Instructions Chymotrypsin crystalline lyophilized powder for solution for injection 0.01 g ampoule No. 10
Composition
active ingredient: chymotrypsin;
1 ampoule or vial contains 0.01 g of chymotrypsin.
Dosage form
Lyophilisate for solution for injection.
Main physicochemical properties: porous mass or white powder, odorless, hygroscopic.
Pharmacotherapeutic group
Means for the treatment of wounds and ulcers. Enzymes. ATX code D03B.
Pharmacological properties
Pharmacodynamics
Proteolytic enzyme, obtained from the pancreas of cattle, hydrolyzes mainly bonds formed by residues of tyrosine, phenylalanine and other aromatic amino acids. It cleaves peptide bonds in protein molecules and its breakdown products. It has an anti-inflammatory effect, since inflammatory factors are proteins or high-molecular peptides (bradykinin, serotonin, necrotic products).
Lyses necrotic tissues without affecting viable cells due to the presence of specific antienzymes in them.
Pharmacokinetics
Not studied.
Indication
Respiratory diseases accompanied by the accumulation of thick, viscous sputum - tracheitis, bronchitis, bronchiectasis, pneumonia, lung abscesses, atelectasis, bronchial asthma with increased secretion.
In surgery and traumatology – prevention of complications after lung surgery, burns and bedsores, thrombophlebitis, purulent wounds.
In otorhinolaryngology - for purulent sinusitis, acute and subacute laryngotracheitis and bronchitis with thick viscous sputum, after tracheotomy to facilitate the removal of thick viscous exudate, for acute and subacute purulent otitis media and eustachitis with viscous exudate.
In ophthalmology – for large thrombosis of the central retinal vein, acute obstruction of the central retinal artery, vitreous opacities of traumatic and inflammatory origin, cataract extraction.
Contraindication
Decompensation of cardiac activity, pulmonary emphysema with respiratory failure, decompensated forms of pulmonary tuberculosis, acute dystrophy and cirrhosis of the liver, infectious hepatitis, pancreatitis, nephritis, hemorrhagic diathesis. Chymotrypsin is not administered into inflammation centers, bleeding wounds and cavities, and is not applied to the surface of detected malignant neoplasms. Hypersensitivity to the drug or proteolysis products.
Interaction with other medicinal products and other types of interactions
Chymotrypsin can be used in combination with antibiotics and bronchodilators.
Application features
Crystalline chymotrypsin should be used with caution in the treatment of respiratory diseases in patients with active acute tuberculosis due to the development of a pronounced temperature-like histamine reaction. In connection with the above, it is recommended to administer antihistamines for prophylactic purposes (prevention of respiratory diseases) before using chymotrypsin, remove necrotic tissues after exposure to the drug (coughing up or suctioning sputum, washing wounds).
Chymotrypsin should also be used with caution in patients with pleural empyema of tuberculous etiology, since resorption of the exudate may contribute to the development of bronchopleural fistula.
Use during pregnancy or breastfeeding
Not studied.
Ability to influence reaction speed when driving vehicles or other mechanisms
Not studied.
Method of administration and doses
In case of using novocaine as a solvent, we recommend taking into account the information on the safety of novocaine, and also before using the drug, an allergic test for novocaine should be performed. In respiratory diseases (tracheitis, bronchitis, bronchiectasis, pneumonia, lung abscesses, atelectasis, bronchial asthma with increased secretion), the drug should be administered intramuscularly to adults at 5-10 mg 1 time per day for 10-12 days. In the future, after 7-10 days, the course of treatment can be repeated. In chronic long-term processes, the treatment can be repeated 3-4 times.
The drug can be used for exudative pleurisy, empyema - intrapleurally:
in surgical practice:
– in phthisiosurgery, the drug should be prescribed for the same purpose and in the same doses against the background of specific antibacterial therapy. In chronic fibro-cavernous pulmonary tuberculosis complicated by bronchitis, the course of preoperative preparation is longer (10-12 days), sometimes repeated until maximum rehabilitation of the bronchial tree;
– in general surgery in the treatment of burns and bedsores after removal of necrotic tissues that are freely removed, chymotrypsin at a dose of 20 mg is diluted in 20 ml of 0.25% novocaine solution and injected under the scab with a thin needle in several injections. It is advisable to make incisions on the scab before injection. During the next dressing, lysed necrotic tissues must be removed mechanically;
- for thrombophlebitis, the drug is administered intramuscularly to adults at a dose of 5-10 mg once daily for 7-10 days. In case of ineffectiveness of the first course of treatment, repeated courses are inappropriate;
- for the treatment of purulent wounds, intramuscular administration of the drug should be combined with local treatment of the wound with tampons moistened in a 5% solution (prepared in 0.9% sodium chloride solution);
in ophthalmology:
– during cataract extraction, chymotrypsin at a dilution of 1:5000 should be injected into the posterior chamber of the eye, followed by washing the anterior chamber with 0.9% sodium chloride solution 4 minutes after the drug is injected;
- in the treatment of thrombosis of the central retinal vein, acute obstruction of the central retinal artery, chymotrypsin should be used in the form of a 5% solution prepared in 1% novocaine solution. Administer subconjunctivally 0.2 ml
1-2 times a week;
in otorhinolaryngology:
– for sinusitis, the drug should be injected into the maxillary cavity in an amount of 5-10 mg in 3-5 ml of 0.9% sodium chloride solution after its puncture and washing;
– for otitis, instill 0.5-1 ml of 0.1% chymotrypsin solution (prepared in 0.9% sodium chloride solution) into the ear;
– during microsurgery on the ear, the purpose of which is to restore or improve hearing (tympanoplasty, stapedectomy), to soften fibrous formations in the middle ear during the operation, a 0.1% solution of chymotrypsin should be injected into the cavity. Simultaneously with local application, chymotrypsin should be administered intramuscularly to adults at a dose of 5 mg 1-2 times a day. The drug should be diluted in 1-2 ml of 0.25-0.5% novocaine solution or 0.9% sodium chloride solution.
Children
There is no experience of use in children.
Overdose
Pronounced manifestations of adverse reactions.
Adverse reactions
On the part of the respiratory system: after inhalation of chymotrypsin, irritation of the mucous membrane of the upper respiratory tract and hoarseness are occasionally observed, which disappear without any therapeutic measures.
Cardiovascular system: tachycardia.
On the part of the organs of vision: irritation and swelling of the conjunctiva. In such cases, it is recommended to use the drug in a lower concentration.
Skin: reactions at the injection site, including pain and hyperemia.
On the part of the immune system: hypersensitivity reactions, including hyperthermia, itching, rash, skin hyperemia, urticaria, anaphylactic shock, difficulty breathing.
Neurological disorders: dizziness.
Expiration date
3 years.
Storage conditions
Store in the original packaging to protect from light at a temperature of 2°C to 8°C.
Incompatibility
Not studied. The drug should not be mixed with other drugs. Use only recommended solvents.
Packaging
0.01 g in an ampoule or vial. 10 ampoules in a cardboard pack.
5 vials or ampoules in a blister. 2 blisters in a cardboard pack.
Vacation category
According to the recipe.
Producer
PrJSC "BIOPHARMA", Ukraine; LLC "FZ "BIOPHARMA", Ukraine.
Location of the manufacturer and its business address.
Ukraine, 03680, Kyiv, M. Amosova St., 9;
Ukraine, 09100, Kyiv region, Bila Tserkva, Kyivska st., 37.
