Structure
In tablets, the De-Nol is contained colloidal bismuth salt form, and citric acid. In terms of the dry residue in the form of bismuth oxide in each tablet is 120 mg of this component.
Mechanism of action
At the heart of De Nol play a role gastrotsitoprotektivny, astringent and anti-microbial effects.
Principle enveloping effect De Nol associated with chemical transformations bismuth citrate in a low pH environment (rN≤4.0). Under the action of acids, which catalyze the reaction of the soluble salt of bismuth tablets react with hydrochloric acid in the stomach to form an insoluble precipitate. In the form of a film it covers the affected region of the mucosa, thereby terminating the ingress of gastrointestinal enzymes rich content, food and digestive acids.
Specificity of the film formation is in the affected areas due to the fact that bismuth salts also form chelate intermolecular attached to the protein structures that have emerged when damaged layer of the epithelium and the connective tissue in the area erosions and ulcers.
The antibacterial effect is due to a specific effect on Helicobacter pylori. De-Nol is capable of blocking prrteoliticheskie enzymes, penetrating deep into microbial cells as well as protein binding to its membrane permeability and cause a violation. Thus, the reduced ability of bacteria to multiply and movement that suppresses their growth and spread of the digestive system. Today was not detected Helicobacter strains that are resistant to the action of bismuth.
Cytoprotective influence is evident in this complex:
- Stimulation overproduction PG E2, which increases the amount of mucin (protective protein binder in gastric secretions) and changing buffer properties juice by increasing bicarbonate concentration. PG E2 stimulates Mucocytes stomach that leads to the production of more mucus;
- Improved performance of capillary channel anterior duodenum, which promotes rapid healing of the cells with the active flow of blood enriched with oxygen and nutrients;
- Decreased activity fundic gastroepiteliotsitov (Produktoriya-cell hydrochloric acid), which reduces the acidity of chyme;
- Conjugation of bismuth salts with proteolytic enzyme pepsin, which takes part in destroying the protein structure forming the stomach wall. Bismuth leads to its inactivation in the acidic environment.
Admission Regulations De Nola
According to the foregoing, the answer to the question, to take before or after meals De Nol, is obvious.
The drug must form a protective barrier on the mucosal surface of the defect, so the stomach before it must be empty reception. For the appearance of a film of bismuth salts you need to De-Nol drink before eating, not earlier than 30 minutes before the meal. When the medicament is washed down with clean water.
For half an hour before and half an hour after administration of De Nol should not be consumed beverages that can inactivate medicine: tea, juice, coffee, milk and containing his food, cocoa, carbonated water, alcohol.
Because alcohol triggers an increase in the acidity of the stomach and has an irritant effect, it is recommended to exclude beverages with its content until the end of the therapeutic course.
To active drug components moved in a soluble form and take effect in the stomach, De-Nol necessarily need to drink with plenty of water.
Reception after eating
Although it is correct drink preparation De-Nol before eating is not always easy to orient the patients food intake and medication on time. That is why patients often wonder if you can De-Nol taken after meals and what time intervals between the food and drink drugs should still be.
The duration of the chyme Spent a lot of factors affect the stomach: The presence of disorders of motor-evacuation function of the level of acidity and the number of enzymes in the digestive juice. But on average, depending on the type of food it is digested about:
type of product |
The exposition in the stomach |
Liquid: drinks, vegetable broths |
15-20 min |
Vegetables and fruits without refueling |
30-40 min |
Root vegetables and seasoned vegetables |
50 min - 1 hour |
Eggs, fish |
1 hour |
Starchy food (cereals, potatoes, etc.) |
1.5-2 hours |
Milk products |
2 hours |
Bird |
2.5-3 h |
Nuts, beans |
3 h |
Lean red meat |
4 hours |
Fat meat |
5.5-6 h |
From what has been eaten before receiving the De-Nol, will depend on the time interval between meals and medication.
The instructions stated that after a meal to drink De Nol after at least two hours after the end of the meal. But if the patient is at the discharge diet and consume light food, such as vegetable soups, fish, steamed vegetables and eggs are allowed an hour after eating to take De-Nol.
After emptying into the duodenum must be at least half an hour, so the manual states that you need to De-Nol drink two hours after a meal.
Dosages and dosing frequency
Reception De Nola depends not only on food, but also on the patient's age.
The medicine is prescribed to 4 years of age, according to the schemes of two- or four-stages:
- Patients up to 8 years of medicine are calculated individually, based on the child's body weight. Per day is necessary to take from 4 to 8 mg / kg body weight. The dosage per day should not exceed 2 tablets with medication is divided into two stages, one of which must be at bedtime;
- From 8 to 14 years of age drink 1 tablet De Nola before eating. Recommend doing an evening reception of a medicament for the night;
- Adults should drink De Nol four times: three doses should be before a meal, and the last - on the night. At a time should take 1 tablet of the drug.
Treatment course lasted from 1 to 2 months (days 30-60; 4-8 weeks). Time limits linked to the ability of bismuth compounds cumulated in brain tissues and affect the kidneys.
Break in the treatment for removing residual dose lasts for at least 10-14 days, which is primarily due to the need to prevent renal dysfunction.
If the doctor sees a need to continue receiving the De-Nol, it makes sense after a treatment course of time to be tested to determine the amount of bismuth in the blood. The normal value for those just completed therapy - ≤0,56 nmol / ml.
Contraindications
De-Nol is a small list of contraindications:
- Age less than 4 years. There are two reasons: a large susceptibility to toxicity effects of the compounds of bismuth and immature kidney (their formation continues even during the first 2 years of life);
- in order to avoid toxic effect on the fetus bismuth salts De-Nol forbidden to drink during pregnancy;
- the drug can penetrate into breast milk, so it does not apply to women who breast-feed their children;
- De-Nol is not applicable if the patient has severe renal insufficiency;
- intolerance to components of the drug.
side effects
De-Nol can provoke such states:
- Anaphylactic allergy (immediate) and delayed type (dermatitis);
- dyspepsia: vomiting, changes in stool, nausea;
- Encephalopathy: impaired memory and ability to concentrate, impaired motor coordination; It provoked by prolonged excess of recommended doses and course of treatment;
- Nephropathy: deterioration of kidney, proteinuria. Signs of disease in the absence of a history of renal diseases tested 10-14 days after cancellation means without additional measures;
- darkening of the tongue, gums swelling and the appearance of bluish fringe on them.
The last three states usually indicate an overdose of De Nol and excessive accumulation of bismuth. If there should be rinsed with these manifestations patient stomach give adsorbents (activated charcoal), and osmotic laxative action.
In a complicated history of hemodialysis may be required on the part of the urinary system.
Output
Receiving De Nol conjugate in time with food intake, and also requires a non-specific products for half an hour prior to receiving medikamaenta and after half an hour after that.
The need to drink De Nol before eating is associated with a feature of its action, which manifests itself in the formation of a protective layer on top of erosions or ulcers of the gastrointestinal tract. Enveloping effect De Nola helps get rid of the symptoms of peptic ulcer or inflammation of the stomach and duodenum.
The uniqueness of the De-Nol for the treatment of peptic ulcer and gastroduodenitis - simultaneous symptomatic, causal and pathogenetic effect of the drug, ie the treatment of all parts of the pathological process.
sources:
Vidal: https://www.vidal.ru/drugs/de-nol__6730
GRLS: https://grls.rosminzdrav.ru/Grls_View_v2.aspx? routingGuid = 7696368a-c3a6-4fd8-b73c-69a9af455d51 & t =
Found a bug? Select it and press Ctrl + Enter
