CARDIASK KANOPHARMA tab. 100 mg No. 60
Overdose
Salicylate intoxication (develops when taking ASA at a dose of more than 100 mg/kg/day for more than 2 days) can result from prolonged use of toxic doses of the drug as part of improper therapeutic use of the drug (chronic intoxication) or a single accidental or intentional intake of a toxic dose of the drug adults or children (acute intoxication).
Symptoms of chronic intoxication with salicylic acid derivatives are nonspecific and are often difficult to diagnose. Mild intoxication usually develops only after repeated use of large doses of the drug and is manifested by dizziness, tinnitus, hearing loss, increased sweating, nausea and vomiting, headache and confusion. These symptoms disappear after reducing the dose of the drug. Tinnitus may appear when the concentration of ASA in the blood plasma is from 150 to 300 mcg/ml. More severe symptoms appear when plasma ASA concentrations are above 300 mcg/ml. The main manifestation of acute intoxication is a severe disturbance of the acid-base state, the manifestations of which may vary depending on the age of the patient and the severity of intoxication. In children, the most typical development is metabolic acidosis. Treatment of intoxication is carried out in accordance with accepted standards and depends on the severity of intoxication and the clinical picture and should be aimed mainly at accelerating the elimination of the drug and restoring the water-electrolyte balance and acid-base state. Overdose is especially dangerous in elderly patients. Symptoms of mild to moderate overdose: Dizziness, tinnitus, hearing impairment, increased sweating, nausea, vomiting, headache, confusion, profuse sweating, tachypnea, hyperventilation, respiratory alkalosis.
Treatment: gastric lavage, repeated intake of activated carbon, forced alkaline diuresis, restoration of water-electrolyte balance and acid-base state.
Symptoms of moderate to severe overdose: - respiratory alkalosis with compensatory metabolic acidosis; -hyperpyrexia (extremely high body temperature); -respiratory disorders: hyperventilation, non-cardiogenic pulmonary edema, respiratory depression, asphyxia; - disorders of the cardiovascular system: cardiac arrhythmias, decreased blood pressure, depression of cardiac activity; - disturbances of water and electrolyte balance: dehydration (dehydration), impaired renal function from oliguria up to the development of renal failure, characterized by hypokalemia, hypernatremia, hyponatremia; - impaired glucose metabolism: hyperglycemia, hypoglycemia (especially in children), ketoacidosis; - tinnitus, deafness; -gastrointestinal bleeding; - hematological disorders: from inhibition of platelet aggregation to coagulopathy, prolongation of prothrombin time, hypoprothrombinemia; - neurological disorders: toxic encephalopathy and depression of the central nervous system (drowsiness, confusion, coma, convulsions).
Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, repeated intake of activated charcoal, forced alkaline diuresis, hemodialysis, restoration of water-electrolyte balance and acid-base status, symptomatic therapy.
CardiASK®
When used simultaneously, CardiASK® enhances the effect of the following drugs:
- methotrexate, by reducing renal clearance and displacing it from association with plasma proteins; combined use increases the incidence of side effects from the hematopoietic organs; the use of the drug with methotrexate is contraindicated if the dose of the latter exceeds 15 mg per week; and possibly with caution at methotrexate doses less than 15 mg per week;
- heparin, indirect anticoagulants, due to disruption of platelet function and displacement of indirect anticoagulants from connection with plasma proteins;
- when used simultaneously with anticoagulants, thrombolytic and antiplatelet agents, the risk of bleeding increases; in addition, the damaging effect on the mucous membrane of the gastrointestinal tract increases;
- selective serotonin reuptake inhibitors, which may lead to an increased risk of gastrointestinal bleeding;
- digoxin due to a decrease in its renal excretion, which can lead to an overdose;
- hypoglycemic drugs for oral administration and insulin due to the displacement of sulfonylurea derivatives and binding to blood plasma proteins;
- when used simultaneously with valproic acid, its toxicity increases due to displacement from the connection with blood plasma proteins;
- NSAIDs and salicylic acid derivatives in high doses increase the risk of ulcerogenic effect and bleeding from the gastrointestinal tract;
- ethanol (alcoholic beverages), increases the risk of damage to the gastrointestinal mucosa and prolongation of bleeding time as a result of synergistic action.
If it is necessary to use ASA simultaneously with the listed drugs, the need to reduce the dose of these drugs should be considered.
ASA reduces the effect of the following drugs:
- any diuretics (glomerular filtration rate decreases);
- angiotensin-converting enzyme (ACE) inhibitors (a dose-dependent decrease in glomerular filtration rate is noted, resulting in a weakening of the hypotensive effect), a clinically significant decrease in glomerular filtration rate is observed with a daily dose of ASA more than 160 mg; in addition, the positive cardioprotective effect of ACE inhibitors in the treatment of chronic heart failure is reduced.
- drugs with uricosuric action (benzbromarone, sulfinpyrazone, probenecid). If it is necessary to use ASA simultaneously with these drugs, their dose must be adjusted.
When used simultaneously with ibuprofen, antagonism is observed against the irreversible platelet inhibition caused by the action of ASA, which leads to a decrease in the cardioprotective effects of ASA. The combination of ASA with ibuprofen is not recommended in patients with an increased risk of cardiovascular disease.
When used simultaneously with systemic glucocorticosteroids (GCS), with the exception of GCS used for replacement therapy of Addison's disease, there is an increase in the elimination of salicylates and, accordingly, a weakening of their effect.
CardiASK tablets coated. quiche-dissolved film. vol. 50 mg 60 pcs
Release form
Pills
Package
60 pcs.
pharmachologic effect
CardiASK is an NSAID, antiplatelet agent. The main mechanism of action of the drug CardiASK is the irreversible inactivation of the enzyme cyclooxygenase (COX-1), as a result of which the synthesis of thromboxane A2 is blocked and platelet aggregation is suppressed. CardiASK also has anti-inflammatory, antipyretic and analgesic effects.
Pharmacodynamics
The mechanism of the antiplatelet action of acetylsalicylic acid (ASA) is based on irreversible inhibition of COX-1, as a result of which the synthesis of thromboxane A2 is blocked and platelet aggregation is suppressed. The antiplatelet effect develops even after the use of small doses of the drug and persists for 7 days after a single dose. It is believed that ASA has other mechanisms of suppressing platelet aggregation, which expands the scope of its use in various vascular diseases. In high doses, ASA also has anti-inflammatory, antipyretic and analgesic effects.
Pharmacokinetics
After oral administration, ASA is quickly and completely absorbed from the gastrointestinal tract. ASA is partially metabolized during absorption. During and after absorption, ASA is converted to its main metabolite, salicylic acid, which is metabolized primarily in the liver under the influence of enzymes to form metabolites such as phenyl salicylate, salicylic acid glucuronide and salicyluric acid, found in many tissues and in the urine. In women, the metabolic process is slower (less enzyme activity in the blood serum). Tmax ASA in blood plasma is 10–20 minutes after oral administration, salicylic acid is 0.3–2 hours.
Due to the fact that the tablets are coated with an acid-resistant coating, ASA is not released in the stomach (the coating effectively blocks the dissolution of the drug in the stomach), but in the alkaline environment of the duodenum. Thus, the absorption of ASA in the form of enteric-coated tablets is delayed by 3–6 hours compared to conventional (without such a coating) tablets. ASA and salicylic acid bind to plasma proteins (from 66 to 93% depending on the dose) and are quickly distributed in the body. Salicylic acid crosses the placenta and into breast milk.
The elimination of salicylic acid is dose-dependent, since its metabolism is limited by the capabilities of the enzymatic system. T1/2 ranges from 2–3 hours when using ASA in low doses and up to 16 hours when using the drug in high doses (usual doses of acetylsalicylic acid as an analgesic). Unlike other salicylates, with repeated administration of the drug, non-hydrolyzed ASA does not accumulate in the blood serum. Salicylic acid and its metabolites are excreted by the kidneys. In patients with normal renal function, 80–100% of a single dose of the drug is excreted by the kidneys within 24–72 hours.
Indications
- Prevention of acute myocardial infarction in the presence of risk factors (including diabetes mellitus, hyperlipidemia, arterial hypertension, obesity, smoking, old age) and recurrent myocardial infarction;
- Unstable angina;
- Prevention of stroke (including in patients with transient cerebrovascular accidents);
- Prevention of transient cerebrovascular accidents;
- Prevention of thromboembolism after operations and invasive interventions on blood vessels (including coronary artery bypass surgery, carotid endarterectomy, arteriovenous bypass, carotid angioplasty);
- Prevention of deep vein thrombosis and thromboembolism of the pulmonary artery and its branches (including with prolonged immobilization as a result of extensive surgery).
Contraindications
- Hypersensitivity to acetylsalicylic acid and other NSAIDs;
- erosive and ulcerative lesions of the gastrointestinal tract;
- gastrointestinal bleeding;
- bronchial asthma induced by taking salicylates and NSAIDs;
- “aspirin triad” (Fernand-Vidal triad: a combination of bronchial asthma, recurrent polyposis of the nose and paranasal sinuses and intolerance to acetylsalicylic acid);
- hemorrhagic diathesis;
- combined use with methotrexate at a dose of 15 mg per week or more;
- liver failure;
- renal failure;
- I and III trimester of pregnancy;
- lactation (breastfeeding);
- age up to 18 years.
With caution: prescribed for gout, hyperuricemia, as well as for patients with a history of ulcerative lesions of the gastrointestinal tract or gastrointestinal bleeding, bronchial asthma, chronic respiratory diseases, hay fever, polyposis of the nasal mucosa, allergic reactions to drugs, combined use with methotrexate in doses of less than 15 mg per week, with deficiency of vitamin K and glucose-6-phosphate dehydrogenase.
Compound
1 tablet contains:
Active substance: acetylsalicylic acid 50 mg;
Excipients: stearic acid; corn starch; lactose monohydrate (milk sugar); hydrogenated castor oil; povidone (plasdon K90 or collidon 90F); polysorbate (tween 80); MCC;
Film shell: methacrylic acid and ethyl acrylate copolymer 1:1 (collicut MAE 100P); macrogol and polyvinyl alcohol copolymer (collicut IR); copovidon (plasdon S630); triethyl citrate; talc; titanium dioxide
Directions for use and doses
CardiASK should be taken orally, before meals, with plenty of liquid. CardiASK is intended for long-term use. The duration of therapy is determined by the attending physician.
Prevention for suspected acute myocardial infarction: 100-200 mg/day or 300 mg every other day (the first tablet must be chewed for faster absorption).
Prevention of new-onset acute myocardial infarction in the presence of risk factors: 100 mg per day or 300 mg every other day.
Prevention of recurrent myocardial infarction, unstable angina, prevention of stroke and transient cerebrovascular accident, prevention of thromboembolic complications after surgery or invasive studies: 100-300 mg per day
Prevention of deep vein thrombosis and thromboembolism of the pulmonary artery and its branches: 100-200 mg per day or 300 mg every other day.
Side effects
Allergic reactions: urticaria, Quincke's edema.
From the digestive tract: nausea, heartburn, vomiting, pain in the abdomen, ulcers of the mucous membrane of the stomach and duodenum, including perforations, gastrointestinal bleeding, increased activity of liver enzymes.
From the respiratory system: bronchospasm.
From the immune system: anaphylactic reactions.
From the hematopoietic system: anemia (rarely), increased bleeding.
From the central nervous system: dizziness, tinnitus.
Drug interactions
When used together, CardiASK enhances the effects of methotrexate by reducing its renal clearance and displacing it from bonds with blood plasma proteins.
When used simultaneously, CardiASK enhances the effect of heparin and indirect anticoagulants by disrupting platelet function and displacing indirect anticoagulants from bonds with blood plasma proteins.
When used in combination, CardiASK enhances the effect of thrombolytic and antiplatelet drugs (including ticlopidine).
CardiASA increases the concentration of digoxin in the blood plasma by reducing renal excretion and enhances its effects.
CardiASK enhances the effect of hypoglycemic drugs (insulin and sulfonylurea derivatives) due to the hypoglycemic effect of acetylsalicylic acid (in high doses) and displacement of sulfonylurea derivatives from communication with blood plasma proteins.
CardiASK enhances the effect of valproic acid by displacing the latter from its connection with blood plasma proteins.
When used together, CardiASK weakens the effect of uricosuric drugs (benzbromarone) due to competitive tubular elimination of uric acid.
When used simultaneously, GCS enhances the excretion of salicylates and weakens their effect.
When used simultaneously with ethanol, an additive effect is observed.
Overdose
Symptoms of moderate overdose: nausea, vomiting, tinnitus, hearing loss, dizziness, confusion.
Treatment: reducing the dose of the drug.
Symptoms of severe overdose: fever, hyperventilation, ketoacidosis, respiratory alkalosis, coma, cardiovascular and respiratory failure, severe hypoglycemia.
Treatment: immediate hospitalization in specialized departments for emergency treatment - gastric lavage, determination of acid-base status, alkaline and forced alkaline diuresis, hemodialysis, administration of solutions, activated charcoal, symptomatic therapy. When carrying out alkaline diuresis, it is necessary to achieve pH values between 7.5 and 8. Forced alkaline diuresis should be carried out when the concentration of salicylates in the blood plasma is more than 500 mg/l (3.6 mmol/l) in adults and 300 mg/l (2 .2 mmol/l) in children.
Storage conditions
In a dry place, protected from light, at a temperature not exceeding 25°C. Keep out of the reach of children.
Best before date
2 years
Possible product names
- Kardiask 0.05 n60 tablet p/intestinal solution/captivity/shells
- Kardiask 0.05 n60 tablet p/capt/intestinal/membranous
- Kardiask 50 mg tab. cover captivity. intestinal about. x60 (r)
- Kardiask tablet p/o 50 mg x 60
- Cardiask tab. p.p.o ksh/sol 50 mg No. 60
