PAMBA
PAMBA: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. Drug interactions
- 12. Analogs
- 13. Terms and conditions of storage
- 14. Terms of dispensing from pharmacies
- 15. Reviews
- 16. Price in pharmacies
Latin name: Pamba
ATX code: B02AA03
Active ingredient: Aminomethylbenzoic acid (Aminomethylbenzoic acid)
Manufacturer: FSUE "Moscow Endocrine Plant" (Russia)
Description and photo update: 2019-31-10
PAMBA - first line hemostatic agent; a fibrinolysis inhibitor with proven efficacy; the drug of choice for the provision of emergency medical care to patients with bleeding of varying intensity and etiology, providing stable hemostasis and reducing the volume of blood loss.
Release form and composition
Dosage form - solution for intravenous (i / v) and intramuscular (i / m) administration: colorless transparent liquid (in a cardboard box 2 packs, cell contour with 5 ampoules containing 5 ml of solution, and instructions for use of PAMBA).
Composition for 1 ml of solution:
- active substance: aminomethyl benzoic acid (Amben) - 10 mg (in terms of anhydrous substance);
- auxiliary components: water for injection - up to 1 ml; sodium chloride - 9 mg.
Pharmacological properties
Pharmacodynamics
PAMBA is a synthetic analogue of lysine, an inhibitor of fibrinolysis. The action of the drug is similar to epsilon-aminocaproic acid, but much more effective.
In cases of bleeding caused by an increase in fibrinolysis, a specific hemostatic effect of the drug is manifested, associated with a partial inhibition of the effect of plasmin and a blockade of plasminogen activators.
The drug inhibits fibrinolysis by competitive saturation of lysine-binding receptors, due to which plasmin (plasminogen) binds to fibrin (fibrinogen). PAMBA also inhibits biogenic kinin polypeptides.
The use of the drug serves to suppress antitelogenesis, enhances the detoxifying function of the liver.
Pharmacokinetics
The maximum concentration of the drug in the blood with intravenous administration is achieved during the administration of the solution and is maintained over a period of 30 to 45 minutes; after 3 hours, the drug disappears from the blood. With intramuscular injections, the maximum concentration of aminomethylbenzoic acid in the blood plasma is determined after 30-60 minutes.
The drug is excreted by the kidneys. In unchanged form, elimination with daily urine accounts for more than 70% of the PAMBA dose used. In the form of N-acetylated form (pharmacologically indifferent), 10 to 15% of the dose is released. The plasma concentration of a substance in cases of impaired renal excretory function is significantly increased.
Indications for use
- conditions against which systemic hyperfibrinolysis occurs (overdose of urokinase, streptokinase and other plasminogen activators);
- decreased ability to form a hemostatic thrombus (violation of the vascular, vascular-platelet or procoagulant components of hemostasis);
- localized hemorrhages due to an increase in local fibrinolytic activity (after surgery on the bladder or prostate, tonsillectomy, menorrhagia);
- an increase in the fibrinolytic activity of the blood;
- operations on the brain (with subarachnoid hemorrhages inclusive), pancreas and thyroid gland, heart, lungs and blood vessels;
- dental interventions;
- uterine bleeding, prolonged retention in the uterine cavity of a dead fetus, premature detachment of a normally located placenta;
- acute pancreatitis;
- liver pathology;
- gastrointestinal, nosebleeds;
- prevention of secondary hypofibrinogenemia during massive transfusions of canned blood.
Contraindications
Absolute:
- kidney disease with impaired function;
- tendency to thrombosis and thromboembolic pathologies;
- the hypercoagulable phase of the syndrome of disseminated intravascular coagulation (DIC syndrome);
- severe forms of cerebral ischemia and coronary heart disease;
- vitreous hemorrhage;
- I trimester of pregnancy;
- individual intolerance to the components of the drug.
Relative (PAMBA is prescribed under medical supervision): disorders of cerebral circulation, II and III trimester of pregnancy, breastfeeding period.
PAMBA, instructions for use: method and dosage
The PAMBA solution is injected intravenously by jet or intramuscularly.
The recommended single dose of the drug is from 5 to 10 ml of solution (50-100 mg).
If necessary, repeated repeated administration of the drug is allowed, observing the interval between injections of at least 4 hours.
Patients with acute fibrinolysis are additionally prescribed fibrinogen. At the same time, the fibrinolytic activity of the blood and the content of fibrinogen in it are controlled.
The maximum single dose of the solution is 10 ml (100 mg). The daily (total) dose and duration of therapy depend on the course of the pathology.
Side effects
- digestive system: diarrhea, vomiting;
- cardiovascular system: tachycardia, decrease / increase in blood pressure;
- local reactions: thrombophlebitis at the injection site;
- immune system: allergic reactions;
- others: catarrhal phenomena from the upper respiratory tract, renal colic; in some cases - convulsions, orthostatic hypotension, dizziness (in such cases, reduce the dose of the drug or cancel treatment).
Overdose
The main symptom of an overdose of aminomethylbenzoic acid is increased blood clotting. This condition is noted extremely rarely.
For the purpose of treating the condition, it is recommended to administer iv heparin at a dose of 5000 international units (IU) and / or discontinue the drug.
special instructions
Before prescribing PAMBA, it is required to check the level of fibrinogen and blood activity.
With intravenous administration of the solution, it is important to control the coagulogram, especially in liver pathologies, coronary heart disease and after myocardial infarction.
PAMBA injections can be combined with the introduction of hydrolysates, mainly glucose solution, and anti-shock solutions.
Patients with acute fibrinolysis are additionally injected with fibrinogen, the average dose of which is from 2 to 4 g, maximum 8 g.
Influence on the ability to drive vehicles and complex mechanisms
There is no information about the adverse effect of the hemostatic agent PAMBA on the ability to drive vehicles and complex mechanisms.
Application during pregnancy and lactation
PAMBA is contraindicated for use in the first trimester of pregnancy.
The teratogenic effect of aminomethyl benzoic acid was not observed in preclinical studies on animals. It has not been established whether it passes into breast milk.
With extreme caution and only in cases of extreme necessity, the drug can be prescribed in late pregnancy and lactation.
Animal studies have not demonstrated the reproductive toxicity of PAMBA.
With impaired renal function
PAMBA is not prescribed for patients with impaired renal function.
Drug interactions
It should be borne in mind that the combined use of high doses of the drug with other hemostatic drugs, such as etamsylate, for example, can cause blood clots. On the one hand, this is associated with an increase in the formation of fibrin under the influence of hemostatics, on the other hand, with the slow dissolution of the formed thrombi due to the antiplasminic action of PAMBA.
Analogs
PAMBA analogs are Amben, Aminocaproic acid, Hemostatic sponge with Amben, Gumbix, Sanksamik, Stagemin, Trameston, Traxara, Tranexamic acid, Tranexam, Troxaminate, etc.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
The shelf life is 3 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about PAMBA
Considering the specifics of the use of hemostatic agents, there are practically no reviews of PAMBA from patients.
Experts have carried out a number of studies comparing the effectiveness and safety of fibrinolysis inhibitors of various natures: derivatives of aminomethylbenzoic, tranexamic and aminocaproic acids. The results of the use of drugs for the treatment of bleeding from the upper gastrointestinal tract, postpartum hemorrhages, and a decrease in intraoperative blood loss in advanced ovarian carcinoma were compared with three courses of neoadjuvant chemotherapy. As a result, it was found that PAMBA is more effective than other drugs that inhibit fibrinolysis, since it provides a more stable hemostatic effect in a lower dosage and begins to exert a hemostatic effect earlier.
In addition, the great advantage of the drug, in contrast to analogues in the mechanism of action, is considered the possibility of its introduction not only into the vein, but also into the muscle.
Price for PAMBA in pharmacies
The approximate price for PAMBA, solution for injection (10 ampoules in a package of 5 ml of solution), varies in the range of RUB 3,199–3,399.
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
