Parkopan

Parkopan has muscle relaxant and m-anticholinergic effects.

[1], [2], [3]

Indications Parkopana

It is used for the combined treatment of the following conditions:

• trembling paralysis and spastic dysplegia;
• dystonia ;
• secondary type parkinsonism;
• motor or extrapyramidal disorders;
• hyperkinesis.

Release form

The release of the substance produced in tablets of 2 or 5 mg; inside a pack - 100 tablets.

Pharmacodynamics

The drug has anti-Parkinsonian effect and has muscle relaxant and m-holinoblokiruyuschim properties. It is an antagonist of m-cholinergic receptors - it contributes to blocking the activity of synapses with acetylcholine conductor, affecting the connection between dopamine and acetylcholine. This leads to a decrease in cholinergic effects associated with dopamine deficiency within the central nervous system.

The central anticholinergic effect prevails, due to which the drug weakens the severity or completely eliminates the motor disturbances that appear in extrapyramidal disorders. In addition, it also helps to relax the tremor at rest and has little effect on muscle rigidity.

The peripheral anticholinergic effect helps to reduce salivation, and also slightly reduces the greasiness of the glands and the intensity of sweating. In addition, the drug has antispasmodic properties due to myotropic effects.

As a monotherapeutic element, it is used for trembling paralysis and secondary parkinsonism, and also for extrapyramidal disorders; weakens the tone in the case of paresis, having a pyramidal character. The effect of the drug develops after 60 minutes; the maximum effect is observed for 2-3 hours, after which it begins to decrease. In total, the duration of the drug effect is within 6-12 hours.

Pharmacokinetics

After oral use, the drug is absorbed at high speed from the gastrointestinal tract. It has a high lipotropic. Excreted with mother's milk. Under the influence of esterases undergoes hydrolysis, being converted into organic acids and alcohol.

Half-life is in the range of 5-10 hours. A small part of the substance in an unchanged state is excreted through the kidneys, and everything else is in the form of metabolic products.

Dosing and administration

To use the drug is required orally, the initial dose is 1 mg per day. Tablets should be taken after eating food (if after this dryness of the oral mucosa appears, the drug is used before meals).

In the absence of the desired result, the dosage is increased by 1 mg per day with 5-day intervals. It is necessary to take medication 3-5 times per day. Older people the serving size is halved (this dosage is sufficient to achieve a medicinal effect).

For trembling paralysis, take 5 mg per day or 10 mg of a substance (10 mg is the maximum allowable 1-fold dosage). Per day is allowed to use no more than 20 mg of the drug. If the drug is used with levodopa, the dose should be reduced.

To correct extrapyramidal disorders, take 5 mg of the substance per day (maximum portion - 15 mg). Children aged 5-17 years per day can use 8-80 mg of the drug (the number of doses - 3-4 times).

The abolition of the drug is carried out gradually - for 7-14 days, because with a sharp cessation of the intake there is a rapid deterioration of the condition. It is also necessary to remember that there is a possibility of the development of drug dependence. During therapy, it is necessary to monitor the IOP.

[4]

Use Parkopana during pregnancy

It is forbidden to use Parkopan during pregnancy.

Contraindications

Main contraindications:

• the presence of intolerance in relation to the components of the drug;
• glaucoma;
• atrial fibrillation;
• BPH;
• stenoses in the gastrointestinal tract, having a mechanical nature.

Caution is required when used in patients with kidney or liver disease, atherosclerosis of a pronounced nature, increased blood pressure, as well as the elderly.

Side effects Parkopana

The use of medication can lead to the following side effects:

• feeling of nervousness, severe fatigue or drowsiness, increased IOP values, delusions, dizziness, hallucinations or psychosis;
• vomiting, constipation, dryness of the oral mucosa, nausea;
• rash on the epidermis, drug dependence;
• accommodative paresis, tachycardia, urinary retention and purulent parotitis.

Overdose

Among the first symptoms of intoxication are facial hyperemia, dryness of the mucous membranes and the epidermis, an upset swallowing process, pupil dilation and a feverish state. Severe overdose leads to anxiety, weakness in muscles, cramps, urinary disorders, rhythm of heartbeat and consciousness, and in addition to the weakening of peristalsis and arrest of the respiratory process.

Hemodialysis can be performed only during the first hours after intoxication. Sodium bicarbonate is infused as well as physostigmine (intravenously via an IV; a portion of 2–8 mg). In addition, it is required to constantly monitor the ECG.

Interactions with other drugs

Use with IMAO leads to potentiation of the anticholinergic effect.

When using levodopa increases the activity of the drug, which may require a decrease in its dosage.

Tricyclics, phenothiazine derivatives, as well as H1-histamine blockers potentiate the likelihood of negative symptoms (especially the anticholinergic influence of the peripheral nature).

Combining with reserpine weakens the effectiveness of the active element Parkopan.

Use with chlorpromazine reduces plasma drug values.

Trihexyphenidyl reduces the therapeutic effect of nitrates used by the sublingual method.

[5]

Storage conditions

Parkopan must be maintained at temperatures of 25 ° C.

Shelf life

Parkopan can be used within 5 years from the date of manufacture of a therapeutic agent.

Analogs

Analogues of the drug are such drugs as Anti-Spas, Pipanol, Cyclodol, Aparcan with Romparkin, and in addition Tremin, Artan, Parkan, Trixil with Antithrem, Triphenidil with Peragit and Pacitan.

Reviews

Parkopan is considered to be not a very effective treatment for trembling paralysis. In this disease, cholinolytics are actively used, which reduce the functional activity of the cholinergic system (it prevails over dopaminergic in people with tremulous paralysis). The drug must restore the necessary balance between these systems, with the result that the characteristic pathology signs disappear. This is precisely what Parkopan does not always cope with, judging by the comments on medical forums.

Nowadays, there is a tendency to limit the use of anticholinergics in the elderly, because they increase the likelihood of developing mental disorders and mental disorders. The use of medication is considered appropriate for younger people and only in situations where there is a marked improvement. It was found that this category of drugs shows efficacy in only 20% of patients.

The use of individual neuroleptics (such as haloperidol with zuclopentixol, as well as olanzapine with trifluoperazine) often causes the appearance of extrapyramidal disorders, which makes it necessary to use anti-Parkinsonian drugs, which are correctors. It is revealed that Parkopan with Akineton, used in small portions, shows the highest efficiency. This is often mentioned in the comments commenting.

A fairly large number of patients with the use of the medication observed the development of negative symptoms - it is usually a feeling of irritability or drowsiness, dry mucous membranes and constipation. But with prolonged use, the severity of negative symptoms decreases.