Hypersensitivity, malignant hyperthermia (including history), myasthenia gravis, and congenital dystrophic myotonia, Duchenne muscular dystrophy, angle-closure glaucoma, acute liver failure, pulmonary edema, penetrating eye injury, asthma, hyperkalemia, chest age (up to 1 year), pregnancy.
Precautions – reduced activity of serum pseudocholinesterase (end-stage liver failure, anemia, cachexia, prolonged starvation, chronic infections, widespread burns, trauma), postpartum period, tetanus, tuberculosis, cancer, chronic renal failure, trenbolone acetate 100mg myxedema , systemic disease of the connective tissue, post plasma transfusion, plasmapheresis, cardiopulmonary bypass, acute or chronic toxicity insecticide – cholinesterase inhibitors (ingestion) or anticholinesterase drugs (neostigmine, physostigmine, distigmin, phospholine), the simultaneous use of drugs. competing with succinylcholine for cholinesterase (procaine intravenously), emergency surgery in patients with “full stomach”.
- Dosage and administration :
Dosage regimen:. Intravenous (bolus infusion), intramuscular
Adults: slow intravenous, bolus or infusion (0.1% solution is used for continuous drip infusion). Depending on the clinical situation, when administered intravenously single dose ranges from 100 mg / kg and 1.5-2 mg / kg.
Intramuscular applied only to children in doses of 2.5 mg / kg, but not more than 150 mg intravenously – 1.2 mg / kg.
For intubation – 0.2-0.8 mg / kg; for muscle relaxation and disconnection of spontaneous breathing – 0.2-1 mg / kg; relaxation of skeletal muscles at reduction of dislocation and repositioning of bone fragments at fractures – 0.1-0.2 mg / kg; for endoscopy – 0.2 mg / kg; for the prevention of complications of cardioversion (convulsions, muscle and tendon avulsion) -. 0.1-1 mg / kg intravenously, and 2.5 mg / kg intramuscularly, but not more than 150 mg
for prolonged muscle relaxation during the entire operation can be administered fractionally through 5-7 min at 0.5-1 mg / kg. Repeated doses are more lasting.Side effects :
Allergic reactions (anaphylaxis, bronchospasm); hyperkalemia. lowering blood pressure, arrhythmia, bradycardia (more common in children, with the re-introduction – in children and adults), conduction disturbances, cardiogenic shock; increased intraocular pressure, salivation, fever; myalgia (in the postoperative period); long paralysis of respiratory muscles (associated with genetically caused violation education serum cholinesterase): rarely – rhabdomyolysis with development mioglobinemii and myoglobinuria.
Symptoms: respiratory arrest.
Treatment: mechanical ventilation in case of decrease in serum cholinesterase blood – transfusions of fresh blood.
Interaction with other drugs :
Pharmaceutical incompatible trenbolone acetate 100mg with donor blood and blood products (hydrolysis), preservatives, and blood serum; with barbiturates and alkaline solutions with solutions of (a precipitate). Compatible with isotonic sodium chloride solution, Ringer’s solution, 5% solution of fructose and 6% dextran solution
Anticholinesterase agents, procaine, procainamide, lidocaine, verapamil. beta-blockers, aminoglycoside antibiotics, amphotericin B, clindamycin, cyclopropane, propanidid, organophosphate insecticides, salt Mg 2+ and Li +. quinidine, quinine, chloroquine, pancuronium, strengthen and lengthen the muscle relaxant effect. Compatible with other muscle relaxants, narcotic analgesics.
Enhances cardiac effects of cardiac glycosides (bradycardia).
Reduces the antimiastenicheskih drugs.
Halogen means for general anesthesia increase, and sodium thiopental and atropine reduce undesirable effects on the cardiovascular system.
The drugs have the potential to reduce the activity blood cholinesterase (aprotinin, diphenhydramine, promethazine, oestrogens, oxytocin. high dose steroids, oral contraceptives), and increase the effect of muscle relaxant suxamethonium extend.
Special instructions :
Apply only in a specialized department in the presence of the apparatus for artificial respiration and personnel, owning this technique, and against the background of general anesthesia.
Pretreatment for 1 minute before the infusion of the drug suxamethonium chloride 3-4 mg of d-tubocurarine or 10-15 mg diplatsina prevent fibrillar twitching of the muscles and the subsequent appearance of muscle pains.
With the appropriate dose and repeated administration may be used for longer operations, but for long-term muscle relaxation is usually used non-depolarizing muscle relaxants are administered after pre-tracheal intubation on a background of suxamethonium iodide.
The slow introduction of the drug as well as preliminary intravenous injection of atropine at a dose of 1-1.5 mg largely prevents bradycardia and increase of bronchial secretions.
renal failure patients (with no signs of hyperkalemia and neuropathy), the drug is administered once in moderate doses, but do not apply for multiple injections or . in high doses because of the risk of hyperkalemia
Prolonged muscle relaxation with possible sleep apnea can be caused by several reasons:. “atypical” serum cholinesterase, serum cholinesterase deficiency hereditary or temporary decline in its level
if the drug is administered repeatedly, and after 25-30 minutes after the last injection the patient does not recover muscle tone, breathing is shallow, it is possible to think about moving depolarizing block in antidepolyarizuyuschego (appearance of “double block”). To remove this effect should be applied Neostigmine in the usual manner: introduced into the vein at a dose of pre atropine 0.5-0.7 mg (0.5-0.7 ml of 0.1% solution), increased heart rate and wait 1-2 Neostigmine minutes intravenously at a dose of 1.5 mg (3% solution 0.05 mL).
in children, women, and young patients (mainly the vagotonics) may be transient bradycardia and asystole in some cases.
after 10-12 hours after application the drug may experience muscle pain. Repeated administration of the drug can sometimes develop over prolonged muscle relaxation trenbolone acetate 100mg and prolonged apnea.
Product form :
Solution for intravenous administration in 5 ml ampoules. 5 vials in blisters plastic (cassette) with lancet ampoule. One, two or five contour cell packages with instruction on the medical application in paper cartons.
10 ampoules with instruction on the medical application and the lancet ampoule in a cardboard box.
Shelf life :. 2 years
Do not use after the expiration date printed on the package.
List A. The temperature is not higher than 5 ° C (freezing not allowed), protected from light, out of reach of children.