80．脑通

出处：按学科分类—医药、卫生 军事医学科学出版社《临床常用进口药物手册》第447页（5848字）

【中文释文】：

(尼麦角林)

脑通(尼麦角林，麦角溴烟酯)是由意大利爱宝大药厂生产的一种周围血管扩张剂，具有α受体阻滞作用及促进脑部新陈代谢作用。

〔作用〕

1．脑血管 减少脑血管阻力，增加动脉血流量及增加脑动脉血氧浓度及葡萄糖水平。

2．肺血管 减少肺血管阻力。

3．四肢循环 增加肢体血流量，特别是对由于功能性血管病变引起的血流灌注不足症状的改善，效果显着。临床试验显示，脑通可非常有效地改善大脑循环系统及肢体血流量不足之症状。

治疗剂量的脑通通常不影响全身正常血压。脑通对高血压病人有一定的降压功用。

〔适应证〕

急性或慢性脑血管障碍或脑血管代谢功能不良(脑动脉硬化症、脑中风、脑血栓形成、脑栓塞、暂时性脑供血不足)。

急性或慢性周围循环障碍(肢体血管闭塞性疾病、雷诺综合征，其它末梢循环不良症状)。头痛。注射剂脑通可用作动脉性高血压危象时之辅助治疗。

脑通适用于慢性脑部功能不足症候群如头痛、耳鸣、眩晕、疲倦、失眠、视觉障碍、感觉迟钝、注意力不集中、记忆力衰退、缺乏意念、忧郁、不安等精神障碍症状。

脑通也适用于行动不便，语言障碍等症候群。

中风后偏瘫病病人神经恢复的辅助治疗剂。

〔禁忌证〕

对尼麦角林过敏者。

〔用量〕

口服：每次5～10mg，每天3次。应长期固定时间服用，两餐之间服用，吸收更佳。

肌肉注射：每次2～4mg，每天2次。

静脉滴注：每次剂量4～8mg，溶于100ml生理盐水或葡萄糖液缓慢滴注。可由医师指定每日次数。

动脉注射：每次剂量4mg，溶于10ml生理盐水，用2min作缓慢注射。

剂量：治疗期及用药途径可根据临床病情调整。在一些病例，我们建议先针剂注射，然后口服片剂维持治疗。需要服用一段时间，才能观察到主观及客观症状的改善，而非即时能见效。

〔副作用〕

只有很少的病人有轻微的副作用，通常与脑通的血管扩张作用有关。例如，静脉注射后头晕和低血压，轻微的胃部不适，颜面潮红、昏昏欲睡或失眠。

〔注意〕

脑通可能加强其它降压药的作用。曾有报道，静脉注射脑通后发生低血压现象，故建议，注射后应休息几分钟，尤其是开始治疗的病人。虽然毒理学没有显示脑通有致畸作用，但孕妇仍仅限必需时才使用。

贮放在儿童不能触及的地方。

〔包装〕

糖衣片：50粒装，每粒含10mg尼麦角林。

针剂：每盒药剂1瓶。

每瓶含4mg尼麦角林。

配制好的溶液，在避光及室温下可保存48h。

〔生产厂家〕

意大利爱宝大药厂

(附本品别名：瑟米恩，Vasospa，F．I．6714，Nicotargoline，Varson)．

【外文释文】：

FARMITALIA

Sermion(Nicergoline or 1，6-dimethyl-8-b-(5-bromonicotinoyl-oxymethyl)-10_-α- methoxy-ergoline)is a vasoactive drug，synthesized in Farmitalia Research Laboratories，characterized by an alpha-adrenolytic and metabolism-activating activity．

Sermion acts

·At cerebral level，by reducing the vascular resistances，and by increasing the arterial flow and consumption of oxygen and glucose．

·At level of pulmonary vessels，by reducing the vascular resistances．

·On the circulation of the limbs by increasing blood flow，this activity is particularly evident in subjects with insufficient blood flow due to functional arteriopathies．

In clinical trals Sermion was shown to be highly effective in improving and normalizing the alterated cerebral circulation and those disorders related to insufficient arterial flow in the limbs． The systemic arterial pressure is generally not influenced by therapeutic doses of Sermion．

In hypertensive subjects Sermion may induce a gradual decrease in blood pressure values．The drug is devoid of haemetic action also after parenteral administration．

Indications

Acute or chronic vascular or metabolic cerebral insufficiency(cerebral arteriosclerosis，cerebral thrombosis and embolism，transient cerebral ischaemia)．

Acute or chronic peripheral vascular insufficiency(obliterative vascular diseases of the limbs，Raynaud syndrome，other syndromes due to altered peripheral flow)．Headache．As an adjuvant to the therapy of arterial hypertension and，parenterally，of hypertensive crises．Adjuvant of neurological rehabilitation after stroke hemiplegic patients．

Contraindications

Hypersensitivity to nicergoline．

Dosage-oral

5-10 mg Three times daily at regular intervals for prolonged periods．

In order to improve absorption，the drug should be taken between meals．

Intramuscular：2-4 mg twice daily．

Drip infusion：4-8 mg per dose in 100 ml of physiological saline or glucose solution by slow intravenous drip infusion，at the clinician’s discretion，this dose can be repeated several times per day．

Sermion can also be used by intra-arterial route：4 mg per dose in 10 ml of physiological saline injected over a period of two minutes．

Dosage，duration of treatment and route of administration depend on the severity of the clinical conditions．In certain cases it is advisable to start therapy with parenteral administration，followed by an oral maintenance therapy．It may occur that both subjective and objective effects are observable only after a certain period of time and not immediately．

Side effects

Rare cases of mild side-effects have been reported，which in general may be related to the vasoactive action of Sermion．These are：hypotension and vertigo after parenteral adminisrtation，slight gastric disturbances，feeling of heat and flushing，drowsiness，insomnia．

Warnings

Sermion may potentiate the action of anti-hypertensive drugs．As rare cases of hypotension phenomena have been reported after parenteral administration，it is advisable for the patient to remain in a resting position for some minutes after injection，particularly at the beginning of treatment．Although toxicological studies have not shown a reactogenic activity of nicergoline，the drug should be used during pregnancy only when necessary．

Keep out of reach of children．

Presentation

Coated tablets：blister pack of 50 coated tablets each containing 10 mg nicergoline．

Injections：box of 1 vial．Each vial contains 4 mg nicergoline．The reconstituted injectable solution can be stored，protected from light，for up to 48 hours at room temperature．

Manufacturer

Erba，Ltd．，Italy