Cebrotonin Mechanism of Action

Pharmacotherapeutic Group: Piracetam is a substance belonging to the group of nootropics. ATC code: N06BX03.
Pharmacology: MODE OF ACTION: Piracetam is a substance out of the group of the nootropic agents. As a result of trials in man, an increase in blood circulation, oxygen turnover rate and oxygen extraction rate of ischaemic areas of the brain as well as an increased glucose turnover rate of primary ischaemically damaged areas of the brain were found. EEG-checks showed an intensification of the alpha-components with a simultaneous reduction of the theta- and the delta-components. Piracetam has influence on the disturbed function of learning and memorising. Furthermore, Piracetam shows haemostasiologic and haemorheologic effects caused by improvement of the red cell deformability, decrease in red cell aggregation, lowering of plasma viscosity, improved blood flow and inhibition of platelet aggregation.
Pharmacodynamics: Experimental studies with humans revealed an increase of perfusion as well as an increase of the oxygen turnover rate such as oxygen extraction rate in ischemic cerebral areas. In primarily damaged ischemic cerebral areas, an increase of the glucose turnover rate could be found. Examinations carried out through an EEG revealed a reinforcement of the alpha components and showed simultaneously a decrease of the theta and delta components.
Piracetam affects the disturbed learning and memory function of the patient.
Furthermore, Piracetam has haemorheologic effects by improving the erythrocyte deformability, decrease of erythrocyte aggregation, reduction of plasma viscosity, decrease of flow stress as well as inhibition of thrombocyte aggregation.
Pharmacokinetics: Piracetam is rapidly and extensively absorbed following oral administration. In fasted subjects, the peak plasma concentrations are achieved 1 hour after dosing. The absolute bioavailability of piracetam oral formulations is close to 100 %.
Piracetam is not bound to plasma proteins and its volume of distribution is approximately 0.6 l/kg. Piracetam crosses the blood brain barrier as it has been measured in cerebrospinal fluid following intravenous administration. In cerebrospinal fluid, the tmax was achieved about 5 hours post-dose and the half-life was about 8.5 hours.
Piracetam is not known to be metabolised in the human body. The plasma half-life of piracetam in adults is about 5 hours following either intravenous or oral administration. The apparent total body clearance is 80-90 ml/min. The major route of excretion is via urine, accounting for 80 to 100% of the dose. Piracetam clearance is correlated to creatinine clearance. It is therefore recommended to adjust the daily dose of piracetam based on creatinine clearance in patients with renal impairment.
There are no adequate data from the use of piracetam in pregnant women. Piracetam crosses the placental barrier. Drug levels in the newborn are approximately 70% to 90% of maternal levels. Piracetam is excreted in human breast milk.