Magneghite

The drug with the trade name Magnesium (acid gadopentetovaya) refer to radiopaque means belonging to the group of pharmacotherapeutic substances with the general encoding ATC V08CA01 (application in nuclear magnetic resonance examination). In one milliliters of solution contains active substances: gadopentetate dimeglumin about 500 mg, gadolinium about 80 mg. Auxiliary components: meglumine, pentetic acid and water. The injection solution is used for diagnostic purposes, namely:

• in the process of conducting magnetic resonance imaging of the spinal cord and brain;
• for the detection of stenoses (arterial angiography);
• with the tomography of the parts of the body - the cervical zone, heart, liver, kidneys and urogenital organs, mammary glands, pancreas, and also the musculoskeletal system.

Ampoules with a colorless, clear solution (yellowish, yellow-brown and yellowish-green shades are permissible). Magnegite from the pharmacy network is only released by prescription.

[1], [2]

Indications Magneghite

Paramagnetic contrast preparations are indispensable for magnetic resonance imaging. Indications for Magnesium:

1. Inspection of the spinal cord and brain:

• with the aim of differentiating tumor processes, including small ones, that are difficult to diagnose;
• relapses of tumor formations in the postoperative state, or as a result of radiotherapy, detection of metastasis sites;
• diagnosis of various tumor sites (with adenoma of the pituitary gland of small size, ependymoma, hemangioblastoma);
• if it is necessary to confirm or refute the diagnosis of meningioma, a tumor process with infiltration into nearby cells (like, glioma), neurinoma of the auditory nerve;
• recognition of intra- and extramedullary formations;
• Improving the image quality of intracranial lesions of non-cerebral origin. Magnesium is used as an additional substance in the spinal MRI;
• when it is necessary to evaluate the extent of intramedullary tumor growth;
• obtaining data on the volume of large spinal cord formations.

2. Magnetic resonance imaging with increasing quality and contrast of the image (diagnosis of the facial part of the skull, neck, sternum, peritoneum, pelvic organs, mammary glands and musculoskeletal system), which makes it possible to judge the state of the vascular bed (excluding coronary arteries) :

• differentiation of foci of inflammation and tumor origin, vascular pathology;
• Assessment of kidneys and their functioning;
• with the purpose of revealing the spread of a pathogenic focus;
• the likelihood of a relapse of the intervertebral disc displacement after surgery;
• if necessary, diagnosis of internal structural changes in pathology;
• to help a diagnostician who assesses the postoperative condition of the tumor and scar tissue;
• to determine the blood supply of tissues during normal functioning and in the stage of the disease.

[3], [4]

Release form

The preparation of Magnesite solution 10, 15, 20, 30 or 100ml, packed in glass bottles, is clogged with a rubber stopper and from above is covered with a cap made of aluminum, equipped with a plastic cover of "flip-off". Cardboard packaging includes one or ten bottles, sold together with instructions for use in the state language.

There is a form of release for a volume of up to 20ml in glass syringes, placed in containers.

[5], [6], [7], [8],

Pharmacodynamics

To improve the accuracy of differentiation of pathological conditions using the method of magnetic resonance scanning, drugs with a contrasting effect, to which the Magnesium solution is referred, help. What became possible due to the presence in the pharmacological substance of the gadolinium complex with pentetic acid, which has seven unpaired electrons. The stable paramagnetic action is manifested by the di-N-methylglucamine salt of the gadopentetate. By means of the gadolinium ion, which increases the intensity of the signal during the tomography, a clear image of the tissues is achieved.

Pharmacodynamics of Magnesite is based on the properties of DTPA-diethylenetriaminepentaacetic acid, which ensures a decrease in the time of spin-lattice relaxation of excited atomic nuclei. The effectiveness of the paramagnetic action or the ability to relax is based on the effect of even a small concentration of matter on the spin-lattice relaxation of plasma protons. The paramagnetic gadolinium ion creates a strong relationship with the DTPA, which is characterized by high stability.

Gadopentetat has high hydrophilic properties, which minimizes the possibility of anaphylactic reaction. The drug does not interact with the plasma protein, does not affect the enzymatic activity, which causes its good tolerability and insignificance of general and local side effects.

[9], [10], [11], [12]

Pharmacokinetics

The magnesium solution is characterized by a rapid spread over the extracellular space. The ability to detect tumor processes, subacute infarcts, abscesses is determined by the property of contrast medium to concentrate in the zone with the altered tissue - scars, cysts, pathologies of the vascular network. At the same time the concentration of the drug in healthy areas does not occur. Pharmacological substance does not violate the boundaries of intact blood-brain (associated with the brain, regulates metabolic processes between the central nervous system and the bloodstream) and histohematological (blood and fluid tissues) barriers. Acid gadopentetova partially passes through the placental barrier, however, immediately withdrawn. The pharmacokinetics of Magnesite indicates that the solution has an insignificant relationship with the plasma protein and does not metabolize it.

Dipregumate dimeglumine is displayed in its original form through a glomerular filter located in the kidneys, a small volume (up to 1%) of the solution comes out with mildew masses and breast milk. The elimination half-life is 90 minutes.

[13], [14], [15], [16], [17], [18],

Dosing and administration

The use of Magnesium is allowed only under stationary conditions under the supervision of personnel of relevant qualifications who have undergone special training and are aware of all possible negative consequences after the injection.

The method of administration and dose depends on the type of study and age of the patient:

• newborns and infants until the year the advisability of using a contrast solution is determined by the doctor;
• children under 2 years of age can be administered up to 0.2ml / kg;
• at the age of 2 years, the dosage can be increased to a maximum value of 0.4ml / kg;
• for adults, the amount of solution varies from 0.2 to 0.4 ml / kg and can be administered sequentially in two portions, if the development of the pathological focus is questionable;
• sometimes to increase the accuracy of the study, the figure increases to 0.6ml / kg (with metastases and relapses of tumor processes, as well as for the study of blood vessels);
• Persons with kidney problems are allowed a maximum of 0.2ml / kg of acid gadopennetova if the benefit of tomography exceeds the risk for the patient (after the scan requires hemodialysis).

It is important to understand that the data on the use of Magnegetic in whole body tomography in children under two years of age are very limited.

[22], [23], [24]

Use Magneghite during pregnancy

It should be noted that there is no sufficient information on the application and operation of Magneghit during the gestation period. Experimental data obtained by testing the drug on animals indicate a negative effect on the reproductive organs.

Use of Magnetite during pregnancy is possible if the need for tomographic examination exceeds possible risks. Having weighed the potential threat to the developing baby in the womb, the doctor gives an opinion on the possibility of scanning and the necessary control measures.

There is a partial elimination of dimegluminum gadopentetate through milk during lactation. The percentage of the drug does not exceed four hundredths of the initial dosage, which usually does not pose a danger to the baby. In any case, the administration of the solution should be carried out under the supervision of the attending physician, since there are side effects from the central nervous system, the cardiovascular system in the mother and baby. For this reason, it is not recommended to continue feeding for 12 hours after an MRI.

Contraindications

MTP with contrast agent requires compliance with the following rules:

• the studied patients should not have neuro- and pacemakers, insulin pumps, as well as ferromagnetic implants;
• The use of Magnesium is possible only intravenously and once, necessarily in stationary conditions;
• the last meal is allowed at least two hours before the scan;
• injection of the solution should be done in the recumbent position, then for half an hour, constant monitoring of the patient is required (during this period all possible side changes develop);
• Persons with increased excitability before tomography are assigned sedatives, which prevent the risk of negative actions;
• The manipulation should be provided with medicines and special equipment that helps qualified personnel to minimize and avoid adverse reactions (in cases of respiratory arrest, convulsions, etc.).

Contraindications to the use of Magnesite concern the individual intolerance of one of the components of the pharmacological solution, as well as patients with severe renal dysfunction. Hypersensitivity is manifested by reactions from the dermis, respiratory organs and the cardiovascular system. Negative phenomena, as a rule, occur within half an hour after the introduction of Magnegetitis, less often there are delayed pathological conditions. Therefore, people who are prone to allergic manifestations who have a history of bronchial asthma, represent a special group of risk. Caution is used in the preparation of Magnesite in patients with epilepsy because of the risk of seizures and seizures. To all persons, especially over 60 years, before the introduction of a contrast agent, it is recommended to check the functioning of the kidneys.

[19], [20], [21]

Side effects Magneghite

As the clinical practice shows, the side effects are short-lived and differ in a moderate course. In order to prevent the development of life-threatening conditions, it is important to consider possible side effects of Magneghit:

• general appearance - pain from the head, back, sternum, joint, feeling of weakness and malaise, fever, severe sweating, fainting;
• Locally revealed - swelling, inflammatory reactions, pain syndrome, necrosis, phlebitis or thrombophlebitis;
• disorders of the digestive function - pain in the abdomen, loose stools, nausea, vomiting, taste disorders, increased salivation, changes in hepatic fermentation, and quantitative growth of bilirubin in the blood;
• allergic manifestations - conjunctivitis, discharge from the nose and eyes, cough and sneeze, swelling, anaphylactic shock, rash or redness on the skin, itching, broncho- and laryngospasm;
• cardiovascular complications - arrhythmia and hypotension are detected, tachycardia and even cardiac arrest are possible;
• influence on the central and peripheral nervous system - headache, dizziness, pre-stupor, overexcitation, loss of consciousness, problems with speech apparatus, vision and hearing, increased weakness and drowsiness, convulsions, asthenic manifestations, coma;
• exposure to breathing - lack of oxygen, shortness of breath, cough of varying strength, swelling of the lung, cessation of breathing;
• from the urinary system - involuntary urination, frequent urination, increased creatinine levels with existing kidney pathology, kidney failure.

Using Magnetite can affect the presence of iron and bilirubin in the serum.

Overdose

The cases of application of the Magnesiumite preparation indicate that the overdose in clinical practice was not revealed. It is possible only negative symptoms caused by hyperosmosis of the contrast solution:

• diuresis of osmotic type;
• increased pressure in the arteries of the lungs;
• dehydration;
• local pain syndrome in the vascular bed;
• activation of the circulation of blood and plasma, characterized by an increase in their volume.

When acute renal failure occurs, extrarenal blood purification (hemodialysis) is required.

[25], [26], [27], [28]

Interactions with other drugs

Data on the interaction of magnesium with other drugs are not given, as compatibility testing has not been conducted. It is undesirable to use Magnenitol along with other medicinal substances. It is known that the reception of patients with beta-blockers against the background of the introduction of acid gadopennetova can lead to a hypersensitivity reaction. Contrast substance contains a small number of pentetal acid, which influences the blood test when a quantitative content of iron is detected (the indices can be underestimated within 24 hours after the tomography).

At the end of the MRI, it is recommended to refrain from driving for a day and to exclude the work with dangerous mechanisms in view of possible side effects observed from the central nervous or cardiovascular systems, and also due to a decrease in the reaction rate.

[29]

Storage conditions

Injection solution of Magneghite is stored in the original packaging in a temperature range of 5-25 degrees. It is inadmissible to get direct sunlight on the medicine. The storage conditions for Magneghit include the presence of a dark, cool place where the kids can not reach.

It is important to remember the safety measures:

• use only intravenously;
• the substance is placed in a syringe immediately before manipulation;
• The excess of unused acid gadopentetova use is prohibited.

[30], [31], [32], [33], [34]

Shelf life

The shelf life of the radiopaque substance is 3 years, while maintaining the integrity of the packaging and meeting the required storage requirements. It is forbidden to use the pharmacological agent Magneghite after the expiration date, if the glass bottle or the cap is damaged.