, premature contractions in most cases cease, which allows to prolong pregnancy until the normal term of childbirth.
Due to its beta2-selectivity, the drug has an insignificant effect on the cardiac activity and blood flow of the pregnant woman and fetus.
During the period of application of Ginipral, careful monitoring of the functions of the cardiovascular system (heart rate, blood pressure) of the mother and fetus is recommended. It is recommended that ECG be recorded before and during treatment.
Patients with hypersensitivity to sympathomimetics should be prescribed Ginipral in small doses, selected individually, under the constant supervision of a physician.
With a significant increase in heart rate in the mother (more than 130 beats per minute) or / and with a marked decrease in blood pressure, the dose of the drug should be reduced.
If there is shortness of breath, pain in the heart, signs of heart failure, Ginipral should be stopped immediately.
The use of ginipral may cause an increase in plasma glucose (especially in the initial treatment period), so you should monitor the carbohydrate metabolism in mothers with diabetes mellitus. If the birth occurs immediately after the course of treatment with Ginipralum, it is necessary to take into account the possibility of the appearance of hypoglycemia and acidosis in newborns due to transplacental penetration of lactic and ketonic acids.
With the use of Ginipral, diuresis decreases, so you should closely monitor the symptoms associated with fluid retention in the body.
In some cases, simultaneous use of GCS during infusions of Ginipral can cause pulmonary edema. Therefore, when infusion therapy requires constant careful clinical observation of patients. This is especially important in the combined treatment of GCS in patients with kidney disease. Strict limitation of excess fluid intake is necessary. The risk of the possible development of pulmonary edema requires limiting the volume of infusion as much as possible, as well as the use of dilution solutions that do not contain electrolytes. It is necessary to limit the intake of salt with food.
It is recommended to monitor the regularity of the intestinal activity during the period of application of the drug.
Before the beginning of tocolytic therapy, it is necessary to take potassium preparations. with hypokalemia, the effect of sympathomimetics on the myocardium is enhanced.
Simultaneous use of funds for general anesthesia (halothane) and sympathomimetics can lead to heart rhythm disturbances. Ginipral should be discontinued before halothane is used.
With prolonged tocolytic therapy, it is necessary to monitor the state of the fetoplacental complex, to make sure that there is no abruption of the placenta. Clinical symptoms of premature placental abruption can be mitigated against the background of tocolytic therapy. When rupture of the bladder and when the cervix is opened more than 2-3 cm, the effectiveness of tocolytic therapy is low.
During tocolytic therapy with beta-adrenomimetics, symptoms of concomitant dystrophic myotonia may increase. In such cases, the use of diphenylhydantoin preparations (phenytoin) is recommended.
When applying the drug in the form of tablets with tea or coffee, it is possible to increase the side effects of Ginipral.
The contents of the ampoule should be administered iv slowly for 5-10 minutes using automatically dosing infusomats or with the help of conventional infusion systems - after dilution with isotonic sodium chloride solution up to 10 ml. The dose of the drug should be selected individually.
In acute tocolysis: the drug is prescribed in a dose of 10 μg (1 amp on 2 ml). In the future, if necessary, the treatment can be continued with the help of infusions.
With massive tocolysis: the administration of the drug begins with 10 μg (1 amp to 2 ml), followed by infusion of Ginipral at a rate of 0.3 μg / min. As an alternative treatment, it is possible to use only infusions of the drug at a rate of 0.3 μg / min without a preliminary bolus administration of the drug.
With prolonged tocolysis: the drug is prescribed as a continuous drop infusion at a rate of 0.075 μg / min.
If there is no resumption of contractions within 48 hours, continue treatment with Ginipral tablets 500 μg.
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