In the complex of therapeutic measures in the conservative therapy of pancreatitis, anti- enzymes are prescribed. Gordoks( active ingredient Aprotinin) refers specifically to this group of medicines. Produced in Hungary( Gedeon Richter).It is a polypeptide, which consists of 58 amino acids. Aprotinin is traditionally obtained from animal raw materials due to the maximum similarity in chemical composition. In particular, Gordoks used the salivary gland of a bull.
The drug is used to treat the following forms of pancreatitis:
- acute( interstitial);
- recurrences of chronic;
- postoperative and traumatic;
- necrotic.
Gordoks is an inhibitor preparation whose use in pancreatitis is due to its pharmacological action. Acute inflammation of the pancreas is accompanied by enzymatic disorders. Particularly fraught with severe consequences of proteolytic activity. The content of such proteases as trypsin, kallikrein, plasmin, kininogenase in tissues and plasma during an attack sharply increases, which entails an intense cleavage of proteins( rupture of peptide bonds).Therefore, in order to avoid development in pancreatitis of destructive processes, their inactivation is required. This function is performed by the antiprotease agent Gordoks.
Form
A medical preparation in the form of a concentrate is contained in 10 ml ampoules. Produced in two versions: 10,000 KIE and 100,000 KIE.It is diluted in isotonic NaCl solution.
Treatment standards
Gordoks is intended for intravenous administration( drip or in the form of an injection) with pancreatitis strictly in the supine position. The speed of medication delivery to the main vein should be 5 ml per minute. Dosage for adults is selected individually, but usually a shock is prescribed:
- In acute pancreatitis, the primary dose is 0.5-1 million KIE, in the following days it is reduced to 50-300 thousand KIE.Duration of treatment 2-6 days before the normalization of the fermentogram. A more frequent, fractional administration is allowed.
- If a chronic course of the disease recurs, 25-50 thousand KIE per day are administered once every 3 to 6 days.
- After operations on the pancreas. Initial introduction - 200 thousand KIE, subsequent - 100 thousand with a six-hour break for two days.
Therapy of pancreatitis by Gordoksom begins already in the first hours of the development of pathological disorders. Children's admission scheme necessarily takes into account the weight of the child's body. To avoid unanticipated allergic reactions, it is recommended to pre-test for sensitivity.10 ml before injection, 1 ml( 10,000 KIE) of the drug is administered.
Possible complications:
- Gordoks - hemostatic, due to the increase in blood clotting can avoid large blood loss during operations on the pancreas. But it also has a retarding effect on the fibrinolysis of a person as a whole. And this antifibrinolytic property of the drug can contribute to the development of pancreatic fibrosis. Therefore, the timing of therapy has limitations.
- Allergic reactions up to anaphylactic shock( can develop after repeated injections).
- Tachycardia, lowering blood pressure.
There is evidence that Gordox( Aprotinin) is currently excluded from the list of drugs recommended for the treatment of chronic( and acute) pancreatitis, not only in the US, but in Europe and in Russia. Rationale: lack of evidence-based medical basis for the effectiveness of anti- enzyme therapy.