Neurological and psychiatric emergencies, such as anxiety and anxiety attacks, fits of agitation and aggression. Prevention and / or treatmentdelirium tremens and other symptoms of alcohol abstinence syndrome. A supportive medicine in tonic spasms in tetanus.
Composition:
One vial contains 20 mg of dipotassium clorazepate as a lyophilisate.
Action:
A drug from the group of 1-4 benzodiazepines, showing activity similar to that observed with the use of other drugs in this group, ie: reducing muscle tone, alleviating anxiety, calming, sleeping pills, anticonvulsants, causing amnesia. The effect results from the specific inhibitory effect on central receptors, belonging to the "GABA-OMEGA macromolecular receptors", called BZD1 and BZD2; clorazepate modulates the opening of the chloride ion channel. After intramuscular administration of Cmax drug and its metabolite occur after 0.5 - 1 h. After intravenous administration of Cmax occurs much earlier. The drug is more than 97% bound to plasma proteins. The main metabolite of clorazepate is desmethyl disiazepam.
Contraindications:
Severe respiratory failure. Sleep apnea syndrome. Severe, acute or chronic impairment of liver function (risk of encephalopathy). Myasthenia gravis. Known hypersensitivity to benzodiazepines or to any of the excipients.
Precautions:
The efficacy of benzodiazepines may change during long-term administration due to the possibility of tolerance. With long-term use, physical and mental addiction may develop from this preparation. Benzodiazepines and similar substances should not be used as monotherapy in the treatment of depression or anxiety associated with depression, as they may increase the risk of suicide. The drug should be used very carefully in patients with alcoholism or other addictions. In patients with respiratory failure, the benzodiazepine inhibitory effects on breathing should be taken into account. It is not recommended to use the drug in children. Avoid mixing medication in the same syringe. Only use the solvent attached to the medicine pack.
Pregnancy and lactation:
Avoid using the drug in the first and third trimester of pregnancy. Do not use the drug in breast-feeding mothers.
Side effects:
Post-mortem obesity, dizziness, headache, fatigue, disturbed consciousness, ataxia, drowsiness (especially in elderly patients), reduction of skeletal muscle tone; risk of apnea in the event of a rapid intravenous injection, phlebitis or pain at the injection site (due to the potassium content of the preparation), weakness; deceleration of mental reactions, paradoxical reactions (especially in children and elderly patients): anxiety, irritability, aggressiveness, agitation, snathematical entanglement syndrome, hallucinations, delusions, anger, nightmares, psychoses, improper behavior and other behavioral disorders; rebound syndrome, physical addiction, withdrawal symptoms, libido disorder; papillary-maculopapular and pruritic skin rashes; double vision.
Dosage:
The drug can be given intramuscularly, by slow intravenous injection or by slow intravenous infusion. Severe fits of anxiety and states of psychomotor agitation or aggression: 20-200 mg / day intramuscularly or intravenously, after which the oral preparation should be continued if necessary. Symptoms of abstinence syndrome in alcohol dependence: 50-100 mg / day parenterally. If there is a need for further use in the injections, after 2 - 3 days the dose should be halved; continued use of the drug can be continued in oral form. Tetanus: in cases not requiring tracheostomy - 120-500 mg / day in intravenous infusions; in severe tetanus, with assisted breathing - 500-2000 mg / day as an intravenous infusion. The dose should be reduced in the elderly and in patients with renal and hepatic impairment. Sometimes a dose that is half the average dose is sufficient. Treatment should last as short as possible.
(C)
