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Systematic (IUPAC) name 2-oxo-1-pyrrolidineacetamide Clinical data Breinox, Dinagen, Lucetam, Trade names Nootropil, Nootropyl, Oikamid, and many others AHFS/Drugs.com International Drug Names Pregnancy cat. ? Legal status POM (UK) Routes Oral and parenteral Pharmacokinetic data Bioavailability ~100% Half-life 45 hr Excretion Urinary Identifiers CAS number 7491-74-9 ATC code N06BX03 PubChem CID 4843 ChemSpider 4677 UNII ZH516LNZ10 KEGG D01914 ChEMBL CHEMBL36715 Chemical data Formula C6H10N2O2 SMILES[show] InChI[show] (what is this?) (verify)

Piracetam (sold under many brand names) is a nootropic drug. Piracetam's chemical name is 2oxo-1-pyrrolidine acetamide; it shares the same 2-oxo-pyrrolidone base structure with 2-oxopyrrolidine carboxylic acid (pyroglutamate). Piracetam is a cyclic derivative of GABA. It is one of the group of racetams. Piracetam is prescribed by doctors for some conditions, mainly myoclonus,[1] but is used off-label for a much wider range of applications. Popular trade names for Piracetam in Europe are "Nootropil" and "Lucetam", among many others. In Argentina, it is made by GlaxoSmithKline S.A. laboratories and sold under the trade name of "Noostan" (800 mg or 1200 mg). In Venezuela and Ecuador, Piracetam is produced by Laboratorios Farma S.A. and sold under the brand name of "Breinox". Contents [hide]

1 Effects 2 Mechanisms of action 3 History 4 Approval and usage

o o o o o o o o o o

4.1 Aging 4.2 Alcoholism 4.3 Alzheimer's and senile dementia 4.4 Clotting, coagulation, vasospastic disorders 4.5 Depression and anxiety 4.6 Stroke, ischemia and symptoms 4.7 Dyspraxia and dysgraphia 4.8 Schizophrenia 4.9 Preventive for breath-holding spells 4.10 Closed craniocerebral trauma

5 Dosage 6 Side effects 7 Piracetam and lucid dreaming 8 Availability 9 Notes

10 See also 11 References 12 External links

[edit] Effects There is very little data on piracetam's effect on healthy people, with most studies focusing on people with seizures, dementia, concussions, or other neurological problems. A two week regimen of piracetam was reported in 1976 to enhance verbal memory in healthy college students in a double-blind, placebo-controlled study.[2] Numerous positive individual studies supported the use of piracetam in people suffering from a wide range of cognitive disorders,[3][4] A 2002 meta-analysis by UCB, S.A. concluded that piracetam had a therapeutic effect in older patients with cognitive impairment.[5] In 2008, a working group of the British Academy of Medical Sciences noted that many of the clinical trials of piracetam for dementia were methodologically flawed.[6][7] Several meta-reviews of literature on piracetam indicate that piracetam increases performance on a variety of cognitive tasks among dyslexic children, though this may reflect its enhancement of cross-hemispheric communication and of cognitive function in general, rather than a specific improvement in whatever causes dyslexia. Piracetam also seems to inhibit brain damage caused by a variety of factors including hypoxia and excessive alcohol consumption.[8][9] Piracetam has been studied in an extensive number of clinical experiments, and has shown positive results in the treatment of post-stroke aphasia, epilepsy, cognitive decline following heart and brain surgery, dementia,[5] and myoclonus.[10][11] Its peripheral vascular effect has indicated its use for vertigo, dyslexia and, at one time, sickle cell anemia as well,[3] but a subsequent Cochrane review of the evidence found that it did not support piracetam's use in sickle cell crisis prevention.[12] Piracetam possesses pronounced antihypoxic and antiarrhythmic effect; the latter is carried out by decreasing the rhythm rate and increasing the contraction amplitude. The animals treated with piracetam in a dose when its antiarrhythmic effects (300 mg/kg) exhibited a decrease of the membrane potential of erythrocytes as compared with control. Similar effects occurred in the animals treated with lidocaine. It can be concluded that in certain types of arrhythmias the use of piracetam restores the normal rhythm of contractions that is perhaps connected with its positive influence on metabolic processes in the myocardium.[13] Piracetam appeared in animal studies to have increased communication between the two hemispheres of the brain and increased activity of the corpus callosum.[14][15]

[edit] Mechanisms of action Piracetam's mechanism of action, as with racetams in general, is not fully understood. The drug influences neuronal and vascular functions and influences cognitive function without acting as a sedative or stimulant.[3] Piracetam is a positive allosteric modulator of the AMPA receptor.[16] It is hypothesized to act on ion channels or ion carriers,[citation needed] thus leading to non-specific increased neuron excitability, while explaining its lack of agonistic or inhibitory effect on synaptic action (quite unlike most neurotransmitters), and its low toxicity.[17] GABA brain metabolism and GABA receptors are not affected by piracetam. It has been found to increase blood flow and oxygen consumption in parts of the brain but this may be a side effect of increased brain activity rather than a primary effect or mechanism of action for the drug.[18] Piracetam improves the function of the neurotransmitter acetylcholine via muscarinic cholinergic (ACh) receptors, which are implicated in memory processes.[19] Furthermore, Piracetam may have an effect on NMDA glutamate receptors, which are involved with learning and memory processes. Piracetam is thought to increase cell membrane permeability.[19][20] Piracetam may exert its global effect on brain ( memory processes. ) neurotransmission via modulation of ion channels (i.e., Na+, K+).[17] It has been found to increase oxygen consumption in the brain, apparently in connection to ATP metabolism, and increases the activity of adenylate kinase in rat brains.[21][22] Piracetam, while in the brain, appears to increase the synthesis of cytochrome b5,[23] which is a part of the electron transport mechanism in mitochondria. But in the brain, it also increases the permeability of the mitochondria of some intermediaries of the Krebs cycle.[21] [edit] History Piracetam was first synthesized in 1964 by scientists at the Belgian pharmaceutical company UCB led by Dr Corneliu E. Giurgea; struck by its apparent ability to boost mental functioning in even healthy individuals and by its safety, Giurgea coined the term nootropic to describe it and other substances. Piracetam (trade name "Nootropil") was launched clinically by UCB in the early 1970s, and currently is in use in many European countries.[24] [edit] Approval and usage Piracetam is primarily used in Europe, Asia, South America and the U.S. Piracetam is legal to import into the United Kingdom for personal use with or without prescription, and was unregulated in the United States, as of 2006.[25] However, in August 2010, the FDA issued a single letter to one supplier ordering the discontinuation of the sale of Piracetam in the U.S. as a dietary supplement owing to the relatively strict definition of what constitutes a dietary supplement. Under section 201(ff)(1) of the Act, 21 U.S.C. 321(ff)(1): Piracetam is not a vitamin, mineral, amino acid, herb or other botanical, or dietary substance for use by man to supplement the diet by increasing the total dietary intake. Further, piracetam is not a concentrate, metabolite, constituent, extract or combination of any such dietary ingredient.[26] As of April 2011, Piracetam continues to be widely available online and in some shops in the United States, but is no longer marketed as a dietary supplement. Piracetam has no DIN in Canada, and thus cannot be sold but can be imported for personal use in Canada.[citation needed] It has become popular

as a cognitive enhancement drug among students.[27] It may even be possibly used for the treatment of childhood autism, a practice partially supported by clinical research.[28] [edit] Aging Piracetam appears to reverse the effects of aging in the brains of mice.[29][30] Piracetam appears to reduce levels of lipofuscin in the rat brain.[31] (Lipofuscin accumulation is a common symptom of aging and alcoholism.) [edit] Alcoholism Piracetam appears to be effective in treating cognitive impairment in alcoholism.[32][33][34][35][36][37] [edit] Alzheimer's and senile dementia Once thought to be effective for improving cognition in Alzheimer's disease and senile dementia patients, the evidence is now seen as too inconsistent to support the use of piracetam for these conditions.[38] [edit] Clotting, coagulation, vasospastic disorders Piracetam is useful as a long-term treatment for clotting, coagulation, and vasospastic disorders such as Raynaud's phenomenon[39] and deep-vein thrombosis.[19][40] It is an extremely safe antithrombotic agent that operates through the novel mechanism of inhibiting platelet aggregation and enhancing blood-cell deformability.[19] Because traditional anti-thrombotic drugs operate through the separate mechanism of inhibiting clotting factors, co-administration of piracetam has been shown to highly complement the efficacy and safety of traditional Warfarin/Heparin anticoagulation therapy.[41] The most effective treatment range for this use is a daily dose of 4.8 to 9.6 grams divided into three daily doses at 8 hours apart.[40] Piracetam was investigated as a complement or alternative to Warfarin as a safe and effective long-term treatment for recurring deep-vein thrombosis.[40] [edit] Depression and anxiety Some sources suggest that Piracetam's overall effect on lowering depression and anxiety is higher than improving memory.[42] [edit] Stroke, ischemia and symptoms Piracetam has been found to improve cognition after stroke, and reduce symptoms, such as aphasia.[43] It also improves cognition in cases of chronic ischemia.[44][45] [edit] Dyspraxia and dysgraphia

Due to its supposed effect on nerves and muscles it is sometimes prescribed as an aid to muscle or dexterity training, particularly in cases of agraphia and dyspraxia. There has not been a specific study as to whether it is beneficial in this. Vinpocetine, another purported nootropic with which piracetam is indirectly synergistic, is confirmed to help with these conditions to a certain degree.[citation needed] [edit] Schizophrenia At least one study shows that, while piracetam positively affected the cognition of patients suffering from schizophrenia in the same way as it positively affected the cognition of others, the severity of subjects' schizophrenia remained unaffected, for better or worse.[46] [edit] Preventive for breath-holding spells Two articles support the use of Piracetam as a prophylactic for severe cases of breath-holding spells. A 2008 study in the International Journal of Psychiatry Medicine supported the notion that Piracetam was effective as a preventive, but did not use a control to evaluate results against normal recovery times from severe BHS.[47] A 1998 study by the Turkish ministry of health evaluated 76 children, half of them in a control group. Children in the experimental group were three times as, and almost completely likely, to exhibit "overall control" over their BHS, with BHS episodes dropping by 60% over two months.[48] The 2008 study notes: Breath holding spells (BHS) are apparently frightening events occurring in otherwise healthy children. Generally, no medical treatment is recommended and parental reassurance is believed to be enough, however, severe BHS can be very stressful for the parents and a pharmacological agent may be desired in some of these children. [edit] Closed craniocerebral trauma Piracetam has positive therapeutic effects on adolescents with closed craniocerebral trauma (CCT). Treatment with piracetam was initiated 1.5 to 5 years after trauma. Compared to controls, after one month of daily treatment with 16002400 mg of piracetam there were meaningful and statistically significant improvements in the higher mental functions (visual memory, attention and executive), motor functions (gait, balance and sequential limb movements) and in the rates of cognitive and motor operations.[49] [edit] Dosage For blood coagulation, clotting, and vasospastic disorders such as Raynaud's phenomenon or deep-vein thrombosis, the most effective treatment range is a daily dose of 4.8 to 9.6 grams divided into three daily doses at 8 hours apart.[19][39][40] Many people take a dosage of 800 mg twice per day to improve cognition.[50] The LD-50 for oral consumption in humans has not been determined.[17]

[edit] Side effects Piracetam has been found to have very few side effects, and those it has are typically "few, mild, and transient."[51] A large-scale, 12-week trial of high-dose piracetam found no adverse effects occurred in the group taking piracetam as compared to the placebo group.[52] Many other studies have likewise found piracetam to be well tolerated.[10][51][53] Symptoms of general excitability, including anxiety, insomnia, irritability, headache, agitation, nervousness, and tremor, are occasionally reported.[54][55] Headache from large doses of piracetam may be alleviated by coadministration of an acetylcholine biosynthetic precursor, or a drug with cholinergic effects, such as choline bitartrate, choline citrate, choline alfoscerate, lecithin, cyprodenate or centrophenoxine.[54][55] [edit] Piracetam and lucid dreaming Piracetam has become a popular supplement in the subculture of lucid dreaming. Its use has been largely made popular by a book published by "Thomas Yuschak" titled "Advanced Lucid Dreaming The Power of Supplements". Piracetam is not used directly to cause vivid dreams; it is even said to prevent them. The premise for its use is to counter the desensitization of acetylcholine receptors in the brain caused by taking another supplement, Galantamine, which is said to cause stronger, more vivid dreaming experiences. Piracetam is taken immediately after having a lucid dream experience with Galantamine. The lucid dreamer will then not take the supplement combination again until the Galantamine has completely left their system (approximately 30 hours). Piracetam has a peak plasma time of 1.5 hours and an elimination half-life equal to 5 hours. For the purpose of lucid dreaming dosing is much lower than doses taken in clinical studies, averaging typically 2400 mg. [edit] Availability Piracetam is sold under a wide variety of brand names world wide.

NootropylUnited States NootropilEurope, Brazil, Hong Kong Lucetam, Oikamid, Smart, Geratam, BiotropilEurope, Brazil NeurobasalColombia BreinoxEcuador, Venezuela DinagenMexico NoostanArgentina StimulanEgypt NootropilIndia (sold by UCB India)[56]

FUNGSI PIRACETAM Nootropic Agents - PiracetamPiracetam (2-oxo-1 pyrolidine-acetamid) merupakan golongan nootropic agents yang berbentuk bubuk kristal putih dan tidak berbau. Piracetam bekerja dengan cara meningkatkan efektifitas dari fungsi telensefalon otak melalui peningkatan fungsi neurotransmiter kolinergik. Telensefalon inilah yang mengatur fungsi kognitif pada manusia (memori, kesadaran, belajar dan lain). Fungsi lain dari piracetam adalah menstimulasi glikolisis oksidatif, meningkatkan konsumsi oksigen pada otak, serta mempengaruhi pengaturan cerebrovaskular dan juga mempunyai efek antitrombotik. Oleh karena itu piracetam biasanya digunakan untuk pengobatan stroke , terutama stroke iskemik Piracetam mempengaruhi aktifitas otak melalui berbagai mekanisme yang berbedaantara lain: * Merangsang transmisi neuron di otak * Merangsang metabolisme otak * Memperbaiki mikrovaskular tanpa efek vasodilatasi*Farmakokinetik*1. Distribusi, Piracetam di distribusikan melewati sawar otak dan terkonsentrasi pada bagian abu-abu dari korteks cerebri dan cerebelum, nukleus caudatus, hipokampus, korpus genikulatum lateral, dan pleksus koroideus.2. Ekskresi, Piracetam di ekskresi melalui urin dan feces, ekskresi melalui urin mencapai 98% oleh karena itu diperlukan perhatian khusus pada penderita dengan gangguan ginjal *Indikasi*Berikut ini adalah beberapa indikasi dari piracetam; * * * Sindrom yang berkaitan dengan penuaan, seperti defisit memori, astenia, dan gangguan psikomotor * Sindrom post taumatik * Terapi pada anak-anak dengan dysleksia * Kelainan dimana terdapat gangguan peredaran otak seperti iskemiaDemikian sedikit penjelasan blog ini tentang piracetam, sebagai salah satu nootropic agents Piracetam Kapsul Rating: . Direkomendasikan oleh 14 pembaca. Beri rekomendasi:

Indikasi:

1. Gejala-gejala involusi yang berhubungan dengan usia lanjut - Kemunduran daya pikir - Astenia - Gangguan adaptasi - Reaksi psikomotorik yang terganggu 2. Alkoholisme kronik dan adiksi - Pre-delirium - Delerium trements - Gangguan fungsi dan kemunduran intelegensia yang diakibatkan oleh alkoholisme kronik (gangguan ingatan, konsentrasi pikiran, perhatian dan intelegensia) - Pengobatan detoksikasi (untuk gangguan karena penghentian obat secara mendadak, gangguan selesar makan dan defisiensi). 3. Gejala pasca trauma Disfungsi serebral sehubungan dengan akibat pasca trauma (sakit kepala, vertigo, agitasi, gangguan ingatan dan astenia)

Kontra Indikasi: Hipersensitif terhadap Piracetam. Gangguan ginjal berat (bersihan kreatinin < 20 ml/menit). Komposisi: PIRACETAM 400 Tiap kapsul mengandung: Piracetam 400 mg PIRACETAM 800 Tiap kaplet salut selaput mengandung: Piracetam 800 mg PIRACETAM 1200 Tiap kaplet salut selaput mengandung: Piracetam 1200 mg Farmakologi: Piracetam adalah suatu nootropic agent. Dosis dan Cara Pemberian: - Gejala psiko-organik sehubungan usia lanjut: Dosis awal: 2,4 g sehari selama 6 minggu dilanjutkan dengan 1,2 g sehari (dosis pemeliharaan)

- Gejala pasca trauma Dosis rata-rata sebagai berikut: Dosis awal: 800 mg, 3 x sehari. Bila sudah didapat efek yang diinginkan, kurangi dosis secara bertahap sampai 400 mg, 3 x sehari. - Terapi jangka panjang pada penderita usia lanjut dan gagal fungsi ginjal, perlu dilakukan penyesuaian dosis, sebagai berikut:

Bersihan Kreatinin Kreatinin serum Dosis (ml/menit) (mg/100 ml) 60-40 1,25-1,7 dari dosis lazim 40-20 1,70-3,0 dari dosis lazim Peringatan dan Perhatian: Harap hati-hati terhadap penderita yang hipersensitif terhadap Piracetam

Hati-hati pada penderita gangguan fungsi ginjal karena Piracetam diekskresi terutama melalui ginjal sehingga perlu dilakukan pengamatan fungsi ginjal. Hati-hati penggunaan pada wanita hamil dan menyusui. Perlu dilakukan evaluasi hasil yang didapat selama 3 bulan pertama kehamilan atau menyusui. Piracetam belum dinyatakan aman digunakan pada wanita hamil.

Studi preklinis menyatakan Piracetam tidak memiliki indikasi ke arah teratogenik atau fertilitas. Piracetam dapat melalui barier plasenta.

Efek Samping: Rasa gugup, agitasi, iritabilitas, rasa lelah dan gangguan tidur. Gangguan saluran cerna misalnya nausea, muntah, diare, dan gastralgia. Yang jarang terjadi adalah pusing-pusing, sakit kepala, tremor, peningkatan libido. Kegelisahan yang ringan dan akan hilang bila pemberian dihentikan. Interaksi Obat: Pemberian bersama dengan ekstrak tiroid, menyebabkan confusion, iritabilitas dan gangguan tidur. Penyimpanan: Simpan di tempat kering pada suhu di bawah 30 derajat Celsius, terlindung dari cahaya.

PIRACETAM Komposisi Injeksi : Tiap ml mengandung Piracetam 200 mg. Kaplet salut selaput : Tiap kaplet salut selaput mengandung Piracetam 800 mg. Farmakologi Piracetam adalah suatu nootropic Agent. Indikasi Injeksi IV/IM : Pengobatan infark serebral. Kaplet : 1. Gejala gejala involusi yang berhubungan dengan usia lanjut : Dosia awal 2,4 g selama 6 minggu (terbagi dalam 3 dosis). Diikuti dengan dosis 1,2 g sehari (terbagi dalam 3 dosis) sebagai dosis pemeliharaan. 1. Alkoholisme dan adiksi : Predelirium, delirium tremens, gangguan fungsi dan kemunduran mental yang diakibatkan oleh alkoholisme kronik (gangguan daya ingat, konsentarsi pikiran, perhatian dan gangguan mental), pengobatan detoksifikasi (untuk gangguan karena penghentian obat secara mendadak, hilang dan kurang nafsu makan). 2. Sindrom pasca trauma : Disfungsi otak yang berhubungan dengan akibat pasca trauma (sakit kepala, vertigo, agitasi, gangguan daya ingat dan astenia). Kontra Indikasi Hipersensitif terhadap piracetam, gangguan ginjal berat (bersihan kreatinin < 20 ml/menit). Efek Samping Rasa gugup, agitasi, iritabilitas, rasa lelah dan gangguan tidur. Gangguan saluran cerna misalnya : nausea, muntah, diare dan gastralgia. Yang jarang terjadi adalah pusing pusing, sakit

1. 2.

3. 4.

kepala, tremor, peningkatan libido. Mulut kering, penambahan berat badan dan umunya reaksi hipersensitivitas dermatologik. Dosis Injeksi : Dosis umum : 1 gram 3 x 1 sehari IV atau IM Kaplet : Gejala psiko organik yang berhubungan dengan usia lanjut : Dosis awal 2,4 g selama 6 minggu (terbagi dalaam 3 dosis). Diikuti dengan dosis 1,2 g sehari (terbagi dalam 3 dosis) sebagai dosis pemeliharaan. Gejala pasca trauma : Dosis rata rata : Dosis awal : 3 kali sehari 800 mg secara oral. Bila efek yang diinginkan sudah diperoleh kurangi dosis secara bertahap sampai pada 400 mg 3 kali sehari. Dosis lazim : 1,2 4,8 mg/hari (terbagi dalam 2 atau 3 kali dosis) Dosis untuk pasien lanjut usia dan gangguan fungsi ginjal : pada pasien tersebut waktu paruh akan meningkat secara langsung sesuai dengan fungsi ginjal atau kliren kreatinin. Penelitian menunjukkan bahwa perubahan ekskresi kreatinin dipengaruhi oleh umur. Karena itu dilakukan penyesuaian dosis seperti tabel berikut bila kliren kreatinin < 60 mL/min atau serum kreatinin > 1,25 mg/100 mL pada pasien diatas 65 tahun. Kliren Kreatinin Serum Kreatinin Dosis (mL/min) (mg/100mL) 60 40 1,25 1,7 dosis lazim 40 20 1,70 3,0 dosis lazim

Piracetam (dijual dengan nama merek banyak) adalah obat nootropic. Nama kimia Piracetam adalahasetamida 2-oxo-1-pirolidin, melainkan saham struktur basis 2-oxo-pirolidon sama dengan asamkarboksilat 2-oxo-pirolidin (pyroglutamate). Piracetam merupakan turunan siklik dari GABA. Iniadalah salah satu racetams. Piracetam yang diresepkan oleh dokter untuk beberapa kondisi, terutamamyoclonus, [1] tapi digunakan off-label untuk berbagai aplikasi yang lebih luasMekanisme aksiPiracetam's mekanisme aksi, karena dengan racetams pada umumnya, tidak sepenuhnya dipahami.Obat ini mempengaruhi fungsi neuron dan pembuluh darah dan mempengaruhi fungsi kognitif tanpabertindak sebagai obat penenang atau stimulan. [3] Piracetam adalah modulator alosterik positif darir e s e p t o r A M P A . [ 1 3 ] H a l i n i d i d u g a b e r t i n d a k a t a s s a l u r a n i o n a t a u p e m b a w a i o n [ k u t i p a n diperlukan ], sehingga mengarah ke rangsangan non-spesifik neuron meningkat, sementaramenjelaskan kurangnya efek atletik atau penghambatan pada tindakan synaptic (sangat tidak sepertikebanyakan neurotransmitter), dan toksisitas rendah. [14] Telah ditemukan untuk meningkatkan alirandarah dan konsumsi oksigen di bagian otak namun ini mungkin merupakan efek samping dari aktivitasotak meningkat daripada efek primer atau mekanisme aksi untuk obat. [15]Piracetam meningkatkan fungsi neurotransmiter asetilkolin melalui kolinergik muscarinic (AcH)reseptor yang terlibat dalam proses memori [16] Selain itu,. Piracetam mungkin memiliki efek padareseptor glutamat NMDA, yang terlibat dengan proses belajar dan memori. Piracetam ini diyakiniakan meningkatkan permeabilitas membran sel. [16] [17] Piracetam dapat menggunakan

efek globalpada neurotransmisi otak melalui modulasi saluran ion (yaitu, Na +, K +). [14] Telah ditemukan untuk meningkatkan konsumsi oksigen di otak, tampaknya yang berkaitan dengan metabolisme ATP, danmeningkatkan aktivitas kinase siklase dalam otak tikus. [18] [19] Piracetam muncul untuk meningkatkan sintesis dari sitokrom b5, [20] yang merupakan bagian dari mekanisme transpor elektron di mitokondria . Hal ini juga meningkatkan permeabilitas mitokondria dari beberapaperantara dari siklus Krebs. [Efek Ada sangat sedikit data pada efek piracetam terhadap orang yang sehat, dengan studi paling berfokuspada orang dengan kejang, demensia, gegar otak, atau masalah neurologis lainnya. [2]Pada tahun 2008, sebuah komite dari Akademi Ilmu Kedokteran Inggris mencatat bahwa banyak dariuji klinis dari piracetam untuk demensia adalah cacat metodologis. [2] Namun, sejumlah studi individu positif mendukung penggunaan piracetam dalam orang yang menderita berbagai kognitif gangguan, [3] [4] dan 2002 meta-analisis menyimpulkan piracetam yang memiliki efek terapi padapasien tua dengan gangguan kognitif. [5]Beberapa meta-review literatur tentang piracetam piracetam menunjukkan bahwa kinerja meningkatpada berbagai tugas kognitif antara anak-anak disleksia, meskipun ini mungkin mencerminkan peningkatan pada komunikasi lintas-setengah bulat dan fungsi kognitif secara umum, daripadaperbaikan yang spesifik dalam apa pun yang menyebabkan disleksia . Piracetam juga tampaknya menghambat kerusakan otak yang disebabkan oleh berbagai faktor termasuk hipoksia dan konsumsialkohol yang berlebihan. [6] [7]Piracetam telah dipelajari dalam jumlah yang luas percobaan klinis, dan telah menunjukkan hasil yangpositif dalam pengobatan aphasia pasca-stroke, epilepsi, penurunan kognitif setelah operasi jantungdan otak, demensia, [5] dan myoclonus. [8] [9] efek sampingan vaskular Its telah menunjukkanpenggunaannya untuk vertigo, disleksia, dan anemia sel sabit juga. [3]Piracetam memiliki efek antihypoxic diucapkan dan antiarrhythmic, yang terakhir dilakukan denganmenurunkan tingkat irama dan meningkatkan amplitudo kontraksi. Hewanhewan diperlakukandengan piracetam dalam dosis ketika efek antiarrhythmic nya (300 mg / kg) menunjukkan penurunanpotensial membran eritrosit dibandingkan dengan kontrol. efek serupa terjadi pada hewandiperlakukan dengan lidokain. Dapat disimpulkan bahwa pada jenis tertentu aritmia penggunaanpiracetam mengembalikan irama normal kontraksi yang mungkin berhubungan dengan pengaruh positif pada proses metabolisme dalam miokardium. [10]Piracetam tampaknya meningkatkan komunikasi antara dua belahan otak, dan meningkatkan aktivitascorpus callosumEfek sampingPiracetam telah ditemukan memiliki efek samping yang sangat sedikit, dan mereka telah biasanya"sedikit, ringan, dan sementara." [51] A, skala besar 12 minggu persidangan piracetam dosis tinggitidak menemukan efek samping terjadi pada kelompok mengambil piracetam dibandingkan dengankelompok plasebo [52] Banyak penelitian lain juga ditemukan piracetam dengan baik-ditoleransi.. [8][51] [53]Gejala rangsangan umum, termasuk kecemasan, insomnia, iritabilitas, sakit kepala, gelisah, gugup,dan tremor, kadang-kadang dilaporkan [54] [55] Sakit kepala dari dosis besar piracetam. mungkinakan diatasi dengan coadministration dari prekursor biosintesis asetilkolin, atau obat dengan efek kolinergik, seperti choline bitartrate, kolin sitrat, alfoscerate kolin, lesitin, cyprodenate ataucentrophenoxineDosisUntuk pembekuan darah, pembekuan, dan gangguan vasospastic seperti fenomena Raynaud atautrombosis vena, rentang perawatan yang paling efektif adalah dosis harian 4,8-9,6 gram dibagimenjadi tiga dosis harian pada 8 jam terpisah. [16] [42] [43]

Piracetam Injeksi Injeksi IM/IV Infus IV

Komposisi: Tiap ml mengandung: Piracetam 200 mg

Farmakologi: Piracetam adalah suatu nootropic-Agent.

Indikasi: Pengobatan infark serebral

Kontraindikasi: Hipersensitif terhadap piracetam. Gangguan ginjal berat (bersihan kreatinin < 20 ml/menit)

Dosis: Dosis umum: 1 gram 3 x 1 sehari IV atau IM.

Cara penggunaan: Intramuskular dan intravena, dapat juga diberikan bersama infus. Larutan injeksi piracetam dapat diberikan bersamaan dengan Glukosa 5%, 10%, 20%. Fruktosa 5%, 10%, 20%, Levulosa 5%, NaCl Isotonik (0,9%). Dekstran 40 10% dalam NaCl 0,9%. Dekstran 75,6% dalam larutan NaCl 0,9%. Ringer, Ringer-laktat. Manitol Rheo Macrodex dalam larutan HES (Hydroxyethyl Starch) 6%. Larutan injeksi piracetam stabil dalam infus di atas kurang dari 24 jam.

Efek samping: Rasa gugup, agitasi, iritabilitas, rasa lelah dan gangguan tidur. Gangguan saluran cerna misalnya: nausea, muntah, diare, dan gastralgia. Yang jarang terjadi adalah pusingpusing, sakit kepala, tremor, peningkatan libido. Mulut kering, penambahan berat badan dan umumnya reaksi hipersensitivitas dermatologik.

Peringatan dan perhatian:

Hati-hati pada penderita gangguan fungsi ginjal karena piracetam diekskresikan terutama melalui ginjal sehingga perlu dilakukan pengamatan fungsi ginjal. Hati-hati penggunaan pada wanita hamil dan menyusui. Perlu dilakukan evaluasi hasil yang didapat selama 3 bulan pertama kehamilan atau menyusui. Piracetam belum dinyatakan aman digunakan pada wanita hamil. Piracetam dapat melalui sawar plasenta.

Interaksi obat: Pemberian bersama dengan ekstrak tiroid, menyebabkan confusion, iritabilitas dan gangguan tidur.