Asparkam -L (solution for injections)

Solutio pro injeсtionibus “Asparkam-L”

 

Potassium and magnesium aspartate.

Potassium aspartate. Magnesium aspartate.

Pharmacotherapeutic group

Metabolics. Preparations of potassium and magnesium. Antiarrhytmic agents.Electrolytic solutions for intravenous injections.

Composition

1 ml solution for injections contains 45 mg potassium Laspartate, 40 mg magnesium L-aspartate, 50 mg sorbite.

Pharmacological action

Pharmacodynamics

The preparation promotes elimination of potassium and a magnesium deficiency, has antiarrhytmic effect, improves metabolism in myocardium, and normalizes electrolytic balance. It is the donor of potassium and magnesium ions, promotes their penetration into intracellular space. Acting in cells, L-aspartate joins in processes of metabolism. Use of L- aspartate instead of DL- aspartate favors depression of the preparation toxicity. Ions Mg++reduce excitability of neurons, slow down neuromuscular transmission, participate in many enzymatic reactions, activate Na+-K+-ATPase, excreting Na+ and returning K+ to a cell, reduce Na+ concentration, prevents exchange Na+ on Ca++ in unstriated vessels muscles, lowering their resistance. Ions of K+ stimulate synthesis of ATP, glycogen, proteins, acetylcholine, etc., reduce excitability and conduction of myocardium, and at high concentration oppress automatism. Both of ions participate in intracellular osmotic pressure maintenance, processes of transfer and transmission of nervous impulses, contraction of skeletal muscles.

Pharmakokinetics

Ions K+and Mg++ are quickly and fully absorbed and distributed in all tissues of an organism. Concentration of potassium in plasma remains increased not so long because of its fast entering inside of cells and excretion from an organism. The appreciable part of Mg++ ions in plasma (25-30 %) forms complex compounds with proteins. Ions K+ and Mg++ are excreted mainly with urine, in small amounts - with excrements, sweat, tears, etc. At kidneys failure the elimination of K + and Mg ++ ions can be slowed down.

As acid-forming residue L- aspartate acid is endogenous compound and consequently possesses higher rate of redistribution in an organism that can provide higher bioavailability.

Indications 

ventricular premature beats; stenocardia, myocardial infarction, heart failure (as an adjuvant agent); correction of hypopotassemia (caused by saluretics, laxatives, steroid hormones, chronic vomiting, etc.). The preparation is applied also for preliminary and subsequent therapy of cardiosurgery patients.

Indications to application of a preparation are: the arrhythmias caused by hypopotassemia, arrhythmias at intoxication by cardiac glycosides, ventricular premature beats; stenocardia, myocardial infarction, heart failure (as an adjuvant agent); correction of hypopotassemia (caused by saluretics, laxatives, steroid hormones, chronic vomiting, etc.). The preparation is applied also for preliminary and subsequent therapy of cardiosurgery patients.

Dosage and method of administration 

The preparation is entered intravenously dropwisely per 300-500 ml of solution 1-2 times a day with rate of 20-25 drops in a minute. The dose and duration of the preparation infusion is determined individually depending on indications and a degree of hyperpotassemia. For a week before and after cardiosurgery interventions should be entered per 300-500 ml a day daily.

The preparation is entered intravenously 1-2 times a day during 5 days. The dose of the preparation is determined individually depending on indications. As a rule, contents of 1-2 ampoules or vials (10 ml) is diluted in 20-30 ml of isotonic sodium chloride solution or 5 % glucose solution and enter slowly (no more than 5 ml in a minute) in a vein or dilute the contents of 1-2 ampoules or vials (10 ml) in 100-200 ml of 5 % glucose solution and enter into a vein dropwisely 1-2 times a day.

Special indications

Strophanthin or preparations of digitalis can be administrated together with «Asparkam-L» solution for injections in case of need.

Side effects

Nausea, giddiness, abnormality of intraventricular conduction, face reddening, phlebitis,  reduction of arterial pressure, hyporeflexia, respiratory depression, convulsions are possible at the preparation introduction.

Contraindications

The preparation is counter-indicative at acute and chronic renal failure, hyperpotassemia, hypermagnesemia, atrioventricular blockade, severe myasthenia, hypersensitivity to sorbite.

Interactions with other preparations

Reduces effect of cardiac glycosides. Simultaneous prescription of potassium-sparing diuretics can lead to hyperpotassemia and hypermagnesemia. At mixing with others injection solutions can arise turbidity or opalescence, such admixtures does not permitted to inject.

Overdosage

Signs: hyperpotassemia (bradycardia, arrhythmia, ABP  reduction, vascular collapse, diastolic arrest of cardiac activity, neurotoxic signs) and hypermagnesemia (nausea, vomiting, lethargy, weakness of urinary bladder, impairement of atrioventricular conduction and ventricular spread of activation, at higher concentration of ions Mg++in plasma – ABP reduction, respiration paralysis, «magnesia narcosis», at extremely high concentration - diastolic arrest of cardiac activity).

Treatment: intravenous introduction of calcium and sodium salts solutions, intravenous dropwise  introduction of glucose with insulin (1 UNIT of insulin per 3-5 g of glucose). At peripheric paresises caused by toxic action of Mg++ ions, especially at paralysis of respiratory muscles, introduction of physostigmine is possible. At presence of renal failure extrarenal elimination can be carried out by hemodialysis or peritoneal dialysis.

The form of release

Solution for injections in glass ampoules per 5 ml vials. 5 ampoules in a pack or blister. 1  blisters in a pack. 5 vials in a pack.