Piracetam (solution for injections 20%)
Solutio Piacetami pro injectionibus 20%
International unlicensed name
Piracetam.
Pharmacotherapy group
Nootropic agent.
Composition
1 vial with 5 ml of solution for injections contains piracetam 1 g.
Pharmacological action
Pharmacodynamics
Piracetam induces metabolic processes in the brain. It increases ATP concentration in the brain tissue, intensifies RNA and phospholipids biosynthesis, stimulates glycolytic processes and increase glucose utilization. The preparation improves the brain integrative activity and memory, as well as protects on various forms of cerebral anoxia and improves the learning process. Piracetam improves feedbacks between cerebral hemispheres and synaptic conduction in the neocortical structures, regenerate and stabilize cerebral functions, especially consciousness, memory and speech, intensifies mental efficiency and increases cerebral blood flow.
Pharmacokinetics
After intravenous and intramuscular administration piracetam is distributed in all the organs and tissues. The preparation penetrates through blood-brain barrier and is accumulated in the brain tissue. It is much slower to be excreted from the cerebrospinal fluid than from other tissues, what proves a high tropism in the brain tissue. Piracetam is practically not subject to biotransformation in the organism. It is mainly excreted by the kidney.
Indication
Piracetam is administered intravenously and intramuscularly on serious cerebral diseases, states of coma, as well as for arresting of abstinent, preliminary or delirious states or acute complications occurred in the period of psychopharmacotherapy.
Route and dosage
The preparation is administered intramuscularly or intravenously in adults starting with the dose of 2—4 g and then the dose can be immediately increased up to 4—6 g per day. The duration of treatment and the individual dose depend on the disease severity and reverse dynamics speed of the clinical presentation. For treatment of ischemic stroke piracetam is administered drop-by-drop in the doses 4 – 12 g per day during 2—4 weeks.
Amelioration being achieved, piracetam for oral administration should be prescribed.
For treatment of acute brain injuries piracetam is prescribed in the complex with other disintoxication and rehabilitation therapy, and for treatment of psychiatric diseases – with corresponding psychotropic agents.
Administration of piracetam can be sometimes accompanied by administration of psychotropic, cardiovascular and other medicines.
Special indications
The preparation affects the ability to drive.
Side effects
Side effects mainly occur when the preparation is administered in the dose more than 5 g per day. Higher irritability, excited state, sleep disturbance, headache, dyspeptic disturbances, sexual stimulation, higher motor activity are possible, and in elderly patients exacerbation of coronary deficiency sometimes is registered. In this case the dose of the preparation shall be decreased, the its administration shall be ceased.
Contraindications
Acute kidney failure, depression with anxiety (agitated melancholia), Huntington disease, pregnancy and lactation. The administration of piracetam is contraindicated in kids younger than 1 year old.
Precautions
In patients with kidney failure rest nitrogen and creatinine should be monitored, and in patients with liver diseases – laboratory parameters characterizing liver function.
The preparation shall be taken with care on serious cardiovascular diseases with marked blood hypotension, compromised kidney and liver functions. In patients taking antiepileptic agents piracetam should be administered as a long-term principal antiepileptic therapy, as the threshold of readiness for convulsions may fall down in predisposed patients.
Interaction with other medications
Piracetam intensifies the effects of thyroid hormones, neuroleptics, antidepressants and other psychotropic and stimulating agents increasing cerebral blood flow and indirect anticoagulants; antianginal agents (in elderly patients). It weakens the effect of anticonvulsion agents.
Overdosing
Side effects may be intensified on overdosing.
Product form
Solution for injections 20% in vial 5 ml. 5 or 10 vials in the package or blister. 1 or 2 blisters in the package.
