Instructions Panangin concentrate for infusion solution ampoule 10 ml No. 5
Composition
active ingredients: magnesium asparaginate, potassium asparaginate;
1 ml of concentrate for solution for infusion contains 40 mg of magnesium asparaginate (equivalent to 3.37 mg of magnesium) and 45.2 mg of potassium asparaginate (equivalent to 10.33 mg of potassium);
excipient: water for injections.
Dosage form
Concentrate for solution for infusion.
Main physicochemical properties: colorless or slightly greenish, clear solution.
Pharmacotherapeutic group
Mineral substances. Magnesium preparations.
ATX code A12C SZ0.
Pharmacological properties
Pharmacodynamics.
Potassium and magnesium ions, as important intracellular cations, are involved in the work of a number of enzymes, in the process of binding macromolecules to subcellular elements, and in the mechanism of muscle contraction at the molecular level. The ratio of extracellular and intracellular concentrations of potassium, calcium, sodium, and magnesium ions affects the contractile ability of the myocardium. Asparaginate, as an endogenous substance, is a carrier of potassium and magnesium ions; it has a pronounced affinity for cells, its salts are subject to dissociation only to a small extent. As a result, the ions penetrate the intracellular space in the form of complex compounds. Magnesium and potassium asparaginate improves the metabolism of the cardiac muscle. Insufficient intake of potassium and magnesium into the body contributes to the development of arterial hypertension, sclerotic coronary vascular pathology, heart rhythm disturbances, and myocardial degeneration.
Pharmacokinetics.
Magnesium
The total magnesium store in a human body weighing 70 kg is on average 24 g (1000 mmol); more than 60% of magnesium is in bone tissue and about 40% in skeletal muscle and other tissues. About 1% of the total magnesium store in the body is in the extracellular fluid, mainly in blood serum. In healthy adults, the magnesium content in blood serum is in the range of 0.7 - 1.1 mmol/l.
The recommended dietary intake of magnesium for men is 350 mg per day, and for women, it is 280 mg. The need for magnesium increases during pregnancy and breastfeeding.
Magnesium is absorbed from the gastrointestinal tract by active transport. The kidneys are the main regulator of magnesium balance in the body. 3-5% of ionized magnesium is excreted by the kidneys.
Increased urine volume (e.g., with highly effective loop diuretic therapy) leads to increased excretion of ionized magnesium. If magnesium absorption in the small intestine is reduced, subsequent hypomagnesemia leads to decreased excretion (< 0.5 mmol/day).
Potassium
The total body potassium store in a 70 kg person is on average 140 g (3570 mmol). The total body potassium store is slightly lower in women than in men and decreases slightly with age. 2% of the total body potassium store is extracellular, and the remaining 98% is intracellular.
The optimal dietary intake of potassium is 3-4 g (75-100 mmol) per day. The main route of potassium excretion is renal (about 90% of potassium is excreted by the kidneys daily). The remaining 10% is excreted through the gastrointestinal tract. Thus, the kidneys are responsible for long-term potassium homeostasis, as well as for serum potassium. In the short term, blood potassium is also regulated by the exchange of potassium between intracellular and extracellular spaces.
Indication
For additional therapy in chronic heart diseases (heart failure, post-infarction period), heart rhythm disorders, primarily ventricular arrhythmias.
Adjunctive therapy in treatment with digitalis drugs.
Contraindication
Hypersensitivity to the active substances of the drug.
Acute and chronic renal failure.
Addison's disease.
Third degree atrioventricular block.
Cardiogenic shock (BP < 90 mm Hg).
Interaction with other medicinal products and other types of interactions
Concomitant use of the drug with potassium-sparing diuretics and/or ACE inhibitors, beta-blockers, cyclosporine, heparin, nonsteroidal anti-inflammatory drugs increases the risk of developing hyperkalemia.
Application features
Rapid administration may cause facial flushing.
Panangin, as a drug containing potassium and magnesium, should be used with caution in patients with myasthenia gravis; in conditions that may lead to hyperkalemia, such as decreased renal function, acute dehydration, widespread tissue damage, in particular severe burns. In this category of patients, it is recommended to regularly examine the level of electrolytes in the blood serum.
Use during pregnancy or breastfeeding
To date, no harmful effects have been reported when using the drug in this category of patients.
Ability to influence reaction speed when driving vehicles or other mechanisms
The drug does not affect the ability to drive vehicles and other mechanisms.
Method of administration and doses
The drug is intended for intravenous administration only. Adults are administered slowly intravenously drip - 10-20 ml (the contents of one or two ampoules are diluted in 50-100 ml of 5% glucose solution). If necessary, the dose can be repeated after 4-6 hours. The drug is suitable for combination therapy.
The course of treatment is determined by the doctor.
Children
Experience with the use of the drug in children is insufficient.
Overdose
Cases of overdose are not known.
Given the ability of the kidneys to excrete large amounts of potassium from the body, increasing the dose of the drug may lead to hyperkalemia only if it is associated with acute or severe impairment of potassium excretion.
The therapeutic index of magnesium is wide, and in the absence of renal failure, severe side effects are extremely rare.
In case of rapid intravenous administration, symptoms of hyperkalemia/hypermagnesemia may occur.
In case of overdose, symptoms of hyperkalemia and hypermagnesemia may be observed.
Symptoms of hyperkalemia: general weakness, paresthesias, bradycardia, paralysis. Extremely high plasma potassium concentrations can lead to death from cardiac depression, arrhythmia, or cardiac arrest.
Symptoms of hypermagnesemia: nausea, vomiting, drowsiness, hypotension, bradycardia, weakness, slurred speech, double vision. At very high plasma concentrations of magnesium, hyporeflexia, muscle paralysis, respiratory arrest, and cardiac arrest may develop.
In case of overdose, it is necessary to cancel K+-, Mg2+-aspartate and carry out symptomatic treatment (calcium chloride 100 mg/min intravenously, dialysis, if necessary).
Side effects
With rapid administration of the drug, the possibility of symptoms of hyperkalemia/hypermagnesemia should be taken into account.
Expiration date
3 years.
Storage conditions
Store at a temperature not exceeding 30 ºС.
Keep out of reach of children.
Incompatibility
Unknown.
Packaging
10 ml of solution in a colorless glass ampoule with a break point; 5 ampoules (5x1) in a contour plastic package; 1 contour plastic package in a cardboard box.
Vacation category
According to the recipe.
Producer
JSC "Gedeon Richter".
Address
H-1103, Budapest, Demrei Street 19-21, Hungary.
