Journalist

Jurnista is a strong analgesic drug, a natural opium alkaloid. Its active ingredient is hydromorphone, a derivative of the well-known strong painkiller morphine hydrochloride. Jurnista is considered a narcotic drug, is dispensed strictly by prescription and taken under strict supervision.

Indications Journalist

The drug is used for severe pain syndrome of various etiologies:

• severe pain caused by traumatic or other pathological lesions (except for head injuries and stroke);
• myocardial infarction condition;
• extensive burn lesions;
• state of pain shock;
• pain in acute inflammatory processes of internal organs;
• intestinal, hepatic and renal colic;
• inoperable cases of oncological diseases;
• before and after surgical interventions;
• cardiac asthma.

Release form

The drug is available in tablets, 7 pieces in synthetic blister plates. Cardboard boxes with annotation may contain one or 4 blisters.

The active ingredient is hydromorphone.

• Tablets of 8 mg contain 7.12 mg of the active ingredient.
• Tablets of 16 mg contain 14.24 mg of the active ingredient.
• Tablets of 32 mg contain 28.48 mg of the active ingredient.
• Tablets of 64 mg contain 59.96 mg of active substance.

Additional substances in the preparation include lactose, polyethylene oxide, macrogol, butylhydroxytoluene, cellulose acetate, povidone, sodium chloride, titanium dioxide, magnesium stearate, iron oxide, etc.

The tablets have a prolonged effect, are round in shape, have a convexity on both sides, and a logo indicating the dosage of the drug.

The tablets may also have different colors depending on the dosage:

• 8 mg – red;
• 16 mg – yellow;
• 32 mg – white;
• 64 mg - blue.

Pharmacodynamics

The active ingredient of the drug is a synthetic derivative of morphine, an opium alkaloid. The strong analgesic effect is explained by the depressing effect on opioid receptors, which are located in the subcortical structure of the brain, as well as blocking the passage of pain impulses to the cerebral cortex. The drug directly affects the central nervous system and smooth muscles, including those in the digestive system.

Jurnista can cause depression of respiratory functions, secretory and motor capacity of the gastrointestinal tract, as well as increased tone of the bladder valve system and smooth muscles of the bronchial system, gall bladder and internal female genital organs. The drug can slow down metabolic processes and lower body temperature.

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Pharmacokinetics

A single dose of the prolonged-release drug Zhurnista involves a slow increase in the concentration of the active ingredient over seven hours, after which its content in the blood remains unchanged for about 20-24 hours. The maximum amount of the substance is detected 12-14 hours after administration. Such indicators indicate that Zhurnista is sufficient to be used only once a day.

The drug becomes bioavailable by 23-25%, and a large amount of fat in food does not affect the absorption of the active substance.

Multiple administration of the drug (more than 4 times) allows achieving stability of the content of the active component in the blood serum, while the pharmacokinetic parameters of Jurnista do not change.

Taking Jurnista with prolonged action once every 24 hours determines the same concentration in blood serum as taking hydromorphone of usual use in the amount of 4 times a day. Plasma protein binding is <30%.

Metabolites are excreted from the body mainly through the urinary system, the rest through the bile ducts.

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Dosing and administration

To determine an effective and at the same time safe dosage of the drug, it is necessary to assess the patient's condition, taking into account the nature of the pain and concomitant pathologies. Opium preparations can have different effects on patients, in this regard, specialists recommend starting therapy using the minimum therapeutic dosage. The initial dosage is increased gradually until the optimal level of pain relief is achieved with a minimum number of side effects.

The Zhurnista tablet should be swallowed without chewing or crushing, washed down with at least 200 ml of liquid. It is advisable to take it every time at the same time of day, exactly 24 hours later. If the patient forgot to take the dosage on time, it must be taken as soon as possible. The next dose is now counted from the new last time of taking the tablet.

The initial dosage should not exceed 8 mg per day. Further increase in dosage, if necessary, is carried out once every two to three days, increasing the dose by 25-100% of the previous one.

Sometimes, along with the use of Jurnista, patients with constant severe pain symptoms may be prescribed other opium preparations of normal (not prolonged) action. The proportion of such preparations compared to Jurnista should not exceed 10-25% of its daily dosage.

The course of treatment is stopped gradually, reducing the dosage by 50% every two days until returning to the minimum dosage, after which the therapy can be completed. Abrupt cessation of treatment may provoke the development of withdrawal syndrome. If pain resumes during the period of dosage reduction, the dosage is briefly increased again by 25%, using longer intervals.

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Use Journalist during pregnancy

There have been no full-scale clinical trials regarding the use of Jurnista during pregnancy. It is known for certain that the active ingredient of the drug is found in breast milk in small quantities, but is still found, therefore it is prohibited to use Jurnista during lactation.

The danger of teratogenic effects when using the drug has not been studied at present, but experts do not recommend using Jurnista during pregnancy. This is due to the fact that hydromorphone can affect the smooth muscle fibers of the uterus and inhibit the respiratory function of the newborn baby.

There are known cases where children whose mothers underwent treatment with opiate drugs subsequently developed withdrawal symptoms (somatoneurological or mental disorders).

Contraindications

Taking the painkiller Zhurnista has a number of contraindications:

• allergic reactions to the components of the drug;
• narrowing of any parts of the digestive tract (condition after some operations or pathologies), obstruction of the gastrointestinal tract, blind loop syndrome in the intestine;
• liver dysfunction;
• respiratory disorders;
• acute pain with an unclear diagnosis;
• active stage of bronchial asthma;
• treatment with MAO inhibitors, as well as the first two weeks after discontinuing these medications;
• treatment with other opiates;
• childhood (up to 2 years);
• head injury, stroke;
• feverish and convulsive conditions;
• pregnancy and breastfeeding.

Journalist has a pronounced effect on the ability to drive a vehicle or other complex mechanisms. This effect is especially evident on the first day of therapy, when increasing the dosage or when the drug is discontinued.

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Side effects Journalist

The drug Zhurnista has quite a large number of side effects:

• dyspeptic symptoms (delayed bowel movements, bouts of nausea);
• increased appetite, bowel disorders, thirst, epigastric pain, bloating and rumbling in the abdomen, development of gastroenteritis;
• insufficient secretion of androgens;
• sleep disorders, depression, irritability, impaired consciousness, psychoemotional disorders;
• headaches, dizziness, impaired sensitivity, changes in taste, emotional instability;
• deterioration of visual functions, double vision;
• heart rhythm disturbances, destabilization of blood pressure, reddening of the skin;
• the appearance of shortness of breath, a feeling of lack of air;
• increased sweating, itching of the skin;
• pain in muscles, joints, limbs;
• urinary disorders;
• decreased libido, erectile dysfunction;
• lethargy, swelling, fever, withdrawal syndrome;
• disturbance of electrolyte and water balance, increase in the amount of liver enzymes, decrease in the amount of testosterone in the bloodstream.

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Overdose

Signs of a Journalist overdose:

• depression of the respiratory center;
• drowsiness, up to the development of a stuporous and comatose state;
• apathy, decreased blood pressure and temperature;
• constriction of the pupils;
• cardiac disorders;
• severe overdose – respiratory arrest, cardiac arrest, circulatory hypoxia and collapse, even death.

Emergency measures in case of overdose should be aimed at restoring respiratory function, possibly using artificial ventilation of the lungs. If a large amount of the drug has just been consumed, it is necessary to immediately wash out the stomach.

Shock and incipient pulmonary edema require additional oxygen supply and the administration of vasoconstrictors.

Cardiac arrest usually requires cardiac massage or defibrillation.

Specific antidotes (naloxone and nalmefene) may be used to restore respiratory function. Antidotes have a short-term effect, so careful monitoring of the patient is necessary until stable spontaneous breathing is restored. Antidotes should not be used without reliable signs of opioid effects on the body, and they should be used with extreme caution in the case of physical dependence of the patient on opium preparations: abrupt cessation of hydromorphone action may provoke withdrawal syndrome.

Interactions with other drugs

The combined use of Jurnista and MAO inhibitors may provoke an excited or depressed state of the central nervous system, destabilization of blood pressure.

The use of Jurnista with morphine agonist and antagonist drugs (pentazocine, buprenorphine, nalbuphine) can lead to a decrease in the analgesic effect and the risk of withdrawal syndrome. The combination of such drugs is strictly prohibited.

The use of Jurniste with barbiturates, sedatives and neuroleptics, alcoholic beverages can provoke an addictive depressant effect, in particular, on the respiratory centers. Hypotension and comatose state can develop.

Jurnista can enhance the effect of muscle relaxants and cause respiratory depression.

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Storage conditions

The drug should be stored in a dark, dry place, out of reach of children. The optimal temperature for storing the drug is from 15 to 30°C.

Shelf life

Maximum shelf life is up to 2 years.

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