Pamirs

Pamiri refers to medical radiopaque substances containing iodine. The international name is Iopamidol. Other trade names: Yopamidol, Yopamiro, Yopamiron, Nyopam, Tomoskan, Scanlux.

[1]

Indications Pamirs

The drug is used for diagnostic purposes in the conduct of such X-ray examinations as angiography of the cardiovascular system, including the brain; peripheral arteriography; coronary angiography and ventriculography; angiocardiography; selective visceral arteriography and retrograde aortography; peripheral venography (phlebography); lumbar and thoracocervical myelography; intravenous urography.

It is also used to enhance the contrast of images in the computed tomography of various systems and organs. Pamiras can be useful for detecting the size of malignant new formations, such as glioblastomas, astrocytomas, oligodendrogliomas, medulloblastomas, meningiomas, neurinomas, pituitary adenomas, craniopharyngiomas, and their metastatic lesions.

[2], [3]

Release form

Form release: solution for injection in vials of 50 and 100 ml.

[4], [5]

Pharmacodynamics

The mechanism of action of this substance is based on the ability of iodine, which is part of its composition, to absorb X-rays. Due to this, the contrast of the X-ray image of the vascular bed increases and the quality of its visualization is enhanced.

Pamir is a water-soluble non-ionic radiopaque drug that does not increase the osmotic concentration of blood plasma. One milliliter of the solution contains 612.4 mg or 755.2 mg of organically bound iodine. The pH at 6.5-7.5 was adjusted with hydrochloric acid and sodium hydroxide. Due to the absence of ions, the active substance yopamidol has a less pronounced toxic effect and significantly improves the tolerance of the drug, reducing the risk of possible complications.

[6], [7]

Pharmacokinetics

When the agent is injected into the blood vessels, it enters the blood plasma, slightly binding to its albumin, fibrinogen and lipoproteins, does not penetrate the cell membranes, partially penetrates the blood-brain barrier.

Within the next 24 hours, the entire volume of Pamiria circulates in the bloodstream, but after 48 hours the blood is completely released from the drug.

Pamiri - an urotropic drug: it is excreted in the urine with glomerular filtration of the kidneys; metabolites are absent. Complete elimination may last 3-4 days.

[8], [9], [10], [11]

Dosing and administration

The method of application of this radiopaque substance is intravenous or intraarterial injection (depending on the nature of the diagnostic procedure).

The exact dosage depends on the type of examination, the age and body weight of the patient, the state of the cardiovascular system and the kidneys. The drug has the maximum allowable dose in a volume not exceeding 250 ml.

With angiography, lumbar and thoracocervical myelography, the dose ranges from 5 to 10 ml; with phlebography and urography, 30-50 ml is administered; with angiocardiography, coronary angiography, aortography of the thoracic or abdominal cavity, the dose is determined from the calculation of 1 ml of the drug per kilogram of body weight.

[19],

Use Pamirs during pregnancy

The use of Pamirs during pregnancy is prohibited.

Contraindications

It is contraindicated to use pamiria in cases of suspected or susceptible hypersensitivity to iodine and other components of the drug, with increased production of thyroid hormones (hyperthyroidism and thyrotoxicosis), liver or kidney failure, blood oncology in the form of multiple myeloma, and malignant growth of macroglobulin-producing plasma blood cells (Waldenstrom macroglobulinemia).

[12], [13], [14], [15],

Side effects Pamirs

The side effects arising after the introduction of Pamiria are expressed in such symptoms as:

• feeling of heat and cold all over the body, chills;
• headache and dizziness;
• a violation of taste sensations;
• increased total body temperature;
• skin reaction in the form of a small rash, spots or papules;
• nausea and vomiting;
• tremor of muscles, cramps;
• change in blood pressure;
• more frequent heart rhythm;
• shortness of breath, bronchospasm.

The possibility of developing pulmonary edema, vascular collapse and anaphylactic shock is not ruled out; with cerebral angiography - paresis, stupor, coma.

Since, like all iodine-containing contrast agents, the Pamirs can cause severe or fatal reactions, patients should be provided with free access to their veins for emergency care, as well as the necessary resuscitation equipment and appropriate medications during the examination.

[16], [17], [18]

Overdose

Overdose is manifested by a significant increase in side effects. To eliminate the consequences of excess dosage should be symptomatic treatment, good results give hemodialysis.

[20], [21], [22]

Interactions with other drugs

Simultaneous use of Pamiri with analgesic, neuroleptic and analeptic drugs, as well as with tricyclic antidepressants leads to the appearance and intensification of seizures.

In patients with chronic diabetic nephropathy who take a hypoglycemic drug Metformin, the kidney function temporarily worsens and the excretion of lactic acid and poly-p-hydroxybutyric acid from the body slows down, which leads to diabetic acidosis.

Beta-adrenoblockers used in hypertension and cardiac arrhythmia, in combination with the Pamirs, lead to an immediate allergic reaction in the form of an anaphylactic state.

[23], [24], [25], [26]

Storage conditions

Storage conditions of the Pamir: in the original packaging, in a dark place, at a temperature of not more than + 25 ° C.

[27], [28], [29]

Shelf life

Shelf life in the original packaging is 36 months. After opening the vial, the Pamir is used immediately, unused residues are destroyed.