What is parabulbar insertion. Parabulbar introduction what does it mean

Parabulbar introduction - how is it? An exhaustive answer to the question posed will be presented in the materials of this article. In addition, we will tell you about what such an injection is used for, how it is carried out and what medicines are used for this.

general information

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid area. Such an injection procedure is most often carried out in ophthalmic practice.

The course of the procedure

Parabulbar insertion is a rather painful procedure in which the needle is inserted to a depth of about 1 centimeter towards the equator of the eye, that is, into the tissue around the eyeball. This method of administering a medicinal substance is used only when absolutely necessary. It should also be noted that only an experienced ophthalmologist should carry out such a procedure.

In what cases is it used?

Parabulbar insertion is the one most often used during eye surgery for anesthesia. This method of anesthesia of the operated area is carried out by reducing the sensitivity of nerve receptors. As a rule, in such cases, the anesthesiologist uses a 0.5% solution of lidocaine with hyaluronidase for injection.

Features of the procedure

It should be especially noted that parabulbar injection - which is used to administer a drug into the lower eyelid area, not only for an analgesic effect, but also for therapeutic purposes. During therapy, such injections are used for inflammation of the anterior and posterior segments of the eye, as well as for keratitis, neuroretinitis, iridocyclitis and scleritis.

The presented method of introducing a medical agent has its own characteristics, namely:

pain during the procedure;
limited dose of administered medication;
toxicity;
possible development of necrosis;
scarring of the injection site.

We cannot ignore the fact that not so long ago, autoradiographic studies showed that, compared with the subcutaneous, intramuscular and intravenous route of administration of antibiotic drugs and steroids, parabulbar leads to the highest content of the drug in vitreous body.

Possible Complications

Complications that may well arise with this method of administering the drug include the following pathological conditions:

dropping out ;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
subconjunctival or retrobulbar hemorrhage;
iris prolapse.

As you can see, parabulbar drug administration is far from a safe procedure. In this regard, doctors resort to it only in extreme cases.

Drugs intended for parabulbar administration

There are quite a few drugs that are designed specifically for such painful administration. But most often, an injection with the medicine "Mildronate" is made in the area of the lower eyelid. This is a synthetic drug that significantly improves tissue metabolism and provides them with energy.

As a result of the use of such a drug, patients increase the ability to withstand heavy loads, as well as recover very quickly after them. Due to these properties, the presented medication is used for:

physical stress;
reduced performance;
thrombosis of the central vein of the retina, as well as its branches;
retinopathy of various origins, including hypertensive and diabetic;
hemophthalmos;
retinal hemorrhages of various origins;
as part of complex therapy for chronic alcoholism (withdrawal syndrome).

Parabulbar introduction of "Mildronate" - how is it? For this procedure, the drug is used in the form of a clear, colorless solution. 1 ml of this product contains about 100 mg active component- meldonium. It should also be noted that the drug "Mildronate" goes on sale in ampoules of 5 ml.

Why can not the drug be administered intramuscularly?

In what form to use such a drug, only an experienced doctor should decide. However, the instructions for this medication clearly state that when administered intramuscularly, the drug "Mildronate" can not only have an irritating effect, but also lead to the development of local pain and an allergic reaction.

Other methods of drug administration in ophthalmology

Now you know what parabulbar drug administration is. However, it should be noted that in some diseases of the organs of vision, there is an urgent need to inject the drug directly under. To carry out such a procedure, not only parabulbar injection is used. For such an introduction, the subconjunctival method is often used. The choice of this or that method remains with the attending physician. Although the subconjunctival injection of the drug, compared with the parabulbar one, is more painful.

As you know, such an injection is made directly under the conjunctiva of the eye. Due to the pain, it is carried out only after preliminary local anesthesia (instillation of a solution of lidocaine or dicaine).

The course of the procedure

In what cases is it used?

Features of the procedure

pain during the procedure;
toxicity;
possible development of necrosis;
scarring of the injection site.

Possible Complications

vitreous prolapse;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
iris prolapse.

physical stress;
reduced performance;
hemophthalmos;

Instructions for the use of drugs, analogues, reviews

Instructions from tablet.rf

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Only the most up-to-date official instructions for the use of medicines! Instructions for medicines on our website are published unchanged, in which they are attached to the medicines.

MILDRONAT® solution for intramuscular, intravenous and parabulbar administration

PRECISION MEDICINES SHALL BE PRESCRIBED TO THE PATIENT ONLY BY A PHYSICIAN. THIS INSTRUCTION IS FOR HEALTH PROFESSIONALS ONLY.

INSTRUCTIONS for medical use of the drug MILDRONAT®

Registration number: P N016028/

Trade name of the drug

International non-proprietary name

solution for intramuscular, intravenous and parabulbar administration.

1 ml of solution contains:

active substance - meldonium dihydrate 100 mg;

excipient - water for injection.

Transparent colorless liquid.

metabolic agent. ATX code: C01EB.

Pharmacological properties

Meldonium (MILDRONAT®) is a structural analogue of gamma-butyrobetaine, a substance found in every cell of the human body.

Under conditions of increased load, MILDRONAT® restores the balance between the delivery and demand of cells for oxygen, eliminates the accumulation of toxic metabolic products in cells, protecting them from damage; also has a tonic effect. As a result of its use, the body acquires the ability to withstand the load and quickly restore energy reserves. Due to these properties, MILDRONAT® is used to treat various disorders of the cardiovascular system, brain blood supply, as well as to increase physical and mental performance. As a result of a decrease in the concentration of carnitine, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized. In case of acute ischemic myocardial injury, MILDRONAT slows down the formation of the necrotic zone and shortens the rehabilitation period. In heart failure, it increases myocardial contractility, increases exercise tolerance, and reduces the frequency of angina attacks. In acute and chronic ischemic disorders of cerebral circulation, MILDRONAT® improves blood circulation in the focus of ischemia, promotes the redistribution of blood in favor of the ischemic area. The drug eliminates functional disorders of the nervous system in patients with chronic alcoholism with withdrawal syndrome.

The bioavailability of the drug after intravenous administration is 100%. The maximum plasma concentration is reached immediately after its administration. It is metabolized in the body with the formation of two main metabolites, which are excreted by the kidneys. The half-life (T1 / 2) is 3 - 6 hours.

Indications for use

In complex therapy coronary disease heart (angina pectoris, myocardial infarction); chronic heart failure and dishormonal cardiomyopathy, as well as in the complex therapy of acute and chronic disorders of the blood supply to the brain (stroke and cerebrovascular insufficiency).

Hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathy of various etiologies (diabetic, hypertensive).

Reduced performance; mental and physical overload (including athletes).

Withdrawal syndrome in chronic alcoholism (in combination with specific alcoholism therapy).

Contraindications

Hypersensitivity to the components of the drug, increased intracranial pressure (in violation of venous outflow, intracranial tumors), age under 18 years (efficacy and safety have not been established), pregnancy, lactation.

Carefully

With diseases of the liver and / or kidneys.

Dosage and administration

In view of the possible development of an exciting effect, it is recommended to apply in the morning.

MILDRONAT® is prescribed intramuscularly (in / m), intravenously (in / in) and parabulbarno. The route of administration, doses and duration of the course of treatment are set individually, depending on the indications, the severity of the condition, etc.

As part of complex therapy:

Ischemic heart disease (myocardial infarction) in / in a stream of 0.5-1.0 g per day (5-10 ml of the drug MILDRONAT®), using the entire dose at once or dividing it into 2 injections;

Ischemic heart disease (stable angina); chronic heart failure and dyshormonal cardiomyopathy i.v. bolus 0 5-1.0 g per day (5-10 ml of MILDRONAT®), using the entire dose at once or dividing it into 2 injections, or i/m 0.5 g 1-2 times a day, course of treatment for days, followed by the transition to oral administration. The general course of treatment is 4-6 weeks.

2. Violation of cerebral circulation

As part of complex therapy in the acute phase, 0.5 g (5 ml of MILDRONAT®) 1 time per day IV for 10 days, switching to oral administration of 0.5-1 g. The general course of treatment is 4-6 weeks.

In chronic cerebrovascular insufficiency (dyscirculatory encephalopathy), 0.5 g (5 ml of MILDRONAT®) intramuscularly or intravenously 1 time per day for 10 days, then 0.5 g orally. The general course of treatment is 4-6 weeks.

Repeated courses (usually 2-3 times a year) are possible after consultation with a doctor.

3. Ophthalmopathology (hemophthalmos and retinal hemorrhages of various etiologies, thrombosis of the central retinal vein and its branches, retinopathy of various etiologies (diabetic, hypertensive)).

0.05 g (0.5 ml of MILDRONAT®) parabulbarno for 10 days. Including used as part of combination therapy.

4. Mental and physical overload

0.5 g (5 ml of MILDRONAT®) intramuscularly or intravenously 1 time per day. Course of treatment days. If necessary, the treatment is repeated after 2-3 weeks.

0.5 g (5 ml of MILDRONAT®) intramuscularly or intravenously 2 times a day. Course of treatment days.

Side effect

Rarely - allergic reactions (redness, drying, itching, swelling), as well as dyspepsia, tachycardia, decrease or increase blood pressure, excitement.

Very rarely - eosinophilia, general weakness.

Overdose

Symptoms: lowering blood pressure, accompanied by headache, tachycardia, dizziness and general weakness.

MILDRONAT® has low toxicity and does not cause side effects dangerous to the health of patients.

Interaction with other drugs

Can be combined with antianginal agents, anticoagulants, antiplatelet agents, antiarrhythmic agents, diuretics, bronchodilators.

Enhances the action of cardiac glycosides.

In view of the possible development of moderate tachycardia and arterial hypotension, caution should be exercised when combined with nitroglycerin, nifedipine, alpha-blockers, other antihypertensive drugs and peripheral vasodilators, since MILDRONAT® enhances their effect.

special instructions

Many years of experience in the treatment of acute myocardial infarction and unstable angina pectoris in cardiology departments shows that MILDRONAT® is not a first-line drug for acute coronary syndrome and its use is not urgently needed.

Use during pregnancy and during breastfeeding

The safety of use in pregnant women has not been studied, therefore, in order to avoid possible adverse effects on the fetus, its use is contraindicated. The excretion of the drug MILDRONAT® with milk and its effect on the health of the newborn have not been studied, therefore, if necessary, breastfeeding should be stopped.

Influence on the ability to drive vehicles and mechanisms

There are no data on the adverse effect of the drug MILDRONAT® on the speed of the psychomotor reaction.

Solution for intramuscular, intravenous and parabulbar administration, 100 mg/ml.

5 ml in a colorless glass ampoule with a line or a break point.

5 ampoules in a blister pack made of PVC film or uncoated polyethylene terephthalate film (pallet).

Two cellular packages (pallets) together with instructions for use in a pack of cardboard.

Store at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Do not use after the expiry date stated on the packaging.

Registration certificate holder

st. Krustpils 53, Riga, LV-1057, Latvia

Phone: +

Email:

st. Veiveryu 134 V, Kaunas, LT-46352, Lithuania

Elfa Pharmaceutical Company S.A. st. Wincentego Polja, 21, Jelenia Góra, Poland

Pharmstandard-UfaVITA OJSC, Russia.

tel./fax: ,

HBM Pharma s.r.o.

Organizations accepting claims

Representative office in Moscow (in the production of the drug Sanitas JSC, Lithuania; Elfa Pharmaceutical Company S.A., Poland; HBM Pharma s.r.o., Slovakia).

117556, Moscow, Varshavskoye shosse, 74, bldg. 3, 5th floor,

OJSC Pharmstandard-UfaVITA, Russia (in the production of the drug by OJSC Pharmstandard-UfaVITA, Russia).

450077, Republic of Bashkortostan, Ufa, st. Khudaiberdina, 28;

general information

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid area. Such an injection procedure is most often carried out in ophthalmic practice.

The course of the procedure

Parabulbar insertion is a rather painful procedure in which the needle is inserted to a depth of about 1 centimeter towards the equator of the eye, that is, into the fiber around the eyeball. This method of administering a medicinal substance is used only when absolutely necessary. It should also be noted that only an experienced ophthalmologist should carry out such a procedure.

In what cases is it used?

Parabulbar injection is the method of drug administration most commonly used during eye surgery for anesthesia. This method of anesthesia of the operated area is carried out by reducing the sensitivity of nerve receptors. As a rule, in such cases, the anesthesiologist uses a 0.5% solution of lidocaine with hyaluronidase for injection.

Features of the procedure

It should be especially noted that parabulbar injection is a procedure that is used to introduce a drug into the lower eyelid region, not only for an analgesic effect, but also for therapeutic purposes. During therapy, such injections are used for inflammation of the anterior and posterior segments of the eye, as well as for keratitis, neuroretinitis, iridocyclitis and scleritis.

The presented method of introducing a medical agent has its own characteristics, namely:

pain during the procedure;
limited dose of administered medication;
toxicity;
possible development of necrosis;
scarring of the injection site.

We cannot ignore the fact that not so long ago, autoradiographic studies showed that, compared with the subcutaneous, intramuscular and intravenous route of administration of antibiotic drugs and steroids, the parabulbar method leads to the highest content of the drug in the vitreous body.

Possible Complications

Complications that may well arise with this method of administering the drug include the following pathological conditions:

vitreous prolapse;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
subconjunctival or retrobulbar hemorrhage;
iris prolapse.

As you can see, parabulbar drug administration is far from a safe procedure. In this regard, doctors resort to it only in extreme cases.

Drugs intended for parabulbar administration

physical stress;
reduced performance;
thrombosis of the central vein of the retina, as well as its branches;
retinopathy of various origins, including hypertensive and diabetic;
hemophthalmos;
retinal hemorrhages of various origins;
as part of complex therapy for chronic alcoholism (withdrawal syndrome).

Parabulbar introduction of "Mildronate" - how is it? For this procedure, the drug is used in the form of a clear, colorless solution. 1 ml of this product contains about 100 mg of the active ingredient - meldonium. It should also be noted that the drug "Mildronate" goes on sale in ampoules of 5 ml.

Why can not the drug be administered intramuscularly?

Other methods of drug administration in ophthalmology

Now you know what parabulbar drug administration is. However, it should be noted that in some diseases of the organs of vision there is an urgent need to administer the drug directly under eyeball. To carry out such a procedure, not only parabulbar injection is used. For such an introduction, the subconjunctival method is often used. The choice of this or that method remains with the attending physician. Although the subconjunctival injection of the drug, compared with the parabulbar one, is more painful.

B and parabulbar administration 500 mg

Parabulbar introduction of "Mildronate" - how is it? For this procedure, the drug is used in the form of a clear, colorless solution. Parabulbar introduction - how is it? An exhaustive answer to the question posed will be presented in the materials of this article. To carry out such a procedure, not only parabulbar injection is used.

In chronic cerebrovascular insufficiency (dyscirculatory encephalopathy), 0.5 g (5 ml of Mildronate®) intramuscularly or intravenously 1 time per day for 10 days, then 0.5 g orally.

Contraindicated in patients under the age of 18 years, tk. efficacy and safety have not been established. In addition, we will tell you about what such an injection is used for, how it is carried out and what medicines are used for this. This method of administering a medicinal substance is used only when absolutely necessary. As a rule, in such cases, the anesthesiologist uses a 0.5% solution of lidocaine with hyaluronidase for injection.

In this regard, doctors resort to it only in extreme cases. There are quite a few drugs that are designed specifically for such painful administration. But most often, an injection with the medicine "Mildronate" is made in the area of the lower eyelid. 1 ml of this product contains about 100 mg of the active ingredient - meldonium. For such an introduction, the subconjunctival method is often used.

The difference lies in the bioavailability of meldonium and the method of administration of the drug: enteral or parenteral route of administration, which, in turn, affects the speed of achieving the effect. With the parenteral route of administration of the drug, its action occurs faster and the bioavailability of the drug increases. The drug is produced in factories in the countries of the European Union - in Latvia and Slovakia. As a result of a decrease in the concentration of carnitine, gamma-butyrobetaine, which has vasodilating properties, is intensively synthesized.

Repeated courses (usually 2-3 times a year) are possible after consultation with a doctor. The excretion of the drug Mildronate® with milk and its effect on the health of the newborn have not been studied, therefore, if necessary, breastfeeding should be prepared.

In the case of acute ischemic myocardial injury, Mildronate® slows down the formation of a necrotic zone and shortens the rehabilitation period. In acute and chronic ischemic disorders of cerebral circulation, it improves blood circulation in the focus of ischemia, promotes the redistribution of blood in favor of the ischemic area.

Bioavailability is about 78%. Cmax is reached in 1-2 hours. Biotransformed in the body with the formation of two main metabolites, which are excreted by the kidneys. Cardiovascular diseases, adults, as part of complex therapy: inside (capsules) - 0.5–1 g per day or intravenously - 5–10 ml of injection solution, in 1 or 2 divided doses.

Parabulbar insertion - what is this procedure?

The medicinal directory contains prices for medicines and pharmaceutical market products in Moscow and other cities of Russia. It should also be noted that only an experienced ophthalmologist should carry out such a procedure.

This is a synthetic drug that significantly improves tissue metabolism and provides them with energy. The nurse injects mildronate intramuscularly into me, maybe because at the same time she makes an intravenous injection of actovegin?

Parabulbar injection is the method of drug administration most commonly used during eye surgery for anesthesia. As a result of its use, the body acquires the ability to withstand the load and quickly restore energy reserves.

Parabulbar injection

Subconjunctival and parabulbar injections are equally used to resolve ocular hemorrhages. Subconjunctival and parabulbar injections are used both in the treatment of inflammatory diseases and chronic eye pathologies.

An additional route of administration is the use of periocular injections. 1-2 cm; the cut of the needle is directed towards the eyeball (Fig. 6b). Thin and sharp needles (for example, insulin) should not be used for injection. Instill 1 drop of anesthetic into the patient's eye. Before injection, the tip of the needle should be slightly blunted.

In one hospital, they injected me with insulin syringes, and in another hospital with two-cubic meter ones, and they said that they do insulin only for conjunctiva. Now I am doing retinalamin and I have high hopes for it, I will endure any pain from the thickness of the needle if only there is a benefit, but I am again in the hospital where they make insulin syringes. 1] The difference in the diameter of the needles and the size of the syringe, which you noticed, is explained very simply - it, this difference, is not significant.

Parabulbar injection

We wish you good luck and 100% vision. It should be noted that mercury preservatives, boric acid and borates are used less and less in modern pharmaceuticals. The most convenient and safe preservatives at the moment are benzalcopy chloride, chlorobutanol and chlorhexidine. Not only the range of preservatives used is changing, but also their concentration.

Thus, the effectiveness of treatment depends not only on the active substance, but also on other ingredients that make up the drug and determine its individual tolerance. The effectiveness of the therapy also depends on the volume of the instilled drop of the drug.

Mildronate intramuscularly

AT last years both in domestic and foreign literature, terms such as compliance (complace) and non-compliance (non complace) of the patient are quite often used. He is not bothered by pain and blurred vision. In order to increase the amount of the drug entering the eye, the technique of forced instillations is used.

Mildronate injections - instructions for use

E. G. Rybakova believes that the most rational is the use of SCL with a moisture content of 38% and a thickness of 0.7 mm to prolong the action of low molecular weight drugs. An example of a change in pharmacokinetic and pharmacodynamic parameters is the study of Podos S. (1972). After puncturing the conjunctiva, the needle is inserted at an angle of 25° and advanced 2-3 mm (the cut of the needle should be directed towards the eyeball).

Before injecting the drug, the syringe plunger is pulled towards itself to make sure that the needle is not in the vessel. For the treatment of diseases of the retina and optic nerve apply the implantation of the infusion system in the sub-Tenon space. Rice. 10. The method of implantation of the infusion system and the sub-Tenon space (according to Nesterov A.P., 1995). After the incision of the conjunctiva and Tenon's membrane in the upper temporal segment of the eye, the collagen sponge is passed into the Tenon's fissure to the posterior pole of the eyeball.

A second course of treatment should be carried out after 2-3 months, for children - after 1.5-2 months. Electrophoresis can be combined with phonophoresis, UHF therapy and diadynamic therapy. Electrophoresis is used to treat inflammatory, ischemic and dystrophic processes in the tissues of the eye, hemorrhages and injuries of the organ of vision.

Mildronate and alcohol

You can enter not only simple solutions, but also mixtures of drugs. When compiling a mixture, it is necessary to take into account the possibility of drug interactions and their polarity. Methodology: the position of the patient lying on his back. Before the procedure, to enhance the effect of treatment, you can drip 1 drop of the drug into the conjunctival sac. Phonophoresis is performed for the same eye diseases as electrophoresis.

Method of application: Mildronate is applied orally, intravenously, intramuscularly and parabulbarno. Its parabulbar administration reduces eye edema and improves visual acuity. Rice. 7. Method of parabulbar injection (2nd method). Ask the patient to look up (or down depending on the insertion site) and pull the lower (or upper) eyelid away from the eyeball. Like acidity, the tonicity of the solution affects the tolerability of the drug.

Parabulbar injections

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid. Such an injection procedure is quite common in ophthalmic practice.

Parabulbar injections are a rather painful injection in which a needle is inserted to a depth of 1 centimeter in the direction of the equator of the eye, into the tissue surrounding the eyeball. This method of administering medications is used only in case of urgent need. It is also worth noting that this procedure is carried out only by a qualified ophthalmologist.

When appointed

Parabulbar administration is a method of administering medicinal substances, which is usually performed for anesthesia during eye operations. This is a method of anesthesia of the required area by reducing the sensitivity of nerve receptors, which is achieved by introducing a 0.5% solution of lidocaine and hyaluronidase.

Peculiarities

It is worth pointing out that parabulbar injection is used not only for pain relief, but also for medicinal purposes. Such injections are prescribed for inflammation of the anterior or posterior segments of the eye, for neuroretinitis, keratitis, iridocyclitis, scleritis.

The features of the procedure performed are considered to be:

Pain while doing it.
Limitation of the dose of the administered drug.
Some toxicity.
Possibility of development of necrosis and scarring of the injection zone.

Conducted studies have revealed that with parabulbar injections, in comparison with subcutaneous, intramuscular and intravenous methods of administering antibacterial drugs and steroids, the content of medicinal substances in the vitreous body is especially high.

Possible Complications

The parabulbar injection procedure is quite complicated and can threaten the development of the following pathological conditions:

Vitreous prolapse;
Chemosis of the conjunctiva;
Rupture of the posterior capsule;
Rupture of zinn ligaments;
Prolapse of the iris;
Subconjunctival or retrobulbar hemorrhage.

Our advantages

"Moscow Eye Clinic" is a modern medical facility providing a full range of professional services in the field of ophthalmology. The clinic has at its disposal the best samples of modern equipment from leading world manufacturers.

Leading domestic specialists with an extremely wide practical experience conduct appointments at the Clinic. Thus, the surgeon of the highest category Tsvetkov Sergey Alexandrovich consults in the clinic, who performed more successful operations. Thanks to the high professionalism of doctors and the use of modern technologies, MHC guarantees the best result of treatment and the return of vision. Turning to the Moscow Eye Clinic, you can be sure of a quick and accurate diagnosis and effective treatment.

The specialists of our ophthalmological clinic perform any kind of parabulbar injections. And the technical equipment allows for high-quality diagnostics and subsequent monitoring of the treatment.

At the Moscow Eye Clinic, you can undergo a complete diagnostic examination and receive recommendations on the most effective methods treatment. A comprehensive examination of the patient (including such methods as checking visual acuity, biomicroscopy, autorefractometry, ophthalmoscopy with a narrow pupil, pneumotonometry) is 3,500 rubles.

The cost of performing a parabulbar injection at the Clinic is 700 rubles (without the cost of the drug).

The final cost of treatment is determined in each case individually and depends on the specific diagnosis, the stage of the disease, the tests available on hand, etc.

You can clarify the cost of a particular procedure by contacting by phone or online, using the appropriate form on the website, you can also familiarize yourself with the “Prices” section.

Parabulbar drug administration and what it looks like

In ophthalmic practice, in some cases, doctors have to resort to parabulbar injections of certain drugs. This procedure is understood as the introduction of various drugs or painkillers to patients in the lower eyelid area through the skin.

Naturally, parabulbar insertion is a painful procedure used only in selected cases. About when such injections are prescribed, and what drugs are used, we will talk below.

When is parabulbar administration of drugs prescribed and what does it look like?

Parabulbar injections are understood as an extremely painful procedure, which involves the introduction of a needle to a depth of up to a centimeter in the direction of the ocular equator into the area of \u200b\u200bthe fiber located around the eyeball. Such a procedure can only be performed by a specialist of a high category and only in case of emergency.

Quite often, parabulbar injections of drugs are necessary for anesthesia before surgery in the eye area. This method of anesthesia of the operated area helps to significantly reduce the sensitivity of nerve receptors. In this case, the injection includes a solution of lidocaine (0.5%) and hyaluronidase.

What is the peculiarity of parabulbar introduction

Drugs that are administered to patients of ophthalmic clinics parabulbarno are used not only for the purpose of pain relief during operations, but also for treatment. So, these injections are prescribed by doctors for such diseases:

inflammation of the anterior or posterior ocular segment;
keratitis;
sclerites;
neuroretinitis;
iridocyclitis.

Parabulbar injections have the following features when administered:

severe pain during the procedure;
the dose of the administered agent is limited;
partial toxicity;
can provoke necrosis and scarring at the injection site.

A number of studies have been conducted that have shown that, compared with the intravenous, subcutaneous or intramuscular route of administration of steroids or antibacterial drugs, the content of the drug in the vitreous body is especially high with parabulbar administration.

What complications can the procedure cause?

As already mentioned, the procedure for parabulbar drug administration is painful and very complicated. In some cases, it can lead to complications such as:

conjunctival chemosis;
iris prolapse;
vitreous prolapse;
retrobulbar or subconjunctival hemorrhage;
rupture of zinn ligaments.

What drugs are administered by the parabulbar method

There are a large number of different drugs that can be administered by the parabulbar method, but the most common practice is to administer a drug such as Mildronate. It is a synthetic agent that perfectly improves tissue metabolism and provides tissues with energy. Therefore, thanks to its use, patients gain the ability to withstand huge loads of a different nature, and then quickly return to normal after them.

If we talk directly about the parabulbar administration of Mildronate, then this medicine is taken in the form of a colorless and transparent solution. 1 ml of the drug includes about 100 mg of the active substance - meldonium. On sale for injections, Mildronate is present in ampoules with a capacity of 5 ml.

Indications for the use of Mildronate

Due to its properties, Mildronate has a fairly wide scope. It is prescribed for such diseases:

physical stress;
coronary heart disease, including heart attack or angina pectoris;
chronic heart failure;
dishormonal cardiomyopathy;
chronic and acute disorders of cerebral circulation in the form of a stroke or cerebrovascular insufficiency (as part of complex therapy);
thrombosis of the central retinal vein and branches;
hemophthalmos;
various kinds of hemorrhages in the retina;
hypertensive or diabetic retinopathy;
withdrawal syndrome on the background of chronic alcoholism;
decrease in working capacity, etc.

Application of Mildronate

The drug is produced in the countries of the European Union on the territory of Slovakia and Latvia. It is contraindicated in patients under 18 years of age, like other drugs for parabulbar administration, since neither safety nor efficacy has yet been thoroughly investigated.

Mildronate is the most common drug administered by the parabulbar method. As already mentioned, often for anesthesia, patients are also injected with a solution based on lidocaine. And if we talk directly about Mildronate, then injections with this agent are introduced into the lower eyelid area in an amount agreed with a specialist. The introduction can also be carried out by means of the subconjunctive method.

Can Mildronate be introduced in another way?

The form of use of Mildronate is always prescribed only by a specialist. As for the parabulbar introduction, here one should pay attention to the procedure Special attention because there are high risks of worsening the patient's condition.

It is forbidden to administer Mildronate intramuscularly, since with this method of administration this agent can cause severe irritation, cause a number of painful syndromes, and also provoke an allergic reaction.

Other methods of administration of drugs in ophthalmic practice

Parabulbar administration of drugs and painkillers is a specific procedure that is practiced only in ophthalmology. However, this is not the only way to administer various drugs to a patient with diseases of the organs of vision. But if the instruction involves the administration of the drug directly under the eyeball, then this method is the highest priority, although some experts also choose the subconjunctival method of administration.

The attending physician should at his discretion choose the appropriate method. But it is worth noting that administering the drug by the subconjunctival method is even more painful than by the parabulbar one. In this case, the injection is carried out directly under the ocular conjunctiva. This procedure is carried out only after local anesthesia with dicaine or lidocaine.

Cost of injections

Naturally, such injections are prescribed only by a highly professional ophthalmologist after the patient passes full complex diagnostic examinations and chooses the most suitable method of treatment.

Diagnosis, as a rule, includes such activities;

visual acuity test;
ophthalmoscopy with a narrow pupil;
biomicroscopy;
autorefractometry.

Such an examination, on average, will cost residents of Moscow in private clinics about 3,500 rubles. But the cost of the parabulbar injection itself is about 700 rubles, not counting the price of the drug itself.

Treatment with injections can cost the patient in different ways. It all depends on its individual characteristics, diagnosis, stage of an ophthalmic disease, the presence of certain tests and other factors.

The parabulbar method of administering drugs in ophthalmic practice is not a very pleasant procedure, but it is necessary when performing operations or when it is necessary to administer this or that drug to achieve a better result.

what is parabulbar insertion

In the section Diseases, Medicines, to the question of what is the parabulbar administration of drugs. given by the author Irina Kosikhina, the best answer is Parabulbar drug administration - this is an injection through the skin of the lower eyelid to a depth of about 1 cm towards the equator of the eye. The method is less painful compared to subconjunctival injection.

you mean the introduction of drugs into the space near the eyeball

business-hospitality.ru

Parabulbar insertion - what is this procedure?

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid area. Such an injection procedure is most often carried out in ophthalmic practice.

The presented method of introducing a medical agent has its own characteristics, namely:

pain during the procedure;
limited dose of administered medication;
toxicity;
possible development of necrosis;
scarring of the injection site.

We cannot ignore the fact that not so long ago, autoradiographic studies showed that, compared with the subcutaneous, intramuscular and intravenous route of administration of antibiotic drugs and steroids, the parabulbar method leads to the highest content of the drug in the vitreous body.

Complications that may well arise with this method of administering the drug include the following pathological conditions:

vitreous prolapse;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
subconjunctival or retrobulbar hemorrhage;
iris prolapse.

As you can see, parabulbar drug administration is far from a safe procedure. In this regard, doctors resort to it only in extreme cases.

Drugs intended for parabulbar administration

There are quite a few drugs that are designed specifically for such painful administration. But most often, an injection with the medicine "Mildronate9raquo;" is made into the area of the lower eyelid. This is a synthetic drug that significantly improves tissue metabolism and provides them with energy.

physical stress;
reduced performance;
thrombosis of the central vein of the retina, as well as its branches;
retinopathy of various origins, including hypertensive and diabetic;
hemophthalmos;
retinal hemorrhages of various origins;
as part of complex therapy for chronic alcoholism (withdrawal syndrome).

Parabulbar introduction of "Mildronate9raquo; - How is that? For this procedure, the drug is used in the form of a clear, colorless solution. 1 ml of this product contains about 100 mg of the active ingredient - meldonium. It should also be noted that the drug "Mildronate9raquo; goes on sale in ampoules of 5 ml.

Why can not the drug be administered intramuscularly?

In what form to use such a drug, only an experienced doctor should decide. However, the instructions for this medication clearly indicate that when administered intramuscularly, the drug "Mildronate9raquo; can not only have an irritating effect, but also lead to the development of local painful sensations and an allergic reaction.

Other methods of drug administration in ophthalmology

Now you know what parabulbar drug administration is. However, it should be noted that in some diseases of the organs of vision there is an urgent need to administer the drug directly under the eyeball. To carry out such a procedure, not only parabulbar injection is used. For such an introduction, the subconjunctival method is often used. The choice of this or that method remains with the attending physician. Although the subconjunctival injection of the drug, compared with the parabulbar one, is more painful.

Vasonat

Compound

1 capsule of Vazonat contains:

Meldonium dihydrate - 250 mg;

Meldonium dihydrate - 500 mg;

Vasonat is an anti-ischemic and cytoprotective drug. The composition of the drug includes meldonium dihydrate, a medicinal substance that is a structural analogue of gamma-butyrobetaine (a precursor of carnitine). Vasonat improves the condition of cells under hypoxic conditions, regulates the transport of ATP and oxygen, stimulates glycolysis, which reduces energy costs and oxygen demand of cells under hypoxic conditions. Meldonium reduces the level of activated forms of acylcarnitine and acylcoenzyme A in cells, thus preventing their toxic effects. The drug inhibits the formation of carnitine from gamma-butyrobetaine, reduces the level of carnitine in plasma. By increasing the level of gamma-butyrobetaine, the drug has some vasodilating and antioxidant effect.

In patients with impaired cerebral circulation, meldonium contributes to the normalization of blood circulation and the redistribution of blood in favor of ischemic tissues.

The drug somewhat stimulates the central nervous system, reduces the severity of functional disorders of the autonomic and somatic nervous system.

After oral administration, meldonium is well absorbed, its bioavailability reaches 78%. The peak plasma concentration of the active substance is observed after 1-2 hours. It is metabolized in the body, metabolic products of meldonium are excreted mainly through the kidneys. The half-life at a single dose reaches 4 hours, 8 days after the start of drug therapy, the half-life is about 10 hours.

Vasonat is used in the complex therapy of patients suffering from ischemic heart disease, acute and chronic disorders of cerebral circulation, as well as retinal hemorrhage of various origins and degenerative diseases of the retina.

Meldonium is prescribed for reduced work capacity in patients with increased mental and physical stress, including athletes.

In combination with other drugs, Vazonat is prescribed to patients suffering from chronic alcoholism for the treatment of withdrawal symptoms.

The drug is intended for oral use. The daily dose of the drug is recommended to be taken at one time in the morning, however, if necessary, the dose can be divided into 2 doses. To prevent sleep disorders, it is recommended to take meldonium in the morning.

Adults and adolescents over the age of 12 years are usually recommended to take 500 mg of meldonium per day.

The duration of the course of taking meldonium is 2-6 weeks.

If necessary, a second course of therapy is prescribed.

The drug is intended for intravenous administration only. In ophthalmic practice, parabulbar administration of the Vasonat solution is allowed.

Patients suffering from diseases of the cardiovascular system are usually recommended to prescribe 5-10 ml of Vasonat solution per day (administered at a time or divided into two injections).

The duration of the course of therapy is 1-1.5 months.

Patients with acute disorders of cerebral circulation are usually recommended to prescribe 5 ml of the drug per day for 10 days, after which therapy with the oral form of the drug Vasonat should be continued. Therapy of chronic disorders of cerebral circulation is carried out by the oral form of the drug.

In ophthalmological practice, in case of vascular pathology or degenerative diseases of the retina, it is usually recommended to introduce 0.5 ml of Vasonat solution parabulbarno.

The duration of the course of therapy is 10 days.

The duration of therapy is days. By decision of the doctor, the course is repeated after a few weeks.

For the treatment of withdrawal symptoms, Vazonat is prescribed in combination with other drugs at a dose of 500 mg of meldonium 2 times a day for 1 week.

Vasonat is usually well tolerated by patients, but there are reports of the development of such undesirable effects:

From the side of the heart and blood vessels: arterial hypertension or hypotension, palpitations.

From the gastrointestinal tract: indigestion, nausea.

From the side of the central nervous system: excessive excitability, headache.

Allergic reactions: urticaria, hyperemia, swelling and itching of the skin.

With parenteral use of the drug, the development of hyperemia and pain in the area of administration of the drug Vasonat is possible.

Vazonat is not used to treat patients with hypersensitivity to the components of the drug.

Meldonium should not be taken by patients suffering from increased intracranial pressure of various etiologies, including those caused by impaired venous outflow and intracranial tumors.

The drug is not used in pediatric practice.

With caution, meldonium is prescribed to patients with impaired liver and kidney function.

It is forbidden to use meldonium during pregnancy and lactation.

If it is impossible to avoid the appointment of Vasonat during lactation, breastfeeding should be discontinued.

The combined use of the drug Vasonat with other drugs, which include meldonium dihydrate, is prohibited.

Combination therapy with Vasonat and other cardiac drugs is allowed.

Meldonium, with simultaneous use, potentiates the action of nitroglycerin, beta-blockers, nifedipine, as well as other antihypertensive drugs and drugs that dilate peripheral vessels.

When using excessive doses of the drug Vasonat in patients, the development of arterial hypotension, tachycardia and excessive arousal was noted.

In case of an overdose of meldonium, symptomatic therapy is indicated.

In case of severe intoxication with the drug, liver and kidney functions should be monitored.

Capsules of 10 pieces in a blister pack, 4 or 6 blister packs placed in a cardboard box.

Solution for parenteral use, 5 ml in ampoules, 10 ampoules placed in a cardboard box.

The drug Vasonat should be stored in dry rooms with a temperature of 15 to 25 degrees Celsius for 2 years after release.

Celebis, Metamax, Mildrocard.

Active substance:

Official instructions for the drug Vazonat.
WHO Collaborating Center for Drug Statistics Methodology.

Description of the drug "Vazonat" on this page is a simplified and supplemented version of the official instructions for use. Before purchasing or using the drug, you should consult your doctor and read the annotation approved by the manufacturer.

Information about the drug is provided for informational purposes only and should not be used as a guide to self-medication. Only a doctor can decide on the appointment of the drug, as well as determine the dose and methods of its use.

Availability: In stock

All materials on this site are intended solely for healthcare professionals and pharmacists.

The site should not be used as a source of information on self-medication.

Thanks

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Mildronate is a drug that improves metabolism and provides energy at the tissue and cellular level in all organs. Mildronate is used to eliminate the lack of energy and accelerate metabolism in tissues in various chronic diseases and functional disorders, such as coronary heart disease, heart failure, myocardial dystrophy, retinopathy, bronchial asthma, chronic bronchitis, alcohol withdrawal syndrome, reduced mental and physical performance, overstrain and circulatory disorders in the brain and retina.

Names, forms of release, composition and dosage of Mildronate

Currently, Mildronate is available in three dosage forms:
1. Capsules for oral administration;
2. Syrup for oral administration;
3. Solution for injection (intramuscular, intravenous and parabulbar).

The composition of all three dosage forms of Mildronate includes the same active substance - meldonium. This active ingredient is also called mildronate or trimethylhydrazinium propionate dihydrate. In some instructions for use attached to the drug, the name of the active substance (INN) is meldonium, in others - mildronate, and in the third - trimethylhydrazinium propionate dihydrate. However, in all cases we are talking about the same chemical substance, which is indicated by different names.

Mildronate capsules as excipients contain gelatin, titanium dioxide, silicon dioxide, calcium stearate and potato starch. The solution for injection does not contain any excipients, since it contains only meldonium and purified water. Mildronate syrup contains the following excipients:

Methyl parahydroxybenzoate;
Propyl parahydroxybenzoate;
propylene glycol;
Glycerol;
Citric acid monohydrate;
cherry essence;
Allura Red dye (E129);
Dye Brilliant Black BN (E151);

Capsules are available in two dosages - 250 mg and 500 mg of meldonium. The syrup contains 250 mg of meldonium per 5 ml, that is, it has a concentration of 50 mg / ml. A solution for injection contains 100 mg of meldonium in 1 ml (100 mg / ml).

Mildronate capsules are often called pills. However, since the drug does not have such a dosage form, the term "tablets" means a variety of Mildronate for oral administration, and these are capsules. Therefore, in this case, capsules = tablets. To indicate the required dosage of capsules, short names are usually used, such as Mildronate 250 and Mildronate 500, where the number corresponds to the dose of the active substance. To refer to a solution for injection in everyday life, short forms of names are often used, such as Mildronate injections and Mildronate ampoules.

Therapeutic action of Mildronate

Mildronate improves metabolism and provides energy to tissues, and due to this it has the following therapeutic effects:

Cardioprotective action – protection of heart cells from negative influences and improvement of their viability;
Antianginal action - a decrease in the oxygen demand of myocardial cells (due to this effect, even a small amount of oxygen supplied under ischemia is enough for myocardial cells, which reduces the severity of pain, reduces the frequency of angina attacks and increases the tolerance of physical and emotional stress);
Antihypoxic action - reducing the negative impact of oxygen deficiency;
Angioprotective action - protection and ensuring the integrity of the walls of blood vessels;
Tonic action.

In addition, Mildronate dilates blood vessels and normalizes the cellular link of immunity, which increases the body's resistance to viral infections.

Mildronate injection solution is available in one concentration of 100 ml / ml and is intended for intravenous, intramuscular or parabulbar administration. That is, the same solution is used for any type of injection.

Ampoules with a solution should be opened immediately before the injection. Do not store open solution either outdoors or in the refrigerator. If the ampoule with the solution was opened in advance and stood for more than 20 minutes, then such a drug cannot be used, it should be discarded and a new ampoule opened.

Before opening the ampoule, carefully inspect the solution for cloudiness, flakes and other inclusions. If there are any, then the solution cannot be used. For injection, only a clear and completely transparent solution can be used.

Injections must be done in the morning, since Mildronate has a stimulating effect. If you need to make several injections per day, then the last of them should be made at least 4 to 5 hours before going to bed.

Intramuscular injections can be done independently at home, and intravenous and parabulbar injections can only be done in a clinic or hospital. Intravenous injections at home can only be given by a qualified nurse.

Dosages and rules for the introduction of Mildronate intramuscularly and intravenously

Dosages, frequency of injections and duration of application of the solution for intravenous and intramuscular administration of Mildronate are the same. The choice of injection method - intravenously or intramuscularly is determined mainly by the required speed of obtaining a clinical effect.

So, if you need the drug to act quickly and the effect occurs within a short period of time, then the solution is administered intravenously. This is usually necessary in acute conditions. If it is necessary to ensure a long-term effect of the drug with a not very rapid development of the clinical effect, then the solution is administered intramuscularly. This is usually justified in the treatment of chronic conditions. Thus, it can be briefly summarized that intravenous injections are used in acute conditions, and intramuscular injections in the treatment of chronic diseases. Parabulbar injections are used only in the treatment of eye diseases.

The standard dosage of solutions for intravenous and intramuscular injections is 500 mg per day (5 ml of solution), and for parabulbar ones - 50 mg per day (0.5 ml). However, these dosages may vary depending on the severity of the person's condition and the type of disease for which the drug is used. Consider the dosage, frequency and duration of intravenous and intramuscular injections of Mildronate for various diseases and conditions.

For unstable angina or myocardial infarction Mildronate should be administered intravenously at 500-1000 mg (5-10 ml of solution) per day. This dosage can be administered at one time or divided into two. That is, if a person does not tolerate injections well, then it is better to administer the entire daily dosage of 500-1000 mg at once. If a person normally tolerates intravenous injections, then it is better to divide the daily dosage equally into 2 parts and inject a solution of 250-500 mg twice a day.

Injections are required only for one day, after which the person can be transferred to receive Mildronate in the form of tablets or syrup. However, if for some reason a person cannot take pills or syrup, or their effectiveness will be low due to diseases of the digestive tract, then the further course of treatment is continued with intramuscular injections. In this case, within 4-6 weeks, 500-1000 mg per day is already administered intramuscularly every 3 days. The daily dose can also be administered at one time or divided into two.

With chronic heart failure Mildronate is administered intravenously at 500-1000 mg (5-10 ml of solution) 1 time per day or intramuscularly at 500 mg (5 ml of solution) 2 times per day for 10-14 days. After completing the course of intravenous or intramuscular injections, they switch to taking Mildronate in the form of tablets or syrup for another 3 to 4 weeks.

In the acute period of cerebrovascular accident Mildronate is administered intravenously at 500 mg (5 ml) once a day for 10 days. After that, the person is transferred to taking the drug in the form of tablets or syrup, or to intramuscular injections. Intramuscular injections are made at 500 mg (5 ml of solution) once a day for 2 to 3 weeks.

With chronic disorders of cerebral circulation Mildronate can be taken in the form of tablets or administered intramuscularly. In such cases, the choice of the method of using the drug (taking tablets or intramuscular injections) is determined by the personal preferences of the person, as well as his objective condition and the body's ability to absorb drugs when taken orally. For example, if a person cannot swallow tablets, or they are poorly absorbed due to diseases of the digestive tract, then he should prefer intramuscular injections. If there are no obstacles to taking the pills, then it is better to choose this particular method of using the drug.

So, in chronic disorders of cerebral circulation, it is necessary to inject 500 mg (5 ml of solution) of Mildronate intramuscularly 1 time per day for 2 to 3 weeks. The course of therapy can be repeated 2-3 times a year.

With pain in the heart against the background of dyshormonal myocardial dystrophy Mildronate is administered intravenously at 500 - 1000 mg (5 - 10 ml of solution) 1 time per day, or intramuscularly at 500 mg (5 ml of solution) 2 times a day for 10 - 14 days. With incomplete disappearance of pain after the completion of the course of injections of Mildronate, the drug is prescribed in tablets for another 12 days.

With mental and physical overload or to speed up rehabilitation after surgery Mildronate can be administered intravenously, intramuscularly, or taken as tablets. The choice of method of administration is based on the same criteria as for chronic cerebrovascular accidents. Intravenously or intramuscularly, Mildronate is administered at 500 mg (5 ml of solution) 1-2 times a day for 10-14 days. If necessary, the course of therapy is repeated after 2 to 3 weeks.

With chronic alcoholism Mildronate is administered intravenously for severe lesions of the nervous system. In this case, 500 mg (5 ml of solution) is administered 2 times a day for 7 to 10 days.

With pathology of the vessels of the fundus or retinal dystrophy Mildronate is administered parabulbarno 500 mg (5 ml of solution) once a day for 10 days. In the presence of inflammatory process in the eyes, Mildronate is combined with intravenous or also parabulbar administration of corticosteroid hormones (Prednisolone, Dexamethasone, Betamethasone, etc.). And with retinal dystrophy, it is rational to combine Mildronate with the use of drugs that improve microcirculation.

special instructions

Tablets, syrup and injections of Mildronate are interchangeable ways of using the drug. This means that during one course of treatment it is possible to switch from tablets, for example, to syrup or injections. Such transitions from any dosage form to another can be carried out within the same course of therapy.

People suffering from chronic diseases of the liver and kidneys, with prolonged use of Mildronate, should periodically monitor the functioning of these organs.

In myocardial infarction, Mildronate is not a first-line drug, the use of which is mandatory for the effective treatment of an acute condition.

The inclusion of Mildronate in the complex therapy of patients suffering from chronic heart failure increases their tolerance to physical and emotional stress.

In clinical studies, it was found that Mildronate reduces the concentration of atherogenic lipid fractions ("bad cholesterol") in the blood.

Since there are no scientifically confirmed data on the safety of Mildronate for children, it is recommended to refrain from using this drug in children under 12 years of age.

Influence on the ability to control mechanisms

Mildronate does not adversely affect the ability to control mechanisms, therefore, against the background of the use of this drug, a person can engage in any kind of activity.

Overdose

For capsules and syrup, cases of overdose have not been identified even once during the entire period of use of the drug. With the injection of Mildronate, an overdose is possible and it manifests itself with the following symptoms:

Decreased blood pressure;
Tachycardia (palpitations);
General weakness.

Treatment of an overdose of Mildronate is only symptomatic, aimed at stopping painful manifestations and maintaining the normal functioning of vital organs.

Interaction with other drugs

Mildronate enhances the effects of cardiac glycosides (Strophanthin, Digoxin, Korglikon, etc.), beta-blockers (Propranolol, Metoprolol, Atenolol, Bisoprolol, etc.), as well as some drugs that reduce pressure.

Mildronate is well combined and improves the severity of the clinical effect of the following drugs:

Antianginal agents (Sustak, Nitrong, Betalok, Kordanum, Trental, Dipyridamole, Riboxin, etc.);
Anticoagulants (Warfarin, Thrombostop, etc.);
Antiplatelet agents (Prostacycline, Aspirin Cardio);
Antiarrhythmic drugs (Adenokor, Amiodarone, Bretilat, Difenin, Kordaron, Moratsizin, Propanorm, Ritalmex, Rhythmiodarone, etc.);
Diuretic drugs (Veroshpiron, Diakarb, Furosemide, etc.);
Bronchodilators (Ventolin, Berotek, etc.).

With caution, Mildronate should be combined with Nitroglycerin, Nifedipine, alpha-blockers (Doxazosin, Setegis, Tulazine, etc.), antihypertensive drugs and peripheral vasodilators (Traklir, Naniprus, Cormagnesin, etc.), since there is a high risk of developing tachycardiaMildronate is contraindicated for use if a person has the following conditions or diseases:

Some instructions for use indicate that Mildronate is contraindicated for children under 18 years of age, however, such terms are reinsurance on the part of the drug manufacturer.

Meldonium - analogues

Analogues of Mildronate in the domestic pharmaceutical market are two groups of drugs - synonyms and actual analogues. Synonyms are called drugs containing, like Mildronate, meldonium as an active substance. Analogues are drugs that have similar therapeutic effects, but contain different active substances.

Synonyms of Mildronate are the following drugs:

Angiocardil solution for injection;
Vasomag capsules and solution for injection;
Idrinol solution for injection;
Cardionate capsules and injection;
Meldonium capsules and injection;
Midolat capsules;
Mildrakor injection solution (only in Ukraine);
Mildrocard capsules (only in Belarus);
Melfor capsules;
Medatern capsules.

Analogues of Mildronate are the following drugs:

Angiosil retard tablets;
Antisten and Antisten MB tablets;
Biosint lyophilisate for solution for injection;
Bravadin tablets;
Valeocor-Q10 tablets;
Vero-Trimetazidine tablets;
Gistochrome solution for injections;
Deprenorm MB tablets;
Dibikor tablets;
Dinaton solution for injection;
Doppelherz Cardiovital tablets;
Ezafosfin lyophilizate and ready solution;
Inosie-F and Inosin-Eskom solution for injection;
Carditrim tablets;
Koraksan tablets;
corona pellets;
Kudevita capsules;
Kudesan drops;
Medarum 20 and Medarum MB tablets;
Mexicor capsules and injection;
Metaguard tablets;
Sodium adenosine triphosphate (ATP) solution for injection;
Neoton lyophilisate for solution for injection;
Orocamag capsules;
Pedea solution for injection;
Predizin tablets;
Preductal and Preductal MB tablets;
precard tablets;
Ranex tablets;
Riboxin capsules, tablets and injection;
Rimecor and Rimecor MV tablets;
Taufon tablets;
Triducard tablets;
Trimectal capsules;
Trimectal MB tablets;
Trimet tablets;
Trimetazid tablets and capsules;
Trimetazidine and Trimetazidine MB tablets;
Trimitard MV tablets;
Ubinon capsules;
Firazir solution for injection;
Fosfaden tablets and solution for injection;
Ethoxydol tablets.

Mildronate - reviews

Almost all reviews of Mildronate are positive, due to the effectiveness of the drug in improving the functioning of the cardiovascular system. The entire set of positive reviews can be divided into two groups - concerning the use of the drug in severe chronic diseases and the use of the drug for functional disorders or overloads.

So, in positive reviews regarding the use of the drug for serious illnesses, people indicate that they took or periodically take Mildronate for vegetative-vascular dystonia, hypertension, heart failure or angina pectoris. With vegetative-vascular dystonia, Mildronate for 3-5 months completely normalized the condition of a person who practically forgot about his illness for this period. When the symptoms of dystonia reappear, people take a course of Mildronate and are satisfied with the result.

With hypertension, angina pectoris and heart failure, Mildronate is taken as part of complex therapy. In the reviews, people who took Mildronate for these diseases noted that the drug relieves fatigue, eliminates shortness of breath, a feeling of weakness, hopelessness and apathy, reduces the frequency of angina attacks, increases the overall endurance of the body and the tolerance of physical and emotional stress.

People who took Mildronate for functional disorders of the cardiovascular system (for example, low blood pressure, pain in the heart due to stress or high loads, darkening before the eyes when moving from a sitting to standing position, etc.), note in the reviews, that the drug quickly and completely eliminated their problem, instead of weakness and fatigue, lightness, energy, vigor, clarity in the head and a desire to live appeared.

Many reviews note that Mildronate helped to cope with high mental and physical stress, increasing efficiency and speeding up recovery after work. Athletes note that when using Mildronate, it becomes much easier to breathe during aerobic training and endurance increases significantly.

Negative reviews about Mildronate are literally single and they are usually associated with the development of a side effect that was poorly tolerated by a person, and therefore forced to stop using the drug.

Health

Parabulbar insertion - what is this procedure?

July 3, 2014

general information

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid area. Such an injection procedure is most often carried out in ophthalmic practice.

The course of the procedure

In what cases is it used?

Features of the procedure

The presented method of introducing a medical agent has its own characteristics, namely:

pain during the procedure;
limited dose of administered medication;
toxicity;
possible development of necrosis;
scarring of the injection site.

We cannot ignore the fact that not so long ago, autoradiographic studies showed that, compared with the subcutaneous, intramuscular and intravenous route of administration of antibiotic drugs and steroids, the parabulbar method leads to the highest content of the drug in the vitreous body.

Possible Complications

Complications that may well arise with this method of administering the drug include the following pathological conditions:

vitreous prolapse;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
subconjunctival or retrobulbar hemorrhage;
iris prolapse.

As you can see, parabulbar drug administration is far from a safe procedure. In this regard, doctors resort to it only in extreme cases.

Drugs intended for parabulbar administration

physical stress;
reduced performance;
thrombosis of the central vein of the retina, as well as its branches;
retinopathy of various origins, including hypertensive and diabetic;
hemophthalmos;
retinal hemorrhages of various origins;
as part of complex therapy for chronic alcoholism (withdrawal syndrome).

Why can not the drug be administered intramuscularly?

Other methods of drug administration in ophthalmology

Now you know what parabulbar drug administration is. However, it should be noted that in some diseases of the organs of vision there is an urgent need to administer the drug directly under the eyeball. To carry out such a procedure, not only parabulbar injection is used. For such an introduction, the subconjunctival method is often used. The choice of this or that method remains with the attending physician. Although the subconjunctival injection of the drug, compared with the parabulbar one, is more painful.

It is thanks to this effect that mildronate is so popular in bodybuilding: after all, the faster the body recovers, the more vivid results can be obtained during the next workout.

The drug Mildronate: indications for use

As mentioned above, Mildronate can be used in a variety of cases. As a rule, it is prescribed for those who suffer from diseases of the heart or blood vessels, as well as in case of cerebrovascular accidents.

Mildronate has gained particular popularity in the sports field - both weightlifters and other athletes use it with pleasure. By the way, the drug is not doping, so its use in any sport is completely legal. Thanks to Mildronate, your body will have time to recover from heavy loads, so that sports results will be higher and higher. The main thing is to follow the recommended dosages and courses of administration, because with prolonged use, addiction develops and the drug loses its effectiveness.

How to take Mildronate?

To date, Mildronate can be found in pharmacies, produced in one of two possible forms: either in capsules for oral administration, or in ampoules for intravenous administration. It has been proven that the drug administered intravenously is much more effective than oral capsules (the efficiency increases by about 2 times). The instructions for the drug indicate that it can also be administered parabulbarno - that is, by injection under the eyeball.

Many are interested in whether it is possible to inject Mildronate intramuscularly, and not intravenously. Based on the fact that the instructions for this drug do not indicate otherwise, this method of administration is possible. However, since it was not provided by the manufacturer, there is a possibility that its effectiveness will be reduced and approximately equal to that which can be obtained by taking the capsules inside. Moreover, the official website of the drug contains information that it is dangerous to use it intramuscularly, because it acts irritatingly and can lead to local pain and allergic reactions.

Thus, when considering the possibility of intramuscular administration of Mildronate, you should, first of all, be guided by the advice of your doctor and common sense. Uncontrolled actions in this case can be very dangerous for your health! It is not recommended to deviate from the instructions given by the manufacturer of the medicinal product.

Mildronate: dosage

Athletes Mildronate is prescribed, as a rule, to be used immediately before training, 0.5-1 g orally 2 times a day. The course during the competition period can last days, and during the preparation period - 2-3 weeks.

Mildronate and alcohol

Like any other drug, Mildronate is forbidden to use with alcohol. Its instructions contain information that it is recommended to use it for the complex treatment of people with alcoholism, but this must be done not directly on the day of drinking alcohol.

Copying information is allowed only with a direct and indexed link to the source

B and parabulbar administration 500 mg

In chronic cerebrovascular insufficiency (dyscirculatory encephalopathy), 0.5 g (5 ml of Mildronate®) intramuscularly or intravenously 1 time per day for 10 days, then 0.5 g orally.

Also

August 21, 2016
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Alexandra Volska
Which

new entries

Parabulbar drug administration and what it looks like

Naturally, parabulbar insertion is a painful procedure used only in selected cases. About when such injections are prescribed, and what drugs are used, we will talk below.

When is parabulbar administration of drugs prescribed and what does it look like?

Quite often, parabulbar injections of drugs are necessary for anesthesia before surgery in the eye area. This method of anesthesia of the operated area helps to significantly reduce the sensitivity of nerve receptors. In this case, the injection includes a solution of lidocaine (0.5%) and hyaluronidase.

What is the peculiarity of parabulbar introduction

inflammation of the anterior or posterior ocular segment;
keratitis;
sclerites;
neuroretinitis;
iridocyclitis.

Parabulbar injections have the following features when administered:

severe pain during the procedure;
the dose of the administered agent is limited;
partial toxicity;
can provoke necrosis and scarring at the injection site.

What complications can the procedure cause?

As already mentioned, the procedure for parabulbar drug administration is painful and very complicated. In some cases, it can lead to complications such as:

conjunctival chemosis;
iris prolapse;
vitreous prolapse;
retrobulbar or subconjunctival hemorrhage;
rupture of zinn ligaments.

What drugs are administered by the parabulbar method

Indications for the use of Mildronate

Due to its properties, Mildronate has a fairly wide scope. It is prescribed for such diseases:

physical stress;
coronary heart disease, including heart attack or angina pectoris;
chronic heart failure;
dishormonal cardiomyopathy;
chronic and acute disorders of cerebral circulation in the form of a stroke or cerebrovascular insufficiency (as part of complex therapy);
thrombosis of the central retinal vein and branches;
hemophthalmos;
various kinds of hemorrhages in the retina;
hypertensive or diabetic retinopathy;
withdrawal syndrome on the background of chronic alcoholism;
decrease in working capacity, etc.

Application of Mildronate

Can Mildronate be introduced in another way?

The form of use of Mildronate is always prescribed only by a specialist. As for the parabulbar introduction, special attention should be paid to the procedure, since there are high risks of worsening the patient's condition.

Other methods of administration of drugs in ophthalmic practice

Cost of injections

Naturally, such injections are prescribed only by a highly professional ophthalmologist after the patient undergoes a full range of diagnostic examinations and chooses the most suitable method of treatment for himself.

Diagnosis, as a rule, includes such activities;

visual acuity test;
ophthalmoscopy with a narrow pupil;
biomicroscopy;
autorefractometry.

Parabulbar insertion - what is this procedure?

general information

Parabulbar injection is the introduction of an anesthetic or some other drug through the skin into the lower eyelid area. Such an injection procedure is most often carried out in ophthalmic practice.

The course of the procedure

In what cases is it used?

Features of the procedure

It should be especially noted that parabulbar injection is a procedure that is used to introduce a drug into the lower eyelid region, not only for an analgesic effect, but also for therapeutic purposes. During therapy, such injections are used for inflammation of the anterior and posterior segments of the eye, as well as for keratitis, neuroretinitis, iridocyclitis and scleritis.

The presented method of introducing a medical agent has its own characteristics, namely:

pain during the procedure;
limited dose of administered medication;
toxicity;
possible development of necrosis;
scarring of the injection site.

We cannot ignore the fact that not so long ago, autoradiographic studies showed that, compared with the subcutaneous, intramuscular and intravenous route of administration of antibiotic drugs and steroids, the parabulbar method leads to the highest content of the drug in the vitreous body.

Possible Complications

Complications that may well arise with this method of administering the drug include the following pathological conditions:

vitreous prolapse;
rupture of the posterior capsule;
conjunctival chemosis;
separation of zinn ligaments;
subconjunctival or retrobulbar hemorrhage;
iris prolapse.

As you can see, parabulbar drug administration is far from a safe procedure. In this regard, doctors resort to it only in extreme cases.

Drugs intended for parabulbar administration

physical stress;
reduced performance;
thrombosis of the central vein of the retina, as well as its branches;
retinopathy of various origins, including hypertensive and diabetic;
hemophthalmos;
retinal hemorrhages of various origins;
as part of complex therapy for chronic alcoholism (withdrawal syndrome).

Why can not the drug be administered intramuscularly?

Other methods of drug administration in ophthalmology

Now you know what parabulbar drug administration is. However, it should be noted that in some diseases of the organs of vision there is an urgent need to administer the drug directly under the eyeball. To carry out such a procedure, not only parabulbar injection is used. For such an introduction, the subconjunctival method is often used. The choice of this or that method remains with the attending physician. Although the subconjunctival injection of the drug, compared with the parabulbar one, is more painful.

Mildronate (Meldonium - tablets, capsules, syrup, injections) - indications, instructions for use, analogues, reviews, price

Names, forms of release, composition and dosage of Mildronate

1. Capsules for oral administration;

2. Syrup for oral administration;

3. Solution for injection (intramuscular, intravenous and parabulbar).

Methyl parahydroxybenzoate;
Propyl parahydroxybenzoate;
propylene glycol;
Sorbitol;
Glycerol;
Citric acid monohydrate;
cherry essence;
Allura Red dye (E129);
Dye Brilliant Black BN (E151);
Purified water.

Therapeutic action of Mildronate

Cardioprotective action– protection of heart cells from negative influences and improvement of their viability;
Antianginal action- a decrease in the oxygen demand of myocardial cells (due to this effect, even a small amount of oxygen supplied under ischemia is enough for myocardial cells, which reduces the severity of pain, reduces the frequency of angina attacks and increases the tolerance of physical and emotional stress);
Antihypoxic action- reducing the negative impact of oxygen deficiency;
Angioprotective action- protection and ensuring the integrity of the walls of blood vessels;
Tonic action.

In addition, Mildronate dilates blood vessels and normalizes the cellular link of immunity, which increases the body's resistance to viral infections.

Mildronate - indications for use

Ischemic heart disease (as part of complex treatment);
Angina pectoris (as part of complex treatment);
Myocardial infarction (as part of complex treatment);
Chronic heart failure;
Pain in the heart with myocardial dystrophy;
Dishormonal cardiomyopathy (myocardial dystrophy);
Functional disorders of the cardiovascular system in adolescents;
Myocardial dystrophy in adolescents;
Neurocirculatory dystonia in adolescents;
Acute and chronic circulatory disorders of the brain (strokes, cerebrovascular insufficiency);
Violation of blood circulation in the retina of the eye;
Hemophthalmos (injection solution only);
Hemorrhages in the retina of the eye (only solution for injection);
Thrombosis of the central retinal vein or its branches (injection solution only);
Diabetic and hypertensive retinopathy (injection solution only);
Bronchial asthma (as part of complex therapy);
Chronic bronchitis (as part of complex therapy);
Alcohol withdrawal (as part of complex treatment);
Chronic alcoholism (as part of complex treatment);
Low mental and physical performance;
Physical overexertion and overwork;
Postoperative period after any surgical intervention.

For quick recovery after high loads in training and competitions;
overtraining;
Low performance.

Mildronate - instructions for use

Mildronate tablets (Mildronate 250, Mildronate 500) and syrup

A teaspoon contains 5 ml of liquid;
A dessert spoon contains 10 ml of liquid;
A tablespoon contains 15 ml of liquid.

That is, you can simply take a spoon that holds the right amount of syrup and pour it into it.

250 mg in 5 ml (this is the concentration declared by the manufacturer);

X \u003d 312.5 * 5/250 \u003d 6.25 ml.

Mildronate injections - instructions for use

Dosages and rules for the introduction of Mildronate intramuscularly and intravenously

special instructions

Influence on the ability to control mechanisms

Overdose

Treatment of an overdose of Mildronate is only symptomatic, aimed at stopping painful manifestations and maintaining the normal functioning of vital organs.

Interaction with other drugs

Antianginal agents (Sustak, Nitrong, Betaloc, Kordanum, Trental, Dipyridamole, Riboxin, etc.);
Anticoagulants (Warfarin, Thrombostop, etc.);
Antiplatelet agents (Prostacycline, Aspirin Cardio);
Antiarrhythmic drugs (Adenokor, Amiodarone, Bretilat, Difenin, Kordaron, Moratsizin, Propanorm, Ritalmex, Rhythmiodarone, etc.);
Diuretic drugs (Veroshpiron, Diakarb, Furosemide, etc.);
Bronchodilators (Ventolin, Berotek, etc.).

With caution, Mildronate should be combined with Nitroglycerin, Nifedipine, alpha-blockers (Doxazosin, Setegis, Tulazine, etc.), antihypertensive drugs and peripheral vasodilators (Traklir, Naniprus, Kormagnesin, etc.), since there is a high risk of developing tachycardia and a sharp decrease in blood pressure.

Side effects

Contraindications for use

Increased intracranial pressure (against the background of impaired venous outflow or in the presence of intracranial tumors);
Pregnancy and breastfeeding (due to lack of evidence of complete safety);
Hypersensitivity or allergic reactions to the components of tablets, syrup or solution;
Age under 12 years old.

Some instructions for use indicate that Mildronate is contraindicated for children under 18 years of age, however, such terms are reinsurance on the part of the drug manufacturer.

Meldonium - analogues

Angiocardil solution for injection;
Vasomag capsules and solution for injection;
Idrinol solution for injection;
Cardionate capsules and injection;
Meldonium capsules and injection;
Midolat capsules;
Mildrakor injection solution (only in Ukraine);
Mildrocard capsules (only in Belarus);
Melfor capsules;
Medatern capsules.

Analogues of Mildronate are the following drugs:

Angiosil retard tablets;
Antisten and Antisten MB tablets;
Biosint lyophilisate for solution for injection;
Bravadin tablets;
Valeocor-Q10 tablets;
Vero-Trimetazidine tablets;
Gistochrome solution for injections;
Deprenorm MB tablets;
Dibikor tablets;
Dinaton solution for injection;
Doppelherz Cardiovital tablets;
Ezafosfin lyophilizate and ready solution;
Inosie-F and Inosin-Eskom solution for injection;
Carditrim tablets;
Koraksan tablets;
corona pellets;
Kudevita capsules;
Kudesan drops;
Medarum 20 and Medarum MB tablets;
Mexicor capsules and injection;
Metaguard tablets;
Sodium adenosine triphosphate (ATP) solution for injection;
Neoton lyophilisate for solution for injection;
Orocamag capsules;
Pedea solution for injection;
Predizin tablets;
Preductal and Preductal MB tablets;
precard tablets;
Ranex tablets;
Riboxin capsules, tablets and injection;
Rimecor and Rimecor MV tablets;
Taufon tablets;
Triducard tablets;
Trimectal capsules;
Trimectal MB tablets;
Trimet tablets;
Trimetazid tablets and capsules;
Trimetazidine and Trimetazidine MB tablets;
Trimitard MV tablets;
Ubinon capsules;
Firazir solution for injection;
Fosfaden tablets and solution for injection;
Ethoxydol tablets.

Mildronate - reviews

Feedback from cardiologists

The results of clinical trials of the drug Mildronate, expert comments - video

What is better than Mildronate?

Mildronate (tablets, ampoules) - price

Capsules 250 mg, 40 pieces - 243 - 308 rubles;
Capsules 500 mg, 60 pieces - 561 - 712 rubles;
Solution 10%, 10 ampoules of 5 ml - 303 - 391 rubles.

Reviews

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The drug for parabulbar and intravenous administration Pharmstandard "Mildronate" - reviews

The same meldonium.

Advantages: Well tolerated when administered intravenously.

Disadvantages: If you are an athlete taking tests for doping, then you are not here.

This type of mildronate for injection is intended exclusively for intravenous and parbulbar (injection into the lower eyelid) use. For normal use, mildronate is also available in capsules. The drug mildronate as an active substance contains meldonium, which was synthesized.

Russia, Pskov region.

Cardiogram before and after drug administration.

Disadvantages: There are contraindications.

This drug was prescribed to my mother when signs of coronary heart disease, angina pectoris were revealed on the cardiogram. The T wave was weakly positive. A week later, a repeat cardiogram showed a change in the T wave from positive to negative. Normally he should.

This "dope" helps my eyes a lot.

Pros: Really helpful.

Leaving my review of medical alcohol wipes, I mentioned that I had placed an order for the medicine I needed in our village pharmacy. And yesterday they called me and said that he was brought. Now, this is the cure.

I was given this drug in the hospital.

Benefits: cheerfulness, clarity of mind, improved vision.

Disadvantages: the price is high, it is necessary to inject into the veins.

Earlier, even before the birth of a child, I often (a couple of times a year) lay in a hospital, in the ophthalmology department, due to high myopia. There they injected me with taufon under the sclera, vitamins of group B intramuscularly, and they always injected me intravenously.

Good and affordable product

Pros: Price and performance

Cons: Recognized as doping

Assigned in complex therapy to restore the body after prolonged alcohol intoxication

Advantages: Helped in complex treatment to restore shaken health

Good afternoon, dear readers of the review! I continue to write reviews about the drugs that were prescribed to my close relative by a doctor when the body malfunctioned after a long alcoholic binge. The liver and heart began to require restoration, a common one appeared.

Helps me a lot to live

Advantages: In hypotensive patients, it raises a little blood pressure, well-being, normalizes the pulse, reduces arrhythmias. Improves the quality of life.

Cons: Haven't noticed yet.

Hypotension has been haunting after problems with the gastrointestinal tract since 1987. Doctors prescribed Riboxin 10 cubes for 5-10 days. efficiency 2-3 weeks, so I tried for several years. I tried other medicines, but there was no better mildronate. Mildronate (now also called.

Benefits: Facilitates the work of the body under increased stress.

Disadvantages: Listed on the anti-doping agency's prohibited list.

Friends! So the vile European officials found justice for our athletes. Mildronate was banned. Although, as our experts say, it has an analogue in Europe itself. This analogue is not included in the prohibited anti-doping list. BUT.

Grandma's "doping"

Benefits: Reduced recurrence of atrial fibrillation, reduced weakness, improved physical condition and mood.

As usual, during the autumn-spring periods, on the appointment of a cardiologist - an arrhythmologist, I conduct an intravenous course of metabolic therapy for my grandmother. It is shown to her as a prophylaxis, together with other antiarrhythmic drugs for coronary heart disease and.

Improves overall well-being

Benefits: Improves overall health

Cons: I didn't find

Great help and support to the heart.

Advantages: Significantly facilitates the work of the heart and the whole body as a whole.

I have not been taking the drug "Mildronate" only for the last two years, and before that I took it for five years, regularly went to the polyclinic for intravenous injections twice a year. On weekends, when the clinic is closed, I replaced intravenous injections with capsules.

Helped me a lot

Pros: rejuvenation

Disadvantages: carefully read the instructions for use

In connection with a very unpleasant situation, she was at the limit of her physical and moral strength. I went to the doctor and they prescribed mildronat intravenously. Pricked 2 weeks in the morning 1 time per day. In the beginning there was a very strong upsurge of strength, possibly self-hypnosis. Then somewhere.

Russia, Nizhny Tagil

A prescription drug that your doctor must prescribe.

I am only writing this review based on my personal experience with this product. This medicine was prescribed to me by a doctor during the time when my dizziness became more frequent against the background of severe stressful situations. The drug is taken in a course, first there are intravenous injections.

"Dope" of modern man! Down with Chronic Fatigue Syndrome!

Advantages: very fast acting, Latvian production, helps with chronic fatigue syndrome, activates all processes, acts faster than capsules

I have no words to express my delight and joy from taking the drug. I haven't felt this good in years. You can, of course, take capsules, but injections work much faster and better. Especially if.

Mildronate is the best metabolite!

Disadvantages: Tachycardia rarely occurs.

Mildronate use all my medical practice. This is a universal drug that is suitable in all cases in the practice of a polyclinic doctor! Is your patient tired and fatigued? "Mildronate". Does your patient have problems with cerebral circulation? "Mildronate".

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