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    Komposisi:

    Methylergometrine maleate

    Bentuk sediaan:

    Tablet salut selaput 0,125 mg : Dus isi 10 strip x 10 tablet  
    Ampul 0,2 mg/mL  : Dus isi 2 blister x 5 ampul @ 1 mL

    Farmakologi:

    Methylergometrine maleate menimbulkan kontraksi otot uterus dengan cara meningkatkan frekuensi dan amplitudo kontraksi pada dosis rendah dan meningkatkan tonus uterus basal pada dosis tinggi dengan cepat dan poten melalui reseptor
    alfa-adrenergik sehingga menghentikan perdarahan uterus. 
    Pada pemberian oral bioavailabilitasnya kurang lebih 60%, kadar puncak plasma dicapai setelah 30 menit.  Absorbsinya lebih lambat pada gastrointestinal puerperium, kadar maksimum plasma dicapai setelah 3 jam. Efek kontraksi uterus terjadi 5 -15 menit setelah pemberian per oral dan 2 - 5 menit setelah penyuntikan IM. Pada penyuntikan IV, efek kontraksi uterus terjadi dengan segera (30 - 60 detik). Kontraksi uterus ini berlangsung selama 3 jam atau lebih pada pemberian per oral dan penyuntikan IM, pada penyuntikan IV bertahan sampai dengan 2 jam. Eliminasinya terutama melalui empedu.

    Indikasi:

    1. Mencegah dan mengobati pendarahan pasca persalinan dan pasca abortus, termasuk pendarahan uterus karena sectio caesaria.
    2. Penanganan aktif kala III pada partus.
    3. Pendarahan uterus setelah placenta lepas, atoni uterus, subinvolusi uterus pada puerperium, lokhiometra.

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    Dosis:

    1. Sectio caesarea : setelah bayi dikeluarkan secara ekstraksi, 1 mL IM atau 0,5-1 mL IV.
    2. Penanganan aktif kala III : 0,5-1 mL IM setelah kepala atau bahu interior keluar atau selambat-lambatnya segera setelah bayi dilahirkan.
    3. Kala III pada partus dengan anestesi umum : 1 mL IV.
    4. Atoni uterus : 1 mL IM atau 0,5-1 mL IV.
    5. Membantu involusi uterus : 1 tablet 3 kali sehari, umumnya 3 - 4 hari.
    6. Pendarahan puerperal, subinvolusi, lokhiometra : 1 atau 2 tablet 3 kali sehari, atau 0,5  - 1 mL IM sehari.

    Kontraindikasi:

    1. Penggunaan untuk induksi atau augmentasi partus sebelum persalinan.
    2. Hipertensi, termasuk hipertensi karena kehamilan  (pre-eklampsia, eklampsia).
    3. Abortus iminens.
    4. Inersia uterus primer dan sekunder.
    5. Kehamilan.
    6. Hipersensitivitas.

    Peringatan dan Perhatian:

    1. Suntikan  intravena  diberikan secara lambat minimum 60 detik dengan pengawasan tekanan darah. Penggunaan secara IV jangan digunakan rutin karena  adanya kemungkinan  meningkatnya tekanan darah dan serangan  serebrovaskuler.  
    2. Pada letak sungsang, Pospargin baru diberikan setelah bayi dilahirkan, pada partus kembar, setelah bayi terakhir dilahirkan.
    3. Sepsis berat atau menetap.
    4. Penyakit vaskuler perifer.
    5. Penyakit jantung iskemik.
    6. Gangguan fungsi ginjal dan hati.

    Efek Samping:

    Mual, muntah dan sakit perut dapat terjadi pada pemberian dosis yang besar. Hipertensi dapat terjadi terutama setelah penyuntikan IV yang cepat. Dilaporkan timbulnya kelainan kulit, nyeri kepala atau reaksi kardiovaskular seperti vertigo, takikardia atau bradikardia.

    Interaksi Obat:

    -

     

     

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    POSPARGIN

     

    Composition:

    Methylergometrine maleate

    Presentation:

    Film coated tablet 0.125 mg : Box of 10 strips of x 10 tablets Ampoule 0.2 mg / mL: Box of 2 blisters x 5 ampules @ 1 mL

    Pharmacology:

    Methylergometrine maleate causes uterine muscle contractions by increasing the frequency and amplitude of contractions at low doses and increasing uterine tone at high doses quickly and potently through receptors alpha-adrenergic so that it stops uterine bleeding. Given orally, bioavailability of approximately 60%, plasma levels are obtained after 30 minutes. The absorption is slower during the gastrointestinal postpartum period, the maximum plasma level is reached after 3 hours. The effect of uterine contractions occurs 5-15 minutes after oral administration and 2-5 minutes after IM injection. At IV injection, the effect of uterine contractions occurs immediately (30-60 seconds). This uterine contraction lasts for 3 hours or more at oral administration and IM injection, in IV injection lasting up to 2 hours. The elimination is mainly through bile.

    Indications:

    1. Prevent and treat postpartum bleeding and post-abortion, including uterine bleeding due to sectio caesaria. 2. Active handling of stage III during labor. 3. Uterine bleeding after the placenta is released, uterine atony, uterine subinvolution during the puerperium, lokhiometra.

    Contraindications:

    1. Use for induction or augmentation of parturition before labor. 2. Hypertension, including hypertension due to pregnancy (pre-eclampsia, eclampsia). 3. Abortion iminens. 4. Primary and secondary uterine inertia. 5. Pregnancy. 6. Hypersensitivity.

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    Dosage:

    1. Sectio caesarea: after the baby is extracted, 1 mL IM or 0.5-1 mL IV. 2. Active treatment in the third stage: 0.5-1 ml of IM after the head or shoulder of the interior is out or at the latest as soon as the baby is received. 3. Stage III during labor with general anesthesia: 1 mL IV. 4. Uterine atoni: 1 mL IM or 0.5-1 mL IV. 5. Helps uterine involution: 1 tablet 3 times a day, generally 3-4 days. 6. Puerperal bleeding, subinvolution, lokhiometra: 1 or 2 tablets 3 times a day, or 0.5 - 1 mL IM every day.

    Warning and Precautions:

    1. Intravenous injections are given slowly at least 60 seconds with blood pressure monitoring. Free use do not use routine because there is pressure and cerebrovascular attack. 2. When laying breeches, Pospargin is only given after the baby is born, during twin deliveries, after the last baby is born. 3. Severe or persistent sepsis. 4. Peripheral vascular disease. 5. Ischemic heart disease. 6. Impaired kidney and liver function.

    Adverse events:

    Nausea, vomiting and abdominal pain can occur in large doses. Hypertension can occur especially after rapid IV injection. Reported skin abnormalities, headache or cardiovascular reactions such as vertigo, tachycardia or bradycardia.

    Drugs Interaction:

    -

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