Phosphocreatine plays an important role in the energy mechanism of muscle contraction. It is an energy reserve in myocardial and skeletal muscle cells and is used for the re-synthesis of adenosine triphosphoric acid (ATP), the hydrolysis of which releases energy to ensure the process of actomyosin contraction.

Insufficient energy supply to cardiomyocytes, associated with a slowdown in oxidative processes, is a key mechanism for the development and progression of myocardial damage. Lack of phosphocreatine leads to a decrease in the force of myocardial contraction and its ability to functional recovery. In myocardial injury, there is a strong correlation between the amount of energy-rich phosphorylated compounds in the cells, cell viability and their ability to recover contractility.

Preclinical and clinical studies have made it possible to demonstrate the cardioprotective effect of phosphocreatine, which is manifested in a dose-dependent positive effect against the toxic effects of isoprenaline, thyroxine, emetine, and p-nitrophenol on the myocardium; in a positive inotropic effect in case of deficiency of glucose, calcium ions or overdose of potassium ions; in reducing the negative inotropic effect caused by anoxia. In addition, the addition of phosphocreatine to cardioplegic solutions at a concentration of 10 mmol/l improves the cardioprotective effect:

• the risk of developing myocardial ischemia during cardiopulmonary bypass surgery is reduced;

• the risk of developing reperfusion arrhythmia during infusion administration is reduced before the development of experimental regional ischemia as a result of applying a ligature to the anterior descending branch of the left coronary artery for 15 minutes;

• reduces the degradation of ATP and phosphocreatine in myocardial cells, preserves the structure of mitochondria and sarcolemma, improves the process of functional recovery of the myocardium after cardiac arrest caused by the administration of a large dose of potassium, and reduces the frequency of reperfusion arrhythmia.

Phosphocreatine has a cardioprotective effect in experiments with myocardial infarction and arrhythmia caused by coronary artery occlusion: it preserves the cellular pool of adenine nucleotides by inhibiting enzymes that cause their catabolism, suppresses the degradation of phospholipids, possibly improves microcirculation in the ischemic zone, which is due to the suppression of adenosine diphosphoric acid-mediated aggregation platelets, stabilizes hemodynamic parameters, prevents a sharp decrease in functional parameters of the heart, has an antiarrhythmic effect, reduces the frequency and duration of ventricular fibrillation and limits the area of myocardial infarction.

Indications

Neoton is used as part of combination therapy for the following diseases:

• acute myocardial infarction;

• chronic heart failure;

• intraoperative myocardial ischemia;

• intraoperative ischemia of the lower extremities, as well as in sports medicine to prevent the development of acute and chronic physical overstrain syndrome and improve the adaptation of athletes to extreme physical activity

Contraindications

hypersensitivity to the drug;

chronic renal failure (when using the drug in doses of 5 – 10 g/day);

age under 18 years (efficacy and safety have not been established).

Side effects

Hypersensitivity to the drug, decreased blood pressure (with rapid intravenous administration).

Interaction

When used as part of combination therapy, Neoton helps to increase the effectiveness of antiarrhythmic, antianginal drugs and drugs with a positive inotropic effect. Neoton remains stable in water for injection, 5% dextrose (glucose) solution and in cardioplegic solutions

How to take, course of administration and dosage

INTRAVENOUS ONLY (drip or rapid infusion)

Acute myocardial infarction

1 day: 2-4 g of the drug, diluted in 50 ml of water for injection, in the form of a rapid intravenous infusion, followed by an intravenous infusion of 8-16 g in 200 ml of a 5% dextrose (glucose) solution for 2 hours.

Day 2: 2-4 g in 50 ml of water for injection intravenously (infusion duration is at least 30 minutes) 2 times a day.

Day 3: 2 g in 50 ml of water for injection intravenously (infusion duration is at least 30 minutes) 2 times a day.

If necessary, a course of infusions of 2 g of the drug 2 times a day. can be carried out within 6 days.

Chronic heart failure

Depending on the patient’s condition, you can begin treatment with “shock” doses of 5-10 g of the drug in 200 ml of a 5% dextrose (glucose) solution intravenously at a rate of 4-5 g/hour for 3-5 days, and then switch for intravenous drip administration (infusion duration of at least 30 minutes) 1-2 g of the drug diluted in 50 ml of water for injection, 2 times a day. for 2-6 weeks or immediately begin intravenous drip administration of maintenance doses of the drug Neoton (1-2 g in 50 ml of water for injection 2 times a day for 2-6 weeks).

Intraoperative myocardial ischemia

A course of intravenous drip infusions is recommended lasting