Kalimin

A drug that helps to eliminate health problems of a person of a neurological nature is Kalimin. This drug was developed and manufactured by the joint German-German pharmaceutical corporation Merkle GmbH for Teva Pharmaceutical Industries Ltd.

What many diseases can affect the human body? But modern medicine has learned to fight most of them. In this it comes to the rescue products of pharmaceutical companies. One of such medicines of anticholinesterase pharmacological group, related to pyridostigmines is Kalimin. It is active and with a high therapeutic result used by qualified specialists for the relief of a number of neurological diseases. 

Indications Kalimin

Kalimin is a drug that acts as a substance that inhibits the action of cholinesterase. Hence the indications for the use of the drug in question.

1. Detunement of muscles.
2. Full or partial paralysis.
3. Myasthenia gravis - pathological fatigue of the muscles and general weakness of the whole organism.
4. Postoperative deterioration of intestinal motility.
5. Problems with urination during the postoperative period (with gynecological surgery) or after obstetric care.
6. Atonic constipation.
7. Myasthenic syndrome.
8. Post-traumatic failure in the coordination of motor function.
9. Encephalitis is an inflammatory process that takes place in the cells of the brain.
10. The period of rehabilitation recovery after poliomyelitis.

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Release form

Merkle GmbH for Teva Pharmaceutical Industries Ltd manufactures the drug in question in the form of oblong white tablets - this is, to date, one form of the Kalimin product.

The tablet has a convex view from both sides. One side is redistributed with a deepening risk. In any pharmacy this medicine can be found packaged in 100 units in a bottle with a darkened glass. It is sealed with a plastic cover and a foil covering, which controls the first opening.

The main active substance of the drug Kalimin is pyridostigmine bromide. Its concentration in one tablet is 0.06 g.

Additional chemical compounds present in the preparation are: microcrystalline cellulose (0.336 g), glutamic acid hydrochloride (0.002 g), corn starch (0.12 g), polyvidone K25 (0.06 g), colloidal silicon dioxide (0.063 g), magnesium stearate (0.003 g) and pure, sanitized water (0.016 g).

The most common name for the drug in question is Kalimin 60, Kalimin 60 N.

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Pharmacodynamics

The main active substance of the drug under consideration is pyridostigmine bromide. It is his pharmacological properties that determine the pharmacodynamics of this drug.

Cholinesterases necessary and very important enzymes of the human body are mostly found in skeletal muscle structures, in the cells of the nervous system. But the largest number is located in the red blood cells - red blood cells.

These cholinesterases are called acetylcholinesterase (AChE), and those that are located in the blood serum are termed pseudocholinesterase.

These substances have a direct effect on the hydrolysis of acetylcholine, which in turn ensures a normal transmission of nerve impulses. If the system, for some reason, violates its excitability, drugs that can in some way influence the elements of the central nervous system come to the aid of a person. In this case, these are preparations of the anticholinesterase pharmacological group (pyridostigmine), one of which is the drug Kalimin.

Pyridostigmine bromide is the active element of the drug in question, it acts on the organs of the central nervous system as an anticholinesterase and cholinomimetic substance. When it gets into the patient's body (at the recommended recommended doses), the drug improves the neuromuscular transmission of the signal, improves the tone of the skeletal muscles and improves the motor system of the digestive tract, including the intestines, positively affects the work of the bronchus and urinary organs in terms of improving the prolonged stress , not accompanied by fatigue, excitation of nerve centers. 

But there are also alarming factors that should be considered when appointing Kalimin in the protocol of treatment. Pyridostigmine bromide becomes a catalyst in activating the secretion of the glands of the human exocrine system, it can provoke an attack of bradycardia (kind of arrhythmia, with a heart rate of less than 60 beats per minute).

Similarly, the drug is able to cause miosis (narrowing of pupils), as well as functional vision disorder, prolonged spasm of ciliary muscle, called in medicine by the term spasm of accommodation.

The drug Kalimin, when used in the treatment of the disease, does not have a central patient on the patient's body.

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Pharmacokinetics

If you need to connect to the treatment of a particular drug, in addition to the pharmacological dynamics of the drug in question, the doctor who leads the disease is also interested in its pharmacokinetics. An important factor of any therapy is the ability of the drug, in this case Kalimin, to penetrate into the patient's body at high speed, and without special delay to be excreted from it by the excretory system. An effective conclusion concerns both the volumes of unchanged substance and its metabolites.

The considered drug enters the body orally, the time interval of adsorption and distribution takes on average from one and a half to three hours. At the end of the stated time period in the patient's blood, the greatest amount of active ingredient of the pyridostigmine bromide preparation is detected.

Bioavailability of the components of the drug under consideration, depending on the individual characteristics of the body, is from 8 to 20%. If the process of myasthenia develops in the patient's body, this indicator usually decreases and is able to reach the index of 4%.

The level of binding to blood proteins is very low.

Due to the insignificant level of lipid solubility, Kalimin shows a reduced level of penetration into the elements of the central nervous system.

Pyridostigmine bromide, mainly, metabolizes in hepatic cells, transforming into metabolites of non-active action. The averaged plasma clearance in a person who does not suffer from pathological changes in the body's work corresponds to a figure falling in the range from 0.36 to 0.65 l / h per kilogram of the patient's weight.

The drug is partially excreted from the body in an unchanged form, and partly in the form of metabolites. Kalimin half-life is defined by 2 hours and 30 minutes.

As shown by clinical studies, the chemical compounds of the drug in question do not penetrate the blood-brain barrier.

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Dosing and administration

Any person is obliged to know that a medicament, including Kalimin, is used in the treatment of a disease only with the permission of a qualified experienced specialist. Only the recommended method of administration and dose of the drug in question is proposed by the developers, and a more specific method and sequence of administration, the method of treatment and dosage adjustment remains for the doctors treating the therapy.

The company - manufacturer recommends taking Kalimin to the patient during the period of his greatest physical activity. This method will bring the maximum effect.

The tablet is swallowed by drinking enough water.

The starting dosage recommended by the specialists of the company - the manufacturer, - one - two tablets one - two doses throughout the day.

If the therapeutic effectiveness can not be achieved with this amount of the drug, the dose of Kalinin can be increased to the amount - one to three tablets administered twice - four times during the day.

The maximum daily allowable amount of medication administered should not exceed twelve pieces, which translates to 0.72 g.

But the amount of administered pyridostigmine bromide is prescribed to the patient strictly individually, depending on the severity of the disease and the patient's response to the drug and the treatment in general.

Use Kalimin during pregnancy

After the future mother found out that she was already carrying a baby under her heart, she began to see to it that as little as possible substances that could affect the natural course of the development of the fetus were found in her body. But the woman's health should not be forgotten, because this factor can cause problems in the development of the baby and with obstetric care.

To date, the use during the pregnancy of the drug Kalimin is allowed by medics only if the therapeutic need for treatment outweighs the possibility of negative effects of the drug substances on the normal development of the fetus.

As clinical studies have shown, the drug is not able to penetrate the blood-brain barrier, but it can provoke premature birth, especially if it concerns the last weeks of pregnancy. This fact is explained by the fetotoxic abilities of Kalimin.

Based on these pharmacological features of the drug, doctors do not recommend taking therapy with the drug in question and during lactation, when a woman feeds a newborn baby with breast milk. Pyridostigmine bromide penetrates into the mother's milk. Therefore, the feeding should be interrupted by transferring the baby to food with special adapted mixtures.

Contraindications

Any manufactured product of pharmaceutical companies is therefore also a medicine that can exert a certain influence on the patient's body. And not always such an influence, with the directed relief of one problem, does not affect other areas and systems of the human body, affecting their functionality.

Contraindications to the use of the drug Kalimin are reflected in the list below:

1. Increased individual intolerance of the patient's body to one or more component components of Kalimin.
2. Chronic form of obstructive bronchitis.

3. Obstruction of the intestine, which is based on a mechanical cause.

4. Bronchial asthma.

5. Thyrotoxicosis.

6. Violation of the patency of the bile and urinary tract.

7. Myotonia - a special condition of the muscle fibers, when the muscle, which has come into a contraction state, does not relax for a long time.

8. Irit - inflammation of the iris of the eye.

9. If the preparation of depolarizing muscle relaxants was administered the day before.

10. Shock state of the body.

11. Spasmodic attack of the musculature of the organs of the digestive tract.

12. Pregnancy.

13. Time of feeding a newborn baby.

14. Contraindication to the use of Kalimina is the age limit. It is not recommended to enter the drug in question into the treatment protocol for patients who are under 18 years of age.

15. Prohibition on the use of alcoholic beverages.

Admission is permissible, but with special care and under the supervision of a specialist, in the presence of such diseases:

1. Myocardial infarction.

2. Persistent low blood pressure (hypotension).

3. Decompensated state of cardiac activity.

4. Liver and kidney dysfunction.

5. Violation of the rhythm of the heart activity in the direction of reducing the number of beats per minute (bradycardia).

6. Gallstone or urolithiasis, not burdened by complete obstruction of the ducts.

7. Ulcer of the stomach and duodenum.

8. Parkinson's disease.

9. Diabetes mellitus.

10. Postoperative period after intervention in the area of the intestine or stomach.

11. Hyperthyroidism is an excess of the formation of thyroid hormones in the body.

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Side effects Kalimin

In connection with the individual features of the body and the special pharmacolinamics and pharmacokinetics of Kalinin, the side effects of the drug in question may appear against the background of treatment.

1. Allergic reaction of the body to the injection of the drug: the appearance of rashes on the skin, redness and itching.
2. Strengthening the glands of the secreted system: increased flow, tear and salivation, activation of the bronchial glands.
3. The appearance of nausea in the epigastric region, which at high intensity can provoke and vomit.
4. Diarrhea.
5. Cramping pain symptoms, manifested in the epigastric region and the lower abdomen.
6. Weakness of skeletal muscles.
7. Increase in the number of daily urge to urinate.
8. Falling blood pressure.
9. Visual impairment.
10. The appearance of a tremor.

11. Violation of the rhythm of the heart activity in the direction of reducing the number of beats per minute (bradycardia).

During the period of treatment, care must be taken when driving a car or other moving machinery, work with which requires increased attention.
 

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Overdose

As shown by clinical monitoring of Kalinin administration, an overdose of its leading active chemical component, which is pyridostigmine bromide, is quite possible both because of the excess of the administered amount of the substance, and because of the individual susceptibility of the patient's body. In this case, the patient's body reacts to this by a response pathological symptomatology:

1. Sharp decline of forces.

2. The appearance of problems with eyesight. Miosis.

3. Spasmodic bronchi.

4. Pulmonary edema.

1. Strengthening the glands of the secreted system: increased sweating, tear and salivation.

6. Dizziness.

7. Redness of the skin.

1. The appearance of nausea in the epigastric region, which at high intensity can provoke and vomit.
2. Intestinal colic.

10. Involuntary urine - and caloric exhaustion.

11. Increased muscle weakness.

12. Severe hypotension.

13. Collapse - a sharp drop in blood pressure, which can lead to a patient's heart failure.

14. Paradoxical form of heart rhythm disturbance.

15. Bradycardia.

Measures to eliminate the symptoms of Kalimin overdose may include:

• Gastric lavage - removal of drug residues that did not have time to adsorb into the mucosa.
• Introduction to the vein of atropine (a natural alkaloid belonging to the blockers of m-holinoretseptorov).
• Oral intake of adsorbent substances. It can be activated charcoal or any other enterosorbent.
• If there is a cardiac arrest or severe lung dysfunction is observed, physicians are urgently given resuscitation assistance.

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Interactions with other drugs

The drug in question can be used as the only drug in stopping the problem, but the situation is much more common when the treating doctor needs to enter more than one drug into the protocol of therapy, and two or more. In this situation, the expert must thoroughly know how the drug behaves in complex treatment. Will it bring the expected effect or, conversely, harm the patient's health?

Therefore, the result of complex treatment directly depends on the interaction with other drugs of the drug Kalimin.

Pyridostigmine bromide loses its high pharmacological characteristics in tandem admission with ganglion blockers, as well as with chemical compounds belonging to the pharmacological group of m-cholinolytics.

A similar situation awaits the joint administration of Kalimine with tricyclic antidepressants or drugs taken with therapy associated with Parkinson's disease.

The result is similar (decrease in the intensity of the pharmacological manifestation of pyridostigmine bromide) and concurrent administration of quinidine, local anesthetics, as well as in the tandem effect of procainamide or drugs used in arresting epileptic seizures.

Coupled with derivatives of morphine and drugs of a number of barbiturates, Kalimin reinforces the action of the former.

A similar clinical picture is observed with the simultaneous administration of pyridostigmine bromide with depolarizing muscle relaxants.

Categorically, the work of the drug in question against the background of taking ethanol is not allowed.

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Storage conditions

Patients expect a quick and lasting effect from treatment. It can be achieved only by fulfilling all the requirements and recommendations of the treating doctor, the leading therapist. But not the last place in the effectiveness of the result of therapy takes, and the correct maintenance of the drug over the entire period of time recognized by the manufacturer company as a shelf life.

When doing absolutely all the recommendations, you can be sure that the drug will effectively "serve" the entire period of time allowed for use.

The storage conditions of the drug Kalimin are simple, but are mandatory:

1. The place where the preparation is supposed to be stored must be protected from direct rays of the solar spectrum.
2. The temperature in the room should be maintained, not allowing it to rise more than 25 degrees above zero.
3. The percentage of humidity is low enough.
4. Contain medication is necessary in places that are not available for adolescents and young children.

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Shelf life

Entering the pharmacy market, any product produced by the corporation - manufacturer, is necessarily equipped on the packaging material with date indicators, when this medication was produced. The second number marks the end date, after which the drug in question should not be used to treat a particular disease.

With the release of Kalimin, the expiration date was established as three years from the date of manufacture of the drug. But there is a clarification. After the first tamper evident control membrane has been ripped off, the effective use time of the drug is reduced to six months. 

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