Panangin concentrate for preparation of solution for infusion 10ml, No. 5

• To eliminate the deficiency of potassium and magnesium as an adjuvant in various manifestations of coronary heart disease, including acute myocardial infarction;

• Chronic heart failure;

• Cardiac arrhythmias (including arrhythmias caused by an overdose of cardiac glycosides).

For intravenous use only.
The contents of 1-2 ampoules should be diluted in 50-100 ml of 5% dextrose (glucose) solution and administered intravenously as a slow drip infusion (20 drops per minute). If necessary, you can repeat the dose in 4-6 hours.
The drug is suitable for combination therapy.

for one ampoule:

Active substances: Potassium asparaginate (in the form of potassium asparaginate hemihydrate) 452 mg (corresponds to 103.3 mg of potassium ions), magnesium asparaginate (in the form of magnesium asparaginate tetrahydrate) 400 mg (corresponds to 33.7 mg of magnesium ions);
Excipients: water for injection - up to 10 ml.

Hypersensitivity to the drug,

acute and chronic renal failure;

Addison's disease; atrioventricular block II, III degree;

cardiogenic shock (blood pressure)

Carefully

I degree atrioventricular block, severe liver dysfunction; metabolic acidosis; the risk of edema; impaired renal function in the event that regular monitoring of the magnesium content in the blood serum is impossible (danger of accumulation, toxic magnesium content); cardiogenic shock (systolic blood pressure less than 90 mm Hg); hypophosphatemia; urolithiasis diathesis associated with impaired metabolism of calcium, magnesium and ammonium phosphate.

Trade name : Panangin

International non-proprietary or group name : Potassium asparaginate + Magnesium asparaginate

Dosage form : concentrate for preparation of solution for infusion.

Composition for one ampoule:

Active substances: Potassium asparaginate (in the form of potassium asparaginate hemihydrate) 452 mg (corresponds to 103.3 mg of potassium ions), magnesium asparaginate (in the form of magnesium asparaginate tetrahydrate) 400 mg (corresponds to 33.7 mg of magnesium ions);
Excipients: water for injection - up to 10 ml.

Description : Colorless or slightly greenish, transparent solution.

Pharmacotherapeutic group : potassium and magnesium drug.

ATX code : ј12—’

Pharmacological properties

Pharmacodynamics
Panangin is a source of important electrolytes: potassium and magnesium ions. One of the most important functions of potassium ions is to maintain the membrane potential of neurons, myocytes, and excitable structures of myocardial tissue. An imbalance between intracellular and extracellular potassium leads to a decrease in cardiac contractility, arrhythmias, tachycardia and increased toxicity of cardiac glycosides.
Magnesium is an important cofactor in over 300 enzymatic reactions, including energy metabolism and synthesis of proteins and nucleic acids. In addition, magnesium plays an important role in the work of the heart: it improves contractility and heart rate, leading to a decrease in myocardial oxygen demand. A decrease in the contractility of smooth myocytes of arterioles leads to vasodilation, including of the coronary vessels, and to an increase in coronary blood flow. Magnesium has an anti-ischemic effect on myocardial tissue.
The combination of potassium and magnesium ions in one preparation is based on the fact that potassium deficiency in the body is often accompanied by magnesium deficiency and requires simultaneous correction of the levels of both ions. Further, with the simultaneous correction of the levels of these electrolytes, an additive effect is observed (low levels of potassium and / or magnesium have a proarrhythmogenic effect), in addition, potassium and magnesium reduce the toxicity of cardiac glycosides, without affecting the positive inotropic effect of the latter.
Pharmacokinetics
No data available.

Indications

• To eliminate the deficiency of potassium and magnesium as an adjuvant in various manifestations of coronary heart disease, including acute myocardial infarction;

• Chronic heart failure;

• Cardiac arrhythmias (including arrhythmias caused by an overdose of cardiac glycosides).

Contraindications

Hypersensitivity to the drug,

acute and chronic renal failure;

Addison's disease;

atrioventricular block II, III degree;

cardiogenic shock (blood pressure)

Carefully

I degree atrioventricular block, severe liver dysfunction; metabolic acidosis; the risk of edema; impaired renal function in the event that regular monitoring of the magnesium content in the blood serum is impossible (danger of accumulation, toxic magnesium content); cardiogenic shock (systolic blood pressure less than 90 mm Hg); hypophosphatemia; urolithiasis diathesis associated with impaired metabolism of calcium, magnesium and ammonium phosphate.

Pregnancy and lactation

There is no data on the harmful effects of the drug during pregnancy.

Method of administration and dosage

For intravenous use only.
The contents of 1-2 ampoules should be diluted in 50-100 ml of 5% dextrose (glucose) solution and administered intravenously as a slow drip infusion (20 drops per minute). If necessary, you can repeat the dose in 4-6 hours.
The drug is suitable for combination therapy.

Side effect

With rapid intravenous administration, symptoms of hyperkalemia may develop (fatigue, myasthenia gravis, paresthesia, confusion, cardiac arrhythmias (bradycardia, atrioventricular blockade, arrhythmias, cardiac arrest) and hypermagnesemia (decreased neuromuscular excitability, urge to vomit, vomiting, lethargy, It is also possible to develop phlebitis, atrioventricular blockade and a paradoxical reaction (an increase in the number of extrasystoles).

Overdose

To date, overdose cases have not been described. With an overdose, the risk of symptoms of hyperkalemia and hypermagnesemia increases.
Symptoms of hyperkalemia: fatigue, myasthenia gravis, paresthesia, confusion, cardiac arrhythmias (bradycardia, atrioventricular block, arrhythmias, cardiac arrest).
Symptoms of hypermagnesemia: a drop in neuromuscular excitability, urge to vomit, vomiting, lethargy, a decrease in blood pressure (BP). With a sharp increase in the content of magnesium ions in the blood - inhibition of deep tendon reflexes, respiratory paralysis, coma.
Treatment: In case of symptoms of an overdose, treatment with Panangin should be discontinued and symptomatic therapy should be carried out (intravenous administration of calcium chloride at a dose of 100 mg / min, if necessary, the appointment of hemodialysis).

Interaction with other medicinal products

Enhances the negative dromo- and batmotropic effect of antiarrhythmic drugs.
Eliminates hypokalemia caused by glucocorticoids.
Due to the magnesium content, it reduces the effect of neomycin, polymyxin B, tetracycline and streptomycin. Cyclosporine, potassium-sparing diuretics, heparin, ACE inhibitors may increase the risk of developing hyperkalemia.
Anesthetics increase the inhibitory effect of magnesium on the central nervous system.
May enhance neuromuscular blockade caused by depolarizing muscle relaxants (atracuria besylate, decametonium bromide, suxamethonium (chloride, bromide, iodide)).
Calcitriol increases the concentration of magnesium in the blood plasma, calcium preparations reduce the effect of magnesium.
Beta-blockers, non-steroidal anti-inflammatory drugs increase the risk of hyperkalemia up to the development of arrhythmia and asystole.
Pharmaceutically compatible with solutions of cardiac glycosides (improves their tolerance, reduces the undesirable effects of cardiac glycosides).

special instructions

With rapid introduction, the development of skin hyperemia is possible.
Special care should be taken in the presence of diseases accompanied by hyperkalemia. In these cases, it is recommended to control the content of potassium ions in the blood.

The effect of the drug on the ability to drive vehicles and mechanisms

Has not been studied.

Release form

Concentrate for solution preparation for infusion, 45.2 mg / ml + 40 mg / ml.
10 ml of the drug in a colorless glass ampoule (1 hydrolytic class), 5 ampoules in a plastic tray. 1 plastic pallet in a cardboard box with instructions for medical use.

Storage conditions

Store at temperatures between 15 and 30 ? C.
Keep out of the reach of children!

Shelf life

3 years.
Should not be used after the expiration date.

Vacation conditions

On prescription.