Gordox in pancreatitis

Pancreatitis is used for complex therapy aimed at restoring normal pancreas activity. The patient is prescribed anticholinergics, H2-blockers, antispasmodics, enzymes. With an exacerbation of pancreatitis, the administration of protease inhibitors is indicated.

These substances slow the activation of proteolytic enzymes, relieve swelling of tissues, reduce the intensity of pain, prevent the development of a shock state. One of these inhibitors is Gordoks. The drug is prescribed for patients who have obstruction of the pancreatic ducts( inflammation, trauma or oncology).

If the excretion of pancreatic secretion is violated, then under the action of cytokinase the inactive enzyme passes into the active form not in the intestine, but in the pancreas, which provokes autolysis, that is, self-digestion. The protease inhibitor inactivates trypsin and blocks free kinins, that is, prevents the development of a destructive process in the organ.

How Gordox works

Gordox in pancreatitis interferes with the activation of proteolytic enzymes and is effective in reducing fibrinolytic activity of blood and preventing bleeding. A drug is prescribed if serum levels of trypsin and lipase are elevated, which is accompanied by severe pain in the left hypochondrium.

The active substance of the drug aprotinin, as an auxiliary component, is used alcohol, water, sodium chloride. Aprotinitis is a polypeptide derived from light livestock.

Gordox has antiprotease, hemostatic, antifibrinolytic properties. The main component of the agent does not allow the activation of proteases and acts as an inhibitor of kallikrein. The drug releases inflammatory cytokines and a component that maintains a constant level of glycoproteins.

Thus, Gordox has the following pharmacological action:

• reduces fibrinolytic activity of blood, as it inhibits the action of enzymes( kallikrein, trypsin, chymotrypsin, platinum kininogenase).It inhibits both the overall activity of the enzymes of the gland, and the activity of specific proteases;
• stimulates the dissolution of blood clots and blood clots;
• lowers the activity of cytokines, proteins that trigger an inflammatory reaction;
• prevent the loss of glycoproteins( clotting factors).

The agent is withdrawn from the bloodstream in 10 hours.

After administration of the solution, atropine is located in the intercellular space, which causes its level to drop rapidly. Most aprotinin accumulates in the kidneys, a much smaller fraction accumulates in the cartilage.

In the brain is the minimum amount of the drug, and in the cerebrospinal fluid( spinal fluid), it almost does not come. A small concentration of aprotinin percolates through the placenta. The active ingredient Gordoksa decomposes under the action of lysosomal kidney enzymes.

When Gordox

is required Since Gordox has antiprotease activity, it is indicated for diseases of the pancreas and organs, which are accompanied by an increased content of kallikrein and other proteases.

Gordoks is prescribed for the following diseases:

• acute pancreatitis( used as one of the means of complex therapy);
• chronic pancreatitis( if there are frequent relapses or disease occurs in severe form);
• pancreatitis formed against a background of trauma or surgery;
• primary bleeding due to hyperfibrinolysis;
• pancreatic necrosis;
• angioedema;
• signs of a shock state( toxic, traumatic, hemorrhagic, burn);
• deep tissue traumatization.

Contraindications and undesirable effects of

The list of contraindications for the drug is small. As with any drug, Gordox can not be taken if there is an intolerance to the main or auxiliary substance of the drug, as well as hemorrhagic diathesis( DVS-syndrome), in the first and third trimester of pregnancy.

Undesirable effects during administration of Gordox are very rare. In some patients, the body reacted to the drug with dyspeptic disorder( nausea, vomiting) and allergic manifestations( rash on the skin, runny nose, urticaria, bronchospasm, conjunctivitis, anaphylactic reaction).

Rarely during treatment, muscle pains appear and differ from normal BP indices( hypotension or tachycardia).There may be a side effect from the side of the central nervous system, for example, obscuration of consciousness, psychotic disorders, hallucinations.

Allergy to medication with the first injection occurs very rarely, the risk of its development increases by 5% with the next administration of the solution. Serious allergic or anaphylactic undesirable effects may develop if more than two courses of Gordox therapy were performed within six months.

How the drug

is applied Gordox is produced in liquid form and must be injected into a vein. In the ampoule, 10 ml of the drug( active ingredient 100 thousand KIE or 14 mg aprotinin).The package contains 5 plastic inserts, in which there are 5 glass ampoules with a notch. When using Gordoks, the instructions for use should be followed exactly.

The medication is injected into the vein quite slowly, not more than 5 ml in 60 seconds.

The injection is done only when the patient lies( as the drug may trigger a pressure shock).Gordoks is introduced into the trunk veins, in which other drugs are not administered. To test the reaction of the body to the active ingredient, 1 ml of Gordox is administered to the patient. If allergies did not occur within 10 minutes, then the entire dose prescribed by the doctor is administered.

An adult patient is usually initially given 0.5-2 million KIE, the solution is delivered to a vein for a quarter of an hour. The dose for maintenance of 200 thousand KIE is shown with an interval in 4-6 hours. If the symptoms of pancreatitis gradually disappear, then the supportive decreases to 500 thousand KIE / day.

In acute pancreatitis, 50,000-1,000,000 KIIs are prescribed and gradually decreases within 2-6 days to 50,000-300,000 KIU and are completely canceled after signs of enzymatic poisoning go away. With exacerbation of chronic pancreatitis, 25-50 thousand KIE are administered per day with a course of 3-6 days.

To children Gordoks is appointed proceeding from body weight: on 1 kg is taken 20 thousand KIE.The instructions for the use of Gordox contain information that there is no data on the effects of the substance on the child's body, therefore Gordox is used only under the watchful eye of the doctor.

Additional information

It is allowed to prescribe Gordox to pregnant women in the second trimester. In this case, constant medical monitoring of the health of the mother and child should be carried out. There are no clinical data that would confirm that the drug does not penetrate into the mother's milk and does not affect the immature body, so it is not recommended to take a protease inhibitor during lactation.

With an overdose of Gordox, the patient may develop an allergic reaction, even anaphylactic shock is likely. If there are signs of drug intolerance, then Gordox is canceled and symptomatic therapy of pancreatitis is carried out.

The drug interacts with certain drugs, so the drug should be administered under the supervision of a physician.

Aprotinitis added to heparinized blood leads to an increase in the clotting period. Simultaneous reception of Gordox with Reomacrodex enhances the therapeutic effect of both drugs( sensibilizing effect).

The active component of the solution suppresses the effect of urokinase, alteplase, streptokinase. And it is also a weakly expressed inhibitor of serum cholinesterase, therefore, at one-stage use of funds, myorelaxation is increased, probably the development of apnea.

Gordoks is released in a pharmacy under the prescription of a doctor. Store it at 15-30 ° C.Shelf life 5 years. Before the beginning of the therapeutic course, you need to check whether there is individual sensitivity to the components of Gordox, so a skin test is performed.

If the patient had allergic reactions, then before therapy with aprotinin, it is necessary to take blockers of histamine receptors and GCS.If the DIC-syndrome and hyperfibrinolysis is manifested, then Gordoks' intake is acceptable only when all signs of DIC-syndrome are eliminated and there is a preventive effect of heparin.

Gordoks should be taken carefully if muscle relaxants were taken 2-3 days prior to therapy with aprotinin. With a repeated course of Gordox treatment, the risk of severe allergy and anaphylactic shock increases, so people with a predisposition to allergies should carefully monitor the health status and determine the ratio of risk and benefit.

As an auxiliary substance in Gordox alcohol is used, therefore the daily dose of the drug should not exceed 90 mg / kg

Medications that, like Gordoks, contain aprotinin:

• Aprotinin;
• Aprotex;
• Aeros;
• Inhistrol;
• Troxolan.

Reviews

Gordoks is effective and according to the patients' reviews already on the 2nd day after the beginning of treatment the condition improves significantly, the pain syndrome is less pronounced. Since anaphylactic shock may occur during therapy, the drug is administered to patients in a hospital setting.