Lysthenon ampoules 100mg 5ml №5

Lysthenon

Solution for intravenous and intramuscular administration

Composition

5 ml of the solution contain as an active substance suxamethonia chloride dihydrate, in terms of 100% anhydrous suxametonium chloride - 100.0 mg; excipients: sodium chloride, water for injections.

Packing

5 ampoules of 5 ml.

Mechanism of action

Listenone is a short-acting peripheral muscle relaxant. Interacting with n-cholino receptors, causes depolarization of the end plate of the synapse, which causes a blockade of neuromuscular transmission. At the beginning of the process of muscle relaxation, the appearance of muscle fasciculations is possible (the result of short-term relief of neuromuscular transmission). The relaxation of the muscles occurs in the following sequence: eyelids, chewing muscles, muscles of the extremities, muscles of the abdomen, muscles of the vocal cords and diaphragm. The depolarization process does not stop under the influence of cholinesterase inhibitors (for example, neostigmine).
Lysthenon differs from the long-acting muscle relaxants by its quick and short-term action. When administered intravenously, the action develops in 30-60 seconds and lasts 2-6 minutes. With intramuscular injection, the action begins after 75 seconds - 3 minutes in adults and 3.5 minutes in children and lasts 30 minutes in adults and 21 minutes in children.This allows to achieve the required degree of muscle relaxation in such operations, when prolonged relaxation of the striated muscles is not required.
In rare cases, prolonged muscle relaxant effect may occur if Lysthenon (dose of 3-5 mg / kg body weight) is administered fractionally for a long time (double blocking). In this phase, the Lysthenon action can be neutralized by neostigmine.

Indications and usage

Conditions requiring short-term relaxation of skeletal muscles, including endotracheal intubation before surgical interventions, reduction of dislocations, reposition of bone fragments in fractures with displacement, prevention of spontaneous damage during electroconvulsive therapy.

Contraindications

Hypersensitivity to Suxamethonia chloride, marked abnormal liver function, pulmonary edema, severe hyperthermia, malignant hyperthermia (history), low plasma cholinesterase, hyperkalemia or risk of hyperkalemia after multiple injuries (5-90 days), severe burns, penetrating damage to the eyes, diseases with neuromuscular transmission, children under 1 year, patients with uremia, especially with high levels of serum potassium.

Dosage and administration

Intravenous bolus or as an infusion, intramuscularly. For long-term drip infusion, use 0.1% solution Lysthenon.The dosage depends on the desired degree of muscle relaxation, body weight and individual sensitivity of the patient.
With the introduction of Lysthenon of 0.1 mg / kg, the skeletal muscles relax without relaxation of the respiratory function. A dose of 0.2 mg / kg to 1.0 mg / kg leads to complete relaxation of the muscles of the abdominal wall and skeletal muscles and, further, to limit or completely stop spontaneous breathing. If intravenous administration is not possible, up to 2.5 mg / kg of body weight is administered intramuscularly, up to a maximum of 150 mg. The onset of muscle relaxation with intramuscular injection may be slightly delayed.
Children apply only if absolutely necessary. The dosage for children is 1-2 mg / kg of body weight intravenously or up to 2.5 mg / kg intramuscularly.
Intravenous drip: depending on the patient's body weight and the desired degree of muscle relaxation, the dose for adults is 0.5 mg - 5 mg / min in the form of a 0.1-0.2% solution.

Adverse reactions

Tachycardia or bradycardia, arrhythmia, ventricular fibrillation, a decrease or increase in blood pressure, increased intraocular pressure, broncho or laryngeal spasm, increased salivation, myoglobinuria. muscle stiffness, postoperative muscle pain, malignant hyperthermia, increased intragastric and intracranial pressure, "double" block.
The reasons for the increase in muscle relaxation time, including with apnea, may be a deficiency of serum cholinesterase (including hereditary due to it).

Special notes

The introduction of 1–3 minutes before suxamethonia chloride 3-4 mg of d-tubocurarine or 10–15 mg of diplacin almost completely prevents muscle twitching and subsequent myalgia. With an appropriate dose and repeated administration, it can also be used for longer operations, but for prolonged muscle relaxation, non-depolarizing muscle relaxants are usually used, which are administered after preliminary tracheal intubation in the presence of suxamethonia. Apply only in the conditions of a specialized department in the presence of equipment for artificial ventilation of the lungs and personnel who own this technique, and against the background of general anesthesia. To prevent severe bradycardia, increase bronchial secretion, and other effects associated with the m-choline-stimulating effect, atropine is recommended before administration of suxamethonia. Patients with renal insufficiency (without signs of hyperkalemia and neuropathy) are administered once in medium doses, but not used for repeated injections or in high doses because of the risk of hyperkalemia. Prolonged myorelaxation with possible apnea can be caused by several reasons: "atypical" serum cholinesterase, hereditary serum cholinesterase deficiency or a temporary decrease in its concentration in severe liver diseases, severe anemia, after prolonged fasting, with cachexia, dehydration, feverish conditions,after acute poisoning or chronic exposure to insecticides - cholinesterase inhibitors (by ingestion) or anticholinesterase drugs (neostigmine, physostigmine, distigmine, phospholin), as well as the simultaneous use of drugs competing with suxametonium for cholinesterase (for example, procaine). With prolonged administration in doses of 3-5 mg / kg, a so-called “double block” may develop - a prolonged curare-like effect that can be eliminated by neostigmine.

Drug Interactions

Enhances the effects of cardiac glycosides. Reduces the effectiveness of anti-myasthenic drugs. Pharmaceutically incompatible with donor blood (hydrolysis occurs), blood preservatives, serum preservatives, blood products, barbiturate solutions (a precipitate is formed) and alkaline solutions. Compatible with 0.9% NaCl solution, Ringer's solution, 5% fructose solution and 6% dextran solution. Antholinesterase peroxide, procainam, procainamide Compatible with other muscle relaxants, narcotic analgesics. Halogen-containing drugs for general anesthesia increase, and sodium thiopental and atropine reduce the undesirable effect on cardiovascular system.Drugs with the potential ability to reduce the activity of blood cholinesterase (aprotinin, diphenhydramine, promethazine, estrogens, oxytocin, GCS in high doses, oral contraceptives) increase and prolong the muscle relaxant effect of suxametonium.

Overdosage

Symptoms: increased severity of side effects, respiratory arrest.
Treatment: transfusion of whole blood or canned plasma, artificial respiration with intermittent positive pressure. Translation to "double block" followed by neostigmine.

Storage conditions

Storage at a temperature of 2-8 ° C in a dark place. Keep out of the reach of children!