It has anti-inflammatory, antiallergic, immunosuppressive, antishock effect, increases the sensitivity of injectable deca durabolin for sale the beta-adrenergic receptors to endogenous catecholamines.Interacts with specific cytoplasmic receptors (receptors for glucocorticoids (GCS) in all tissues, especially a lot of them in the liver) to form a complex that induces the formation of proteins ( . including enzymes that regulate cells vital processes) Anti-inflammatory effect is due to inhibition of the release of eosinophils and mast cell mediators of inflammation; lipokortinov inducing formation and reduce the number of mast cells that produce hyaluronic acid; with decreasing capillary permeability, stabilization of cell membranes (particularly lysosomal) membranes and organelles. Acts on all phases of the inflammatory process: inhibits prostaglandin synthesis for arachidonic acid level (Lipokortin inhibits phospholipase A2 suppresses liberatiou arachidonic acid inhibits the biosynthesis endoperekisey, leukotrienes promoting inflammation, allergies, etc.), Synthesis of “proinflammatory cytokine” (interleukin 1, tumor necrosis factor alpha, and others).; increases the resistance of the cell membrane to the action of various damaging factors. Protein sharing reduces the amount of globulin in plasma, increases the synthesis of albumin in the liver and kidneys (with increase of albumin / globulin ratio) decreased synthesis and increases protein catabolism in muscle tissue. Lipid metabolism: increased synthesis higher fatty acids and triglycerides, redistributes fat (mobilization of the subcutaneous tissue of limbs and fat accumulation mainly in the shoulder girdle, face, abdomen), leads to the development of hypercholesterolemia. carbohydrate metabolism: increases the absorption of carbohydrates from the gastrointestinal tract; It increases the activity of glucose-6-phosphatase (increase of glucose from the liver into the blood);fosfoenolpiruvatkarboksilazy increases the activity and synthesis of aminotransferases (activation of gluconeogenesis); contributes to the development of hyperglycemia. Water-eletrolitny sharing delays Na + and water in the body, stimulate the excretion of K + (mineralocorticoid activity) reduces the absorption of Ca2+ from the gastrointestinal tract, causing “washout” of calcium from bones and increase its renal excretion reduces bone mineralization. Immunosuppressive effect is due to induced involution of lymphoid tissue, inhibition of lymphocyte proliferation (especially T-lymphocytes), suppression of B-cell migration and interaction of T and B lymphocytes, the inhibition of release of cytokines (interleukin-1, 2, gamma-interferon ) of the lymphocytes and macrophages, and a reduction of antibody formation. Antiallergic effect is due to a decrease of synthesis and secretion of mediators of allergy, inhibition of release from sensitized mast cells and basophils, histamine, and others. bioactive substances, reducing the number of circulating basophils, suppression of lymphoid and connective tissue, reducing the number of T and B lymphocytes, mast cells, reducing the sensitivity of the effector cells to the mediators of allergy, inhibition of antibody production, changes in the immune response. In obstructive airway diseases action due mainly inflammation inhibition, prevention or reduction of severity of mucosal edema , reduction of eosinophil infiltration submucosal bronchial epithelium layer and deposition in the bronchial mucosa of circulating immune complexes, as well as braking and erozirovaniya desquamation mucosa. It increases the sensitivity of the beta-adrenergic receptors of the bronchi of small and medium caliber to endogenous catecholamines and exogenous sympathomimetic, reduces the viscosity of mucus by reducing its production. It suppresses the synthesis and secretion of ACTH and secondary -. The synthesis of endogenous corticosteroids Stops connective tissue reaction in the course of the inflammatory process and reduces the possibility of the formation of scar . fabric Pharmacokinetics . The on / in the introduction of the maximum concentration is reached after 0.5 hours, the half-life of the drug from plasma is about 3 hours. When i / m administration the maximum concentration is reached after 0.5 – 1 hour: after the I / O in 30 mg / kg for 20 minutes or at / in the drip administered at 1 g for 30-60 minutes, the maximal concentration up to 20 micrograms / ml, while the / m – 34 ug / ml. The absorption when administered into the muscle . hips faster than when administered in the gluteal muscles up to 90% of the drug binds to plasma proteins: transcortin (kortizolsvyazyvayuschim globulin) and albumin. Prednisolone is metabolized in the liver and kidneys and partly in other tissues, mainly by conjugation with glucuronic acid and sulfuric acid. The metabolites are inactive. It is deduced with bile and in the urine by glomerular filtration and 80-90% is reabsorbed tubules. 20% of the dose excreted by the kidneys in an unmodified form.
Medopred used for emergency treatment for conditions requiring a rapid increase in the concentration of glucocorticoids in the body:
- Shock (Burn, traumatic, operational, toxic) – the ineffectiveness vasoconstrictor, plasma-drugs and other symptomatic therapy;
- Allergic reactions (acute severe), transfusion shock, anaphylactic shock, anaphylactoid reactions;
- Cerebral edema (including on the background of a brain tumor or associated with surgery, radiation therapy, or head injury);
- Bronchial asthma (severe), asthmatic status;
- Systemic connective tissue diseases (systemic lupus erythematosus, rheumatoid arthritis);
- Acute adrenal insufficiency;
- Thyrotoxic crisis;
- Acute hepatitis, hepatic coma;
- Decrease inflammation and prevent scarring restrictions (for poisoning cauterizing liquids).
For short-term use for health reasons only contraindication is hypersensitivity to Medopredu or components of the drug.
The children in the period of growth GCS should be used only if absolutely indicated and under particularly close supervision of your doctor. Precautions drug should be used for the following diseases and conditions: Diseases gastrointestinal tract – stomach and duodenal ulcer disease, esophagitis, gastritis, acute or latent peptic ulcer, recently established intestinal anastomosis, ulcerative colitis, with the threat of perforation or abscess, diverticulitis. Parasitic and infectious diseases of viral, fungal or bacterial origin ( currently or recently transferred, including the recent contact with a patient) – herpes simplex, herpes zoster (viremicheskaya phase), chicken pox, measles; amoebiasis, strongyloidiasis; systemic mycosis; active and latent tuberculosis. Application for serious infectious diseases is admissible only against the background of specific therapy. Pre- and post-vaccination period (the period of duration of 8 weeks before and 2 weeks – after vaccination), lymphadenitis after BCG vaccination.Immunodeficiency states (including AIDS or HIV -infektsiya). Diseases of the cardiovascular system, including recent myocardial infarction (in patients with acute and subacute myocardial infarction may spread necrosis, slowing the formation of scar tissue and, as a consequence – the gap of the heart muscle), severe chronic heart failure, hypertension, hyperlipidemia. Endocrine diseases – diabetes (in including breach of tolerance to carbohydrates), hyperthyroidism, hypothyroidism, Cushing’s disease, obesity (III-IV Art). Severe chronic renal and / or hepatic insufficiency, nefrourolitiaz. Hypoalbuminemia and conditions predisposing to its occurrence (liver cirrhosis, nephrotic syndrome). Systemic osteoporosis, myasthenia gravis, acute psychosis, polio (excluding the bulbar form of encephalitis), open-and-closure glaucoma, pregnancy.
Use during pregnancy and breast-feeding
During pregnancy (especially in 1 trimester) apply only for health reasons.
Since steroids penetrate into breast milk, if necessary, use during breast-feeding, breast-feeding is recommended to stop.
Dosing and Administration
Medopred administered intravenously (bolus or infusion) or intramuscularly. Intravenous drug is usually administered first bolus, then infusion.
The dose and duration of treatment is determined by the doctor individually, depending on the indication and the severity of the disease.
In acute adrenal insufficiency single dose is 100 -200 mg, 300-400 mg daily.
In severe allergic reactions Medopred administered in a daily dose of 100-200 mg for 3-16 days.
in asthma drug is administered depending on the severity of disease and the effectiveness of the complex treatment of 75 to 675 mg per treatment of from 3 to 16 days; in severe cases the dose may be increased to 1400 mg per treatment and a gradual reduction in dose.
In asthmatic status Medopred administered at a dose of 500-1200 mg per day, followed by a decrease to 300 mg per day, and the transition to maintenance doses.
When tireotoksicheskom Stroke administered at 100 mg per daily dose of 200-300 mg; if necessary, the daily dose may be increased up to 1000 mg. The duration of administration depends on the therapeutic effect, typically up to 6 days.
In shock, resistant to standard therapy Medopred early therapy is typically administered bolus and then transferred to a drip. If within 10-20 minutes did not increase blood pressure, repeated bolus formulation. After removal from the state of shock continue to drip to stabilize blood pressure. A single dose of 50-150 mg (in severe cases – up to 400 mg). Re-drug is administered 3-4 hours. The daily dose can be 300-1200 mg (followed by a dose reduction).
In acute renal failure (acute poisoning, postoperative and postpartum periods, etc.), Medopred administered at 25-75 mg per day; when indicated daily dose may be increased to 300-1500 mg per day and higher.
In rheumatoid arthritis and systemic lupus erythematosus are administered in addition to Medopred system reception preparation in a dose of 75 -125 mg per day, no more than 7-10 days.
In acute hepatitis Medopred administered at 75-100 mg per day for 7-10 days.
When poisoning cauterizing liquids with burns of the digestive tract and upper respiratory tract Medopred administered at a dose of 75-400 mg per day for 3-18 days.
If not, intravenous administration, Medopred administered intramuscularly at the same dose. After the relief of acute state appointed interior prednisolone tablets, followed by a gradual reduction in dose.
Chronic administration of the drug daily dose should be reduced gradually. Duration of therapy should not be stopped abruptly!
The frequency and severity of side effects depend on the duration of application, size of the dosage used and the possibility of compliance circadian rhythm destination Medopreda.
When using Medopreda may occur: On the part of the endocrine system: reduction of glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, depression adrenal glands, Cushing’s syndrome (moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae) delayed sexual development in children. from the digestive system:nausea, vomiting, pancreatitis, steroid ulcers gastric and duodenal ulcers, erosive esophagitis, gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract, increased or decreased appetite, indigestion, flatulence, hiccups. In rare cases – increased activity of “liver” transaminases and alkaline phosphatase. Cardio-vascular system: arrhythmia, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of heart failure, electrocardiographic changes typical of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction – the spread necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, headache, convulsions. from the sensory organs: posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve, the propensity to develop secondary bacterial, fungal or viral eye infections trophic changes of the cornea, exophthalmos, sudden loss of vision injectable deca durabolin for sale (for parenteral administration in the area of the head, neck, nasal turbinate, the scalp may be the deposition of crystals of the drug in the blood vessels of the eye). On the part of metabolism: increased excretion of calcium, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating. Conditional mineralocorticoid activity – fluid retention and sodium (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue). from the musculoskeletal system: slowing growth and ossification processes in children (premature closure of epiphyseal growth zones), osteoporosis (very rare -patologicheskie fractures, aseptic necrosis of the humeral head and femur) rupture of tendons of muscles, steroid myopathy, reduced muscle mass (atrophy). for the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, striae, susceptibility to the development of pyoderma and candidiasis. allergic reactions: skin rash, pruritus, anaphylactic shock, local allergic reactions.local on parenteral administration: a burning sensation, numbness, pain, tingling at the site of injection, infection at the injection site, rarely – necrosis of surrounding tissue, scarring at the injection site;atrophy of the skin and subcutaneous tissue with the / m introduction (especially dangerous administration in the deltoid muscle). Other: development or exacerbation of infection (the appearance of this side effect contribute jointly used immunosuppressants and vaccination), leucocyturia, “cancellation” syndrome.
may be increased side effects described above. It is necessary to reduce the dose Medopreda. Treatment – symptomatic.
Interaction with other drugs
is possible Medopreda pharmaceutical incompatibility with other intravenously administered drugs – it is recommended to be administered separately from other drugs (in / bolus or through an IV, etc., as the second solution.). When mixed solution Medopreda heparin precipitate formed.
Medopred during prolonged therapy may increase the folic acid content. The simultaneous appointment Medopreda with: inducers of “liver” microsomal enzymes (phenobarbital, rifampin, phenytoin, theophylline, ephedrine) leads to a decrease in its concentration; diuretics (especially “thiazide” and a carbonic anhydrase inhibitor) and amphotericin B – may lead to increased excretion of K + , and increased risk of heart failure, with a sodium-containing drugs – to the development of edema and high blood pressure, cardiac glycosides – worsening their tolerance and increases the likelihood of ventricular arrhythmia (due to induced hypokalemia), indirect anticoagulants – weakens (rarely strengthens) their action (required dose adjustment); anticoagulants and thrombolytics – increases the risk of bleeding from ulcers in the gastrointestinal tract, ethanol or non-steroidal anti-inflammatory drugs (NSAIDs) – enhanced risk of erosive and ulcerative lesions of the gastrointestinal tract and of bleeding (in combination with NSAIDs in the treatment of arthritis may reduce glucocorticosteroids dose due to the summation of therapeutic effect); paracetamol – increases the risk of hepatotoxicity (induction of hepatic enzymes and the formation of toxic metabolites of paracetamol ), acetylsalicylic acid – accelerates its excretion and reduces the concentration in the blood (with the abolition Medopreda salicylate level in the blood increases, and increases the risk of side effects), insulin and oral hypoglycemic agents, antihypertensive agents – their effectiveness is reduced; vitamin the D – reduces its impact on the absorption of Ca 2+in the intestine; STH – reduces the effectiveness of the latter, and with praziquantel – its concentration in the blood; m-holinoblokatorami (including antihistamines and tricyclic antidepressants) and nitrate – contributes to the intraocular pressure; tricyclic antidepressants – can increase the severity of depression caused by the intake of corticosteroids (not shown for therapy data side effects). isoniazid and mexiletine – increases their metabolism (especially for “slow” acetylators), which leads to a decrease in their plasma concentrations. Carbonic anhydrase inhibitors and “loop” diuretics may increase the risk of developing osteoporosis. Indomethacin, displacing prednisolone from an albumin, increases the risk of its side effects. ACTH increases the effects Medopreda. Ergokaltsiferol and parathyroid hormone hinder the development of osteopathy caused Medopredom. cyclosporin and ketoconazole, slowing metabolism Medopreda may increase its toxicity in some cases. Co-administration of androgen and steroidanabolic drugs with Medopredom helps development of peripheral edema and hirsutism, acne. Estrogens and oral estrogensoderzhaschie contraceptives reduce Medopreda clearance, which may be accompanied by increased expression of his actions. while the use of live virus vaccines , and in comparison with other types of immunization increases the risk of activation of viruses and the development of infections. Antipsychotic drugs ( neuroleptics) and azathioprine increases the risk of developing cataracts in the appointment Medopreda. Co-administration of antacids reduces absorption Medopreda. while the use of antithyroid drugs is reduced, and since thyroid hormones – increases Medopreda clearance. hypokalemia caused by corticosteroids may increase the severity and duration of muscle blockade on the background muscle relaxants . Mitotane and other inhibitors of adrenocortical function may necessitate increasing the dose of prednisone. Immunosuppressive drugs increase the risk of infections and lymphoma or other. lymphoproliferative disorders associated with Epstein-Barr virus.
During treatment Medopredom (especially long) must be monitored ophthalmologist, blood pressure control, the state of water and electrolyte balance, as well as patterns of peripheral blood and the blood glucose level.
In order to reduce the side effects can be administered antacids and increase the flow of the K + in organism (diet, potassium supplements). Food should be rich in proteins, vitamins, with the restriction of fat, carbohydrates and salt.
The drug is enhanced in patients with hypothyroidism and liver cirrhosis.
The drug may exacerbate existing emotional instability or psychotic disorders. When referring to the history of psychoses in Medopred in high doses administered under strict medical supervision. The caution should be used in acute and subacute myocardial infarction -perhaps spread necrosis, slowing the formation of scar tissue and rupture of the heart muscle. In stressful situations during maintenance treatment (eg , surgery, trauma, or infectious diseases) should be carried out correction dose due to the increased need for glucocorticosteroids. with the sudden cancellation, particularly in the case of the prior use of high doses may develop the syndrome of “cancellation” (anorexia, nausea, lethargy, generalized myshechno- skeletal pain, general weakness), as well as exacerbation of the disease, about which he was appointed Medopred. during treatment Medopredom should not be vaccinated due to the reduction of its effectiveness (immune response). by assigning Medopred during intercurrent infections, septic conditions, and tuberculosis, it is necessary at the same time to treat antibiotic bactericidal action. The children during long-term treatment Medopredom careful observation of the dynamics of growth and development. Children who during the treatment period were in contact with patients with measles or chickenpox, prophylaxis prescribe specific immunoglobulins. Due to the weak mineralocorticoid effect for replacement therapy in adrenal insufficiency Medopred used in combination with a mineralocorticoid. Patients content of blood glucose should be controlled diabetes and, if necessary, to correct therapy.Showed radiological control of bone and joint system (spine images, brushes). Medopred injectable deca durabolin for sale in patients with latent infectious diseases of kidneys and urinary tract infections can cause pyuria, which may be of diagnostic value. Medopred increases the content of metabolites of 11-and 17-oksiketokortikosteroidov. buy anabolic steroids online bruce lee’s workout anabolic steroids online uk