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Soin
Last reviewed: 23.04.2024
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Pasin is an anti-TB medicine that has a combined therapeutic composition; Included in the group of substances that have a drug effect on the activity of mycobacteria. The composition of this medication contains the components of isoniazid, as well as para-aminosalicylate sodium.
Due to the complex treatment, the habituation processes of tuberculous mycobacteria are delayed relative to isoniazid with streptomycin, and at the same time the potentiation of the activity of anti-tuberculosis drugs is carried out.
Indications Pasina
It is used for the prevention and treatment of various forms of tuberculosis (any localization).
Release form
The release of the drug element is in granules, 100 g inside the bags. The container contains 1 such a bag, as well as a measuring spoon with a capacity of 5 g.
Pharmacodynamics
Sodium para-aminosalicylate has a bacteriostatic effect on tuberculous mycobacteria. The effect of the substance leads to the suppression of the binding of B9-vitamin or the suppression of the synthesis of the cell wall element of mycobacteria. As a result, iron absorption by tuberculosis mycobacteria is weakened.
Isoniazid has an effect on actively multiplying tuberculous mycobacteria; shows less efficiency relative to other bacteria. It acts by inhibiting the binding processes of mycolic acids with a large chain, which are elements of the mycobacterial cell membrane. The drug slows the growth of mycobacteria with the introduction of a dosage concentration of 0.03 µg / ml.
Regarding other common germs, pathogens of various infections, the drug does not have a significant chemotherapeutic effect.
Pharmacokinetics
After 2-3 hours after the use of the drug, the indicators of the active components inside the blood plasma are 50%; the maximum time interval for achieving this result is 6 hours.
Substances at high speed passes inside fluids (pleural, cerebrospinal fluid and ascitic), organs with tissues, as well as secretions (sputum with saliva and feces). At the same time, the drug overcomes the placenta and is found inside the mother's milk (the figure is similar to plasma). Approximately 50-70% of the portions of both components are excreted with the urine for 24 hours.
The exchange processes mostly take place inside the liver - through dehydrosination and acetylation (the latter is due to genetic factors). You can select "slow" and "fast" inactivators. The rate of inactivation in general does not have a significant effect on drug activity, but people with “slow” inactivators may have elevated isoniazid blood levels and, therefore, an increased likelihood of toxic effects.
Dosing and administration
The drug is administered in combination with other anti-TB substances. It should be consumed 60 minutes before or after meals. Prior to treatment, it is required to clarify the sensitivity of bacteria to the drug.
Calculation of portions is carried out on isoniazid. The medicine box contains a 1-n spoon of 5 g in capacity, which has a division by 1 g (1 such spoon contains about 116.5 mg of isoniazid, thus, about 23.3 mg of substance per gram of this spoon).
The dosage is calculated in a proportion of 10-15 mg / kg per day. It is necessary to accept every day, in 1 reception; the portion is up to 0.3 g (2.5 scoops). A dosage of 20-40 mg / kg can also be used - up to 0.9 g (corresponding to 7.5 measuring spoons) per day in 1 dose, 2-3 times per week.
For children aged 3 years and older, a portion of 5 mg / kg is needed - up to 0.3 g (corresponding to 2.5 measuring spoons) per day in 1 dose, every day; or use 10 mg / kg - up to 0.9 g (corresponding to 7.5 measuring spoons) per day in 1 dose, 2-3 times per week.
Take medication should be washed down with tomato juice or milk.
A serving size for children weighing 15 kg equals 75 mg (corresponding to 3/5 measuring spoons) of the drug, 1 time per day.
Children weighing up to 20 kg - 0.1 g (4/5 spoons) of the drug 1-fold per day.
Children weighing up to 30 kg - 0.15 g (1 + about 1/5 spoons) of the substance 1 time per day.
For children weighing up to 40 kg - 0.2 g (1 + about 2/5 spoons) LS 1 times per day.
Children weighing up to 50 kg - 0.25 g (2 + about 1/5 spoons) of the drug 1 time per day.
If there is a strong sensitivity to the drug, you need to reduce the portion.
Therapy for pulmonary types of tuberculosis.
The course is often conducted using one of the 3 schemes described below.
1. The drug is used over a 2-month period, every day or 2-3 times a week. Together with it, streptomycin or ethambutol is injected (until the desired effect on mycobacterial sensitivity is achieved).
2. Daily use of Pasin with pyrazinamide, rifampicin, and also ethambutol or streptomycin (over a 2-week term), and then 2-fold administration per week for a period of 1.5 months. After that, the drug is used 2 times a week for 4 months.
3. The drug is used together with streptomycin or ethambutol, pyrazinamide and rifampicin 3-fold per week in the period of six months.
Therapy for extrapulmonary tuberculosis.
The basic model of therapy is similar to the schemes used in pulmonary tuberculosis. It is not necessary to monitor the course of treatment of extrapulmonary pathology so thoroughly, but clinical data allow us to conclude that short treatment cycles lasting 6-9 months give the desired result.
Due to the limited amount of data in the treatment of bone or miliary tuberculosis and the tuberculous form of meningitis, and in addition in children, in these cases, therapy should last for 1 year.
Preventive procedures.
Prior to the initiation of preventive measures it is required to exclude the probability of the presence of the active form of tuberculosis. For this purpose, radiological and bacteriological diagnostic techniques are used.
For children weighing more than 30 kg and adults, 1-fold servings of 0.3 g of substance per day are required.
Children whose weight is less than 30 kg require 5 mg / kg of drugs, daily, 1 time per day (up to 0.3 g). If it is impossible to strictly follow the preventive treatment regimen, use 10 mg / kg (maximum 0.9 g per dose) 2 times a week. In this case, the use of drugs should be controlled by a physician.
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Use Pasina during pregnancy
It is forbidden to prescribe pregnant women in portions, which, based on isoniazid is more than 10 mg / kg.
Side effects Pasina
Usually, negative manifestations develop on the part of NA - in the form of polyneuropathy, which is expressed through paresthesias in the region of the extremities. This disorder usually depends on the size of the portion and often develops in individuals with “slow” inactivators. Among other signs of NA, appearing single (with the use of medium dosage) - atrophy or neuritis, affecting the optic nerve, convulsions, memory impairment, encephalopathy or psychosis, which are toxic. Epileptic seizures may become more frequent.
Hepatic lesions indicate an increase in transaminase levels, bilirubinemia with hyperbilirubinemia, as well as jaundice and, rarely, hepatitis. Basically, such side effects develop during the first 3 months of the course; they disappear on their own, without requiring cancellation of therapy. With the values of transaminases inside serum, which are three times / five times more than the norm, it is required to carefully assess the need for continuation of treatment. In older patients, the negative symptoms associated with the liver occur more frequently.
Among the disorders of the digestive function are vomiting with stomach pain and nausea.
Signs of allergy may be present - lymphadenopathy, feverish condition, rash (maculopapular, exfoliative, morbiliform or purple) and vasculitis.
Hematological manifestations include aplastic, hemolytic, or sideroblastic forms of anemia, agranulocytosis, eosinophilia, or thrombocytopenia.
Perhaps the development of disorders of the CVS - pain in the chest region, heartbeat and increased blood pressure values.
Occasionally, there are such disorders as SLE, menorrhagia, rheumatic syndrome, and in addition, the tendency to bleeding and gynecomastia.
Overdose
In the case of Pasin poisoning, negative manifestations develop 0.5–3 hours after consuming a large portion. Symptoms include vomiting with nausea and dysarthria, visual hallucinations, visual clouding, suppression of CVS, problems with hepatic activity, and in addition, RDS, hyperglycemia, metabolic acidosis, polyneuropathy, ketonuria, coma, and seizures. An overdose develops after consuming 80-150 mg / kg.
Gastric lavage and the use of activated carbon. People who do not have a noticeable sign of intoxication (with a known amount of the drug taken), you need to enter pyridoxine in / in the way, in a dosage of 1 mg of substance per 1 mg of Pasin. With an unknown amount of the portion that provoked the poisoning, an initial dosage of pyridoxine 5 mg (adults) or 80 mg / kg (children) is used for 0.5-1 hour.
People with noticeable manifestations of poisoning are prescribed treatment that supports vital functions of the body. In addition, a bolus method is administered pyridoxine (with an unknown size of the accepted dose of drugs 5 mg (adult) or 80 mg / kg (child)) for 3-5 minutes. With a known size of the accepted dosage, pyridoxine is administered in the proportion of 1 mg of the substance per 1 mg of consumed medication. In the absence of improvements, pyridoxine can be reintroduced. Often there is enough dosage of 10 g. There is no information about the maximum allowable safe portion of pyridoxine during intoxication.
Diazepam can be used when needed. In addition, phenytoin can be used, but with extreme caution, because it is able to slow down the exchange of isoniazid. Procedures are carried out to eliminate the metabolic form of acidosis. If it is not possible to monitor the condition of the victim, peritoneal dialysis or hemodialysis can be applied.
Interactions with other drugs
Para-aminosalicylate Na increases the blood values of isoniazid, competing with it for general metabolic processes, and in addition it violates the absorption of erythromycin with rifampicin and lincomycin. It also disrupts the absorption of cyanocobalamin, which can cause anemia.
Isoniazid absorption inside the digestive tract is reduced when combined with antacids.
Pasin can be used with other anti-tuberculosis drugs.
In the case of mixed infections, the drug is combined with other antibacterial substances: sulfonamides, antibiotics with a large range of activity, and also fluoroquinolones.
Isoniazid suppresses the biotransformation of difenin with carbamazepine, because of which, when combined, their plasma indices increase and the toxic effect is potentiated.
The toxic activity of isoniazid is enhanced when combined with MAOI.
Shelf life
Pasin can be used for a 36-month term from the date of sale of the drug substance.
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Attention!
To simplify the perception of information, this instruction for use of the drug "Soin" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.