Description
Piracetam Pharmacodynamics
The active ingredient is piracetam, a cyclic derivative of gamma-aminobutyric acid (GABA).
Piracetam is a nootropic; it directly affects the brain, improving cognitive processes such as learning, memory, attention, and mental performance. It affects the central nervous system (CNS) in different ways: it changes the speed of excitation distribution in the brain, improves metabolic processes in nerve cells, improves microcirculation, affects blood rheological characteristics without having a vasodilatory effect. It improves communication between the cerebral hemispheres and synaptic conduction in the neocortical structures, improves cerebral blood flow. Piracetam inhibits platelet aggregation and restores the configuration properties of the outer membrane of rigid red blood cells, as well as the ability of the latter to pass through the vessels of the microcirculatory channel. At a dose of 9.6 g it reduces the concentration of fibrinogen and Willebrand factor by 30-40 % and prolongs the bleeding time. Piracetam has a protective and restorative effect in impaired brain function due to hypoxia and intoxication. Piracetam reduces the severity and duration of vestibular nystagmus.
Indications
In adults: symptomatic treatment of psycho-organic syndrome, accompanied by decreased memory, decreased concentration and activity, mood changes, behavioral disorders, gait disturbances. Treatment of vertigo and related balance disorders (except vertigo of vasomotor and psychogenic origin). Treatment of cortical myoclonias (monotherapy or as part of complex therapy). Cure of sickle cell vasoocclusive crisis. In children: treatment of dyslexia in children from 8 years old in combination with other methods. Cure of sickle cell vasoocclusive crisis.
Contraindications
Hypersensitivity, severe renal insufficiency (creatine clearance (CK) less than 20 ml/min), hemorrhagic stroke, psychomotor agitation, Huntington’s chorea, pregnancy, lactation.
With caution
hemostasis disorders, major surgical interventions, major bleeding, chronic renal failure (CKR 20-80 ml/min).
Administration during pregnancy and breast feeding
It is contraindicated for use during pregnancy and breast-feeding.
Dosage and administration
- Intravenously by injection or dropwise, intramuscularly. Daily dose is divided into 2-4 doses.
- Symptomatic treatment of psycho-organic syndrome: 4.8 g/day during the first week, then switch to maintenance dose: 1.2-2.4 g/day.
- Treatment of vertigo and related balance disorders: 2.4-4.8 g/day.
- Treatment of cortical myoclonias: it is begun with a dose of 7.2 g/day, every 3-4 days the dose is increased by 4.8 g/day until the maximum dose of 24 g/day is reached. Treatment is continued during the whole period of the disease. Every 6 months we should try to reduce a dose or cancel a drug, gradually reducing a dose by 1.2 g/day every 2 days. In case of insignificant therapeutic effect or its absence the treatment is stopped. In sickle cell vaso-occlusive crisis (in adults and children): treatment intravenously at 300 mg/kg/day divided into 4 equal doses. Treatment of dyslexia in children over 8 years of age (in combination with other treatments): 3.2 g divided into 2 equal doses.
- In mild CPN (IQ 50-79 ml/min) – 2/3 dose divided into 2-3 doses; in moderate CPN (IQ 30-49 ml/min) – 1/3 dose divided into 2 doses; in severe CPN (IQ 20-30 ml/min) – 1/6 dose once.
