药品信息:
【药品名称】
通用名：吡拉西坦, 吡乙酰胺、脑复康、酰胺吡咯烷酮，酰胺吡酮，酰胺吡，咯烷酮，吡烷酮醋胺, Piracetam, Euvifor, Nootropil
英文名：Piracetam Tablets
本品主要成份为：吡拉西坦。其化学名称为：2-氧化-1-吡咯烷基乙酰胺。
分子式：C6H10N2O2
分子量：142.16
【药理毒理】
本品为脑代谢改善药，属于g-氨基丁酸的环形衍生物。有抗物理因素、化学因素所致的脑功能损伤似的作用。能促进脑内ATP，可促进乙酰胆碱合成并正增强神经兴奋的传导，具有促进脑内代谢作用。可以对抗由物理因素、化学因素所致的脑功能损伤。对缺氧所致的逆行性健忘有改进作用。可以增强记忆，提高学习能力。
动物实验的急性毒理试验表明，小鼠灌胃剂量大于10g/kg，未见死亡。静脉给药的半数致死量LD50为9.2g/kg。亚急性和慢性毒理实验均未发现对大鼠、狗的生长发育有任何不良影响。对血液、心、肝、肾、脑等重要内脏器官和功能均无影响。
【药代动力学】
口服本品后很快从消化道吸收，进入血液，并透过血脑屏障到达脑和脑脊液，大脑皮层和嗅球的浓度较脑干中浓度更高。易通过胎盘屏障。口服后，30～45分钟血药浓度达到峰值，血浆蛋白结合率30％，半衰期t1/2为5～6小时。表观分布容积（Vd）为0.6L/kg。吡拉西坦口服后不能由肝脏分解，以原形形式从尿和粪便中排泄。肾脏清除速度为86ml/分钟。大便排出量约为1%～2%。
【适应症】
适用于急、慢性脑血管病、脑外伤、各种中毒性脑病等多种原因所致的记忆减退及轻、中度脑功能障碍。也可用于儿童智能发育迟缓。
【用法用量】
口服。每次0.8～1.6g( 2～4片)，每日3次，4～8周为一疗程。儿童每次给予40mg／kg。一般3～6周为1疗程。服完一疗程后，维持剂量减半，或遵医嘱。
【不良反应】
消化道不良反应常见有恶心、口干、纳差、失眠、荨麻疹、腹部不适、腹胀、腹痛等，症状的轻重与服药剂量直接相关。中枢神经系统不良反应包括兴奋、易激动、头晕、头痛和失眠等，但症状轻微，且与服用剂量大小无关。停药后以上症状消失。偶见轻度肝功能损害，表现为轻度转氨酶升高，但与药物剂量无关。
【禁忌】
锥体外系疾病，Huntington舞蹈症者禁用本品，以免加重症状。
【注意事项】
肝肾功能障碍者慎用并应适当减少剂量。
【孕妇及哺乳期妇女用药】
本品易通过胎盘屏障，故孕妇禁用；哺乳期妇女用药指征尚不明确。
【儿童用药】 新生儿禁用。
【药物相互作用】
本品与华法林联合应用时，可延长凝血酶原时间，可诱导血小板聚集的抑制。在接受抗凝治疗的患者中，同时应用吡拉西坦时应特别注意凝血时间，防止出血危险，并调整抗凝治疗的药物剂量和用法。
Nootropil - Nootropil is a nootropic drugs. This medication has a positive effect on metabolism and blood circulation of the brain. It increases glucose utilization, improves the course of metabolic processes, improves microcirculation in the ischemic areas, and inhibits the aggregation of activated platelets. Nootropil has a protective effect for brain damage caused by hypoxia, intoxication, an electric shock. This drug improves the integrative activity of the brain. Nootropil does not have a sedative and stimulating effect.
Nootropil is found to increase blood flow and oxygen consumption by the brain tissue. There for the action of Nootopil consists in facilitating the movement of information between the brain's hemispheres, improves acetylcholines function via muscarinic cholinergic receptors which take their part in the memory process. Also Nootopil may have an impact on the NMDA glutamate receptors that are involved in memory and learning processes.
Nootropil (sold under many brand names) is a nootropic drug. It appears to enhance cognition and memory, slow brain aging, increase blood flow and oxygen to the brain, aid stroke recovery, and ameliorate Alzheimer's, Down's syndrome, dementia, and dyslexia, among other diseases and conditions. Piracetam's chemical name is 2-oxo-1-pyrrolidine acetamide; it shares the same 2-oxo-pyrrolidone base structure with 2-oxo-pyrrolidine carboxylic acid (pyroglutamate). Nootropil is a cyclic derivative of GABA. It is one of the racetams. Nootropil is prescribed by doctors for some conditions, mainly myoclonus, but is used off-label for a much wider range of applications.
Treatment of cerebrovascular insufficiencies and age-associated cognitive impairment. 1200-mg Tablet and IV Infusion: Treatment in cortical myoclonus.
Loss of memory, vertigo, lack of concentration or alertness, personal negligence, change of mood, deterioration in behaviour. Treatment of sickle cell anaemia. Cortical myoclonus, alone or in combination. Together with improving remedial teaching for the treatment of children with learning difficulties in reading which cannot be explained by intellectual backwardness, inadequate education or by family environment.
Adults: Symptomatic treatment of the psycho-organic syndrome whose features, improve by treatment, are memory loss, attention disorders and lack of drive. Treatment of cortical myoclonus, alone or in combination; vertigo and associated disorders of balance, with the exception of dizziness of vasomotor or psychic origin. Children: Treatment of dyslexia with appropriate measures eg, speech therapy.
Treatment of the elderly with some degree of cerebral functional impairment eg, loss of memory, lack of concentration or alertness and vertigo. Nootropil is indicated for patients suffering from myoclonus of cortical origin, irrespective of aetiology and should be used in combination with other anti-myoclonic therapies.
Symptomatic improvement of memory or intellectual impairment of a pathological nature in the absence of a diagnosis of dementia. Studies have shown some improvement in children with learning difficulties associated with the written word, particularly with textual understanding which cannot be explained by intellectual backwardness, inadequate education or by the family environment. The administration of Nootropil does not replace other measures also well adapted to correct these learning difficulties eg, remedial teaching. Nootropil can reduce myoclonus of cortical origin in some patients. In order to test the sensitivity to piracetam, trial treatment can therefore be instituted for a limited period. |
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