Висмут
Интоксикация висмутом может проявляться в виде острой энцефалопатии с спутанностью сознания, миоклоническими движениями, тремором, дисартрией, нарушениями ходьбы и стояния. Интоксикация висмутом может также вызвать желудочно-кишечные нарушения, кожные реакции, изменение цвета слизистых оболочек и почечную дисфункцию в результате острого тубулярного некроза. Лечение включает промывание желудка, очищение и увлажнение. Хелатирующие агенты могут быть эффективными на ранних стадиях после приема внутрь, и может потребоваться гемодиализ.
Салицилат
Передозировка Пепто-Кальбетен Форте также может вызывать симптомы инксификации салицилата. Отравление салицилатом обычно связано с концентрацией в плазме> 350 мг / л (2,5 ммоль / л). Большинство смертей среди взрослых происходит у пациентов, концентрация которых превышает 700 мг / л (95,1 ммоль / л). Разовые дозы менее 100 мг / кг вряд ли вызовут серьезное отравление.
Если симптомы возникают, использование Pepto-Kalbeten Forte следует прекратить. Управление передозировкой такое же, как и при передозировке салицилата
Общие функции включают рвоту, обезвоживание, шум в ушах, головокружение, глухоту, потоотделение, теплые конечности с ограничивающими импульсами, увеличение частоты дыхания и гипервентиляцию. Некоторая степень кислотно-щелочного нарушения присутствует в большинстве случаев.
Смешанный респираторный алкалоз и метаболический ацидоз с нормальным или высоким артериальным pH (нормальная или пониженная концентрация ионов водорода) обычно у взрослых и детей старше четырех лет. У детей в возрасте четырех лет или меньше распространен доминирующий метаболический ацидоз с низким артериальным pH (повышенная концентрация ионов водорода). Ацидоз может увеличить перенос салицилата через гематоэнцефалический барьер.
Необычные функции включают гематемез, гиперпирексию, гипогликемию, гипокалиемию, тромбоцитопению, повышенную МНО / РТП, внутрисосудистую коагуляцию, почечную недостаточность и несердечный отек легких.
Особенности центральной нервной системы, включая спутанность сознания, дезориентацию, кому и судороги, встречаются реже у взрослых, чем у детей.
Управление: Дайте активированный уголь, если взрослый представляет в течение одного часа после приема более 250 мг / кг. Концентрация салицилата в плазме должна быть измерена, хотя тяжесть отравления не может быть определена только из этого, и должны быть приняты во внимание клинические и биохимические особенности. Ликвидация усиливается при подщелачивании мочи, что достигается при введении 1,26% бикарбоната натрия. РН мочи следует контролировать. Исправьте метаболический ацидоз с внутривенным введением 8,4% бикарбоната натрия (первая проверка сыворотки калия). Принудительный диурез не следует использовать, поскольку он не улучшает экскрецию салицилата и может вызвать отек легких.
Гемодиализ является предпочтительным методом лечения тяжелых отравлений и должен рассматриваться у пациентов с концентрациями салицилата в плазме> 700 мг / л (5,1 ммоль / л) или с более низкими концентрациями, связанными с тяжелыми клиническими или метаболическими признаками. Пациенты в возрасте до десяти лет и старше 70 лет имеют повышенный риск токсичности салицилата и могут нуждаться в диализе на более ранней стадии.
Показания к применению
Диарея (в т.ч. диарея путешественников); язвенная болезнь желудка и 12-перстной кишки, хронический гастрит (с нормальной или повышенной секреторной функцией); диспепсия.
Действующее вещество:
BISMUTH SUB SALICYLATE
Описание препарата на английском
Relief of diarrhea, nausea, flatulence, convulsive stomach pains, uspet stomach. As a preventative treatment of traveler’s diarrhea.
| Характеристики | |
| По рецепту | без рецепта |
| Срок годности | 36 мес. |
| Форма употребления | TABLETS |
Ссылка на сайт МинЗдрава Израиля: http://www.old.health.gov.il/units/pharmacy/trufot/PerutTrufa.asp?Reg_Number=114 90 29652 00&safa=e
Бартел драгз Бизмат, Бисмай, Викаир, Викалин, Викрам, Висмута галлат основной, Висмута нитрат основной, Висмутовая мазь, Дерматол, Дерматоло-дегтярный линимент, Десмол, Наш выбор-Розовый висмут, Нео-Анузол
состав:
BISMUTH SUBSALICYLATE 524 MG
Производитель или разрешения владельца:
SAM-ON LTD.,ISRAEL
Терапевтические показания :
Kalbeten Forte Caplets is indicated for relief of diarrhea, nausea, flatulence, convulsive stomach pains, upset stomach, indigestion. Kalbeten Forte Calplets is indicated as a preventative treatment of traveler’s diarrhea.
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Antacid action: Peptocid coats ulcer surface, protecting it from acid and pepsin. It stimulates mucus and bicarbonate secretion and also reacts with HCl, producing bismuth oxychloride and salicylic acid. Thus it reduces HCl.
Anti-diarrheal action: Kalbeten Forte stimulates absorption of water and electrolytes across the intestinal wall. In infectious diarrhea it binds with toxin produced by E.coli and disrupts cell, causing lysis of H.pylori and prevents adhesion of H.pylori in the cell wall of intestine.
Anti-inflammatory action: Salicylic acid from hydrolyzed Kalbeten Forte inhibits prostaglandin G/H synthase. Thus reduces inflammation and coats irritated tissue to retard the expulsion of fluid.
Bismuth subsalicylate is an antacid and antimicrobial, gastroprotective, anti-secretory, and anti-inflammatory actions. It works to reduce the severity and incidence of flatulence and diarrhea, and consequently relieving gastrointestinal discomfort. In one study, bismuth subsalicylate was prevented traveler’s diarrhea with a protection rate >60%.
Organobismuth compounds, formed by the breakdown of bismuth subsalicylate in the gastrointestinal tract, inhibit the growth of Helicobacter pylori and other bacteria implicated in gastrointestinal disorders, and some fungi. In one study, bismuth subsalicylate was shown to eradicate up to 90% of H. pylori infection when used as part of a quadruple therapy regimen containing a proton pump inhibitor, tetracycline, and metronidazole. Bismuth subsalicylate exhibited antimicrobial activity against Clostridium difficile, enterotoxigenic Escherichia coli O157:H7, norovirus, and other common enteric pathogens such as Salmonella and Shigella.
| Attribute | Details |
|---|---|
| Trade Name | Kalbeten Forte |
| Generic | Bismuth Subsalicylate |
| Bismuth Subsalicylate Other Names | Bismuth oxide salicylate, Bismuth oxysalicylate, Bismuth subsalicylate, Pink bismuth, Wismutsubsalicylat |
| Type | |
| Formula | C7H5BiO4 |
| Weight | Average: 362.0926 Monoisotopic: 361.999166889 |
| Protein binding |
Salicylic acid is about 90% plasma protein bound. Bismuth is about >90% bound to plasma proteins. |
| Groups | Approved, Vet approved |
| Therapeutic Class | Anti-dyspeptic/Carminatives |
| Manufacturer | |
| Available Country | Israel |
| Last Updated: | January 7, 2025 at 1:49 am |
Uses
Peptocid is used for indigestion, gastric fullness, bloating, belching, growling stomach, sour stomach and diarrhea.
Kalbeten Forte is also used to associated treatment for these conditions:
Diarrhoea, Dyspepsia, Flatulence, Heartburn, Helicobacter Pylori Infection, Nausea, Traveler’s Diarrhea, Upset stomach, Belching, Gastrointestinal fullness
How Kalbeten Forte works
The exact mechanism of bismuth subsalicylate is not fully understood. Bismuth subsalicylate is an insoluble complex that constitutes salicylic acid and trivalent bismuth. Once orally administered, bismuth subsalicylate hydrolyzes in the stomach into bismuth oxychloride, which is minimally absorbed into the bloodstream, and salicylic acid, which is almost completely absorbed. Bismuth interacts with other anions and compounds, such as hydrochloric acid, bicarbonate, phosphate, and hydrogen sulfide, in the gastrointestinal tract to form bismuth salts such as bismuth oxychloride, bismuth subcarbonate, bismuth phosphate, and bismuth sulfide. Bismuth salts possess bactericidal and antimicrobial activity, mainly by preventing bacteria from binding and growing on the mucosal cells of the stomach. It has no effects on normal gut flora. By preventing bacteria from binding to mucosal cells, bismuth subsalicylate prevents intestinal secretion and fluid loss, promotes fluid and electrolyte reabsorption, reduces gastrointestinal inflammation, and promotes the healing of pre-existing ulcer in the stomach. Salicylic acid from dissociated bismuth subsalicylate adds to the anti-inflammatory actions of bismuth salts by inhibiting the cyclooxygenase enzyme and limiting the formation of prostaglandin, a pro-inflammatory mediator. Bismuth subsalicylate exhibits cytoprotective and demulcent activity, which makes it an effective drug in peptic ulcer disease. It blocks the adhesion of H. pylori to the gastric epithelial cells and blocks the bacteria’s enzyme activities, including phospholipase, protease, and urease.
Dosage
12 years and above: 30 ml at a time.Dose can be repeated after 1-2 hours if necessary. Daily maximum intake should not exceed 8 doses.Less than 12 years: Please contact with physician.
Side Effects
Black stool and black tongue are common with use of Peptocid. Peptocid should not be used if black stool and black tongue are severe or persist for more than 2 days.
Toxicity
Lowest Lethal Dose (LDLo) in humans is 700 mg/kg. LD50 in rats is 1200 mg/kg via oral route, 542 mg/kg via intraperitoneal route, and 980 mg/kg via subcutaneous route.
Overdose of bismuth subsalicylate over an extended period of time and consequently, bismuth toxicity, can lead to blackening of the tongue and teeth, fatigue, mood changes, deterioration of mental status, and neurotoxicity. Other signs and symptoms include impaired cognition, tremors, lethargy, somnolence, insomnia, delirium, myoclonus, seizures, depressed mood, anxiety, and a depressed mood. Salicylate toxicity can occur from chronic bismuth subsalicylate use : it mostly occurs from ingestion of more than 150 mg/kg of salicylates (or >6.5 g of aspirin equivalent). As there are no specific antidotes for bismuth salicylate toxicity, overdose should be managed with supportive care, with or without decontamination with activated charcoal. Hemodialysis may be considered in more severe cases and with the presence of altered mental status and metabolic acidosis.
Precaution
Do not take with aspirin or other salicylates. Caution should be exercised by patients taking medicines for anti-coagulation, diabetes or gout.For elderly patients suffering from renal insufficiency, caution should be taken.
Interaction
There are no known drug interactions and none well documented.
Food Interaction
No interactions found.
Volume of Distribution
There is no information available.
Elimination Route
Following oral administration, bismuth subsalicylate hydrolyzes into bismuth and salicylic acid in the stomach. Salicylic acid is almost completely absorbed in the small intestine and reaches plasma peak levels one to two hours after dosing. In one study involving healthy male subjects, oral administration of 60 mL Pepto-Bismol, a common over-the-counter product of bismuth subsalicylate, equivalent to 1050 mg of bismuth subsalicylate, resulted in the peak plasma concentration of salicylate of 40.1 μg/mL, with a time to peak concentration (Tmax) of 1.8 hours.
Less than 1% of bismuth from bismuth subsalicylate is absorbed from the gastrointestinal tract into the systemic circulation. In one study, oral administration of 787 mg bismuth subsalicylate in the chewable tablet form for two weeks resulted in the mean trough blood bismuth concentration was 5.1 ± 3.1 ng/mL. In another study, the mean trough blood bismuth concentration ranged from five to 32 ng/mL following oral administration of 525 mg bismuth subsalicylate in the liquid suspension form.
Half Life
The terminal half-life of salicylic acid following a single oral dose of 525 mg bismuth subsalicylate is ranges from two to five hours. Bismuth has an intermediate half-life of 5 to 11 days and a terminal half-life of 21 to 72 days.
Clearance
The renal clearance of bismuth is 50 ± 18 mL/min.
Elimination Route
Following oral administration, salicylate dissociated from bismuth subsalicylate is excreted in the urine. Bismuth is primarily eliminated via urinary and biliary routes.
Pregnancy & Breastfeeding use
There are no adequate data concerning the use of Peptocid in pregnant women. Peptocid should be avoided during pregnancy and lactation.
Contraindication
Hypersensitivity to bismuth, aspirin, other salicylates, Infectious diarrhea, high fever, von Willebrand disease, hemorrhage, ulcer or Gl bleeding with black or bloody stool, hemophilia, chicken pox or influenza (risk of Reye syndrome); changes in behavior with nausea and vomiting may be early sign of Reye syndrome.
Acute Overdose
Bismuth intoxication may be present as an acute encephalopathy with confusion, myoclonic movements, tremor, dysarthria and walking and standing disorders. Bismuth intoxication may also cause gastrointestinal disturbance, skin reactions, discoloration of mucus membranes and renal dysfunction as a result of acute tubular necrosis. Treatments include gastric lavage, purgation and hydration. Overdose of Peptocid may also give symptoms of salicylate intoxication e.g. dizziness, tinnitus, sweating, nausea, headache. If symptoms occur, use of Peptocid should be avoided.
Storage Condition
Store in a cool (25 o C) and dry place.Keep out of the reach of children.Shake well before use.
Innovators Monograph
*** Taking medicines without doctor’s advice can cause long-term problems.
The Health Care Plus Beauty
Kalbeten For Travelers — relief in cases of diarrhea, nausea, flatulence, colic, cramping abdominal pain, upset stomach and indigestion. It is also used to prevent diarrhea of travelers.
Regular price
$29.00 USD
Regular price
$39.00 USD
Sale price
$29.00 USD
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Active Ingredients
Each caplet contains:
Bismuth Subsalicylate 524 mg.
Indications
Kalbeten Forte is intended for relief in cases of diarrhea, nausea, flatulence, abdominal cramps, upset stomach and indigestion. As well, Kalbeten Forte used for prevention of traveler’s diarrhea.
Instructions
Swallow the medicine with water.
The caplet can be divided to facilitate swallowing, but both parts must be swallowed together.
The usual dosage is generally:
Adults and children above 12 years of age:
1 caplet as needed, this dosage can be repeated every half hour to an hour, up to 8 times in any 24 hour period.
Do not exceed the recommended dose.
If you forgot to take this medicine at the required time, take a dose as soon as you remember, but never take two doses together!
How can you contribute to the success of the treatment?
In case of diarrhea, drink plenty of caffeine-free fluids in order to make up forthe loss of fluids.
The medicine is intended for adults and children above 12 years of age. For children below 12 years of age, consult a doctor.
Stop taking the medicine and refer to the doctor if signs of the illness (symptoms) worsen or do not improve after two days. Likewise if the diarrhea is accompanied by high fever, if you experience ringing in the ears or loss of hearing.
Warnings
Do not use Kalbeten Forte if you are sensitive (allergic) to the active ingredient or to any other ingredients contained in the medicine.
Do not use Kalbeten Forte for illnesses accompanied by fever such as flu and chickenpox (for fear of Reye’s syndrome).
The medicine contains salicylate. Do not use the medicine if you are allergic to salicylates (including aspirin) or if you are taking other preparations that contains salicylate.
Do not use this medicine if you suffer from a stomach ulcer, bleeding, bloody or black stool.
Before starting treatment with Kalbeten Forte inform the doctor if:
- You are pregnant or breastfeeding
- You are suffering, or have suffered in the past, from impaired function of the respiratory system (e.g., asthma), the kidney/urinary tract, the digestive system (e.g., stomach ulcer), the blood system(e.g., coagulation, etc.), gout, dehydration, if you have fever
- If you are sensitive to any type of food or medicine, in particular to aspirin, inform the doctor before taking the medicine
Do not use this medicine for children and adolescents under 20 years of age suffering from flu chickenpox, or if they have fever or have lost large amounts of fluids.
Do not give to children or adults for treatment of nausea on an organic background.
Do not use the medicine if signs of the illness (symptoms) worsen or do not improve after two days.
Do not use this medicine frequently or for a prolonged period without consulting the doctor.
If you are taking, or have recently taken, other medicines, including non prescription medicines and nutritional supplements, tell the doctor or pharmacist. In particular, inform the
doctor or pharmacist if you are taking aspirin and salicylates, anticoagulants, medicines for gout, probenecid or sulfinpyrazone, tetracyclines, medicines for diabetes, medicines for arthritis.
Do not drink wines or alcoholic beverages during treatment with the medicine.
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