Neoton, powder 1 g 4 pcs.

Phosphocreatine plays an important role in the energy mechanism of muscle contraction. It is an energy reserve in myocardial and skeletal muscle cells and is used for re-synthesis of adenosine triphosphoric acid (ATP), the hydrolysis of which releases energy to support the actomyosin contraction process.

Lack of energy supply to cardiomyocytes, associated with slowed oxidative processes, is the key mechanism of development and progression of myocardial damage. Phosphocreatine deficiency leads to a decrease in myocardial contraction force and the ability of myocardium to functionally recover. In myocardial damage there is a close correlation between the amount of energy-rich phosphorylated compounds in cells, cell viability and their ability to restore contractility.

Preclinical and clinical studies have demonstrated the cardioprotective effect of phosphocreatine, which manifests itself in a dose-dependent positive effect during toxic effects on the myocardium of isoprenaline, thyroxine, emetine, p-nitrophenol; in the positive inotropic effect in glucose and calcium ion deficiency or in potassium ion overdose; in the reduction of the negative inotropic effect due to anoxia. In addition, the addition of phosphocreatine to cardioplegic solutions at a concentration of 10 mmol/l improves the cardioprotective effect:

– the risk of myocardial ischemia during cardiopulmonary bypass;

– the risk of reperfusion arrhythmia during infusion is reduced before the development of experimental regional ischemia by ligation of the anterior descending branch of the left coronary artery for 15 min;

– reduces ATP and phosphocreatine degradation in myocardial cells, preserves the structure of mitochondria and sarcolemma, improves the process of functional myocardial recovery after cardiac arrest caused by high potassium injection, and reduces the rate of reperfusion arrhythmia.

Phosphocreatine has a cardioprotective effect in the experiment with myocardial infarction and arrhythmia caused by coronary artery occlusion: preserves the cellular pool of adenine nucleotides by inhibiting the enzymes that cause their catabolism, suppresses phospholipid degradation, possibly improves microcirculation in the ischemic zone, which, is due to inhibition of adenosine diphosphoric acid-mediated platelet aggregation, It stabilizes hemodynamic indices, prevents drastic reduction of cardiac functional indices, has antiarrhythmic effect, decreases the frequency and duration of ventricular fibrillation and limits the area of myocardial infarction.

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Indications

Active ingredient

Composition

How to take, the dosage

Intravenous ONLY (drip or rapid infusion)

Acute myocardial infarction

1 day: 2-4 g of drug diluted in 50 ml of water for injection as a rapid infusion IV followed by 8-16 g IV infusion in 200 ml of 5% dextrose (glucose) solution for 2 h.

For the 2nd day: 2-4 g in 50 ml of water for injection by IV drip (duration of infusion at least 30 minutes) 2 times a day.

3 days: 2 g in 50 ml of water for injection by IV drop (duration of infusion for at least 30 minutes) 2 times daily.

If necessary, a course of infusions of 2 g of the drug 2 times/day can be carried out for 6 days.

Chronic heart failure

. Depending on the patient’s condition the treatment can be started with “shock” doses of 5-10 g of the drug in 200 ml of 5% dextrose (glucose) solution by IV drops at the rate of 4-5 g/hour during 3-5 days, and then we switch to IV drops (infusion time – at least 30 minutes) of 1 – 2 g of the preparation diluted in 50 ml of water for injection 2 times per day. for 2-6 weeks or immediately start Neoton maintenance doses by IV drip (1-2 g in 50 ml of water for injection 2 times/day for 2-6 weeks).

Intraoperative myocardial ischemia

A course of 2 g of Neoton in 50 ml water for injection 2 times/day by IV drip infusion for at least 30 minutes for 3-5 days prior to surgery and 1-2 days after surgery is recommended. During surgical intervention Neoton is added to conventional cardioplegic solution at a concentration of 10 mmol/l or 2.5 g/l just before injection.

Intraoperative ischemia of the lower extremities

2-4 g of Neoton in 50 ml of water for injection as a v/v rapid infusion before surgical intervention followed by 8-10 g of the drug in 200 ml of 5% dextrose (glucose) solution drip infusion at 4-5 g/h during surgical intervention and the period of reperfusion.

In sports medicine to prevent development of acute and chronic physical overexertion syndrome and to improve adaptation of athletes to extreme physical activity the drug Neoton should be used in a dose of 1 g/day in 50 ml of water for injection by IV drop (duration of infusion at least 30 minutes) for 3-4 weeks.

Interaction

When used in combination therapy, Neoton enhances the effectiveness of antiarrhythmic, antianginal agents and agents with positive inotropic action. Neoton is stable in water for injection, 5% dextrose (glucose) solution and in cardioplegic solutions.

Special Instructions

The drug should be administered as soon as possible after the onset of signs of ischemia, which provides a more favorable prognosis of the disease. Administration of Neoton in high doses (5-10 g/day) is accompanied by increased renal phosphate uptake that affects calcium metabolism, secretion of hormones regulating homeostasis, renal function and purine metabolism, therefore long-term use of Neoton in high doses is not recommended.

Contraindications

Side effects

Hypersensitivity to the drug, decreased blood pressure (if rapidly injected intravenously).

Overdose