Medicinal reference book geotar. Promedol - description of the drug, instructions for use, reviews Promedol injections

Clear, colorless solution that does not wet glass well.

Composition per ampoule

active substance - promedol - 20 mg;

excipient - water for injections.

Pharmacotherapeutic group

Opioids. Derivatives of phenylpiperidine. ATS code: N02AB.

Pharmacological properties

Pharmacodynamics

Promedol (Trimeperidine) - an agonist of opioid receptors (mainly mu-receptors), has analgesic (weaker and shorter than morphine), anti-shock, antispasmodic, uterotonic and mild hypnotic effect. It activates the endogenous antinociceptive system and thus disrupts the interneuronal transmission of pain impulses at various levels of the central nervous system, and also changes the emotional coloring of pain. To a lesser extent than morphine, it depresses the respiratory center, and also excites the n.vagus centers and the vomiting center. Has an antispasmodic effect on smooth muscles internal organs(the spasmogenic effect is inferior to morphine), promotes the opening of the cervix during childbirth, increases tone and enhances contractions of the myometrium. With parenteral administration, the analgesic effect develops after 10-20 minutes, reaches a maximum after 40 minutes and lasts 2-4 hours or more (with epidural anesthesia - more than 8 hours). When taken orally, the analgesic effect is 1.5-2 times weaker than when administered parenterally.

Pharmacokinetics

Absorption is fast with any route of administration. After oral administration, TSmax is 1-2 hours. After i.v. administration, a rapid decrease in plasma concentration is observed and after 2 hours only trace concentrations are determined. Communication with plasma proteins - 40%. It is metabolized mainly in the liver by hydrolysis with the formation of meperidic and normeperidic acids, followed by conjugation. T1 / 2 - 2.4-4 hours, increases with renal failure. In small amounts, it is excreted by the kidneys (including 5% - unchanged).

Indications for use

Pain syndrome (severe and moderate intensity): postoperative pain, unstable angina, myocardial infarction, dissecting aortic aneurysm, thrombosis renal artery, thromboembolism of the arteries of the extremities and pulmonary artery, acute pericarditis, air embolism, pulmonary infarction, acute pleurisy, spontaneous pneumothorax, peptic ulcer of the stomach and duodenum, perforation of the esophagus, chronic pancreatitis, paranephritis, acute dysuria, when removing a foreign body Bladder, rectum, urethra, paraphimosis, priapism, acute prostatitis, acute attack of glaucoma, causalgia, acute neuritis, sciatica, acute vesiculitis, thalamic syndrome, burns, pain in cancer patients, injuries, protrusion of the intervertebral disc, postoperative period.

In combination with atropine-like and antispasmodic drugs for pain caused by spasm of the smooth muscles of the internal organs (hepatic, renal, intestinal colic).

Childbirth (pain relief in parturient women and stimulation).

Acute left ventricular failure, pulmonary edema, cardiogenic shock.

Preparation for surgery (premedication), if necessary - as an analgesic component general anesthesia.

Neuroleptanalgesia (in combination with neuroleptics).

Method of application and dosing regimen

Parenterally (s / c, / m, in emergency cases - in / in, if necessary - epidurally). Adults enter 10-40 mg (1 ml of 1% solution - 2 ml of 2% solution).

Children over 2 years old administered parenterally in doses (depending on age) 0.1-0.5 mg / kg.

With pain caused by spasm of smooth muscles (hepatic, renal, intestinal colic), trimeperidine should be combined with atropine-like and antispasmodic drugs with careful monitoring of the patient's condition.

Forpremedicationbefore anesthesia injected s / c or / m 20-30 mg together with atropine (0.5 mg) 30-45 minutes before surgery. For emergency premedication, it is injected into a vein.

During general anesthesia fractional doses of promedol are administered intravenously at 3-10 mg.

In the postoperative period Promedol is used (in the absence of respiratory failure) to relieve pain and as an anti-shock agent: injected under the skin at a dose of 10-20 mg (0.5-1 ml of a 2% solution).

Pain relief for childbirth it is carried out s / c or / m by administering the drug in doses of 20-40 mg with a pharyngeal opening of 3-4 cm and with a satisfactory condition of the fetus. The last dose of the drug is administered 30-60 minutes before delivery (to avoid respiratory depression of the fetus and newborn).

Higher doses for adults with parenteral administration: single - 40 mg, daily - 160 mg. As a component of general anesthesia - in / in, 0.5-2 mg / kg / h, the total dose during surgery should not exceed 2 mg / kg / h. With constant IV infusion - 10-50 mcg / kg / h. Epidurally - 0.1-0.15 mg / kg, previously diluted in 2-4 ml of 0.9% sodium chloride solution.

Side effect

The frequency of the side effects listed below was determined accordingly according to the following criteria: very often (≥1/10); often (≥1/100,

From the side digestive system: often - constipation, nausea and / or vomiting; infrequently - dryness of the oral mucosa, anorexia, spasm of the biliary tract, irritation of the gastrointestinal tract; rarely - in inflammatory bowel diseases - paralytic ileus and toxic megacolon (constipation, flatulence, nausea, stomach cramps, gastralgia, vomiting); frequency is unknown - hepatotoxicity (dark urine, pale stools, icterus of the sclera and skin).

From the side nervous system and sense organs: often - dizziness, weakness, drowsiness; infrequently - headache, blurred vision, diplopia, tremor, involuntary muscle twitches, euphoria, discomfort, nervousness, fatigue, nightmares, unusual dreams, restless sleep, confusion, convulsions; rarely - hallucinations, depression, in children - paradoxical excitement, anxiety; frequency unknown - convulsions, muscle rigidity (especially respiratory), ringing in the ears, slowing down the speed of psychomotor reactions, disorientation.

From the side respiratory system: rarely - depression of the respiratory center.

From the side of cardio-vascular system: often - a decrease in blood pressure; rarely - arrhythmias; frequency unknown - increased blood pressure.

From the urinary system: rarely - decreased diuresis, spasm of the ureters (difficulty and pain when urinating, frequent urge to urinate).

From the reproductive system: frequency unknown: decreased libido, impotence, erectile dysfunction, lack of menstruation, infertility. In case of data development adverse reactions it is necessary to perform an assessment of the level of sex hormones.

Allergic reactions: often - bronchospasm, laryngospasm, angioedema; seldom - skin rash, skin itching, swelling of the face.

Local reactions: rarely - hyperemia, swelling, burning at the injection site.

Others: infrequently - increased sweating; frequency unknown - addiction, drug dependence.

At. Simultaneous use of Promedol with serotonergic drugs should be closely monitored if the following symptoms develop: agitation, hallucinations, palpitations, fever, increased sweating, chills or tremors, muscle twitching (muscle cramps) or rigidity (stiffness), lack of coordination, nausea , vomiting or diarrhea (see Precautions section - serotonin syndrome).

Contraindications

Hypersensitivity, depression of the respiratory center; with epidural and spinal anesthesia - a violation of blood clotting (including against the background of anticoagulant therapy), infections (the risk of infection entering the central nervous system); diarrhea against the background of pseudomembranous colitis caused by cephalosporins, lincosamides, penicillins, toxic dyspepsia (slow elimination of toxins and the associated exacerbation and prolongation of diarrhea); simultaneous treatment with MAO inhibitors (including within 21 days after their use), childhood up to 2 years.

Carefully. Abdominal pain of unknown etiology, surgical interventions on the gastrointestinal tract, urinary system, bronchial asthma, COPD, convulsions, arrhythmias, arterial hypotension, CHF, respiratory failure, hepatic and / or kidney failure, myxedema, hypothyroidism, adrenal insufficiency, CNS depression, intracranial hypertension, TBI, prostatic hyperplasia, suicidal tendencies, emotional lability, drug addiction (including history), severe inflammatory diseases intestines, strictures of the urethra, alcoholism, seriously ill, debilitated patients, cachexia, pregnancy, lactation, elderly age, children's age is more senior than 2 years.

Overdose

Symptoms of acute and chronic overdose: nausea, vomiting, cold clammy sweat, confusion, dizziness, drowsiness, decreased blood pressure, nervousness, fatigue, bradycardia, severe weakness, slow shortness of breath, hypothermia, anxiety, miosis (with severe hypoxia, the pupils can be dilated), convulsions, hypoventilation, cardiovascular failure in severe cases - loss of consciousness, respiratory arrest, coma.

Treatment: gastric lavage, maintaining sufficient pulmonary ventilation, systemic hemodynamics, normal body temperature. Patients should be under continuous supervision; if necessary - carrying out mechanical ventilation, respiratory stimulants; the use of a specific opioid antagonist - naloxone at a dose of 0.4 mg (if there is no effect after 3-5 minutes, the administration of naloxone is repeated until consciousness appears and spontaneous breathing is restored). The initial dose of naloxone for children is 0.005-0.01 mg/kg.

Precautionary measures

During treatment, the use of alcohol is unacceptable.

Use with caution in patients with a history of drug dependence.

Promedol should be used with caution against the background of the action of anesthetics, hypnotics and neuroleptics in order to avoid excessive depression of the central nervous system and suppression of the activity of the respiratory center. Promedol should not be combined with narcotic analgesics from the group of agonist-antagonists (nalbuphine, buprenorphine, butorphanol, tramadol) of opioid receptors because of the risk of weakening analgesia. Long-term use of barbiturates (especially phenobarbital) or opioid analgesics stimulates the development of cross-tolerance. It should not be combined with MAO inhibitors (excitation, convulsions are possible).

Serotonin Syndrome: while using Promedol with serotonergic drugs, patients should be carefully monitored if the following symptoms develop: agitation, hallucinations, heart palpitations, fever, increased sweating, chills or tremors, muscle twitching (muscle cramps) or rigidity (stiffness), impaired coordination, nausea, vomiting or diarrhea. Symptoms usually develop within hours to days of starting concomitant opioid therapy with other drugs. However, symptoms may develop later, especially after increasing the dose of drugs. If serotonin syndrome is suspected, the use of opioids and/or other concomitant medications should be discontinued.

Adrenal insufficiency: Patients should be closely monitored if symptoms of adrenal insufficiency such as nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or low blood pressure. If adrenal insufficiency is suspected, diagnostic testing should be performed. If necessary, with a positive result of the study, it is necessary to start treatment with corticosteroids and stop opioids. If opioids are discontinued, a follow-up evaluation of adrenal function should be performed to determine the need to continue or stop corticosteroid therapy.

Androgen deficiency: chronic use of opioids can affect the hypothalamic-pituitary-gonadal system, which can lead to androgen deficiency, which manifests itself in the form of low libido, impotence, erectile dysfunction, amenorrhea and infertility. In the event of symptoms or signs of androgen deficiency, it is necessary to conduct a laboratory diagnosis.

Use during pregnancy and lactation .

Use during pregnancy and lactation is possible only under strict indications.

Influence on the ability to drive vehicles and other potentially dangerous mechanisms .

Do not administer during treatment vehicles and engage in potentially hazardous activities that require heightened attention and speed of psychomotor reactions.

Interaction with other drugs .

Enhances the depriming effect and respiratory depression of narcotic analgesics, sedatives, hypnotics, antipsychotic drugs (neuroleptics), anxiolytics, drugs for general anesthesia, ethanol, muscle relaxants. Against the background of the systematic use of barbiturates, especially phenobarbital, it is possible to reduce the analgesic effect. Enhances the hypotensive effect of drugs that reduce blood pressure (including ganglioblockers, diuretics). Drugs with anticholinergic activity, antidiarrheal drugs (including loperamide) increase the risk of constipation up to intestinal obstruction, urinary retention and CNS depression. Enhances the effect of anticoagulants (plasma prothrombin should be monitored). Buprenorphine (including previous therapy) reduces the effect of other opioid analgesics; against the background of the use of high doses of agonists of mu-opioid receptors, it reduces respiratory depression, and against the background of the use of low doses of agonists of mu- or kappa-opioid receptors, it increases; accelerates the onset of symptoms of the “withdrawal syndrome” upon discontinuation of mu-opioid receptor agonists against the background of drug dependence, with their sudden cancellation, partially reduces the severity of these symptoms. With simultaneous use with MAO inhibitors, severe reactions may develop due to possible overexcitation or inhibition of the central nervous system with the occurrence of hyper- or hypotensive crises (should not be prescribed while taking MAO inhibitors, as well as within 14-21 days after the end of their intake). Naloxone restores breathing, eliminates analgesia after the use of morphine, reduces the effect of opioid analgesics, as well as the respiratory depression and central nervous system caused by them; large doses may be required to reverse the effects of butorphanol, nalbuphine, and pentazocine, which have been prescribed to eliminate the undesirable effects of other opioids; may accelerate the onset of symptoms of "withdrawal syndrome" against the background of drug dependence. Naltrexone accelerates the onset of symptoms of the “withdrawal syndrome” against the background of drug dependence (symptoms may appear as early as 5 minutes after the drug is administered, last for 48 hours, are characterized by persistence and difficulty in their elimination); reduces the effect of opioid analgesics (analgesic, antidiarrheal, antitussive); does not affect the symptoms caused by the histamine reaction. Reduces the effect of metoclopramide.

Do not use after the expiry date stated on the package.

Package

1 ml in ampoules. 5 ampoules are placed in a blister pack, 1 or 2 blister packs, together with instructions for use, are placed in a pack.

Termsholidays

For hospitals.

Manufacturer

RUE "Belmedpreparaty"

Republic of Belarus, 220007, Minsk, st. Fabricius. 30, phone/fax: (+37517) 22037 16,

e-mail: [email protected]

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ETHYLMORPHINE HYDROCHLORIDE- similar in action to codeine. In case of persistent cough, ethylmorphine hydrochloride is used as an antitussive agent orally intablets of 0.015 g. In eye practice, 1-2% solutions are administered ethylmorphine hydrochloride and ointments in conjunctival sac. E tilmorphine hydrochloride has analgesic and anti-inflammatory (anti-exudative) effect. Contraindications are the same as for omnopon.

Release form e tilmorphine hydrochloride: powder and tablets of 0.015 g. List A.

Recipe example e tilmorphine hydrochloride in Latin:

Rp.: Aethylmorphini hydrochloridi 0.015

D.t. d. No. 10 in tab.

S. 1 tablet 3 times a day.

INDALGIN- consists of ethylmorphine hydrochloride and indomethacin. Indalgin has a wide spectrum of action and high analgesic activity. when prescribing indalgin, the risk of drug dependence is minimized. Indalgin release form: capsules (Orion-farmos, Finland).

PROMEDOL- has a pronounced analgesic effect, but less strong than morphine. Promedol has a weaker effect on the centers: respiratory, emetic and vagus nerve. Promedol has an antispasmodic effect on the smooth muscles of the internal organs, and therefore it is advisable to use promedol for renal and hepatic colic. Promedol strengthens the rhythmic contractions of the uterus while relaxing its lower parts (promedol is used in obstetric practice to relieve pain and speed up labor). Side effects and contraindications for use are the same as for Omnopon.

Promedol release form: powder; tablets of 0.025 g; ampoules and syringe-tubes of 1 ml of 1% and 2% solutions. List A.

An example of a promedol recipe in Latin:

Rp.: Sol. Promedoli 1% 1 mi.

D.t. d. N. 10 ampull.

S. 1 ml subcutaneously (intramuscularly) 1-2 times a day.

fentanyl- released in the form of citrate. Fentanyl has a strong, but short-lived (up to 30 minutes) analgesic effect, which is 100 times greater than that of morphine, but more pronounced than morphine, it depresses the respiratory center. Fentanyl in combination with the neuroleptic droperidol is used for neuroleptanalgesia (pain relief without turning off consciousness). Fentanyl is also used for severe pain of various origins: renal, hepatic colic, postoperative pain, etc. Fentanyl can develop addiction and drug dependence!

Release form of fentanyl: 2 ml ampoules of 0.005% solution. List A.

Recipe example f entanyl in latin:

Rp.: Sol. Phentanyli 0.005% 2ml

D.t. d. N. 3 in amp.

S. 1 ml intravenously (intramuscularly) for renal colic.

The description is up to date 18.12.2014

Latin name: Promedolum
ATX code: N01AH
Active substance: Trimeperidine (Trimeperidine)
Manufacturer: GosZMP, Federal State Unitary Enterprise (Russia)

Composition

1 tablet includes 25 mg trimeperidine .

1 ml injection solution contains 10 mg or 20 mg trimeperidine .

Release form

The drug Promedol is available in the form of tablets of 10 or 20 pieces per pack, as well as in the form of a 1% or 2% injection solution in ampoules of 5, 10, 100, 150, 200, 250 or 500 pieces per pack.

pharmachologic effect

Analgesic, anti-shock, antispasmodic, uterotonic, hypnotic.

Pharmacodynamics and pharmacokinetics

The drug Promedol belongs to the pharmacological group narcotic (opioid ), with a major analgesic effect. The active substance of Promedol according to the INN classification is trimeperidine , has an agonistic effect on opioid receptors . Activates the endogenous painkiller (antinociceptive ) system , thereby violating, at different levels CNS, transportation pain impulses between neurons . Trimeperidine also affects the higher departments brain modifying emotional coloring pain syndrome .

Pharmacological effects of Promedol are similar to the effects and are expressed by an increase pain threshold with symptoms of pain of various origins, inhibition, as well as mild hypnotic effect .Suppression respiratory center , when using Promedol, manifests itself to a lesser extent, compared with morphine . The drug rarely causes symptoms such as nausea And vomit , somewhat reinforces contractile function And myometrial tone , has a spasmolytic effect of a moderate nature in relation to ureters And bronchi, as well as spasmodic action, yielding to the action morphine , towards intestines And bile ducts .

The development of the analgesic effect of Promedol, with its parenteral administration, is observed after 10-20 minutes, rapidly increases and reaches its maximum value after 40 minutes. High analgesic effects last for 2-4 hours, when carried out - more than 8 hours.

Oral administration provides an analgesic effect of the drug, which is 1.5-2 times less than when administered parenterally.

With any delivery method trimeperidine into the body, its absorption proceeds quite quickly. TCmax when taken orally is observed after 60-120 minutes. When administered intravenously, the content trimeperidine in plasma rapidly decreases and after 2 hours only trace concentrations are detected.

With plasma proteins trimeperidine connects by 40%. Basic metabolism takes place in liver through the process of hydrolysis with the release normeperidine And meperidic acid and further conjugation. T1 / 2 takes from 2.4 to 4 hours, with a slight increase.

Excreted kidneys in small quantities, including unchanged by 5%.

Indications for use

Cupping pain syndrome medium and strong intensity at:

pain after the surgical intervention ;
pain in patients
unstable angina ;
exfoliating aortic aneurysm ;
renal artery ;
sharp pericarditis ;
pulmonary artery and arteries of extremities;
air;
acute pleurisy ;
heart attack lung ;
spontaneous pneumothorax ;
perforation of the esophagus;
chronic;
paranephritis ;
acute dysuria ;
renal and hepatic colic ;
acute attack;
priapism ;
acute;
lumbosacral sciatica;
causalgia ;
sharp vesiculitis ;
thalamic syndrome;
acute neuritis ;
injuries and burns;
protrusions intervertebral disc;
foreign bodies in the urethra, rectum, bladder.

Promedol is prescribed in obstetric practice with the aim of labor pain relief and as an easy stimulant tribal activity.

IN surgical practice drug is indicated for premedication and in the composition, as an analgesic component (for example, holding neuroleptanalgesia in combination with antipsychotics ).

Pulmonary edema , acute left ventricular failure And cardiogenic shock are also among the indications for the use of Promedol.

Contraindications

Absolute contraindications to taking Promedol are:

patient to trimeperidine ;
age up to 2 years;
disease states in which respiratory depression ;
concurrent therapy with MAO inhibitors , as well as up to 21 days after their cancellation.

There are also a number of relative contraindications, in which the use of Promedol is possible only with extreme caution, these are:

respiratory failure ;
and/or liver;
chronic heart failure ;
adrenal insufficiency ;
traumatic brain injury;
CNS depression ;
myxedema ;
urethral stricture ;
surgical manipulations on the urinary system or the gastrointestinal tract system;
convulsions ;
obstructive pulmonary disease , chronic course;
arterial hypotension ;
emotional lability;
cachexia ;
elderly age;
weakened patients;
inflammatory nature;
(including history).

Side effects

blurring of visual perception;
diplopia ;
convulsions ;
involuntary muscle contractions;
weakness;
confusion ;
unusual or nightmare dreams;
anxiety;
paradoxical excitement;
muscle stiffness (especially respiratory);
inhibition of psychomotor reactions ;
tinnitus.

Promedol at appoint for And stimulation of labor activity . Injections are carried out in / m or s / c in doses of 20-40 mg, with a positive assessment of the condition of the fetus and the opening of the cervix by 3-4 cm. Promedol promotes relaxation of the muscles of the cervix thereby speeding up the process of its disclosure. The last injection should be made 30-60 minutes before the expected delivery , in order to avoid negative consequences during childbirth associated with suppression of fetal respiration .

The maximum parenteral dose for adult patients is 40 mg, and the maximum daily dose is 160 mg.

Children, older than 2 years, the dose of Promedol is from 0.1 to 0.5 mg / kg, with s / c, / m and rarely / in the introduction. Repeated injections, in order to relieve pain, can be carried out after 4-6 hours.

When conducting, as its component, Promedol is administered intravenously at 0.5-2.0 mg / kg / hour. Maximum dose throughout the entire duration operations , should be no more than 2 mg / kg / hour.

It is carried out at a dose of 0.1-0.15 mg / kg, previously diluted Promedol in 2-4 ml of sodium chloride for injection. The beginning of the effect of the procedure is observed after 15-20 minutes, the peak of action occurs after about 40 minutes, with a gradual decrease in efficiency over 8 hours or more.

Overdose

In case of an overdose of Promedol, the main negative effect is oppression of consciousness And respiratory depression , up to states . Various increased side effects may also be observed. characteristic feature Miosis (constriction of the pupils) may be diagnosing an overdose.

Interaction

During the parallel use of Promedol with sleeping pills And sedative drugs , anxiolytics, antipsychotics , muscle relaxants , ethanol, means general anesthesia and others narcotic analgesics , intensifies CNS and respiratory depression .

When taken systematically barbiturates , especially Phenobarbital observed a decrease in analgesic effect trimeperidine .

Promedol can increase effectiveness antihypertensive drugs (diuretics , ganglion blockers etc.).

Antidiarrheals And anticholinergic funds can lead to urinary retention , heavy constipation , intestinal obstruction .

Trimeperidine enhances the effects of drugs anticoagulant activity, in connection with which, when they are used together, control is necessary plasma prothrombin .

Therapy using , available in this moment or carried out earlier, lowers the effect of Promedol.

Combined treatment with MAO inhibitors can cause severe consequences associated with braking or overexcitation of the central nervous system and lead to the development hypotensive or hypertensive crises .

The effects are reduced when it is taken together with Promedol.

Naloxone being an antidote trimeperidine , removes it side effects: breath suppression , analgesia, CNS depression . At drug addiction accelerates the development of symptoms withdrawal syndrome «.

Also affects the acceleration of symptoms " withdrawal syndrome " at drug addiction . After the administration of the drug, persistent and difficult to eliminate symptoms appear quite quickly, sometimes after 5 minutes, and are observed for 2 days.

Terms of sale

To purchase this drug, you need a correctly filled Promedol prescription for Latin, on the form established by the rules, with all the attached details and seals.

Storage conditions

Both the injection solution and Promedol tablets belong to list A. The storage temperature of the drug is 8-15 ° C.

Best before date

For tablets and solution - 5 years.

special instructions

During therapy with Promedol, it is better to refrain from delicate and dangerous work, as well as from driving a car.

With the systematic use of Promedol may develop drug-like addiction .

children

It is prescribed for children after 2 years, strictly according to indications, in precisely recommended doses, with extreme caution and under medical supervision.

With alcohol

Treatment with Promedol should not be combined with the intake of alcoholic beverages.

During pregnancy (and lactation)

During periods (except for the onset of labor, in which the drug is indicated as an analgesic and stimulant), as well as during Promedol, it is prescribed with extreme caution, taking into account all possible negative effects of therapy for the mother, fetus or newborn.

Gross formula

C 17 H 25 NO 2

Pharmacological group of the substance Trimeperidine

Nosological classification (ICD-10)

CAS code

64-391-1

Characteristics of the substance Trimeperidine

White crystalline powder. Easily soluble in water, soluble in alcohol. Aqueous solutions have a pH of 4.5-6.

Pharmacology

pharmachologic effect- antispasmodic, anti-shock, uterotonic, analgesic (opioid), hypnotic.

Stimulates opioid receptors in the CNS. With the on / in the introduction of C max (9 μg / ml) is achieved after 15 minutes, then there is a rapid decrease in plasma levels and after 2 hours only trace concentrations are determined. Compared to morphine, it has a weaker and shorter analgesic effect, has less effect on the respiratory, emetic and vagal centers, does not cause smooth muscle spasm (except for the myometrium), and has a moderate antispasmodic and hypnotic effect. With s / c and / m administration, the action begins after 10-20 minutes and lasts 3-4 hours or more; oral administration causes an analgesic effect 1.5-2 times weaker than injection of a similar dose.

Application of the substance Trimeperidine

Expressed pain syndrome(unstable angina pectoris, myocardial infarction, dissecting aortic aneurysm, renal artery thrombosis, thromboembolism of the arteries of the extremities and pulmonary arteries, acute pericarditis, air embolism, pulmonary infarction, acute pleurisy, spontaneous pneumothorax, gastric ulcer and duodenum, perforation of the esophagus, chronic pancreatitis, hepatic and renal colic, paranephritis, acute dysuria, foreign bodies bladder, rectum, urethra, paraphimosis, priapism, acute prostatitis, acute attack of glaucoma, causalgia, acute neuritis, sciatica, acute vesiculitis, thalamic syndrome, burns, injuries, intervertebral disc protrusion, malignant neoplasms, postoperative period), acute left ventricular failure, pulmonary edema, cardiogenic shock, preparation for surgery (premedication), childbirth (anesthesia and stimulation), high fever, post-transfusion complications, poisoning with atropine, barbiturates, barium, gasoline, boric acid, strong acids, carbon monoxide, turpentine, formalin, snake bites, karakurt.

Contraindications

Respiratory failure, general exhaustion, early childhood (up to 2 years) and old age.

Side effects of Trimeperidine

Nausea, vomiting, weakness, dizziness, depression of the respiratory center, addiction, physical dependence.

Promedol is an opioid-type analgesic, which is a semi-synthetic analogue of morphine. It is used in medicine to reduce severe pain(generic, postoperative and others), but, like opiates of natural origin, with uncontrolled intake is highly addictive. We can say that promedol is a drug, the same as other natural or artificial opiates. He:

causes physical and psychological dependence;
when you stop taking it, it provokes a withdrawal syndrome;
even with rare use, it has a destructive effect on the body.

The substance belongs to medicines depressing the central nervous system and suppressing pain impulses. At the same time, it relaxes smooth muscles, has a hypnotic and antispasmodic effect. The substance was synthesized by Academician of the Academy of Sciences of the USSR organic chemist I.N. Nazarov. It is a white powder, tasteless or odorless, which dissolves in water and alcohol and is produced by the pharmacological industry in the form of injection solutions of 0.1-0.2 g of trimeperidine hydrochloride and 25 mg tablets. The effect of the reception is felt after 15-20 minutes and lasts up to 4 hours.

Official authorities classify Promedol as a drug group and stipulate special conditions for its sale and accounting. The widely used analgesic today is increasingly perceived with skepticism. In an English study by Beverly Lawrence Beach that examined questions drug therapy in childbirth, it was noted that promedol depresses the respiratory activity of the child. It becomes the cause of pathological drowsiness in infants, disrupts natural development. Due to its receptor-depressing effect, the artificial opiate harms breastfeeding.

What is promedol used for in medicine

What is promedol from the point of view of a doctor? It's an anesthetic, more powerful than anything morphine is made from. The medical name of the drug is trimeperidine. It was synthesized as part of the morphine molecule as a safer analog that does not cause respiratory arrest, coma and fatal outcome. Their action is similar - it is a quick and effective pain relief, uterotonic and hypnotic effect. The drug has a strong effect on the body:

changes the nature of the transmission of impulses between CNS neurons;
affects the higher parts of the brain;
oppresses conditioned reflexes and slows down the nervous system.

The use of the drug in medicine is justified with individual intolerance to strong anesthetics, with premedication, as an analgesic for oncological diseases, injuries, burns, in the postoperative period. When used with novocaine and other anesthetics, the drug enhances their effect. Under anesthesia, it acts as an anti-shock agent.

Promedol during childbirth is used for anesthesia, stimulation of the opening of the cervix, increasing the activity of the myometrium. The drug is also effective in other cases in which there is a connection between pain and spasms of smooth muscles - stomach ulcers, angina pectoris, heart attacks, colic. With its help, they reduce pain in acute prostatitis, paraphimosis, angina pectoris and other diseases.

With a rare intake, a single dose of addiction does not develop. However, if the indications are violated and the use of promedol is uncontrolled (the instruction warns about this), it causes a pronounced dependence.

Consequences of use and development of dependence

Dependence develops due to prolonged use of the drug (for example, in case of a serious injury), addiction to other drugs of the opium group - promedol, the price of which is lower and the availability is higher, replaces them. Using the drug, patients become indifferent to everything that happens around them, they are in a state of relaxation, to which they quickly get used. The drug has a weaker effect than other opiate drugs, but its abuse leads to:

psycho-emotional disorders, apathy, depression, the appearance of suicidal thoughts;
diseases of the liver, genitourinary and cardiovascular systems;
blood clotting disorder;
gastrointestinal disorders - nausea, vomiting, and so on.

Dependence develops due to internal cravings and social causes - a prescription for promedol in pharmacies is often not required, it is inexpensive and easily accessible. Because of its water solubility, it is easy to consume. Promedol, which is offered to buy on many semi-criminal sites, becomes the reason for switching to "hard" drugs - heroin and morphine.

Drug addicts lose interest in life, become emotionally unstable. Apathy is replaced by aggression, depression develops into severe forms. If the drug is injected, there is a high risk of infection, the development of inflammation. Because of the withdrawal syndrome, patients are unable to cope with the situation on their own.

How to get rid of addiction to promedol

In traditional programs for drug addicts, the emphasis is on drug rehabilitation. In case of drug approach is ineffective. Dependence on promedol is largely psycho-emotional, so an integrated approach is required. It is implemented by the Narconon program. The course, which usually lasts 8-10 weeks, includes non-drug weaning from the drug and practices that help the patient return to a healthy life forever.

The program has several stages:

non-drug weaning - pain syndrome and discomfort are removed with the help of assist techniques;
elimination of consequences toxic injury body using techniques New life» - saunas, running, special nutrition, taking niacin and mineral complexes;
restoration of healthy communication skills according to the methods of "Objective processes";
liberation from the past with support in leaving the former social circle - "Personal values" and "Overcoming ups and downs in life";
building constructive problem-solving skills and getting the tools to stop using drugs in the future - "Change of conditions in life" and "Life skills"

The program excludes relapses, breakdowns and return to the past. Its effect lasts for a lifetime.

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We will help motivate a person so that he has a desire to get rid of addiction.
We will give advice on how to communicate with drug addicts.