Panangin, concentrate 45.2 mg/ml+40 mg/ml 10 ml 5 pcs

Pharmacotherapeutic group: potassium and magnesium drug.

ATC code: A12CX

Pharmacological properties

Panangin is a source of important electrolytes: potassium and magnesium ions. One of the most important functions of potassium ions is to maintain the membrane potential of neurons, myocytes and excitable structures of myocardial tissue. An imbalance between intracellular and extracellular potassium results in decreased cardiac contractility, arrhythmias, tachycardia and increased toxicity of cardiac glycosides.

Magnesium is an important cofactor of over 300 enzymatic reactions, including energy metabolism and the synthesis of proteins and nucleic acids. In addition, magnesium plays an important role in heart function: it improves contractility and heart rate, resulting in lower myocardial oxygen requirements.

Decreasing the contractility of arteriolar smooth myocytes leads to vasodilation, including of coronary vessels, and increases coronary blood flow. Magnesium has an anti-ischemic effect on myocardial tissue.

The combination of potassium and magnesium ions in one product is based on the fact that potassium deficiency in the body is often accompanied by magnesium deficiency and requires simultaneous correction of the levels of both ions. Further, if the levels of these electrolytes are corrected simultaneously an additive effect is observed (low levels of potassium and/or magnesium have a proarrhythmogenic effect). In addition, potassium and magnesium reduce the toxicity of cardiac glycosides without affecting the positive inotropic effect of the latter.

Pharmacokinetics

No data.

Indications

To eliminate potassium and magnesium deficiency as an adjunctive agent in various manifestations of coronary heart disease, including acute myocardial infarction; chronic heart failure; heart rhythm disorders (including arrhythmias caused by overdose of cardiac glycosides).

Active ingredient

Potassium asparaginate, Magnesium asparaginate

Composition

Active ingredients:

Potassium asparaginate (in the form of potassium asparaginate hemihydrate) 452 mg (corresponding to 103.3 mg of potassium ions),

Magnesium asparaginate (in the form of magnesium asparaginate tetrahydrate) 400 mg (corresponds to 33.7 mg of magnesium ions);

Excipients: water for injection – up to 10 ml.

How to take, the dosage

Only for intravenous administration.

The contents of 1-2 ampoules should be diluted in 50-100 ml of 5% dextrose (glucose) solution and administered intravenously as a slow drip infusion (20 drops per minute). If necessary, the dose may be repeated after 4-6 hours.

The drug is suitable for combination therapy.

Interaction

It eliminates hypokalemia caused by glucocorticoids.

Due to the magnesium content it reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin. Cyclosporine, potassium-saving diuretics, heparin, ACE inhibitors may increase the risk of hyperkalemia.

Anesthetics increase the suppressive effect of magnesium on the central nervous system.

May increase neuromuscular blockade caused by depolarizing myorelaxants (atracurium besylate, decamethonium bromide, suxamethonium (chloride, bromide, iodide).

Calcitriol increases the concentration of magnesium in plasma, calcium preparations – reduce the effect of magnesium.

Beta-adrenoblockers, nonsteroidal anti-inflammatory drugs increase the risk of hyperkalemia up to the development of arrhythmia and asystole.

Pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerability, reduces unwanted effects of cardiac glycosides).

Special Instructions

Rapid administration may cause skin flushing.

Particular caution should be exercised in case of diseases accompanied by hyperkalemia. In these cases it is recommended to monitor the content of potassium ions in blood.

Contraindications

Hypersensitivity to the drug, acute and chronic renal failure; Addison’s disease; atrioventricular block of degree II, III; cardiogenic shock (blood pressure Caution

Atrioventricular block of degree I, marked liver function disorders; metabolic acidosis; danger of oedema; renal disorders if regular monitoring of serum magnesium is not possible (danger of cumulation, toxic levels of magnesium); cardiogenic shock (systolic blood pressure less than 90 mm Hg); hypothyroidism (high blood pressure of >90 mm Hg). Hg); hypophosphatemia; urolithiasis associated with impaired calcium, magnesium and ammonium phosphate metabolism.

Side effects

Rapid intravenous administration may cause symptoms of hyperkalemia (fatigue, myasthenia gravis, paresthesias, confusion, heart rhythm disorders (bradycardia, atrioventricular block, arrhythmias, cardiac arrest) and hypermagnesemia (decrease in neuromuscular excitability, urge to vomit, vomiting, lethargy, lower blood pressure). Phlebitis, atrioventricular block and paradoxical reaction (increased number of extrasystoles) may also develop.

Overdose

To date, no cases of overdose have been described. In overdose the risk of symptoms of hyperkalemia and hypermagnesemia increases.

Symptoms of hyperkalemia: fatigue, myasthenia, paresthesias, confusion, heart rhythm disorders (bradycardia, atrioventricular block, arrhythmias, cardiac arrest).

Symptoms of hypermagnesemia: reduction of neuromuscular excitability, urge to vomit, vomiting, lethargy, decreased blood pressure (BP). In case of sharp increase of magnesium ions in blood – suppression of deep tendon reflexes, respiratory paralysis, coma.

Treatment: If symptoms of overdose occur, treatment with Panangin should be stopped and symptomatic therapy (intravenous calcium chloride administration at a dose of 100 mg/min, if necessary hemodialysis should be administered).

Pregnancy use

There are no data on the harmful effects of the drug during pregnancy.

Similarities

Asparkam, Potassium and Magnesium Asparaginate, Asparkam-L