Pharmacy No. 84. Delivery of medicines to your home and office.

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Instructions for use GINIPRAL® (GINIPRAL)

During the use of GINIPRAL®, you should monitor the mother's pulse and blood pressure, as well as the fetal heartbeat. It is recommended to record an ECG before and during treatment. Patients with hypersensitivity to sympathomimetics should use GINIPRAL® in small doses prescribed individually, under constant medical supervision.

If there is a significant increase in the mother's heart rate (more than 130 beats/min) and/or a significant decrease in blood pressure, the dose should be reduced; if there are complaints of difficulty breathing, pain in the heart, or if signs of heart failure appear, the use of GINIPRAL® should be stopped immediately.

Pregnant women with diabetes should monitor carbohydrate metabolism, because the use of GINIPRAL®, especially in the initial stage of treatment, may cause an increase in blood sugar levels. If childbirth occurs immediately after a course of treatment with GINIPRAL®, it is necessary to take into account the possibility of hypoglycemia and acidosis in newborns due to the transplacental penetration of acidic metabolic products (lactic and ketonic acids).

In some cases, the simultaneous use of glucocorticosteroids during GINIPRAL® infusions may cause pulmonary edema. Therefore, during infusion therapy, constant careful clinical monitoring of patients is necessary. This is especially important during combined treatment with corticosteroids in patients with concomitant diseases that contribute to fluid retention (kidney disease). Strict limitation of excess fluid intake is necessary. The risk of possible development of pulmonary edema requires limiting the volume of infusions as much as possible, as well as using dilution solutions that do not contain electrolytes. You should limit your salt intake from food. Before starting tocolytic therapy, it is necessary to take potassium supplements, because with hypokalemia, the effect of sympathomimetics on the myocardium is enhanced. The simultaneous use of certain narcotic drugs (halothane) and sympathomimetics can lead to cardiac arrhythmias. Taking GINIPRAL® must be stopped before using halothane for anesthesia. With prolonged tocolytic therapy, it is necessary to monitor the condition of the fetoplacental complex and ensure that there is no placental abruption. Clinical symptoms of premature placental abruption can be smoothed out with tocolytic therapy. When the membranes rupture and when the cervix is dilated by more than 2-3 cm, the effectiveness of tocolytic therapy is low.

During tocolytic treatment with beta-agonists, the symptoms of concomitant dystrophic myotonia may intensify. In such cases, the use of diphenylhydantoin (phenytoin) drugs is recommended.

Ginipral injection solution 5 µg/ml 2 ml amp 5 pcs

Taking Ginipral should only be started after a careful assessment of the risk/benefit ratio. Treatment should be carried out in a medical facility equipped with the equipment necessary for continuous monitoring of the condition of the mother and fetus. Tocolytic therapy with beta-agonists is not recommended for ruptured membranes and cervical dilation of more than 4 cm.

It is necessary to monitor the state of the cardiovascular system and respiratory function of the mother, as well as ECG changes during therapy.

The following parameters should be continuously monitored in the mother and, if possible/necessary, in the fetus: - Blood pressure, heart rate; — ECG indicators; — Water-salt balance (due to the risk of developing pulmonary edema); — Concentration of glucose and lactate (primarily in patients with diabetes mellitus); — Potassium concentration (the use of beta-agonists is associated with the risk of hypokalemia, which can lead to arrhythmia). If hypokalemia develops in the patient before tocolytic therapy is prescribed, potassium supplements should be started.

If signs of myocardial ischemia appear (chest pain, ECG changes), you should stop taking Ginipral.

Ginipral should not be prescribed for tocolytic therapy in patients with any signs or increased risk factors for heart disease, including tachyarrhythmias, heart failure or heart defects. If there are concomitant heart diseases or if any of these diseases are suspected, therapy with Ginipral should be prescribed after consultation with a doctor experienced in tocolytic therapy in such patients.

Pulmonary edema Since cases of pulmonary edema and myocardial ischemia have been reported during and after the use of beta-agonists to suppress preterm labor, changes in the water-salt balance and the state of the cardiac and respiratory activity of the mother should be carefully monitored during therapy. In patients with predisposing factors such as multiple pregnancies, hypervolemia, infections and preeclampsia, the risk of developing pulmonary edema is especially high.

Using an automatic dosing infusion pump instead of a standard infusion system can reduce the risk of hypervolemia. If signs of pulmonary edema or myocardial ischemia appear, the administration of Ginipral should be discontinued.

This is especially important in combination therapy with glucocorticosteroids in patients with concomitant diseases and complications of pregnancy (kidney disease and moderate to severe preeclampsia in the second half of pregnancy).

You should limit your salt intake from food.

Blood pressure and heart rate The use of beta-agonists usually leads to an increase in maternal heart rate by 20-50 beats/min. During therapy, the mother's pulse should be monitored; if the heart rate increases, the question of reducing the dose or discontinuing the drug should be decided on an individual basis. The mother's heart rate should not be allowed to increase above 120 beats/min.

Also, when using the drug Ginipral, a slight decrease in blood pressure may be observed; in this case, the decrease in diastolic pressure is usually more pronounced than in systolic pressure. The magnitude of the decrease in diastolic pressure is usually 10-20 mm Hg. Art. To a lesser extent, taking Ginipral affects the fetal heart rate; an increase of up to 20 beats/min may be observed.

To minimize the risk of arterial hypotension during tocolytic therapy, it is recommended that the infusion be administered in the lateral decubitus position to avoid inferior vena cava compression syndrome.

Diabetes The use of beta-agonists may cause an increase in blood glucose concentrations. Therefore, you should monitor the concentration of glucose and lactate in patients with diabetes mellitus, and, if necessary, adjust the dose of hypoglycemic drugs during tocolytic therapy.

If childbirth occurs immediately after a course of therapy with Ginipral, it is necessary to take into account the possibility of developing hypoglycemia in newborns, since hexoprenaline can lead to an increase in the concentration of glucose and insulin in the mother, as well as acidosis, since the penetration of acidic metabolic products (lactate, ketone acids) is possible. through the placenta.

Other instructions During tocolytic therapy using beta-agonists, the symptoms of concomitant dystrophic myotonia may increase. In such cases, the use of diphenylhydantoin preparations is recommended.

In case of hypersensitivity to sympathomimetics, Ginipral should be used in small, individually selected doses and under close medical supervision.

In rare cases, sodium disulfite, which is part of the drug Ginipral, can cause a hypersensitivity reaction and bronchospasm. Hypersensitivity may be manifested by symptoms such as nausea, diarrhea, bronchial obstruction, acute attack of bronchial asthma, impaired consciousness or shock. Hypersensitivity reactions can develop with varying severity and speed, and in some cases can lead to life-threatening conditions.

Ginipral may have a depressant effect on intestinal motility (rare cases of intestinal atony have been reported). In this regard, during tocolytic therapy it is necessary to monitor the regularity of bowel movements.

Effect on the ability to drive vehicles and operate machinery During the treatment period, care should be taken when driving vehicles and while engaging in potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

How can secondary effects of ginipral be reduced?

Side effects of Ginipral are no exception, especially rapid heartbeat. When all the signs appear in a pregnant woman, therapy will not bring results, but just the opposite. For this reason, together with ginipral or before a dropper, determine:

Valerian extract in pills. Two pills are used together with a dropper.
Verapamil acts on the cause of a faster heartbeat. The drug is not prescribed in the first trimester of pregnancy.
Infusions of motherwort and valerian are rarely prescribed, since the tincture is not recommended due to the presence of alcohol in the composition.

Signs may not completely disappear, especially when using the substance Ginipral drip. When the symptoms are too pronounced and other additive substances help, Ginipral must be discontinued and replaced with other medicinal substances.

To prevent the drug from causing a deterioration in the condition of the mother and fetus, it is necessary:

Before therapy, do an electrocardiogram for the mother;
In the presence of secondary results, the pregnant woman is consulted by a doctor;
Monitoring potassium levels is important;
Checking daily urine (the volume of water consumed does not have to differ greatly from the amount of urine);
After therapy, it is recommended to perform a method for assessing the condition of the fetus, which includes analyzing the heart rate at rest, during movement, during uterine contractions and the influence of environmental factors.

Prevention of uterine tone

As a precautionary measure to prevent the appearance of uterine tone, the doctor will recommend sedatives. The earlier the factor in the appearance of increased uterine contractions is detected and therapy is determined, the greater the opportunity to bear a healthy child. In position, a relaxed state of the muscles is considered a normal indicator.

If treatment is not carried out for high hypertonicity, contractions may occur, which will provoke a miscarriage. To prevent such an effect, the doctor prescribes drugs to reduce the activity of the uterus. If the uterus is slightly enlarged, a twenty-five percent solution of magnesia is prescribed, which is injected by drip.

Magnesia is prescribed at the end of the fourth month. Hormonal agents can be used until a miscarriage occurs. Because in the first trimester, hormones exclusively play an important role in the entire period of pregnancy.

Ginipral is one of the pharmaceutical substances that affects the vessels of the uterus and the placenta. Under the influence of the medicine, blood supply to the uterus, fetus and placenta increases.

Contraindications

Ginipral cannot be used in the following moments:

if you are allergic to a medicine;
asthmatic attacks;
hyperfunction of the endocrine glands;
problems with the heart, liver and kidneys;
with bleeding of the uterus.

Considering the instructions for use of the drug and the responses of medical workers, Ginipral does not always give the expected result.

We place the IV correctly

Probably, any person at least once in his life has seen an IV or been given one. If people need this method of drug treatment, then they must go to the clinic so that the procedure is performed by a nurse. However, for any patient it is advisable to be able to control the action.

A dropper is a device with a reservoir and a plastic tube with two needles at the ends. One needle is inserted into the bottle of medication, and the second is inserted into the patient intravenously. The container with the drug is fixed on the stand for the correct position. The dropper should be located above the arm. The medicine enters the blood through the tube.

To prevent air from entering the vein, a certain level of liquid is regularly maintained in the IV reservoir. In addition, the doctor regulates the speed of excavation. To prevent the formation of a vacuum in the bottle with the drug, another needle is inserted into it close to the needle from the dropper.

How to use the drug

Ginipral, which is used for women at 40 weeks and during labor, is hexoprenaline. The element is considered a strong selective beta2-agonist, which exhibits a pronounced tocolytic effect. The main indication for the use of such a substance is considered to be the need for urgent relief of contractions, for example, the state of fetal suffocation, when performing a manual turn, which is located transverse to the birth canal, when prolapse of the umbilical cord and other complications are detected.

In emergency surgery options for artificial resolution of labor, the medicine can relax the uterus. Ginipral for uterine tone is used with a dropper during pregnancy. At the same time, the drug slows down early contractions and prevents the resolution of labor in the early stages. A medicine from the tocolytic group prepares the uterus for suturing the cervix to hold it in a closed position and promotes recovery after manipulation.

Popular Antioxidants in Emoxipin injections for vascular function

Description of the drug GINIPRAL

When using hexoprenaline, the mother's pulse and blood pressure, as well as the fetal heartbeat, should be monitored. ECG monitoring is recommended before and during treatment.

In patients with hypersensitivity to sympathomimetics, hexoprenaline should be used in low doses, selected individually, under constant medical supervision.

If there is a significant increase in maternal heart rate (more than 130 beats/min) and/or a marked decrease in blood pressure, the dose should be reduced; If there are complaints of difficulty breathing, pain in the heart, or if signs of heart failure appear, the use of hexoprenaline should be stopped immediately.

Before starting tocolytic therapy, it is necessary to prescribe potassium supplements, because with hypokalemia, the effect of sympathomimetics on the myocardium is enhanced.

While using hexoprenaline, you should limit your dietary salt intake.

When carrying out tocolytic therapy, it is necessary to monitor the regularity of stool.

In pregnant women with diabetes mellitus, blood glucose concentrations should be monitored, because the use of hexoprenaline, especially at the beginning of treatment, may cause an increase in glycemic levels.

If childbirth occurs immediately after a course of treatment with hexoprenaline, it is necessary to consider the possibility of hypoglycemia and acidosis in newborns due to transplacental penetration of acidic metabolic products (lactic and ketonic acids).

In some cases, when corticosteroids are used during the administration of hexoprenaline, pulmonary edema may develop. Therefore, during infusion therapy, constant careful clinical monitoring of patients is necessary. This is especially important when it is necessary to carry out combination therapy with corticosteroids and hexoprenaline in patients with concomitant diseases accompanied by fluid retention in the body (including kidney disease).

Since there is a risk of developing pulmonary edema when administering hexoprenaline, the volume of fluid administered during infusion should, if possible, be limited; in addition, it is preferable to use solutions that do not contain electrolytes to dilute the drug.

With prolonged tocolytic therapy, it is necessary to ensure that there is no placental abruption. Clinical symptoms of premature placental abruption can be smoothed out with tocolytic therapy. When the membranes rupture and when the cervix is dilated by more than 2-3 cm, the effectiveness of tocolytic therapy is low.

Reviews about the drug

Feedback about Ginipral is positive: when carried out in precise treatment with precise dosage, it prevents early labor. Usually the drug is well tolerated by patients. The most common side effects may include darkening of the eyes and vomiting. Consider the responses of women:

Anna Petrova

I was admitted to the hospital for conservation due to the risk of miscarriage. I was immediately put on a drip with medication. I tolerated the drip well. The only thing I didn’t like was the very slow introduction of the drug into the body. I learned from other pregnant women that Ginipral can be injected much faster.

Therefore, I myself asked the nurses to pump me faster. However, after I was given the drug through an IV faster, I felt my pulse quicken. The nurse did not tell me anything about such manifestations. I am glad that other than increased heart rate there were no other side effects. Therefore, I still advise you to drip the drug at a slow pace.

Then I was warned not to get up suddenly after the procedure and to lie down for an additional twenty minutes. The child was born healthy! For this reason, I think you can endure the drip for extra time and lie down for a few minutes so that the drug works better!

Olga Kravchenko

The gynecologist prescribed a pharmaceutical drug in the form of tablets during the third stage of pregnancy. The dosage regimen was one fourth of a tablet per day. The increased tone gradually returned to normal, but the doctor increased the dose to 0.5 tablets. At week 36, contractions suddenly arose, and the maternity hospital already administered the solution by drip for a couple of hours. Afterwards the contractions stopped and my stomach relaxed. At the same time, the heartbeat increased a little. However, the procedure using a dropper was successful and without minor reactions or complications.

Angelina Dolgaya

At approximately 31 weeks, I felt pain in my abdomen on the right side. My husband took me to the hospital and the doctor determined that the uterus was in good shape. First, they put on a drip, then determined a course of treatment in tablet form for 3 days. After treatment, the condition improved. There was a nurse in the room, but there were no minor results.