Periactin

Periactin is a blocker of H1-histamine receptors. It also exhibits m-anticholinergic. Antiallergic effect is most pronounced in relation to itchy dermatoses. It also has anticholinergic and sedative effects, stimulates appetite, blocks hypersecretion of chondrotropic hormone (with acromegaly) and adrenocorticotrophic hormone (with Cushing’s syndrome).

Pharmacokinetics

The absorption is high. TCmax is 2 hours. The therapeutic level of concentration is kept for 4-6 hours. It is well distributed in the body, including the central nervous system. It is extensively metabolized in the liver. It is excreted through the intestines – 2-20% (of which 34% – unchanged); kidneys – 40%, mainly in the form of conjugates with glucuronic acid. The excretion is reduced with chronic renal failure. The possibility of passing through the placental barrier and excretion in breast milk has not been proven.

Indications

  • Allergic reactions (urticaria, hay fever, allergic dermatitis, vasomotor rhinitis, serum sickness, angioedema);
  • Prevention of allergic reactions (including drug administration, blood transfusion);
  • Skin diseases (contact dermatitis, toxicoderma, atopic dermatitis, eczema);
  • Decreased appetite;
  • Chronic pancreatitis (as part of complex treatment).

Contraindications

  • Hypersensitivity;
  • Angle-closure glaucoma;
  • Benign prostatic hyperplasia;
  • Predisposition to edema;
  • Urinary retention;
  • Pregnancy;
  • Lactation;
  • Infancy (up to 6 months).

Dosage

  • Oral application, adults – 4 mg 3 times a day.
  • For the treatment of chronic urticaria – 2 mg 3 times a day.
  • In an acute migraine attack – 4 mg once, in the absence of effect after 30 minutes, the same dose is repeated; as maintenance therapy – 4 mg 3 times a day.
  • Anorexia – 12 mg/day in 3 divided doses, the maximum daily dose is 32 mg.
  • Children from 6 months to 2 years old – only in special cases, at a dose of 0.4 mg / kg / day for 3-4 weeks; children aged 2 to 6 years – 6 mg / day, from 6 to 14 years old – 12 mg / day; with anorexia – up to 8 mg.
  • The maximum daily dose in children 2-6 years old is 8 mg, 6-14 years old – 12 mg.

Side effects

  • Drowsiness;
  • Anxiety;
  • Ataxia;
  • Visual hallucinations;
  • Dizziness;
  • Headache;
  • Dry mouth;
  • Nausea;
  • Exanthema.

Overdose

Symptoms: in children – agitation, hallucinations, athetosis, convulsions, mydriasis and immobility of the pupils, hyperemia of the facial skin, hyperthermia, vascular collapse, coma; in adults – lethargy, depression, psychomotor agitation, convulsions, coma; rarely – hyperthermia, skin hyperemia.

Treatment: gastric lavage, activated carbon; with the development of pronounced atropine-like effects – parenteral administration of a physostigmine salicylate solution; according to indications – vasoconstrictor and antiepileptic drugs, mechanical ventilation, other resuscitation measures. Psychostimulants and analeptics are contraindicated.

Interactions

It strengthens the effect of narcotic analgesics, anxiolytics. Strengthens the m-anticholinergic and deprimating effect of tricyclic antidepressants. Incompatible with ethanol. Caffeine and phenamine reduce the depressant effect on the central nervous system. When taken simultaneously with hypnotic and sedative drugs, their central depressive effect is enhanced.

Special instructions

Due to the presence of a sedative effect, the first dose is recommended in the evening after a meal. Treatment of children and elderly patients should be carried out under medical supervision because of their increased sensitivity to antihistamine drugs. Do not consume ethanol during treatment. It can be used in conjunction with narcotic analgesics, anxiolytics (under strict medical supervision) for complex preoperative preparation of patients, because the drug not only enhances the effect of simultaneously applied drugs, but also prevents the development of undesirable effects of histamine (lowering blood pressure, bronchospasm), which is released as a result of trauma to body tissues during surgery. During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration of attention and speed of psychomotor reactions.