In the article, we will consider the cases in which Eufillin is used intramuscularly.
This is a bronchodilator. The medicine is available in the form of solutions and tablets, but in what case and in what dosages to use it is a difficult question. It depends on the severity of the pathological condition, the diagnosis of the patient, his age, indications and contraindications. Many people are interested: is it possible to inject "Eufillin" intramuscularly or intravenously, or is it better to use a tablet form? Experts are of the opinion that through intramuscular injection, the drug quickly penetrates into the bloodstream and the therapeutic effect occurs within a few minutes. This is indicated in emergency situations and in severe forms of diseases. In the case of moderate and mild severity of the pathology, the drug is administered orally.
Pharmacologicalproperties
The bronchodilator medication is a PDE inhibitor. The active substance is theophylline ethylenediamine s alt (which increases absorption and facilitates solubility). It has a pronounced bronchodilatory effect, which is due to a direct relaxing effect on the smooth muscles of blood vessels in the lungs and respiratory tract. It is believed that this effect is caused by selective inhibition of the activity of specific PDEs, which contributes to an increase in intracellular concentrations of cAMP. The results of the conducted experimental tests in vitro showed that isoenzymes of the 3rd and 4th types play the main role. Suppression of the functionality of these isoenzymes can also provoke some side effects of aminophylline (theophylline), in particular vomiting, tachycardia and arterial hypotension. Blocks purine (adenosine) receptors, which may be one of the factors affecting the bronchi.
Many people wonder if Eufillin can be used intramuscularly. More on that below.
Reduces airway hyperreactivity associated with the late phase reaction induced by inhaled allergens through a mechanism of unknown etiology that is not related to PDE suppression or blockade of adenosine exposure. There is also information that aminophylline increases the number and activity of T-suppressors in the peripheral blood.
The drug increases mucociliary clearance, improves the functioning of the intercostal and respiratory muscles, activates the contraction of the diaphragm and the respiratory center, increases itsensitivity to carbon dioxide molecules and normalizes alveolar ventilation, which ultimately leads to a decrease in the frequency and severity of apnea attacks. By normalizing respiratory functions, this drug helps to saturate the blood with oxygen and reduce the concentration of carbon dioxide. Increases lung ventilation in hypokalemia.
In addition, this medication has a stimulating effect on the activity of the heart, increases the frequency of heart contractions, increases blood flow in the coronary vessels and increases the need for oxygen in the heart muscle. It reduces the tone of the vascular walls (mainly the skin, brain and kidney vessels), has a peripheral venodilating effect, reduces vascular resistance in the lungs, and lowers blood pressure in the pulmonary circulation. Enhances renal blood flow, has a mild diuretic effect.
Expands the biliary extrahepatic tract, stabilizes the structure of the mast cell membrane, slows down the release of mediators that provoke the development of allergic reactions and platelet aggregation (inhibits the activation factor PgE2α and platelets), increases the resistance of erythrocytes to changes in the structure (normalizes the rheological properties of blood), reduces the likelihood of thrombosis and normalizes the processes of microcirculation, has a tocolytic property, increases the acidity of gastric juice. In high dosages, it has an epileptogenic effect.
Instructions for the use of "Euphyllin" intramuscularly isconfirms.
Pharmacokinetic properties
Aminophylline is metabolized in the human body at physiological pH to release free theophylline. The bronchodilating property is manifested at concentrations of theophylline in the blood in the range of 10-20 μg / ml. Concentrations greater than 20 mg/ml are considered toxic. The excitatory effect on the respiratory center is realized at lower concentrations - 5-10 mcg / ml.
The binding of the main element to plasma proteins is approximately 40%; in newborns, as well as in adults with some pathologies, the level of binding is reduced. In adult patients, plasma protein binding is approximately 60%, in newborns - 36%, in people with cirrhosis of the liver - 36%. The substance passes through the placenta (the level in the blood of the fetus is slightly higher than in the blood of the mother) and into mother's milk.
Theophylline is metabolized in the liver with the participation of some cytochrome P450 isoenzymes, the most important of which is CYP1A2. With metabolic changes, 1,3-dimethyluric acid is formed, as well as 3-methylxanthine and 1-methyluric acid. These metabolites are excreted through the urinary system. In adult patients, approximately 10% of the main component is excreted unchanged. In newborns, a significant part is excreted in the form of caffeine (due to the immaturity of the pathways of its subsequent metabolism), in unchanged form - approximately 50%.
Strong individual differences in hepatic metabolic ratetheophylline are considered the main cause of the pronounced variability in clearance, blood concentration, half-life. Hepatic metabolism is affected by factors such as smoking habits, age, dietary preferences, diseases, and concomitant drug therapy.
The half-life of theophylline in non-smoking patients with bronchial asthma with almost no pathological changes in other systems and organs is 6-12 hours, in people with addiction to smoking - 4-5 hours, in children - 1-5 hours, in the neonatal period and in premature babies - 10-45 hours. This interval increases in the elderly and in people suffering from liver disease or heart failure.
Clearance decreases in violation of liver function, heart failure, pulmonary edema, chronic alcoholism, COPD. Ethylenediamine does not affect the pharmacokinetic properties of theophylline.
Is it possible to use "Eufillin" intramuscularly, it is important to find out in advance.
Composition and release form
The main active ingredient of the drug is aminophylline. It is thanks to him that all the pharmacological actions of the drug are achieved. For intramuscular administration, it is produced in the form of ampoules. The composition of the solution (concentration 24 mg / ml) includes the main substance and an auxiliary component - water for injection. Ampoules contain 5 or 10 ml of medical solution.
Indications for prescription
Medication "Eufillin" intramuscularlyis prescribed for the following pathological conditions:
- Asthmatic status (as additional treatment).
- Apnea in the neonatal period.
- Left ventricular failure with bronchospasm and impaired respiratory function of the Cheyne-Stokes type (as part of complex treatment).
- Edematous syndrome of renal nature of origin.
- Ischemic cerebrovascular disease (as part of complex therapy), acute and chronic heart failure (as part of combined treatment).
- Broncho-obstructive syndrome of various etiologies (including COPD, bronchial asthma, pulmonary emphysema, chronic obstructive bronchitis), increased pressure in the pulmonary circulation, apnea, cor pulmonale.
Instructions for use
How to use according to the instructions "Eufillin" in ampoules - intramuscularly or intravenously?
The mode of selection of dosages of this drug is individual, depending on age, indications, clinical situation, the presence of nicotine addiction.
In conditions requiring emergency care, adults are shown the use of "Euphyllin" intramuscularly in a loading dose. If the patient has previously taken theophylline, the dosage of aminophylline should be halved.
What else does the instruction for the use of "Eufillin" in ampoules intramuscularly tell us?
Contraindications
Injection of the drug is contraindicated in the following cases:
- hypersensitivity toaminophylline and other xanthine derivatives;
- angina;
- myocardial infarction in the acute stage;
- acute heart failure;
- extrasystole;
- paroxysmal tachycardia;
- pulmonary edema;
- severe arterial hypertension/hypotension;
- vascular atherosclerosis;
- hemorrhagic stroke;
- having a history of any sudden bleeding;
- hemorrhage in the tissue of the retina;
- peptic ulcer at the stage of exacerbation;
- epilepsy;
- elevated seizure threshold;
- gastroesophageal reflux (GER);
- uncontrolled hypothyroidism;
- thyrotoxicosis;
- porphyria;
- sepsis;
- liver or kidney problems.
Can everyone inject "Eufillin" intramuscularly?
Due to the likelihood of side effects, it is not recommended to use the solution in children under 14 years of age. In children older than 3 years, this medicine can only be used in an emergency, for a period not exceeding 14 days.
Adverse reactions
According to the instructions for use, "Eufillin" intramuscularly can provoke a number of adverse reactions, including the following:
- Nervous system: restlessness, dizziness, tremors, sleep disturbances, convulsions.
- Cardiovascular system: irregular heart rhythms, palpitations, pain in the heart area,tachycardia, lowering blood pressure, various arrhythmias, cardialgia, increased symptoms of angina pectoris.
- Digestive system: gastroesophageal reflux, nausea, heartburn, vomiting, diarrhea, exacerbation of peptic ulcer; with prolonged use, anorexia may develop.
- Urinary system: hematuria, albuminuria.
- Allergic manifestations: skin rash and itching, febrile syndrome.
- Metabolism: Hypoglycemia (rare).
- Reactions of a local nature: hyperemia, induration, soreness at the injection site.
- Other side effects: tachypnea, chest pain, facial flushing, albuminuria, hematuria, increased diuresis, excessive sweating.
Can "Eufillin" in ampoules be used intramuscularly during pregnancy and lactation? Find out further.
Use during pregnancy and lactation
The drug crosses the placenta, and therefore the use of aminophylline during pregnancy can lead to the creation of potentially dangerous levels of the active substance and caffeine in the blood of a newborn baby. Children whose mothers received aminophylline during pregnancy need medical monitoring of possible signs of intoxication in the first days of life.
Theophylline is excreted in breast milk. When using the drug during lactation, excessive agitation and irritability in the child may occur. In this regard, the use of this drug during pregnancy and lactationmay be prescribed only in cases where the benefit of therapy for the mother outweighs the potential risk to the child.
Special Recommendations
With caution, the Euphyllin medical agent is intramuscularly used according to the instructions for severe coronary insufficiency (angina pectoris, acute stage of infarction), obstructive hypertrophic cardiomyopathy, widespread atherosclerosis, rapid ventricular extrasystole, high convulsive readiness, liver or kidney failure, recently past bleeding from the digestive tract, with peptic ulcer, uncontrolled hypothyroidism or thyrotoxicosis, with prolonged fever, prostatic hypertrophy, gastroesophageal reflux, in elderly patients and in children.
Aminophylline dosage adjustment may be necessary in case of heart failure, liver dysfunction, fever, prolonged alcoholism, SARS. Dosage reduction may be required in elderly patients.
Aminophylline is not used simultaneously with other xanthine derivatives. During the period of therapy, the use of products that contain xanthine derivatives should be avoided. With caution, the drug is used simultaneously with purine derivatives and anticoagulants. Combined use with glucose and beta-blockers should be avoided.
Is it possible to inject "Eufillin" intramuscularly, it is now known.
Reviews
Reviews about this medicinal producta little, since most often it is used only in stationary conditions. However, patients point to some cases of prescribing a medication for home use in bronchial asthma, in particular when an attack of this disease occurs.
Reviews indicate that the drug has a very high efficiency, quickly eliminates signs of a serious condition in patients, facilitates breathing and is prescribed for obstructive bronchitis and some cardiac pathologies.
There are quite a lot of side effects from using Eufillin in intramuscular injections according to the instructions. Patients to whom the drug was administered note that about 15 minutes after application, they experienced severe nausea, and sometimes even vomiting. There are also indications of severe dizziness, disturbances in the functioning of the nervous system.
We reviewed the instructions for "Eufillin". It is administered intramuscularly in severe forms of pathologies.
