Whether we like it or not, with the onset of pregnancy, life does not stop taking its course. Mom-to-be everything is also in contact with people, is in public transport, and at first leads an absolutely familiar way of life. Nevertheless, any expectant mother tries to protect herself as much as possible from possible diseases, because she has heard a lot about how an infection or disease can harm an unborn baby. Unfortunately, it is far from always possible to protect yourself.
Reduced immunity and acquired infections on this basis can seriously agitate the expectant mother. But it's best not to be afraid of the problem, but to know how to deal with it.
The usual methods of dealing with diseases are no longer suitable, because chemicals can seriously harm the development of a small unformed organism. Therefore, the treatment of a pregnant woman should always be as democratic and gentle as possible. Efficiency should not be forgotten either. If all of the above factors are taken into account, then one of the most safe means among antispasmodics is papaverine.
Papaverine - instructions for the use of suppositories during pregnancy
Suppositories with papaverine during pregnancy help to relax and eliminate various painful conditions. The drug is released in the form of tablets, solutions for injections and rectal suppositories. During pregnancy, candles are most often used, considering them as safe and effective as possible. Papaverine works especially well for problems such as hypertonicity of the uterus. Ease of application and local action can quickly improve a woman's well-being.Recall that hypertonicity is enough dangerous condition for a pregnant woman, as the constant tension of the uterus can cause spontaneous miscarriage... In order to avoid these unpleasant consequences, it is necessary to relieve the spasm and help relax the smooth muscles of the woman. It is with this task that candles with papaverine do. In addition, thanks to the candles, a woman can experience a certain sedative effect, normalization of the heart rate and general improvement.
Some doctors consider it inappropriate to use this drug during pregnancy. Nevertheless, most mothers who have experienced it on themselves testify to the opposite: the drug does not affect the baby and produces positive effect to the health of his mom.
Side effects
Unfortunately, like anyone medical drug, suppositories with papaverine have contraindications and side effects are possible. Among the side effects, it is necessary to highlight the appearance of nausea, drowsiness, increased sweating, intestinal problems, a decrease in blood pressure... Suppositories can provoke allergic reactions (especially if you have an individual intolerance to the components of the drug). Side effects are less common and are usually a natural reaction of the body to prolonged use or overdose.Please note that, despite all the positive reviews about this drug, it is categorically contraindicated to take it yourself, without prior consultation with a specialist. The doctor will prescribe the doses of the drug you need. The usual dose does not exceed three suppositories per day. If you have liver, eye pressure, heart or work problems thyroid gland- notify your doctor about this, papaverine may be contraindicated for you.
When introducing rectal suppositories, do not forget about the rules for their introduction. After you have performed the procedure, you need to lie down a little - this will contribute to a more effective action of the drug.
Pregnancy without any medication, with a glowing smile and good mood- this is something on the verge of fantasy. Usually, ecology, unhealthy diet and various diseases that were present before pregnancy leave an imprint on the state of a woman in a position. One of the very unpleasant symptoms is uterine hypertonicity. Usually, this condition is a consequence of insufficient production of progesterone, which makes the muscles of the uterus elastic and smooth. In such situations, papaverine is attributed to the tone of the uterus. It reduces cramping and reduces the risk of miscarriage from the moment the injection is given.
Why is papaverine needed during pregnancy?
What is papaverine for? His injections have a complex effect and are prescribed in order to:
- reduce blood pressure;
- improve blood supply to reduce spasmodic contractions of the muscles of the uterus;
- reduce the risk of termination of pregnancy.
Why is papaverine prescribed for pregnant women?
The action is due to the fact that it is an antispasmodic, thanks to which you can remove the spasm. Everyone knows that the uterus is also a muscular organ that can contract, thereby causing hypertonicity. Why does papaverine relieve spasm? This condition is combined with other symptoms, for example, if present low level progesterone, can provoke detachment of the ovum.
Also, papaverine can be prescribed in combination with other drugs if the problems with bearing a pregnancy are large enough. For example, there was bleeding, severe abdominal pain and other symptoms. If an ultrasound scan determines that the child's heartbeat is present, then hemostatic medications are prescribed along with papaverine. And with a lack of progesterone, hormonal drugs may also be prescribed.
Forms of release of papaverine
Papaverine injections during pregnancy are useful not only for women, but also for the unborn child's future. Papaverine can be used in the form of injections, in special suppositories used rectally, and in tablets. An injection of papaverine is easier to inject intramuscularly, and you can use the introduction through a vein if the patient's condition requires just such a drug intake. And if papaverine injections, which are injected intramuscularly, can be done independently, then intravenous use of the drug should be performed only health workers, because papaverine during pregnancy should be done as slowly as possible.
Experts do not prescribe papaverine tablets during pregnancy so often, they do not act immediately, and you need to wait a long enough time until they begin to give the desired effect. The candles of this remedy are more effective. Where to insert papaverine during pregnancy? Suppositories are used rectally. The action of the drug in this form is similar to the speed of action of the drug administered intramuscularly.
Dosage and combined use
Usually papaverine on early dates pregnancy is used in a small dosage, which is one candle per day. But if there is any indication, then the medicine can be used up to 3 suppositories per day. But for papaverine during pregnancy, the annotation warns that large dosages of the drug can lead to side effects. Therefore, in the admission process, it is imperative to adhere to the recommendations of the attending physician.
Papaverine during early pregnancy, the dosage of which is relatively low, is a very effective and popular remedy.But with the course of pregnancy, the action of the drug becomes insufficient. In such cases, papaverine in injections during pregnancy is combined with magnesium sulfate, and such a "cocktail" must be administered intravenously. But in the third trimester, papaverine tablets during pregnancy become completely ineffective. Therefore, it is used together with magnesia. Usually, this combination of drugs is used in cases where a shortened and softened cervix is present. But papaverine intramuscularly in such situations is only part of a comprehensive treatment. Without fail, a woman must be at rest, and at the same time she can be stitched on the cervical canal so that it does not shorten and contract.
Side effects and unwanted consequences
When using papaverine tablets during pregnancy, many women can observe certain side effects from taking the drug. And first of all, this is due to the fact that they take it thoughtlessly and not as prescribed by a doctor. That is, they exceed the recommended dosage, thinking that the medicine will help faster in this case.
Injections during pregnancy can also lead to a number of undesirable reactions, so it is still better to perform all procedures in a medical facility. When using papaverine, the instructions must be read. First of all, you need to find out the side effects and consequences of an overdose.
These can be various allergic reactions, severe drowsiness and a decrease in blood pressure, a lack of energy. Hyperhidrosis, loss of appetite, headache, nausea and constipation.
Papaverine can only be used as directed by a doctor.
Why is the slow administration of papaverine needed during pregnancy?
If you use the drug very quickly, the normal heart rhythm is disrupted, and this is already fraught with more serious problems for the woman's health.
Papaverine during pregnancy is a fairly safe drug, but in excessive doses it can be quite dangerous. But its danger manifests itself only when the drug is taken incorrectly or in high doses. At the same time, the usual dosage is not harmful to either the mother or her unborn child. It is already clear why papaverine is prescribed during pregnancy, why it is used for different dates pregnancy, and what consequences it causes. But in almost all cases, when a woman underwent a course of treatment with papaverine, the health of her baby was no longer threatened.
With the timely use of papaverine, the threat of miscarriage and premature birth is reduced.
Papaverine injections during early pregnancy are sufficient efficient view treatment. Many years of experience have shown that the medicine makes it possible to endure healthy baby, reduces the risk of spontaneous abortion and premature birth. Papaverine during pregnancy injections are not used for hypertonicity of the uterus in some cases. For example, those patients who have diseases of the liver, thyroid gland, tachycardia, or increased intraocular pressure.
Why are pregnant women prescribed papaverine for later dates if childbirth is just around the corner? The fact is that such a drug is able to prepare the cervix for generic activity... But the paradox of this medicine is that in the third trimester it is able to smooth out the consequences of negative factors as much as possible and slow down the processes of contraction of the muscles of the uterus.
During the period of bearing a baby, the use of any drugs can be carried out only as directed by a doctor. Papaverine during pregnancy refers to such a medication. This medicine is prescribed for strict indications, has a list of contraindications and a number of side effects. The possibility of its use and the appropriate treatment regimen is determined by a specialist.
Papaverine for pregnant women: benefit or harm?
Papaverine hydrochloride, which is the active substance of the drug, has an antispasmodic effect. This action is based on relaxation of the smooth muscles of blood vessels and organs. Papaverine is widely used in the treatment of certain pathological conditions during childbearing, since it does not have negative effects on the development of the child.
The use of this medication can reduce the tone of the uterus and improve blood circulation in the uteroplacental system.
In addition, in the later stages of gestation, this antispasmodic is prescribed in a form for rectal administration in order to prepare the cervix for disclosure, and immediately during delivery, papaverine reduces the severity of pain during contractions.
Based on the above facts, papaverine during pregnancy is undoubtedly a “useful” drug, however, it should in no case be used without the appointment of a qualified specialist. Ignorance of dosages, as well as the erroneous use of this medication, can lead to undesirable consequences, up to the need for hospitalization in order to relieve adverse symptoms and medical supervision.
If you are planning to become pregnant or are already carrying a baby, be sure to heed these recommendations.
One suppository for rectal use contains 20 milligrams (ml) of papaverine hydrochloride. Solid fat type A or witepsol is used as auxiliary substances in an amount sufficient for the preparation of a suppository weighing 1.19-1.31 g.
The drug is produced in a cardboard box, which contains two cell packs, each of which contains five suppositories.
Why is papaverine hydrochloride prescribed at different stages of pregnancy?
Papaverine suppositories when carrying a child are prescribed if there are such indications:
- Hypertonicity of the uterus and the threat of miscarriage as a consequence. It is the most common reason why papaverine is prescribed for expectant mothers. In acute conditions, in order to maintain pregnancy, the administration of injectable forms of the drug is required.
- Arterial hypertension as an independent pathology or as a manifestation of preeclampsia. Papaverine helps reduce blood pressure without adversely affecting the fetus.
- Colic: intestinal, renal, hepatic. The action of the drug is aimed at relaxing spasmodic structures, thereby eliminating pain and restoring the functionality of the affected organ.
- Bronchospasm. Papaverine helps to relax the bronchi, restore breathing and improve well-being.
The doctor prescribes the drug according to the scheme, depending on the pathology to be corrected and the trimester.
First trimester
Suppositories with papaverine during early pregnancy are used in the case of increased tone uterus. You should not start using the drug without a medical prescription, so as not to provoke side effects.
In acute clinical situations, when there is a threat of miscarriage, injectable forms of papaverine are used. In other cases, if necessary, suppositories with papaverine are prescribed for early pregnancy. The form of the drug for rectal administration is characterized by high bioavailability and prolonged action.
Second trimester
The papaverine drug in the form for rectal administration in the second trimester is prescribed for abdominal pain, an increase in blood pressure and in the presence of other indications that have already been listed above. At this time, not only papaverine is used, suppositories for pregnant women are combined with other drugs, depending on the clinical situation.
Third trimester
In the later stages of bearing a child, it is rational to use papaverine in case of excessive tone of the walls of the uterus. Also, closer to the preliminary date of birth, a medication is prescribed in order to prepare the cervical canal for disclosure. At the beginning of labor, the drug helps to reduce the intensity of pain during labor.
Thus, papaverine hydrochloride in the form of rectal suppositories is an effective antispasmodic drug that can be used to relieve various pathological conditions during the period of gestation.
The medicine is safe for the fetus, but it can provoke some side effects in the mother's body, so it should be used with caution.
Contraindications and side effects
The list of contraindications to the use of the form of the drug for rectal administration includes:
- hypersensitivity to components medicinal product;
- high intraocular pressure;
- impaired functionality of the kidneys and liver;
- atrioventricular block;
- diseases of the thyroid gland;
- heart rhythm disturbances.
It should be understood that the fact that papaverine can be used while carrying a child does not give a reason to self-medicate. This drug should be prescribed by a competent specialist if indicated and in the absence of contraindications.
- allergic manifestations (skin rashes and itching);
- heart rhythm disturbances;
- lowering pressure below acceptable indicators;
- drowsiness;
- dizziness;
- difficulty urinating and defecating;
- attacks of nausea and vomiting.
If any adverse reactions occur, you should consult a doctor for symptomatic treatment. In some clinical situations, it may be necessary to admit the patient to a hospital for medical supervision of her condition.
Method of using suppositories with papaverine during pregnancy
Features of the method of using papaverine depend on the trimester and the clinical situation. The answer to the question of where papaverine suppositories are inserted during pregnancy is unambiguous: these suppositories are used rectally, that is, they are inserted into the rectum. Under the influence of body temperature, the suppositories dissolve, and the active substance enters the bloodstream.
How to insert papaverine candles
Suppositories with an antispasmodic agent should be inserted in the supine position, in this sequence:
- first, you must thoroughly wash your hands and wipe them dry with a clean towel;
- then you should separate one candle from the contour packaging and carefully remove it from the cell;
- lie on your side, slightly raise the leg, which is on top, and insert the suppository into the rectum;
- then it is necessary to lie down for a while so that the active substance is released and enters the blood vessels.
Most often, the drug is prescribed 2-3 times a day at regular intervals. The duration of their use is from several days to three weeks. The duration of the course of treatment depends on the specific clinical situation.
Opinion of doctors on the use of papaverine
According to experts, papaverine in the form of a drug for rectal administration is safe for the health of the expectant mother and child. However, self-medication and dose adjustments should not be allowed without specialist advice. Exceeding the prescribed dosage can lead to a deterioration in the well-being of a woman, up to the need for hospitalization.
Dose adjustment when the clinical situation changes is carried out only by the attending physician.
Papaverine does not directly affect the fetus. This drug is approved for use at any time of bearing a child, provided there are indications and no contraindications. During the carrying of a child, the appointment of any kind of medication always causes future mother many questions and concerns.
A detailed study of the instructions for the drug, consultation with a doctor, familiarization with the thematic literature will help get rid of anxiety.
Suppositories with papaverine hydrochloride are safe for the child's body and cannot harm him. It should be accepted that adherence to the dosages recommended by a specialist minimizes the likelihood of adverse reactions from the mother's body.
Therefore, the most important thing is to regularly consult with doctors and take any therapeutic measures only when prescribed by a gynecologist or other medical specialist.
thanks
Papaverine(Latin - papaverine) is a widespread drug that has antispasmodic, vasodilatory and hypotensive effects. By origin and chemical structure, papaverine is alkaloid opium poppy, that is, it is obtained from poppy straw, but is not a narcotic substance.
Varieties, names, release forms and composition of Papaverine preparations
Papaverine is both the trade name of some drugs and the international name (INN) of the active ingredient in many drugs. Preparations with the trade name "Papaverine" are one and the same with the active substance "papaverine". This substance is called either simply papaverine, or papaverine hydrochloride... Moreover, papaverine hydrochloride is the chemical name for papaverine, and from the point of view of a doctor or patient, there is no difference between these terms. Currently, in the countries of the former USSR, drugs that contain only papaverine as an active ingredient are usually called simply "papaverine". In some cases, letters or abbreviations may be added to the word Papaverine, encoding the name of the manufacturer of the drug, for example, "Papaverine MS", "Papaverine Bufus", etc. However, in all cases it comes about the same drug produced by different factories, but containing the active ingredient papaverine.
In addition, there are multicomponent drugs with other names that simultaneously contain several active substances, among which there is papaverine. These are drugs such as Papazol, Andipal, Theodibaverin, etc. However, in this article we will consider exclusively monocomponent preparations containing only papaverine as an active substance and having the same name, respectively. In order to distinguish and not confuse the active substance and the name of the drug, we will write the first with a small letter, and the second with a capital letter.
Mono-component preparations containing only papaverine as an active substance are currently produced under the following commercial names:
- Papaverine;
- Papaverine Bufus;
- Papaverine MS;
- Papaverine hydrochloride.
Accordingly, the composition of the three dosage forms contains papaverine hydrochloride as an active substance in the following dosages:
- Tablets for adults - 40 mg;
- Tablets for children - 10 mg;
- Solution for injection - 20 mg per 1 ml;
- Rectal suppositories - 20 mg per suppository.
Since the pharmacological action of papaverine is multidirectional, it is simultaneously attributed to two groups of drugs, such as vasodilators (vasodilators) and antispasmodics... Accordingly, as an antispasmodic, Papaverine is used to treat functional disorders of the gastrointestinal tract, and as a vasodilator - in the treatment of erectile dysfunction.
Therapeutic effects of papaverine
Papaverine, by blocking the work of a number of enzymes, reduces tone and relaxes smooth muscles of all internal organs... The fact is that the internal organs (stomach, intestines, blood and lymph vessels, bronchi, lungs, urethra, etc.) are equipped with exceptionally smooth muscles, due to the work of which their general tone increases or decreases. With an increase in tone, the organ contracts, that is, its spasm occurs, and when it decreases, on the contrary, relaxation and expansion of the existing lumen occurs. For example, with an increase in the tone of the smooth muscles of the intestines, bronchi or gallbladder, the organs are strongly compressed, characteristic spastic pains appear and the movement of the contents along their lumens is impaired. That is, in the intestine, the movement of the food lump is delayed, bile stops flowing from the gallbladder, and the required amount of air cannot pass through the bronchi. In addition, any spasm of internal organs is accompanied by pain syndrome of varying intensity. Papaverine relieves spasm, relaxes organs, thereby restoring their function and relieving pain. Since the drug is not selective, it effectively relieves spasms and pains of any internal organ, and therefore is widely used. Basically, Papaverine has the same properties and therapeutic effects as the more widely known No-Shpa.
Papaverine has a relaxing effect only on internal organs, since it affects smooth muscles and does not affect striated muscles. The fact is that on the human body and in the heart there are only striated muscles, which have different properties and react to completely different stimuli and substances. Therefore, antispasmodics acting on smooth muscles do not affect the contractility of skeletal and cardiac muscles. Thus, Papaverine is able to relieve spasms and relax the muscles of internal organs without affecting the myocardium and body muscles.
Summarizing the described effects, the following main therapeutic effects of Papaverine can be distinguished:
- Relaxes smooth muscles and relieves spasms of smooth muscles of blood vessels, organs of the digestive, respiratory and genitourinary systems;
- By relaxing the muscles of the blood vessels and their subsequent expansion, it reduces blood pressure;
- High doses reduce the excitability of the heart muscle and slow down the conduction of the impulse through the heart;
- In high dosages, it has a sedative effect on the central nervous system.
Papaverine is rapidly absorbed into the bloodstream by any route of administration (tablets, rectal suppositories, intramuscular injections) and excreted by the kidneys. Half of the administered dose of the drug is excreted after 0.5 - 2 hours.
Papaverine (tablets and injections) - indications for use
The indications for the use of pills, injections and rectal suppositories of Papaverine are exactly the same, since, regardless of the dosage form, the drug is absorbed into the bloodstream and has systemic therapeutic effects.Papaverine tablets, injections and suppositories are indicated for use in the following diseases and conditions:
- Spasms of smooth muscle elements of the gastrointestinal tract in various diseases, such as pylorospasm, colitis, cholecystitis, cholangitis, etc .;
- Cramping pains (for example, with colitis, flatulence, menstruation, irritable bowel syndrome (IBS), constipation, etc.);
- As part of the complex therapy of cholecystitis and renal colic as an analgesic and relieving spasm of the organ of the drug;
- Spasms and pains in the organs of the genitourinary system (cystitis, pyelitis, kidney stones or urethra, etc.);
- Bronchospasm;
- Cerebrovascular spasm;
- Spasm of peripheral vessels, for example, with endarteritis and other diseases;
- As part of the complex therapy of angina pectoris;
- As an auxiliary drug in pre-anesthetic preparation (premedication).
Papaverine (papaverine hydrochloride) - instructions for use
Consider the rules and nuances of using each dosage form of Papaverine (tablets, suppositories and injection solution) separately.Papaverine tablets - instructions for use
The tablets should be taken orally, swallowing whole, without chewing, biting or crushing in other ways, but with a sufficient amount of water (about 200 ml). Papaverine can be taken regardless of food, and as needed, that is, when spastic pains or painful spasms occur. However, if there are spastic pains in the organs of the gastrointestinal tract, then it is better to take Papaverine 15-30 minutes before meals, so that the drug stops the symptoms, and the person can eat and drink calmly. For spasms and spastic pains of internal organs, adults and adolescents over 15 years of age are recommended to take Papaverine 40-60 mg (1-1.5 tablets) 3-4 times a day. Children should be given tablets with a special pediatric dosage of 10 mg. Moreover, the dosage of Papaverine for children is determined by age:
- 6 - 24 months - 5 mg (1/2 baby tablet) 3 - 4 times a day;
- 2 - 4 years - 5 - 10 mg (1/2 - 1 children's tablet) 3 - 4 times a day;
- 5 - 6 years old - 10 mg (1 tablet for children) 3 - 4 times a day;
- 7 - years old - 10 - 15 mg (1 - 1.5 baby tablets) 3 - 4 times a day;
- 10 - 14 years old - 15 - 20 mg (1.5 - 2 children's tablets) 3 - 4 times a day.
Papaverine in ampoules - instructions for the production of injections
The ampoules contain a sterile 2% solution of Papaverine, ready for administration, containing 20 mg of active substance in 1 ml. Since the ampoule contains 2 ml of solution, the total dosage of Papaverine in a whole ampoule is 40 mg, which is equivalent to one adult tablet. The solution can be administered intact subcutaneously or intramuscularly, and after reconstitution - intravenously. For adults and adolescents over 10 years of age, the solution is administered 2 to 4 times a day, and for children under 10 years of age - 2 times a day. A single dosage of Papaverine is determined by age:
- 6 - 24 months - 0.25 ml of solution 2 - 4 times a day;
- 2 - 4 years - 0.25 - 0.5 ml of solution;
- 5 - 6 years old - 0.5 ml of solution;
- 7 - years old - 0.5 - 0.75 ml of solution;
- 10 - 14 years old - 0.75 - 1 ml of solution;
- 15 years and older - 1 - 2 ml of solution.
For subcutaneous or intramuscular administration, the injection site is selected first. It is optimal to inject the solution intramuscularly into the upper-lateral outer surface of the thigh or the outer upper part of the shoulder, and subcutaneously - into the area around the navel. Before the injection, the skin is wiped with an antiseptic, after which the required amount of solution is drawn into the syringe and injected into the prepared place. For intramuscular injection, the needle is inserted deep into the tissue perpendicular to the surface of the skin. And for subcutaneous injection, approximately 1 cm of skin is first captured with a large and forefinger making a fold out of it. After that, the needle of the syringe is set at approximately 45 ° to the skin surface and inserted into this fold. The solution is released into the tissue and the needle is carefully removed, after which the injection site is again wiped with an antiseptic. Each time, the solution should be injected at a point that is at least 1 cm away from other marks from past injections.
For intravenous administration, you must first dilute the required amount of Papaverine in 10 - 20 ml of physiological solution. Then this mixture administered intravenously, slowly. Intravenous injections should be made only in a hospital setting, and subcutaneous or intramuscular injections can be done at home on their own, if the person has mastered their technique and does not feel fear.
Papaverine - instructions for the use of suppositories
Suppositories are inserted into the rectum by gently pushing with the index finger through the anus. Candles should be inserted with clean hands that have just been washed with soap or with sterile gloves. The dosage of suppositories for various diseases accompanied by spasms and spastic pains is determined by age and is 1 - 2 suppositories 2 - 3 times a day for adults, and 1 suppository 2 times a day for children over 10 years old. For children under 10 years old, the candles are cut into 2 or 4 equal parts and injected with these pieces containing the required amount of the active substance. So, children under 4 years old are injected with a quarter or half of a candle, and from 5 to 10 years old - half a suppository, 2 times a day. Dosage for various diseases
The dosage of Papaverine in all dosage forms is the same for various diseases and conditions, but differs only depending on the age of the person using the drug. So, single dosages of solution, suppositories and pills of Papaverine for people different ages the following:- 6 - 24 months - 5 mg each;
- 2 - 4 years - 5 - 10 mg each;
- 5 - 6 years - 10 mg each;
- 7 - years - 10 - 15 mg each;
- 10 - 14 years old - 15 - 20 mg each;
- Over 14 years old - 20 - 60 mg.
The maximum permissible single dose of Papaverine is the highest dose indicated for each age, multiplied by four. That is, for an adult, the maximum permissible single dosage is 60 * 4 = 240 mg, for a child from 10 to 14 years old - 20 * 4 = 80 mg, etc. The maximum allowable daily dosage is equal to the maximum single dose, multiplied by three.
special instructions
For any diseases that are indications for the use of Papaverine, you can choose the dosage form that seems most convenient at the current time. For example, if it is most convenient for a person to take pills, then this particular form should be chosen.If you need to quickly achieve a therapeutic effect, especially in the first days of an exacerbation of the disease, then injections should be used. After 2 to 3 days, if a person can swallow, injections should be replaced with tablets or rectal suppositories. It is not recommended to perform the entire course of therapy using subcutaneous or intramuscular injections, since this entails greater risks compared to taking pills. Therefore, injections should be given only if suppositories and tablets cannot be used for some reason. In general, doctors recommend being guided by a simple rule in choosing the form of the drug - always use either suppositories or tablets, and use injections only if necessary to obtain a quick therapeutic effect, but replace them with tablets or suppositories as soon as possible.
If a person suffers from gastrointestinal spasms, then he can use Papaverine both in suppositories and in tablets, based solely on personal preference. However, it should be remembered that when using papaverine suppositories, the clinical effect occurs faster than from tablets. Therefore, if necessary, obtaining quick effect it is better to use candles. It is also recommended to choose suppositories if a person, for some reason, cannot swallow pills.
With spastic pain in the organs of the urinary system, Papaverine suppositories are the best option, since when they are introduced into the rectum, the active substance very quickly reaches the affected tissues and has a powerful therapeutic effect. If, for some reason, suppositories are impossible or difficult to enter into the rectum, then they should be replaced with tablets.
In children, it is recommended to use Papaverine in the form of suppositories or special children's tablets with a low dosage of the active substance of 10 mg. Children should not be given halves or quarters of Papaverine tablets for adults, which contain 40 mg of the active substance.
Papaverine is not a drug intended for long-term course use, therefore it is used exclusively for a one-time relief of spastic pain against the background of an exacerbation of a disease or condition. This means that pills, suppositories or injections of Papaverine can be used on their own for 2 to 3 days, after which an improvement should necessarily appear, expressed in a decrease in spastic pain and unpleasant sensations in localization pathological process... If there is no improvement, then you should immediately consult a doctor, as this may indicate the development of severe surgical pathology, for example, appendicitis, bleeding, peritonitis, etc.
As prescribed by a doctor, Papaverine is usually used for 7-14 days or a little longer, until the complete relief of painful spastic pains. If a person has been suffering from any chronic disease for a long time, for example, cholecystitis, then he knows very well the symptoms of its exacerbation and the dynamics of improvements that occur while taking Papaverine, and therefore can independently determine the duration of taking the drug.
If a person is faced with spastic pain for the first time, then the first course of therapy should be carried out exclusively under the supervision of a doctor and independently record their own feelings, as well as positive dynamics. In the future, with an exacerbation of the disease, the relief of spasms will also be performed by antispasmodics, and their dynamics will not fundamentally differ from that which was recorded for the first time. And a person who remembers well the dynamics of reducing spastic pain and normalizing the condition, during periods of exacerbations in the future will be able to independently control how well and how well the treatment is going without visiting a doctor or going to the hospital. In addition, he will be able to record any distinctive manifestations of the dynamics of treatment and report them to the doctor, who, in turn, will specifically look for their cause and deal with the problem of diagnosing combined or atypical pathology.
Overdose
An overdose of papaverine is possible and is manifested by the appearance of double vision, weakness, drowsiness and a decrease in pressure. For the treatment of an overdose, the stomach is washed, after which the person is given sorbents (activated carbon, Polysorb, etc.) and milk, and the pressure is maintained at a normal level.Interaction with other medications
Papaverine reduces the therapeutic effect of Levodopa and Methyldopa.Papaverine solution is usually administered in a hospital setting, and for home use use only suppositories or tablets. To stop hypertonicity of the uterus, Papaverine is usually used in the form of rectal suppositories, since it is this dosage form that ensures the rapid flow of the active substance into the desired area. For any other diseases and conditions, pregnant women are usually advised to take pills. Dosages of Papaverine are the same as for all adults, that is, 1 suppository 2 to 4 times a day or 1 to 1.5 tablets 3 to 4 times a day. The duration of therapy is determined by the rate of normalization of the condition and is determined by the attending physician.
Suppositories with Papaverine during pregnancy
Suppositories with Papaverine during pregnancy are used quite often to eliminate uterine hypertonicity, introducing them into the rectum 1 piece at a time 2 to 4 times a day. Candles should be inserted with clean hands, washed with soap immediately before performing the manipulation. If it is impossible to wash your hands for any reason, then candles should be inserted with sterile gloves, since the ingress of microbes from the skin of the fingers into the rectum can provoke inflammatory processes in it, including candidiasis. Such inflammatory process will not proceed too violently, and therefore hardly noticeable, but it will increase the tendency to constipation and provoke flatulence and intestinal colic.In addition, No-Shpa with Papaverine is often used to prepare the cervix for childbirth, for which women take 1 tablet or inject 1 suppository of each drug 2 times a day for 2 weeks before the expected date of birth. This practice is widespread, but these preparations for preparing the cervix do more harm than good, because just before childbirth, when the uterus must actively contract and prepare, it is artificially "inhibited" by antispasmodics, relaxing muscles and reducing tone. As a result of the use of No-Shpa with Papaverine "to prepare the cervix", the likelihood of weakness in labor increases and, accordingly, the use of labor stimulation, labor induction and the imposition of forceps or vacuum. That is, it is not the preparation of the cervix that occurs, but the oppression of labor.
The use of No-Shpy with Papaverine does not reduce the risk of rupture, which in most cases depends only on the competent management of childbirth by a doctor. And to prepare the cervix for childbirth, which is carried out only when prolonged or urgent delivery is necessary against the background of a threat to the mother's life, completely different drugs are used (Prostin et al.) And non-pharmacological agents(kelp, Foley catheter, etc.).
Papaverine for children
Papaverine in any dosage form can be used in infants from three months of age. The instructions usually indicate that the drug is approved for use from 6 months, but practicing pediatricians, on the basis of many years of observation of the use of Papaverine, consider it justified and safe to use it from 3 months. After all, Papaverine is also part of the popular drug Omnopon, which is used for pain relief in childbirth.In babies of the first year of life, Papaverine is used mainly to relieve spastic pain and intestinal colic, and in older children - to relieve bronchospasm, as well as in the complex therapy of pancreatitis, hepatic colic and urethral spasms. In addition, if the child has a high fever and white, cold hands and feet, then Papaverine is given for the purpose of vasodilation 15 to 20 minutes before the antipyretic drug. In a situation where the hands and feet are cold, and the temperature is very high, antipyretic without first taking an antispasmodic (Papaverine, No-Shpy, Drotaverin, etc.) will not work, since the constricted, spasmodic vessels will not give off excessive heat and cool the body ...
Papaverine in children is used in all three dosage forms at dosages depending on age:
- 6 - 24 months- 5 mg (1/2 child's tablet, 0.25 ml of solution or 1/4 suppository) 2 times a day;
- 24 years- 5 - 10 mg (1/2 - 1 children's tablet, 0.25 - 0.5 ml of solution or 1/4 - 1/2 suppositories) 2 times a day;
- 5 - 6 years old- 10 mg (1 children's tablet, 0.5 ml of solution or half a candle) 2 times a day;
- 7 - 9 years old- 10 - 15 mg (1 - 1.5 children's tablets, 0.5 - 0.75 ml of solution or 1/2 - 2/3 candles) 2 - 3 times a day;
- 10 - 14 years old- 15 - 20 mg (1.5 - 2 children's tablets, 0.75 - 1 ml of solution, 2/3 - 1 candle) 2 - 3 times a day;
- Teenagers over 14 years old- 20 - 40 mg (1 adult tablet, 1 - 2 ml of solution or 1 - 2 suppositories) 3 - 4 times a day.
Papaverine from pressure
Papaverine dilates blood vessels and moderately lowers blood pressure; however, it is not used as a specific antihypertensive drug for long courses of treatment. Papaverine in combination with Dibazol is usually injected for hypertensive crisis - Hypersensitivity to drug components;
- AV block;
- Liver failure;
- Elderly age over 65;
- Children under 6 months of age.
- Traumatic brain injury suffered during the last 6 months;
- Shock conditions;
- Chronic renal failure 1.
Biospa tablets;
2. Vero-Drotaverine tablets;
3. Droverin injection, tablets;
4. Drotaverin MS, Drotaverin forte, Drotaverin-UBF, Drotaverin-Teva and Drotaverin-FPO - tablets;
5. Drotaverin-Ellara injection solution;
6. Nikoverin tablets;
7. No-Shpa tablets and injection;
8. No-shpa forte tablets;
9. Nosh-Bra injection and tablets;
10. Papazol and Papazol-UBF tablets;
11. Platyphyllinum with papaverine tablets;
12. Ple-Spa tablets;
13. Spazmol injection and tablets;
14. Spazmonet and Spazmonet forte tablets;
15. Spazoverin tablets;
16. Spakovin injection and tablets.Papaverine during pregnancy is widely used as an antispasmodic and analgesic agent, but for the safety of its use, it is necessary to know some of the features of the pharmacological properties of this drug. It carries out its action under certain conditions and does not directly affect the pain syndrome of an inflammatory nature, therefore, it is necessary to clearly differentiate the indications for prescribing the drug. The question of the benefits or harms of papaverine during pregnancy also comes from many factors, one of which is individual characteristics the female body.
Indications for the use of papaverine during pregnancy
The main indications are limited to its antispasmodic effect. Therefore, the drug can be used in the complex therapy of arterial hypertension, hepatic and renal colic, acute spasmodic pain of the intestine, cerebrovascular accident in the form of headache. In pregnancy, the indication for the use of the drug may be the threat of termination of pregnancy with hypertonicity of the uterus; papaverine can be used as a complex tocolytic therapy. Headaches caused by vasospasm or hypertension can also be treated with papaverine.
Pharmacodynamic features of the drug
The release form of the drug is tablets, rectal suppositories, injection solution. Due to the wide range of pharmacological forms, the drug has many uses, both for systemic administration and for local treatment. The drug has a myotropic antispasmodic property, which is realized through the action on muscle fibers. The mechanism of action of the drug is as follows: when papaverine hydrochloride enters the cell, it blocks the synthesis of cyclic adenosine monophosphate. This enzyme is responsible for normal muscle contraction and when it is blocked, the amount of calcium that enters the myocyte decreases, and this, in turn, prevents the muscle fiber from contracting, which expresses the antispasmodic effect of the drug. Due to this, it acts not only on the smooth muscles of the internal organs, but also on the vessels, which causes them to relax. It has a pronounced effect mainly on the arteries, which causes a decrease in blood pressure. If the dose of the drug is exceeded, then it can affect myocardiocytes and disrupt their function, which causes conduction disturbances in the heart muscle.
The method of administration of papaverine and the dose that is used depends on the pharmacological form. Papaverine tablets are dosed in 10, 20, 40 milligrams. Ampoules are available in a concentration of 2% and a volume of 2 milliliters. Rectal suppositories, 20 milligrams each. Putting papaverine during pregnancy in case of using suppositories is necessary at night, after evening dress. The course of treatment is at least five days.
Pharmacokinetic features of the drug
As a result of taking the drug inside, there is a rapid absorption of the active substance in the duodenum, and the maximum concentration of the drug in the blood is determined one hour after administration. The bioavailability of the drug ranges from 30 to 50% and its half-life is about two hours. After entering the blood, papaverine is 90% bound to blood proteins. Then papaverine enters the liver, where its metabolism takes place. The active substances that make up papaverine are excreted by the kidneys after metabolism and, in greater concentration, unchanged. Part of the drug can be stored as a depot in adipose tissue and liver. The drug is able to pass through the blood-brain and placental barrier, but the drug does not have a harmful teratogenic effect.
Basic principles of using papaverine during pregnancy
Can papaverine hydrochloride be used and is this drug harmful during pregnancy? This question is asked by many women who use this drug, but the purposes of its use may be different and, accordingly, the recommendations are also different. The instruction for papaverine says that papaverine is not harmful during pregnancy, since its active substances and metabolites do not have a direct toxic effect. Therefore, we are not talking about the harm of the drug in this case, moreover, it is often prescribed to pregnant women. Why is papaverine prescribed during pregnancy? Due to its myotropic antispasmodic action, papaverine has a wide range of indications for prescription. Papaverine in early pregnancy is most often prescribed as an antispasmodic agent in the event of early preeclampsia. In this case, a pregnant woman may be disturbed by nausea, vomiting, abdominal pain, and there may also be spastic pains that respond well to antispasmodics such as papaverine. Therefore, papaverine can be taken for this purpose. Also, one of the complications in early pregnancy can be the threat of miscarriage, which requires immediate tocolytic therapy. Therefore, together with topical hysterotropic tocolytic drugs, papaverine is administered, which additionally acts on the vessels and relieves not only spasm of the uterus, but also improves blood flow in its vessels and the vessels of the fetus. In this case, papaverine is prescribed in ampoules and administered in injections or drip, which increases the speed of the onset of the effect. A papaverine drip can also be used for a more prolonged effect.
Papaverine in late pregnancy in the second and third trimester of pregnancy also has wide application... It can be used for the same purpose with the threat of premature termination of pregnancy. It often happens that pregnancy is complicated by the development late gestosis with an increase in blood pressure. In this case, not only antihypertensive drugs, but also the use of papaverine, allow to control the pressure. For this purpose, this drug can also be used, since it helps to expand peripheral vessels and reduce pressure. Also, in the later stages, disturbances in the normal functioning of the gastrointestinal tract in the form of constipation or acute intestinal infections may develop. In this case, pronounced spasmodic pain in the abdomen along the intestines can be removed with an additional intake of papaverine, which will also relieve uterine hypertonicity. A very common problem in late pregnancy is hemorrhoids. Hemorrhoids during pregnancy develop due to anatomical and physiological changes in a woman's body during pregnancy. This is due to the fact that the uterus, with an increase in size, presses on all organs of the small pelvis - the rectum, bladder, and also on the inferior vena cava. All these changes contribute to the fact that the normal outflow is disrupted. venous blood from the rectum and its stagnation is formed with a gradual expansion of the venous sinuses. This problem brings a lot of unpleasant sensations and requires complex treatment. Papaverine is also used for hemorrhoids as an antispasmodic. In this case, preference is given to the use of papaverine suppositories, which show their local effect. There are features of the use of papaverine in connection with the gestational age. Thus, papaverine at 38, 39 and 40 weeks, when used, can cause weakness in labor, since it has a tocolytic effect. Therefore, the use of this drug for such a period should be justified, taking into account the possible onset of labor, which may be complicated by irregular contractions.
Thus, although the effect of papaverine is not great, the action and use of papaverine during pregnancy is not limited only to certain indications, but may be more widely used.
Contraindications to taking papaverine during pregnancy and features of side effects
Papaverine during pregnancy is contraindicated in case of acute disorders or serious pathologies of the liver and kidneys, which reduces its metabolism, as well as in the presence of allergic reactions in history or in case of allergy to additional constituent components of the drug. Local forms of papaverine in the form of rectal suppositories should not be used in the presence of erosions or other inflammatory lesions in the rectum. In the case of external hemorrhoids without fistulas, this drug is used. Also, a contraindication to its admission is a violation or depression of the respiratory act, a violation of the heart, in particular its conduction in the form of atrioventricular block. Use with caution in case of concomitant hypotension.
Side effects of papaverine during pregnancy are possible in the form of allergic manifestations with skin rash, nausea and vomiting, stool disorders with constipation, and abdominal pain. There may also be symptoms from the cardiovascular system in the form of conduction disturbances up to the blockade, extrasystole, arterial hypotension. There may be increased sweating and drowsiness, as well as transient asymptomatic elevation of liver enzymes.
An overdose of the drug is possible when the therapeutic dose is exceeded, which is manifested by dizziness, arterial hypotension, weakness, drowsiness, double vision, fading of the heart. There are no specific measures, it is necessary to carry out general detoxification measures.
The storage conditions for paracetamol are as follows: a shelf life of five years. Store at a relative temperature below 25 degrees, avoiding direct exposure to high and low temperatures, and also exclude high humidity.
