Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K45/00—Medicinal preparations containing active ingredients not provided for in groups A61K31/00 - A61K41/00
  • A61K45/06—Mixtures of active ingredients without chemical characterisation, e.g. antiphlogistics and cardiaca
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61K—PREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
  • A61K33/00—Medicinal preparations containing inorganic active ingredients
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P1/00—Drugs for disorders of the alimentary tract or the digestive system
  • A61P1/06—Anti-spasmodics, e.g. drugs for colics, esophagic dyskinesia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
  • A61P11/06—Antiasthmatics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P11/00—Drugs for disorders of the respiratory system
  • A61P11/16—Central respiratory analeptics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P21/00—Drugs for disorders of the muscular or neuromuscular system
  • A61P21/02—Muscle relaxants, e.g. for tetanus or cramps
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P23/00—Anaesthetics
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P25/00—Drugs for disorders of the nervous system
  • A61P25/28—Drugs for disorders of the nervous system for treating neurodegenerative disorders of the central nervous system, e.g. nootropic agents, cognition enhancers, drugs for treating Alzheimer's disease or other forms of dementia
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P27/00—Drugs for disorders of the senses
  • A61P27/02—Ophthalmic agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P31/00—Antiinfectives, i.e. antibiotics, antiseptics, chemotherapeutics
  • A61P31/04—Antibacterial agents
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P39/00—General protective or antinoxious agents
  • A61P39/06—Free radical scavengers or antioxidants
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P7/00—Drugs for disorders of the blood or the extracellular fluid
  • A61P7/02—Antithrombotic agents; Anticoagulants; Platelet aggregation inhibitors
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/08—Vasodilators for multiple indications
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/10—Drugs for disorders of the cardiovascular system for treating ischaemic or atherosclerotic diseases, e.g. antianginal drugs, coronary vasodilators, drugs for myocardial infarction, retinopathy, cerebrovascula insufficiency, renal arteriosclerosis
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61P—SPECIFIC THERAPEUTIC ACTIVITY OF CHEMICAL COMPOUNDS OR MEDICINAL PREPARATIONS
  • A61P9/00—Drugs for disorders of the cardiovascular system
  • A61P9/12—Antihypertensives

Definitions

• It relates to a drug that contains xenon.
• WO 02/22141 A2 describes the use of xenon or xenon-containing gases as medicaments, in particular cardiovascular agents.
• Antispasmodics include drugs that reduce the tone of the smooth muscles (gastrointestinal tract, vessels, bronchi).
• the object of the invention is to provide an alternative medicament, in particular an alternative spasmolytic.
• the invention relates to a spasmolytic with the features described in claim 1.
• the spasmolytic is a substance or mixture of substances that contains xenon.
• the spasmolytic preferably consists of gaseous xenon or a xenon-containing gas mixture which is generally administered by inhalation.
• the spasmolytic generally acts on the smooth muscles, in particular on the smooth muscles of vessels.
• the spasmolytic is generally a smooth muscle spasmolytic.
• the spasmolytic is preferably a medicament for the treatment of vasospasm, in particular for the treatment of cerebral vasospasm or coronary vasospasm.
• Another object of the invention is thus the use of xenon or a xenon-containing gas as a vasodilator, preferably as a capillary or pre-capillary vasodilator, in particular as a vasodilator in capillary or pre-capillary current areas of the human body.
• Another object of the invention is the use of xenon or a xenon-containing gas for the manufacture of a medicament for vasodilation, preferably for the manufacture of a medicament for capillary or pre-capillary vasodilation, in particular for the manufacture of a medicament for vasodilation in capillary or pre-capillary current areas of the human body.
• the spasmolytic is preferably gaseous. It preferably contains no solid or liquid components when administered. The spasmolytic is therefore preferably in the form of a pure gas phase when administered.
• the spasmolytic contains xenon in pharmacologically or therapeutically effective amounts, especially in spasmolytically effective amounts.
• the spasmolytic is a xenon-containing gas mixture with a proportion of at least 1% by volume xenon.
• Spasmolytic is preferably administered by inhalation through the lungs.
• the spasmolytic is an inhalation spasmolytic.
• the spasmolytic is also administered using a heart-lung machine.
• the spasmolytic is preferably used to treat humans.
• the spasmolytic is usually provided as a pure gaseous xenon.
• the spasmolytic can also be provided as a gas mixture.
• the spasmolytic is usually used as a breathing gas mixture that contains xenon and oxygen. Such gas mixtures are used, for example, in emergency medicine, where gas mixing or metering devices are too complex for mobile use.
• Gaseous xenon or xenon-containing gas mixtures are used particularly advantageously for the prophylaxis of spasms, preferably vasospasms.
• the prophylactic administration of xenon or xenon-containing gas mixtures takes place, for example, preoperatively, intraoperatively or postoperatively.
• the spasmolytic provided or the spasmolytic produced directly during use, especially in close proximity to the patient is, for example, a gas mixture which contains 1 to 80% by volume (based on normal conditions, ie 20 ° C., 1 bar absolute) of xenon (e.g. B. balance oxygen).
• xenon e.g. B. balance oxygen
• the spasmolytic agent that is administered to the patient advantageously contains xenon in amounts that do not cause anesthesia.
• Xenon- Amounts that do not produce anesthesia or are insufficient for anesthesia are called sub-anesthetic or sub-anesthetically effective amounts.
• gas mixtures containing up to 70% by volume xenon contain subanesthetic amounts of xenon.
• Gas mixtures administered as an antispasmodic preferably contain up to 65% by volume, particularly preferably up to 60% by volume, in particular up to 50% by volume of xenon.
• pure xenon is dosed accordingly into a patient's breathing gas, so that gas mixtures with the named xenon concentrations are produced.
• the breathing gas produced and supplied to the patient contains, for example, 5 to 60% by volume, 5 to 50% by volume, 5 to 40% by volume, 5 to 30% by volume or 5 to 20% by volume Xenon.
• a dosage of xenon in the breathing gas with a low concentration for example 1 to 35 vol.%, 5 to 25 vol.% Or 5 to 20 vol .-% or 5 to 10 vol .-% xenon in the breathing gas, may be advantageous.
• the gas mixtures administered as an antispasmodic preferably contain one or more gases in addition to xenon or gaseous substances at body temperature and normal pressure.
• gases are, for example, xenon-oxygen gas mixtures or gas mixtures of xenon and one or more inert gases such as nitrogen or a noble gas or xenon-oxygen-inert gas gas mixtures.
• inert gases such as nitrogen or a noble gas or xenon-oxygen-inert gas gas mixtures.
• Inert gases can be very beneficial if little xenon is to be brought into the body.
• gases or gas mixtures which are used as a spasmolytic, in particular as a vasospasmolytic follow: 1.) 100% by volume xenon; 2.) 70% by volume xenon / 30% by volume oxygen; 3.) 65% by volume xenon / 30% by volume oxygen / 5% by volume nitrogen; 4.) 65% by volume xenon / 35% by volume
• Xenon or a xenon-containing gas mixture is preferably used for the manufacture of a medicament for the treatment of spasms, for the manufacture of a medicament for Treatment of vasospasm, for the manufacture of a medicament for the treatment of vasospasm in capillary current areas (eg vasospasm of capillary vessels) or pre-capillary current areas.
• cerebrospasmolytics Medicines to treat cerebral vasospasm that contain xenon are known as cerebrospasmolytics.
• the cerebrospasmolytics work against circulatory disorders in the brain.
• the cerebrospasmolytics are also used to treat cerebral perfusion disorders and cognitive disorders.
• the cerebrospasmolytics are also used for the prophylaxis and / or therapy of cognitive impairment, also postoperatively.
• the cerebrospasmolytics are used to treat stroke and to prevent stroke.
• the cerebrospasmolytics are also used to treat post ischemia syndromes.
• Xenon or a gas mixture containing xenon are also used to produce a bronchospasmolytic.
• Xenon or a xenon-containing gas mixture are also used to produce a vasospasmolytic for the treatment of coronary perfusion disorders.
• the drugs mentioned are considered special forms of an antispasmodic.
• the term "spasmolytic" is the general term to which the listed special medicines are subordinated. The comments on the composition and administration of the spasm lytic are therefore transferable to the special drugs.
• the spasmolytic and the special drugs are used preoperatively, intraoperatively or postoperatively.
• the spasmolytic is used particularly advantageously in intensive care medicine, in particular when the medicament has to be administered over a longer period of time, for example in long-term ventilation.
• the spasmolytic has the particular advantage of not having any side effects based on current knowledge. They form in the body when using xenon or xenon-containing gases as spasmolytic no metabolites in the body and there is no accumulation of the drug in the body.
• Xenon is administered especially for long-term ventilation and for prophylaxis in subanesthetic concentrations in the breathable gas (breathing gas).
• the breathable gas has, for example, a content of 20 to 30 vol .-% oxygen. B. 30 to 95 vol .-% oxygen can be increased.
• the remaining gas in the breathable gas usually consists of nitrogen or another inert gas.
• Gas mixtures containing xenon and oxygen are advantageously used as a bronchospasmolytic by spontaneously breathing patients, in particular in the homecare area for oxygen supply (e.g. long-term oxygen therapy, in particular for asthma or COPD (chronic obstructive pulmonary disease / chronic obstructive pulmonary disease) or in the case of acute shortness of breath).
• the xenon and oxygen-containing gas mixtures have, for example, a xenon content in the range from 1 to 30% by volume xenon, preferably in the range from 1 to 20% by volume xenon, in particular in the range from 5 to 10% by volume Xenon.
• the gas mixture is provided in pressurized gas containers or as cryogenic liquefied gas in insulating containers or is generated on site.
• the xenon gas used generally has the natural isotope composition.
• the xenon isotope composition may differ from the natural isotope composition, particularly when used for diagnostic purposes.
• the xenon gas is preferably used in high purity, as is customary for medical gases.
• the xenon gas preferably serves as a pure gas or in a mixture with other gases for the production of a gaseous medicament for the applications mentioned.
• Gaseous xenon (pure xenon) is generally provided as compressed gas in pressurized gas containers such as pressurized gas cylinders or pressurized cans.
• Xenon-containing gas mixtures can also be provided in pressurized gas containers.
• the gaseous medicament can also be provided in a container as a liquefied gas or gas mixture or in a work hardened form.
• the spasmolytic is usually administered with a ventilator with a gas metering unit or with an anesthesia machine.
• the medicament is advantageously produced for use directly from the pure gases, for example by mixing xenon, oxygen and, if appropriate, an inert gas (for example with the aid of an anesthesia machine) in close proximity to the patient.
• the spasmolytic is administered to the patient as a dry gas, moist gas or water vapor-saturated gas.
• the spasmolytic according to the invention in particular the gaseous and inhaled spasmolytic, is also used in combination with a conventional, in particular orally or intravenously administered spasmolytic.
• a conventional, in particular orally or intravenously administered spasmolytic This allows, among other things, a better adaptation to the individual disease states of the patient, the partially deviating effects of the various spasmolytics being used and metered in such a way that the effects of the spasmolytics advantageously complement one another.
• the spasmolytic according to the invention and one or more conventional spasmolytics are accordingly used as a combination medicament.
• Another object of the invention is therefore a spasmolytic, containing xenon or a gas containing xenon and an orally, inhalatively or intravenously administered spasmolytic, preferably with an organic, spasmolytic active ingredient, as a combination preparation for simultaneous, separate or chronologically graduated use in the treatment of spasms, especially vasospasm.
• the combination of the xenon-containing spasmolytic with an NO source is also advantageous.
• a source of nitrogen monoxide (NO) is NO (nitrogen monoxide), a gas or gas mixture containing NO, or a substance or preparation that releases nitrogen monoxide (NO) that stimulates the body's production of NO or inhibits the breakdown of NO in the body ,
• NO nitrogen monoxide
• a nitrogen monoxide source are, in particular, NO-releasing and / or NO-forming compounds.
• NO sources such as NO-containing gas mixtures and NO-releasing compounds are described, for example, in DE 691 27756 T2 (there, for example, page 8, line 7 to page 9, end of the second paragraph), to which reference is hereby made.
• NO-releasing compounds are e.g. S-nitroso-N-acetylpenicillamine (SNAP), S-nitrosocysteine, nitroprusside, nitrosoguanidine, glycerol trinitrate, isoamyl nitrite, inorganic nitrite, azide or hydroxylamine.
• SNAP S-nitroso-N-acetylpenicillamine
• S-nitrosocysteine nitroprusside
• nitrosoguanidine nitrosoguanidine
• glycerol trinitrate isoamyl nitrite, inorganic nitrite, azide or hydroxylamine.
• the NO-releasing compounds are introduced, for example, as an
• Xenon and an NO source for lung complaints are advantageously administered in combination via the lungs, the effects of xenon and NO complementing one another.
• Medicines, in particular inhalable drugs, with xenon and a source of NO are generally used for the treatment, prophylaxis or prevention of respiratory disorders, functional disorders of the lungs, acute or chronic pulmonary hypertension, in particular pneumonia, traumatic injury, aspiration or inhalation injury, fat embolism the lungs, acidosis, pneumonia, respiratory distress syndrome in adults, acute pulmonary edema, asthma, pulmonary hypertension after cardiac surgery, constant pulmonary hypertension in newborns, perinatal aspiration syndrome, hyaline membrane disease, acute pulmonary thromboembolism, separin-protamine-chronic, heparin-protamine-chronic High pressure, bronchopulmonary dysplasia, chronic pulmonary thromboembolism, idiopathic or primary pulmonary high pressure, IRDS (infant respiratory distress syndrome), asthma, PPH
• Xenon and an NO source are also used to produce an inhalable medicament for the prevention, prophylaxis, treatment or aftertreatment of apnea, in particular after anesthesia.
• Xenon and an NO source are used particularly advantageously for the production of an inhalable medicament for the prevention, prophylaxis, treatment or aftertreatment of apnea in premature and newborn babies, in particular after anesthesia.
• the invention thus relates to a medicament containing xenon and an NO source.
• a medicament consists, for example, of xenon and an NO source such as NO, of xenon, an NO source such as NO and an inert gas or of xenon, an NO source such as NO, oxygen and an inert gas.
• Another object of the invention is a medicament, e.g. an inhalation medication, preferably an antispasmodic, in particular a bronchospasmolytic, containing xenon or a gas containing xenon and an NO source as a combination preparation for simultaneous, separate or staggered use, in particular for disorders of the lungs of humans or mammals.
• an inhalation medication preferably an antispasmodic, in particular a bronchospasmolytic, containing xenon or a gas containing xenon and an NO source as a combination preparation for simultaneous, separate or staggered use, in particular for disorders of the lungs of humans or mammals.
• the gaseous drugs are usually used as a breathing gas mixture that contains xenon and oxygen or xenon, an NO source and oxygen.
• a breathing gas mixture that contains xenon and oxygen or xenon, an NO source and oxygen.
• gas mixtures are used, for example, in emergency medicine, where gas mixing or metering devices are too complex for mobile use.
• gases or gas mixtures which are used as a spasmolytic, in particular as a bronchospasmolytic 1.) 80% by volume xenon / x ppm NO / remainder oxygen; 2.) 70% by volume xenon / x ppm NO / remainder oxygen; 3.) 65% by volume xenon / 5% by volume nitrogen / x ppm NO / remainder oxygen; 4.) 65% by volume xenon / x ppm NO / remainder oxygen; 5.) 60% by volume xenon / 10% by volume nitrogen / x ppm NO / remainder oxygen; 6.) 60% by volume xenon / 5% by volume nitrogen / x ppm NO / remainder oxygen; 7.) 60% by volume xenon // x ppm NO / remainder oxygen; 8.) 55% by volume xenon / 20% by volume nitrogen / x ppm NO / remainder oxygen; 9.) 55% by volume xenon / 15% by volume nitrogen
• the gas mixtures are preferably produced in the vicinity of the patient, for example from xenon gas, NO-inert gas mixture and oxygen or from xenon-NO gas mixture (for example xenon with 10 to 1000 ppm NO; in particular as compressed gas in a compressed gas container) and oxygen.
• Xenon is administered especially in long-term ventilation and in prophylaxis in subanesthetic concentrations in a breathable gas (breathing gas).
• a breathable gas breathing gas
• the administration of breathable gases with a content of 5 to 45% by volume xenon, preferably 5 to 40% by volume xenon is advantageous.
• the breathable gas has, for example, a content of 20 to 30 vol .-% oxygen. B. 30 to 95 vol .-% oxygen can be increased.
• the remaining gas in the breathable gas generally consists of nitrogen or another inert gas and 0 to 100 ppm NO, preferably 0 to 40 ppm NO, particularly preferably 5 to 40 ppm NO, in particular 5 to 20 ppm NO.
• the NO can also advantageously be added to the breathable gas only temporarily.
• NO and NO-containing gases are preferably used as compressed gases in
• Pressure vessels provided, for example 200 to 800 ppm NO in nitrogen.
• the gas mixtures with xenon and NO are preferably freshly produced near the patient.
• the gaseous drug is usually administered with a ventilator with a gas metering unit or with an anesthesia machine.
• the medicament is advantageously produced for use directly from the pure gases, for example by mixing xenon, oxygen, if appropriate an inert gas and a gas containing NO (for example with the aid of an anesthesia machine or a gas metering device) in close proximity to the patient.
• One, several or all gas components of the gaseous medicament, in particular xenon, NO-containing gas and oxygen or a breathing gas are advantageously mixed with the aid of a gas metering device.
• the concentrations of the gas components are advantageously varied during ventilation.
• the device and the various methods of gas metering, in particular the continuous and discontinuous gas metering with constant or variable gas component concentration are described in DE 19746 742 A1 and WO 98/31282, to which reference is hereby made.
• the metering of one or more gases, in particular NO, advantageously takes place only during the phases of inhalation (inspiration). There is no gas metering during exhalation.
• Gas dosing synchronized to the breathing cycles is achieved by triggering with the help of a sensor.
• the start of inspiration or the start and end of inspiration is recognized by a control unit on the basis of sensor measured values.
• the gas is metered continuously (e.g. with a fixed amount or concentration of the metered gas per inspiration over the entire operating time) or discontinuously (e.g. with dosing breaks), preferably program-controlled (e.g. time program), sensor-controlled or with a combined program control and sensor control.
• the metering of a gas is advantageously carried out by combining a basic metering and an additive metering of one or more gases.
• the basic dosage is, for example, a dosage of xenon and NO-containing gas, a dosage of xenon or a dosage of NO-containing gas.
• an additive dosage e.g. Xenon and NO-containing gas, xenon or NO-containing gas are metered into a breathing gas.
• the use of one or more sensors on the patient enables automatic, patient-related metering of one or more gases.

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