Regarding deacetyl piloanthrin, you need to know at least these 3 points

*For medical professionals only

Clinical decision-making can be simpler

Deacetyl pithyroside injection is a more clinically used cardiotonic drug, mainly used for heart failure. Because of its rapid effect, it is suitable for patients with acute cardiac insufficiency or acute exacerbations of chronic cardiac insufficiency [1-2].

The dosage of deacetyl piloidin injection has always been a topic of focus for clinical workers. So, patients who have encountered different situations, how should the dose of deacetyl piloidin injection be adjusted? What should I do if I have an overdose? Let's take a look at the collation of the world's small medicines!

Medication for special populations

1

Medication for children

The usual amount in children should be given in 2-3 doses with an interval of 3-4 hours according to the following doses:

Premature infants and term newborns, or children with renal insufficiency and myocarditis, intramuscular or intravenously, at 0.022 mg/kg of body weight;

Children aged 2 weeks to 3 years, according to body weight 0.025 mg/kg.

After the intravenous injection of this product has a satisfactory effect, it can be changed to the usual maintenance amount of digoxin to maintain the efficacy.

The tolerance of this product in newborns is uncertain, and its renal clearance may be reduced. Premature and immature infants are sensitive to this product, and the dose is reduced according to its immaturity. Given by weight or body surface area, infants over one month of age are slightly larger than adults [1-2].

2

Medication for the elderly

Elderly patients with hepatic and renal insufficiency, decreased apparent volume of distribution or electrolyte imbalance have low tolerance to this product and must reduce the dose [1-2].

3

Medication during pregnancy

This product can pass through the placenta, so the maternal dosage in the third trimester of pregnancy can be appropriately increased, and the dose can be reduced 6 weeks after delivery [1-2].

4

Medication during lactation

This product can be excreted into breast milk, and the use of this product by lactating women must weigh the advantages and disadvantages [1-2].

Precautions[1-2]

This product should be used with caution if:

Hypokalemia;

Incomplete AV block;

Hypercalcemia;

Hypothyroidism;

Ischemic heart disease;

Acute myocardial infarction in the early stages (AMI);

Myocarditis active period;

Impaired renal function.

Follow-up examination should be paid attention to during the medication:

Blood pressure, heart rate and heart rhythm;

Electrocardiogram;

Cardiac function monitoring;

Electrolytes especially potassium, calcium, magnesium;

Renal function;

When digitalis poisoning is suspected, digoxin blood concentration measurement should be done. Digoxin toxicity concentration is >2.0 ng/ml.

When the drug is overdose, due to the small accumulation, the toxic manifestations can generally subside 1-2 days after stopping the drug.

Drug overdose regimens[1-2]

Mild poisoning: discontinue this product and diuretic treatment, if there is hypokalemia and kidney function is still good, potassium salt can be given.

People with arrhythmias can use:

Intravenous infusion of potassium chloride is often effective in eliminating ectopic rhythms.

Phenytoin, which competes with cardiac glycosides for Na+-K+-ATPase, has a detoxifying effect. Adults should be given 100-200 mg plus 20 ml of water for injection slowly intravenously, if the situation is not urgent, it can also be taken orally, 0.1 mg each time, 3-4 times a day.

Lidocaine, effective in eliminating ventricular arrhythmias, is given intravenously in adults with 50-100 mg in addition to glucose injection, which can be repeated if necessary.

Atropine, available in people with bradyarrhythmias. Adults with 0.5-2 mg subcutaneously or intravenously.

When bradycardia or complete AV block has the potential to develop Ashr syndrome, a temporary pacemaker may be placed. Isoproterenol, which can raise a slow heart rate.

Calcium Disodium Edetate, for its integration with calcium, can also be used to treat arrhythmias caused by digitalis.

Digitalis poisoning may be given intravenously via membrane filters to digoxin immune Fab fragments, approximately 0.6 mg of digoxin or digitalis toxin per 40 mg of digoxin immune Fab fragments.

Pay attention to the dose should be reduced when liver function is poor. Simultaneous administration of phenytoin, phenobarbital, phenylbutazone, and rifampicin will reduce the concentration of digitalis toxin in the blood by 50%.

Ultra-complete drug usage, comparison of domestic and foreign instructions, dose adjustment scheme for special populations

All in the "Evidence-Based Medicines" column~

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Source: Clinical Pharmacy Channel of the Medical Community

Editor-in-charge: Zheng Huaju

Proofreader: Zang Hengjia

Plate making: Xue Jiao