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Inflammatory diseases of the stomach and duodenum occur at any age, require timely examination and treatment. The wrong approach to therapy, a violation of the diet, concomitant pathologies provoke the development of peptic ulcer, which can be acute or chronic, often recurring and prone to progression. In treatment regimens for gastroenterological patients, bismuth preparations are used. Attention deserves the drug De-Nol.

De-Nol - a drug consisting of colloidal bismuth subcitrate. The mechanism of action is the formation of chelating compounds in the form of a protective film on the surface of ulcers and erosion of the gastrointestinal mucosa. It stimulates the synthesis of protective prostaglandin E. Participates in the restoration of the epidermal growth factor in the zone of epithelial integrity disorders, stimulating the regeneration of the mucosa. Disrupts the adhesion of pathogenic microorganisms to the mucous membrane, simultaneously disrupting the production of ATP in the bacterial cell.

In 1983, Australian scientists found that bismuth salts effectively inhibit the growth of H. pylori in combination with antibiotics and anti-acid drugs.

Thanks to the action of De-Nol, the absorption processes of some antibiotics are slowed down, which contributes to an increase in their concentration in the gastric contents.

Benefits

Advantages of the drug De-Nol:

  • inhibits pepsin activity;
  • creates a protective layer on the damaged areas of the gastric mucosa;
  • activates the production of prostaglandins and mucus;
  • improves reparative processes;
  • contributes to the formation of a normal microstructure of the epithelium in the healing area;
  • antibacterial effect.

The antidiarrheal, anti-inflammatory and analgesic properties of bismuth subcitrate are also known.

Indications for the use of De-Nol tablets are peptic ulcer of the stomach and duodenum, chronic gastritis, including those caused by Helicobacter pylori. The drug is included in the protocols for the complex treatment of these pathologies.

The active substance is not absorbed in the gastrointestinal tract, the bioavailability of the drug is low. Despite the fact that the compound has the characteristics of a heavy metal, bismuth subcitrate is non-toxic.

De-Nol is well tolerated; stool darkening due to the formation of bismuth sulfide is most often seen from side effects.

Features

In the acidic environment of the stomach, the drug forms a protective film on the surface of ulcers and erosion, which contributes to their scarring and protects from the effects of gastric juice; increases the synthesis of prostaglandin E2, which stimulates the formation of mucus and bicarbonates, leads to the accumulation of epidermal growth factor in the defect zone, reduces the activity of pepsin and pepsinogen. The drug has bactericidal activity against Helicobacter pylori.

Pharmacokinetics

The drug is practically not absorbed from the digestive tract; only a small amount of the active substance enters the bloodstream and is excreted in the urine, while the plasma bismuth concentration rapidly decreases after the end of treatment. It is excreted mainly with feces.

Indications

Peptic ulcer of the stomach and duodenum, chronic gastritis, including those caused by Helicobacter pylori (as part of anti-Helicobacter therapy regimens).

Contraindications

Hypersensitivity to an active substance or to an auxiliary substance. Severe renal failure.

Dosage and administration

  • Adults and children over 14 years of age should be prescribed 1 tablet 4 times a day 30 minutes before meals and at night or 2 tablets 2 times a day.
  • For children aged 8 to 14 years, prescribe 1 tablet 2 times a day 30 minutes before meals.
  • Children aged 4 to 8 years should be prescribed in a dose of 8 mg / kg / day; the daily dosage should be divided into 2 doses, but not more than 2 tablets per day.

Drink tablets with a small amount of water. The duration of treatment is 4-8 weeks.Over the next 8 weeks, bismuth-containing preparations should not be taken.

In the presence of Helicobacter pylori, use in treatment regimens according to national recommendations.

Overdose

Symptoms of intoxication.

An acute massive overdose can lead to kidney failure with a delayed onset of up to 10 days.

Intoxication treatment.

After a single dose of a very high dose, the treatment consists in washing the stomach, followed by doses of activated charcoal and osmotic laxatives. This therapy, as a rule, reduces the absorption of bismuth, so additional measures are not necessary.

The concentration of bismuth in the blood and urine should be determined in acute and chronic intoxication in order to identify the connection of any symptoms with an increased effect of bismuth.

Chelate therapy with dimercaptosuccinic acid (DMSK) and dimercaptopropanosulfonic acid (DMSA) is used if symptoms are caused by acute or chronic overdose of bismuth.

In case of severe renal failure, chelation therapy should be accompanied by hemodialysis.

Application Features

It is possible to change the color of feces in black, in which case you need to consult a doctor. You should not take antacid preparations and consume milk half an hour before and half an hour after taking the drug, since the existing gastric juice is needed to form a protective layer.

Long-term use of high doses of bismuth compounds is not recommended due to the occurrence in rare cases of reverse encephalopathy. Subject to the recommended regimen of taking the drug, the risk of this side effect is very small, however, while taking this drug, it is not recommended to take other drugs containing bismuth.

Structure

Active ingredient in 1 tablet: colloidal bismuth subcitrate - 120 mg (Ві2О3, which is contained in a solution of dry bismuth subcitrate).

Excipients: corn starch, povidone, potassium polacrilin, macrogol 6000, magnesium stearate, hypromellose.

Storage conditions

Store at a temperature not exceeding 25 ° C out of the reach of children.

Shelf life is 4 years.

Do not use after the expiration date printed on the package.

Tags: Bismuth oxide