Isodinite

Cardiovascular diseases are one of the most common health pathologies in the modern world with its tense, restless rhythm of life and a deficiency of substances necessary for the normal functioning of the heart and circulatory system. Therefore, so often our heart requires professional help for the full implementation of its functions. And such an assistant medical science considers the drug "Izodinit", which improves the blood supply and metabolism of various tissues and organs, including the myocardium. 

Indications Isodinite

• painful sensations and discomfort in the chest, caused by shortage of oxygen to the heart (angina, including unstable).

The drug is used mainly in the form of tablets for both treatment and prevention.

• acute forms of myocardial infarction, including a heart attack, developing against the background of left ventricular failure, as well as conditions after a heart attack,
• high pressure in the pulmonary artery, causing an increase in the right heart, resulting from pathology of the lungs and bronchi (pulmonary heart),
• pulmonary edema (accumulation in the lungs of extravascular fluid), accompanied by a shortage of air,
• chronic heart failure (treatment), causing a violation of blood supply to tissues and human organs.

Isodinite is also used to prevent and treat coronary spasms (reaching the heart) and peripheral vessels.

Release form

For convenience of application and increasing the effectiveness of the drug for various pathologies in the pharmacy network, you can find several forms of release of the "Izodinit":

• conventional tablets
• tablets prolonged action with a longer therapeutic effect (retard)
• capsules with long-term action
• spray
• aerosol dosage for injecting drugs under the tongue
• Concentrate from which the solution for droppers is prepared
• films that, according to the indications, are attached to the gum
• in the form of a transdermal therapeutic system (TTS) - a special patch with a slow release of the drug
• ointment

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Pharmacodynamics

The drug "Izodinit" refers to a group of drugs called vasodilators. Isosorbide dinitrate, which is the main active substance of the drug, helps to relax (reduce tone) smooth muscles of blood vessels and increase the clearance inside them (vasodilation).

Thus, the drug promotes the expansion of blood vessels, in particular peripheral arteries and veins, as a result of which the capacity of veins increases, and the return of blood from the veins to the heart is reduced. This leads to a decrease in diastolic pressure in the left ventricle of the heart.

In increased doses, "Izodinit" has an effect already on arterial vessels and arterioles. This reduces their resistance to blood flow and facilitates the work of the heart.

Simultaneous action on veins and arteries promotes reduction of oxygen consumption by myocardium (internal muscle mass of the heart).

In addition, the active substance of the drug is able to redistribute the blood flow to the anterior wall of the myocardium (sudendocardial layer), if due to atherosclerotic plaques coronary blood flow decreases. Since isosorbide dinitrate belongs to the class of nitrates, it can expand eccentric coronary stenosis (narrowing of the coronary arteries), which facilitates the passage of blood and biologically active substances through the vascular system of the myocardium, located beyond a narrow area. Nitrates facilitate the movement of blood through the vessels in patients with heart failure, both at rest and during exercise.

The active substance of the drug has an effect on other organs and systems of the body: it helps to relax (relax) the musculature of the bronchi and the gastrointestinal tract, reduces the tone of the muscles of the bile duct and urinary tract, dilates the vessels of the brain.

It is addictive, but after some interruption in treatment, sensitivity to it quickly returns.

Pharmacokinetics

The beginning of the drug depends on the form of the drug and the way it is used. Receiving tablets:

• if the tablet is placed under the tongue or chew, then the drug begins to act after 2-5 minutes,
• if the tablet or capsule is swallowed whole, the onset of action will vary from 15 to 40 minutes,
• for long-acting tablets, this figure is half an hour.

If the drug is sprayed into the oral cavity or injected intravenously, it begins to act almost immediately, after half a minute. The same applies to films and TTCs.

Absorption in the blood (absorption) of isosorbide dinitrate with oral (oral) medication is virtually complete, but its digestibility (bioavailability) can vary from 10 to 90% (an average of 25% with a high probability of prolonged intake of the drug).

The drug mostly undergoes transformation with a change in structure (it is metabolized) already at the first passage through the liver. Only a small part of the drug is excreted in that form with urine and feces.

The greatest concentration in the plasma is observed after about an hour. The half-life of the drug, during which its effectiveness is reduced by half, is from 1 to 12 hours.

Dosing and administration

There are several ways to take the drug "Izodinit":

• sublingual - in the form of tablets under the tongue or spray, which is sprayed into the mouth,
• oral - through the mouth (pills and cassoles),
• parenteral - in the form of droppers with slow administration of the drug,
• Transbulk - in the form of plates that are glued to the gums,
• TTS - identical to the previous one, but films or plaster are glued to different symmetrical parts of the skin.
• Outer - in the form of a spray sprayed on the skin, or ointment.

With the sublingual administration of the spray, 1 to 3 injections are produced at intervals of half a minute, while breathing should be delayed. The relief should come within 5 minutes, otherwise the procedure is repeated. Such treatment requires constant monitoring of pressure and pulse.

Prevention of coronary spasm is carried out by means of 1-2 injections on the eve of the procedure.

Single dosage of tablets under the tongue is 2.5-5 mg. Take them 2 to 3 times a day. In order to stop (stop) an attack of angina pectoris, it is desirable to chew the tablets.

Usual tablets or capsules are taken orally, without chewing, 4 to 5 times a day. Single dose -10-20 mg. Take the tablets preferably an hour before meals, but it is possible to take the drug and 2 hours after eating. If necessary, the daily dose can be increased to 120 mg per day, but this can be done no earlier than 3 days after the start of therapy with the drug.

The frequency of taking tablets depends on the time of their action and dosage. For regular tablets weighing 5-20 mg - from 3 to 4 times a day. For tablets of prolonged action (retard) weighing 20 mg - from 2 to 3 times, weighing 40-60 mg - strictly 2 times, weighing 120 mg - enough once a day.

For the treatment of chronic heart failure, the dose is 10 or 20 mg 3 to 4 times a day.

The rate of administration of the drug in the form of a dropper depends on the concentration of the active substance in the solution. For a solution of 0.1 mg / ml, the initial speed is 3-4 drops per minute, the maximum speed is 33 drops per minute. For a solution with a concentration of 0.2 mg per 1ml, the initial speed is 1-2 drops per minute, and the maximum rate is 17 drops per minute. Increase the speed should be gradual by 2 or 3 drops every 5 minutes.

Films (20-40 mg) are attached to the anterior surface of the gum in the area of the incisors from 1 to 3 times a day, alternately from one side, then the other.

To install the transdermal system, the skin area to which it will be attached is pre-treated with alcohol, then the protective film is removed and the patch is firmly attached to the skin where the hair is absent and the risk of mechanical impact on the skin is minimal. This is the area of the chest, the back or the inside of the forearm. The next system is recommended to glue on the site, symmetric to the previous one.

The dose of the drug depends on the size of the patch, which can be cut into the necessary pieces. The patch can be on the skin from 12 hours to 1 day. Treatment is carried out for 2 weeks with a gradual withdrawal of this form of the drug.

If external application of the preparation in the form of a spray is indicated, it is necessary to know that "Isodinite" is applied to the skin by spraying from a distance of about 20 cm with 1-2 pressure on the nebulizer. Next, the composition is gently spread over the skin with fingers. The duration of action is 20 minutes, after which the solution can be washed off.

Ointment can be used in the area of the chest, abdomen and the inside of the forearm. Single dose - from 1 g, use area not more than 20 cm ².

Use Isodinite during pregnancy

On the use of "Izodinit" during pregnancy, as well as breastfeeding can not, because the drug is able to affect the hemodynamics of the fetus, which is undesirable, and even dangerous. The doctor can prescribe the drug during the bearing of the child only under strict indications if there is a danger to the life of the patient.

Contraindications

Despite the entire benefit of the drug, especially in the therapy of cardiovascular pathologies, the possibilities of its use are somewhat limited.

In addition to hypersensitivity to the components of the drug, there are other contraindications to the use of "Izodinita", concerning both the intake of its individual forms and the medicine as a whole. For example, with hemorrhagic stroke, craniocerebral trauma, high intracranial pressure, hemodynamic disorders with cardiac tamponade, constructive pericarditis, a decrease in blood volume during hypovolemia, intravenous administration of the drug is not practiced and is used only in rare cases.

With the first 2 pathologies, as well as with acute myocardial infarction, therapy with other drugs is preferable.

With extreme caution, if the beneficial effect of the drug significantly exceeds the risk of developing adverse effects, the drug is taken with glaucoma (there is a certain risk of increasing eye pressure), severe anemia, thyrotoxicosis, with a stably low systolic pressure (can cause a decrease in heart rate and angina attacks), hypertrophic cardiopathy, chronic course of severe heart failure.

With increased peristalsis of the gastrointestinal tract and malabsorption syndrome (impaired absorption of nutrients), the oral administration of the drug is contraindicated.

In addition, the drug is contraindicated in liver failure, in childhood (only according to the doctor). 

Side effects Isodinite

Like any synthetic drug "Izodinit", in parallel with the main medicinal, may exhibit some side effects.

His use can be accompanied by pain in the head with dizziness. Painful sensations are especially strong in the first days of taking the drug, gradually their intensity decreases. If this does not occur, dose adjustment is necessary.

Sometimes the skin on the patient's face turns red, he has a feeling of heat. Against the background of taking medication, blood pressure may decrease and the number of heartbeats may increase. This condition is often accompanied by dizziness, down to loss of consciousness.

The drug may adversely affect the work of the digestive tract, resulting in nausea and vomiting. Sometimes there is a slight burning sensation in the area of the tongue, there is a dryness of the oral mucosa.

In patients, drowsiness, some stiffness of movements, inhibition of mental and physical reactions, visual acuity disorders increase. Occasionally, ischemia (a violation of the blood supply) of the brain is diagnosed.

With external application of the drug, skin reactions are sometimes observed in the form of burning, itching and redness of the skin at the site of application, sometimes the development of Ritter dermatitis is noted. Allergic reactions are possible when the drug is injected into the body.

Overdose

If the treatment is performed incorrectly in high doses, an overdose can be observed with a drug that is accompanied by increased heart rate, visual impairment, a drop in temperature, convulsive reactions, a discoloration of the skin, or cyanosis, hyperhidrosis, increased intracranial pressure, digestive and stool disorders, fainting and other symptoms. In some cases, if the patient is not provided with the necessary assistance, there may be paralysis and coma.

When symptoms of an overdose occur, the patient needs urgent first aid. If the medicine was taken orally in the form of tablets or capsules, a quick gastric lavage will be required. When using films, sprays and patches - wipe and rinse the place of their use, including the gum.

If methigemoglobinemia develops against the background of incorrect drug intake, a 1% solution of methylthioninium chloride should be injected into the vein at a dose of 1-2 mg per kilogram of body weight.

With a strong drop in blood pressure, the introduction of "Epinephrine" or similar drugs intravenously.

When treatment with the drug "Izodinit" a mandatory condition is the constant monitoring of the parameters of blood pressure and pulse. Cancellation of the drug is carried out with a gradual decrease in dosages and multiplicity of administration.

Long-term use of the drug or large doses may cause addiction to it, as a result of which the effectiveness of the drug is reduced. Therefore, it is recommended to take a short (from 3 to 5 days) break in treatment after 3-6 weeks from the start of therapy. Alternatively, the drug can be withdrawn for 1-2 days.

During therapy with the drug, it is undesirable to engage in activities requiring concentration of attention, since "Izodinit" negatively affects the speed of psychomotor reactions, exerting a retarding effect on them.

Interactions with other drugs

For various pathological processes in the body, the drug should be taken in accordance with the data on the drug interaction with other drugs.

The main contribution to the therapy of heart diseases of the active substance of the drug "Izodinit" is to improve hemodynamics due to the expansion of blood vessels. But the parallel administration of this drug with beta-adrenostimulyatorami and alpha-adrenoblokatorami can significantly reduce the effectiveness of the drug, i.e. Cause tachycardia or a dangerous lowering of blood pressure.

Preparations Amiodarone, Propranolol, and also blockers of calcium channels and preparations of amino-salicylic acid, on the contrary, are able to strengthen the antianginal function of isodinite.

Parallel reception of "Izodinit" with drugs for lowering blood pressure, other vasodilators, antipsychotic drugs, some antidepressants, beta-blockers and calcium channel blockers can cause a strong decrease in blood pressure. The same applies to the following medicines: "Quinidine", "Prokainamide", "Dihydroergotamine", "Sildenafil" and ethanol.

The joint assignment of "Isodinite" and m-holinoblokatorov type "Atropin" can lead to an increase in intraocular pressure.

When taking oral medication, you need to take into account that adsorbents, as well as agents that have an astringent and enveloping effect, can negatively affect the absorption of the drug in the form of tablets in the digestive tract.

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Storage conditions

To store various dosage forms of the drug should be in accordance with the requirements specified in the instructions to them. In any case, the storage temperature should not exceed 25 degrees, otherwise this will negatively affect the effectiveness of the drug. And protection from sun rays and children's curiosity will help not only to preserve the drug in its original form, but also to avoid tragedy; nevertheless, "Izodinit", like any other medicinal, and even more so, cardiological remedy is not a toy for children.

Shelf life

When storing and using Isodinite, it is necessary to take into account the storage conditions of the preparation so that during the entire rather long shelf life (5 years from the date of release) it retains its properties and safety for health.