Ditilin is a peripheral muscle relaxant of the depolarizing type, used in interventions that require short-term myorelaxation. Ditilin application provides a quick effect and a quick recovery of muscle tone, allowing you to create controlled muscle relaxation.
Release form and composition
Ditilin is produced in the form of a solution, the active substance of which is suxamethionium iodide.
The solution is available in 5 ml ampoules, 5 or 10 pieces per pack.
Indications for use
According to the instructions, Ditilin applied:
- For complete muscle relaxation with endoscopic examinations, gynecological, abdominal, thoracic surgical interventions, reduction of dislocations and reposition of fractures;
- To disable spontaneous respiration during bronchoscopy and intracheal intubation;
- In case of poisoning with strychnine;
- In order to prevent the development of seizures with electropulse therapy;
- As a symptomatic treatment for tetanus.
According to the instructions, Ditilin contraindicated in:
- The presence of a patient's hypersensitivity to this drug;
- Congenital and dystrophic myotonia;
- Malignant hyperthermia (including history);
- Duchenne muscular dystrophy;
- Acute hepatic failure;
- Angle-closure glaucoma;
- Penetrating eye injuries;
- Pulmonary edema;
- Bronchial asthma;
- Pregnancy and breastfeeding;
and also under the age of 12 months.
Ditilin is carefully applied when:
- Chronic renal failure;
- Reduction of serum pseudocholinesterase activity, which accompanies the terminal stage of liver failure, cachexia, anemia, chronic infections, prolonged fasting, injuries, widespread burns;
- Postpartum period;
- Malignant neoplasms;
- Systemic connective tissue diseases;
- Artificial blood circulation;
- Condition after plasma transfusion;
- Acute or chronic intoxication with insecticides or anticholinesterase agents;
- The simultaneous use of funds that are competitors of succinylcholine;
- Emergency surgery on a "full stomach".
Dosing and Administration
According to the instructions, Ditilin intended for intravenous (drip or jet) and intramuscular injection.
A single dosage of Ditilin depends on the clinical situation and ranges from 100 µg per kilogram of weight to 1.5-2 mg per kilogram of weight.
When performing tracheal intubation, the drug is administered intravenously at the rate of 0.2-0.8 mg per kilogram of weight; to turn off spontaneous breathing and muscle relaxation - 0.2-1 mg per kilogram of weight; with reposition of bone fragments in fractures, with reduction of dislocations for relaxation of skeletal muscles - 0.1-0.2 mg per kilogram of weight; when performing endoscopic studies - 0.2 mg per kilogram of weight; in order to prevent complications (convulsions, tears of muscles and tendons) during electric pulse therapy - 0.1-1 mg per kilogram of weight, but not more than 150 mg.
In order to achieve long-term muscle relaxation, Ditilin is administered fractionally throughout the entire operation in 0.5-1 mg per kilogram of weight in 5-7 minutes.
In childhood, the drug can be administered intramuscularly (up to 2.5 mg per pound of weight, but not more than 150 mg) and intravenously (1-2 mg per pound of weight).
When using Ditilina may develop the following adverse reactions:
- Lowering blood pressure;
- Violation of the conduction of the heart;
- Cardiogenic shock;
- Increased intraocular pressure;
- Myalgia in the postoperative period;
- Rhabdomyolysis with the development of myoglobinuria and myoglobinemia;
- Prolonged respiratory muscle paralysis;
- Allergic reactions (bronchospasm, anaphylactic shock);
- Muscle pain (10-12 hours after administration);
- Excessively prolonged muscle relaxation and prolonged apnea (with repeated administration of the solution).
When applying Ditilina should be borne in mind that:
- The drug can be used only in a hospital with the availability of equipment for artificial ventilation of the lungs and at the same time as general anesthesia;
- 1 minute before the infusion of the drug, the patient is injected with 3-4 mg of tubocurarine chloride or 10-15 mg of diplacine chloride in order to prevent fibrillar muscle twitches and the occurrence of muscle pain;
- Preliminary intravenous injection of 1-1.5 mg of atropine and slow administration of Ditilin prevent the development of bradycardia and an increase in bronchial secretion;
- In patients with renal insufficiency (in the absence of neuropathy and hyperkalemia), the drug is not administered repeatedly, but is used only for a single dose in medium doses due to the risk of hyperkalemia;
- Overdose Ditilina manifested by increased side effects, respiratory failure. In such situations, the patient requires artificial ventilation of the lungs and transfusion of fresh blood (with a decrease in the cholinesterase level in the blood).
- Ditilin is pharmaceutically incompatible with alkaline solutions, donor blood, blood products, barbiturate solutions;
- Myorelaxing effect of the drug chloroquine, protinin, promegasine, estrogen, diphenhydramine, glucocorticosteroids, oral contraceptives, oxytocin;
- Atropine and thiopental sodium are reduced, and halogen-containing drugs for general anesthesia increase the undesirable effect of the drug on the cardiovascular system.
Structural analogues Ditilina are drugs such as Suksametoniyu and Suksametoniya iodide.
Terms and conditions of storage
Ditilin stored in a dark cool place no more than four years.