"Panangin" is a drug that affects metabolic processes. It supplies magnesium and potassium ions. Reviews about the "Panangin" consider in this article. The drug is available in the following forms.
- Film-coated tablets, the color is almost white or white. The shape is biconvex, round, with an uneven and slightly shiny surface, almost odorless.
One tablet contains 166.3 mg of potassium hemihydrate of asparaginate, 175 mg of magnesium tetrahydrate of asparaginate. Auxiliary components: 2 mg of colloidal silicon dioxide, 3.3 mg of povidone K30, 4 mg of magnesium stearate, 10 mg of talc, 86.1 mg of corn starch, 3.3 mg of potato starch.
In cardboard packs, bottles of polypropylene 50 tablets.
- The solution for intravenous administration is colorless or pale green, transparent, there are no noticeable mechanical inclusions.
In one ampoule, 45.2 mg of potassium asparaginate (in hemihydrate form), 40 mg of magnesium asparaginate (in tetrahydrate form). Excipients: 10 ml of water for injection.
Colorless glass ampoules (10 ml), five in plastic pallets, cardboard packaging.
Reviews about the "Panangin" are abundant.
Pharmacological effect
A drug that affects the metabolic processes. It is a source of magnesium and potassium ions, which are intracellular cations that play a major role in the activity of many enzymes, in the formation of bonds between intracellular structures and macromolecules in the mechanism of muscle contractility.
The extra- and intracellular proportion of sodium, calcium, magnesium and potassium ions affects the ability of the myocardium to contract. Endogenous aspartate acts as a conductor of ions: it is characterized by increased cellular affinity; due to a slight dissociation of salts, its ions in the form of complex compounds enter the inner part of the cell. Magnesium and potassium aspartate improves the metabolic processes of the myocardium. Deficiency of magnesium and / or potassium ions predisposes to the formation of atherosclerosis of coronary arteries, arterial hypertension and the appearance of metabolic transformations in the myocardium.
Among the most significant physiological potassium functions is the maintenance of the potential of the membranes of myocytes, neurons, and other excitable tissue structures of the myocardium. Violation of the relationship between extra- and intracellular presence of potassium leads to a decrease in myocardial contractility, the appearance of tachycardia, arrhythmia and increased toxicity of heart glycosides.
Magnesium is a significant cofactor of more than three hundred enzymatic reactions, including the synthesis and energy metabolism of nucleic acids and proteins. In addition, magnesium is of great importance in cardiac activity: it improves heart rate and contractility, leading to a decrease in myocardial oxygen demand. Decreased myocyte contractility of the smooth muscle walls of arterioles, including coronary, causes vasodilation and increased intensity of coronary blood flow. Thanks to magnesium, anti-ischemic effect is exerted on myocardial tissue.
The combination of magnesium and potassium ions in one drug is justified by the fact that a lack of potassium in the human body is often accompanied by a magnesium deficiency, requiring the simultaneous introduction of adjustments to the content of both ions. If the correction of electrolyte levels is carried out simultaneously, an additive effect is noted (a reduced degree of magnesium and / or potassium has a proarrhythmogenic effect). Magnesium and potassium also reduce the toxicity of heart glycosides, without affecting their positive inotropic effect.
Reviews and analogues of Panangin will be presented at the end of the article.
Features of pharmacokinetics
Feature of absorption: during internal use, the drug has high absorption. It is excreted along with urine. Information on the pharmacokinetics of this drug in the form of an intravenous solution does not exist.
Indications
"Panangin" is used:
- as part of the complex therapy of heart failure, acute myocardial infarction, cardiac arrhythmias (mainly ventricular arrhythmias and caused by an overdose of the body with cardiac glycosides);
- to compensate for the lack of magnesium and potassium while reducing their content in the human diet (for tablets);
- to improve cardiac glycoside tolerance.
This is confirmed by the instruction and reviews of cardiologists for Panangin.
Contraindications
The medication is forbidden to be taken orally:
- in chronic and acute renal failure;
- with hypermagnesemia;
- with AV blockade from I to III degree;
- with hyperkalemia;
- with Addison's disease ;
- with severe myasthenia gravis;
- with cardiogenic shock (blood pressure below 90 mm Hg. Art.);
- with hemolysis;
- with defects in amino acid metabolism;
- with acute metabolic acidosis;
- with dehydration of the human body.
Use with caution during pregnancy (especially in the first trimester) and when breastfeeding.
It is not administered intravenously in such cases:
- chronic and acute renal failure;
- hyperkalemia
- Addison's disease;
- hypermagnesemia;
- AV block from II to III degree;
- severe myasthenia gravis;
- cardiogenic shock;
- dehydration;
- adrenal cortex deficiency;
- safety and efficacy not determined when used by minors;
- pregnancy;
- lactation period;
- excessive sensitivity of a person to the composition of the drug.
It should be used carefully in the presence of the first degree of AV blockade, severe defects in liver function, acidosis of metabolism, the likelihood of swelling, defects in kidney function, if it is not possible to constantly monitor the presence of magnesium in the blood serum (risk of cumulation, magnesium toxic content), urolithic diathesis , hypophosphatemia, which are associated with malfunctions of the exchange of ammonium phosphate, magnesium and calcium.
Reviews about the use of "Panangin" are mostly positive.
Dosage
Tablets taken orally: one or two tablets are prescribed (three times a day). The daily maximum dose is three tablets at a time. The drug should be taken after eating, since the acidic environment of the gastric contents reduces its effectiveness.
The duration of the treatment course, as well as its repeated appointment, are determined by the doctor individually.
For intravenous administration, the drug is prescribed drip in the form of a slow infusion (twenty drops per minute). If necessary, can be reintroduced after 4-6 hours.
To prepare a solution for intravenous infusion, one or two ampoules are dissolved in 50-100 milliliters of a solution of glucose (dextrose) of five percent concentration.
The drug can be used for combination treatment.
Side effects
According to reviews of "Pananginum", when taken orally, the following side effects can be observed:
- vascular and heart system: a paradoxical reaction (an increase in the number of extrasystoles), AV block can be observed;
- digestive system: there may be diarrhea, vomiting, nausea, a burning sensation and discomfort in the area under the stomach (in patients with cholecystitis and gastritis);
- balance of water and electrolytes: hyperkalemia (paresthesia, diarrhea, vomiting, nausea), hypermagnesemia (thirst, redness of the face, decreased blood pressure, respiratory depression, hyporeflexia, convulsions).
Intravenous administration also has a number of side effects: if administered quickly, signs of hyperkalemia (myasthenia gravis, fatigue, confusion, paresthesia, cardiac arrhythmias, cardiac arrest, arrhythmias) and hypermagnesemia (decreased neuromuscular irritability, vomiting and urination, lethargy, may develop decrease in blood pressure). In addition, phlebitis, a paradoxical reaction and AV block (an increase in the content of extrasystoles) may develop.
All this is confirmed by the instructions and reviews.
Panangin Forte has exactly the same side effects.
Analogs
"Panangin" has the following structural analogues: "Asparkam", "Pamaton", "Asparkam-L", magnesium and potassium asparaginate "Berlin-Chemie", "Asparkam-Farmak", "Asparkam-UBF".
Reviews about "Panangin"
Reviews about the drug in the vast majority of cases are positive. It helps prevent heart attacks, eliminates severity, discomfort, improves overall well-being.
Of the shortcomings, only dizziness and weakness are noted, in some cases nausea. Very carefully, it should be prescribed to patients with low blood pressure or with a reduced heart rate.
Also below are reviews of cardiologists about Panangin
Opinions of experts
Opinions of specialists about this drug are also positive. True, some cardiologists consider him a "dummy." That is, in their opinion, there is no need to take his heart without serious pathologies with his heart, and in case of serious health problems this medication simply will not help.
We reviewed the Panangin preparation instructions and reviews.