Piracetam - first of drugs classified as nootropics. 1972 was described in the Belgian pharmacists and considered the ancestor medicaments firing higher mental processes and metabolism in the central nervous system. Piracetam for infants and children of all ages used in pediatric neurology for about 50 years, and shows a high degree of efficiency and safety. The drug is approved for use from birth as intramuscular and intravenous injections, since the year - parenterally in the form of crushed tablets.
Description piracetam
piracetam - a synthetic derivative of pyrrolidone - substances whose chemical structure is similar to GABA (main braking mediator). However, in the body pyrrolidone is not transformed into GABA, so piracetam and its analogues (Lutset, Fenotropil, Nootropil) does not have an inhibitory effect on the CNS. Some synergistic (amplification) GABAergic effect observed upon administration of the drug at high concentrations at frequent or repeated use.
The main physiological effect of piracetam in newborns:
- neurotrophic. Piracetam enhances glucose uptake by cells of the brain, especially the cortex, and it activates the oxidation of ATP exchange cycle - the main energy source in cells.
- neuroprotective. Activation ATP exchange cycle contributes to the development of protective phospholipids and proteins, which neutralize free radicals in the marrow and blood cells, normalize permeability and fluidity of the cell membrane, reduce the degree of lipid peroxidation in membranes.
- vascular. Piracetam for infants shows soft antiagregatnoe effects: reduces the viscosity of the blood increases the flexibility and mobility of erythrocytes, removes vasospasms without signs of hypotension. On systemic hemodynamics in a child this pyrrolidone derivative does not affect, however, expressed in violation of the circulatory drug should be used with caution.
Indications:
- newborn hypoxia caused by complications at birth (birth asphyxia, premature detachment of the placenta previa fruit, etc.) or a pathological pregnancy (placental insufficiency, infection, diabetes mother and etc.);
- cranial birth trauma;
- toxic-metabolic lesion child brain (usually due to the use of a pregnant woman to the fetus hazardous medicaments or drugs);
- undifferentiated cases of perinatal CNS lesions (USC); encephalopathy;
- comatose syndrome;
- cortical myoclonus;
- cerebral palsy;
- Down's syndrome;
- autism;
- epilepsy;
- viral and bacterial infections of the CNS.
Contraindications for use in the first year of children:
- chronic renal failure in advanced stages (QC <20ml / min);
- hypersensitivity.
Carefully:
- malfunction of the circulatory system;
- renal failure (creatinine clearance of 20 to 80 ml / min);
- after surgery;
- large blood loss.
The essence of preventive measures in the application of piracetam in children is reduced to a constant monitoring of the kidneys, cardiovascular system and blood profile.
Side effects in children in the first year of life:
- hypertonicity of muscles;
- convulsions;
- tremor;
- increased excitability, irritability, anxiety, insomnia;
- ataxia;
- allergic response (rash, swelling, urticaria);
- dyspepsia; vomiting; vomiting; colic;
- Propafenone and overdose - headache, hallucinations, dizziness;
- in disorders of lipid and carbohydrate metabolism - weight gain;
- very rarely - hypotension, fever.
The risk of a side effect is most pronounced in infants is, as for the relief of the effects of perinatal brain lesions most commonly used injections newborn. Piracetam in the form of injection is most powerful and profound effect, so the appointment of the doctor recommends a course to start with lower dosages.
Interaction with other drugs
- CNS stimulants - strengthening joint action.
- Antipsychotics - increased extrapyramidal disorders.
- Thyroid hormone drugs - a manifestation of irritability, tremor.
clinical application
Piracetam is one of the most popular drugs used in neonatal neurology due to the absence of toxic action, low frequency manifestations of severe side effects and good therapeutic activity with light and medium injuries brain. Agent refers to a class of drugs mild, it has a delayed effect; the possibility of overdose is minimal for the child.
For the treatment of the consequences of birth defects in children are commonly used injections newborn. Piracetam in this case shows the most dramatic effect. Duration determined by a doctor, but even single or episodic administration means substantially improve brain blood flow and intensity reflexes.
Dosage
Children first year of life drug is given at the rate of 30-50 mg / kg body weight per day. The exact dosage of piracetam newborn depends on the degree of CNS involvement, stage of disease and recovery dynamics.
sources:
Vidal: https://www.vidal.ru/drugs/piracetam__41225
GRLS: https://grls.rosminzdrav.ru/Grls_View_v2.aspx? routingGuid = c6acfe2a-e191-431d-90ad-3d92e4f3eb7d & t =
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