Impotence: How to Prevent It?

For people who are at risk of impotence, the adoption of active measures to prevent its occurrence will not only help preserve erectile function, but also to maintain a healthy lifestyle in general. Some steps you can take to prevent impotence include:

•  Quitting smoking
•  Regular exercise
• Maintaining a healthy weight
•  Revise your medications with your doctor and determine replacements for drugs that can cause impotence (never stop taking prescribed medications without consulting first with your doctor) 
• Acceptance of prescription drugs according to the doctor's instructions 
• Avoiding excessive alcohol consumption (no more than two drinks per day) 
• Rejection of illicit drugs 
• In cases where the presence of chronic diseases such as diabetes or kidney disease, follow your doctor's instructions to keep these diseases under control.

What is impotence (erectile dysfunction)?

Impotence is the inability to cause and maintain a penile erection sufficient for normal sexual relations with a partner. Such a condition is not normal at any age and is treated separately from other problems in the genital area, such as a lack of sexual desire and problems with ejaculation and orgasm.

How common is impotence?

According to the National Institutes of Health, approximately 5% of forty years, and from 15 to 25% of sixty-five men regularly suffer from impotence.

A much more common problem faced by most men at some stage in their lives, are isolated cases of inability to achieve an erection. This may happen for many reasons, for example, excessive alcohol or severe fatigue.

The inability to achieve an erection in their hundred twenty cases is not something supernatural and requires treatment only in rare cases. At the same time, the inability to achieve an erection in their hundred and fifty cases, usually an indicator of a problem that requires appropriate treatment.

What causes impotence?

Achieving an erection must be preceded by three things: the nerves leading to the penis should function normally, the blood supply to the penis should be the norm, from the brain must do the appropriate signal. Violation of any of these conditions makes it impossible to achieve a full erection.

Some of the common causes of impotence include: diseases that affect blood flow, such as atherosclerosis (hardening of the arteries), nervous diseases, psychological factors such as stress, depression, and fear of possible failure, contusion penis. Chronic illness, certain medications, and Peyronie's disease (scar tissue in the penis) can also cause impotence. 

Is it possible to prevent the occurrence of impotence?

People at risk of causing impotence as a result of their own behavior, for example, due to excessive alcohol consumption, can be taken to prevent its occurrence. However dysfunction caused by other reasons, can not be prevented.

Which specialists treat impotence?

Specialty doctor who treats impotence, will depend on the cause of the problem. Based on the medical history of your family, and your medical history and your current health status of the attending physician may prescribe you medication pills, such as Viagra or similar medications. If that does not work, he may refer you to a urologist for an examination or a psychologist.

What do I do if I have a problem with calling / maintaining an erection?

If you think you have erectile dysfunction, see your doctor. He will be able to carry out the necessary tests to identify the causes of the disorder or redirect you to a specialist. After you determine the cause, you can resort to various methods of treatment.

How does impotence treat oneself? 

There are many different methods of treatment of impotence, including treatment pills, seksoterapiyu, injections in a penis, suppozitorii, vacuum pumps and surgical interference. Every method of treatment has the advantages and failings. you will appeal to the doctor, to choose on your own the optimum method of treatment. 

What kind of insurance covers treatment of impotence?

Insurance coverage of treatment of impotence depends on the type of the prescribed treatment. If there is the documentarily confirmed medical testimony, defiant impotence, insurance covers usually, at least, part of facilities on treatments. At the same time seksoterapiya and charges on medicinal treatment, not getting approval of Management on control after products and medications, not covered usually. you will appeal to the insurance agent, to know, whether there will be your treatment it is covered insurance.

 

  

Treatment of hepatitis A

In most cases, the virus goes away on its own, but in the course of treatment using medicines. Home treatment can relieve symptoms and prevent the spread of hepatitis A.

• Reduce Activity

Limit your activity to a level that will meet your reserve of energy. Do not lie in bed, as this can slow down the healing process. Do not work or study, as long as the load does not meet your forces. Until full recovery, avoid heavy loads. If you feel better, return to usual activities gradually. If you go back to the old rhythm of life too early, it may aggravate the disease.

• Eat right

Even if you have no appetite, it's important to eat right. Replace the three-volume eating small but frequent. In most cases, nausea and loss of appetite do not bother to evening. Try to eat more in the morning and late at night less.For people who suffer from hepatitis, doctors used to recommend high-calorie, high-protein diet. But to date, it is not considered useful, such food can be hard if you experience nausea. Try to balance the diet and avoid foods that you like.

• Avoid dehydration

At the time of disease for hepatitis A is very important to conserve water balance, especially with vomiting. Drink lots of water. A good option as are fruit juices and broths, as they added calories, of course, if the body can endure them. Many sports drinks are available in the store, can refill the necessary electrolytes that are lost by vomiting.

• Avoid alcohol and drugs

Hepatitis А virus reduces the possibility of the liver breaks down some medications and alcohol. If you take drugs (legal and illegal) or alcohol at the time of hepatitis, their side effects may be more intense and occur over a longer period. In addition, alcohol and some medications can aggravate liver damage.The physician should be aware that all medicines you are taking, are made from natural raw materials. Do not use any medicine without doctor's consent. Discuss with your doctor when you can drink alcohol in moderation.

• Try to control itching

In some cases people suffering from hepatitis, itchy skin. To control it, you can apply the medication sold without a prescription, such as Benadryl or Chlor-trimenol. Use this product according to instructions and discontinue their use in the event of side effects. Before using any medication, consult your doctor.Symptoms of hepatitis A begin to take place in two weeks, but the man is a messenger of infection to full recovery, as the entire period of the disease is a virus in the stool.

• Prevent infection with hepatitis A virus after contact with him

If you have had contact with someone who is ill with hepatitis A, go get a vaccination or injection of immune globulin within two weeks after exposure to the virus.

Fatty liver disease contributes to the development of diabetes.

The accumulation of fat in liver cells may increase the risk of developing type 2 diabetes, regardless of the amount of fat in the body and other parts of the insulin concentration.Fatty liver occurs in about one-third of the adult population. In some cases, this disease leads to irreversible liver damage or liver failure. Fatty liver disease (ZHBP) is often associated with alcoholic liver disease, but it can also occur for other reasons.

Investigators argue that fatty liver is often appears simultaneously with other risk factors of diabetes, such as obesity and insulin resistance, so physicians difficult to determine whether ZHBP itself a risk marker for diabetes.Scientists conducted the study in Korea with the participation of 11,091 adults. The levels of insulin and liver function were measured at baseline in 2003 and then again five years later.At baseline, 27% of the participants suffered from fatty infiltration of the liver, as shown by ultrasound. Nearly two-thirds of them also were overweight or obese. As a result, the researchers found that 4% of people with ZHBP developed type 2 diabetes compared with 1% in those who did not suffer ZHBP.After adjusting for insulin resistance in the beginning of the study, the risk of developing type 2 diabetes still remained high. Furthermore, regardless of insulin resistance in early studies ZHBP people had more risk factors for diabetes such as high blood glucose and disruption of normal cholesterol levels.

What is hepatitis A?

Hepatitis A - is a viral infection of the liver. In most cases it extends itself and causing chronic diseases.Other forms of the virus (hepatitis B and C) also induce hepatitis. 

Hepatitis A - the most common form of the disease.

How is it spread hepatitis A?

This disease is caused by hepatitis A virus, which is located in the stool of infected humans. It is transmitted by the use of food or drinks that are in contact with the infected stool.

Sometimes a group of people can become infected with hepatitis A during a dinner at the restaurant. This can happen if the restaurant worker who is sick with the disease, did not wash hands thoroughly after using the toilet and started cooking.

This disease can also be spread in day care centers for children, if workers do not wash their hands thoroughly after changing diapers.

Sometimes it is possible to increase the risk of contracting hepatitis A. This can happen if you eat raw oysters and clams are not well progotovlennye. If you are traveling to a country where hepatitis A is a common disease, it can reduce the chances of contracting the disease if you do not use neprogotovlennuyu food and unboiled tap water.

Symptoms of hepatitis A 

Diagnosis of hepatitis A

The doctor asks about symptoms, the food that you ate, and the countries you've visited. If the doctor suspects that you have a virus, it can offer a blood test. It will show if there is inflammation of the liver and hepatitis A virus antibodies These antibodies indicate that you have been exposed to the virus.

Avoid actions that can transmit the virus to others. Tell the people with whom you live, or with whom you have had sexual contact that you have hepatitis A. Wash your hands with soap and water every time you visit the toilet or after changing diapers, and before preparing food.

Hepatitis A goes away on its own. You can speed up the healing process by eating lots of water and healthy food.

Unlike other forms of hepatitis, this form of the disease does not cause chronic liver disease and its serious damage. Most people recover within a few months.

If you have hepatitis A, reduce their activities as long as you do not go back to the force. When you feel better, you can get back to normal life. Do not try to return to usual activities until recovery, as the disease may be exacerbated.

Hepatitis A - a disease you can get sick once. After that, the body produces immunity to it.

Prevention of hepatitis A

You can protect yourself against hepatitis A by getting the vaccine. Vaccination is carried out in two stages. If you get two injections prior to infection, they will be 100% effective. Also available is a combination vaccine against hepatitis A and B.U.S. Centers for Disease Control and Prevention recommends vaccination against hepatitis A in children aged one year.If you know that you are in contact with someone who is ill with hepatitis A vaccine or immune globulin injection may prevent infection by the disease. Obtain injected during the first two weeks after exposure to the virus.

Symptoms of hepatitis A

Symptoms of hepatitis A usually appear within 15-50 days after the first exposure to the virus of hepatitis A. They appear within four weeks. In most cases, symptoms are mild and can be invisible in children under six years of age. In older children and adults, early symptoms can be similar to symptoms of viral intestinal infection. Possible symptoms include:

• Weakness
• HeatMyalgia
• Headache
• Pain in the right side under the edge (where the liver is)
• Nausea
• Loss of appetite and weight loss
• Yellow tinge to the skin and whites of the eyes (jaundice), which is also accompanied by dark urine and yellow-tinged stools. Jaundice is less common in children and adolescents.

About 15% of people who were sick with hepatitis, experienced symptoms of hepatitis B infection during or after six or nine months after the first signs of infection. The infection is usually first appears sharper, but then can manifest arthritis. After an illness, people in most cases returned to normal. In rare cases, it may develop cholestatic hepatitis, which causes itching and can last for the entire period of the disease.
Basically, before symptoms of the virus in the stool decreases. The patient is still spreading the virus, but less so after the onset of symptoms.Symptoms of hepatitis A occur within two months.

Those facing prostatitis?

Prostatitis - is the most prevalent of urologic diseases. At risk are confirmed bachelor, office workers, and men older than 35 years.The only way to protect yourself from unpleasant complications of prostatitis - an annual checkups at the urologist in order to timely detect and treat the disease, and receiving bio-regulators of prostate cancer - natural products that protect against prostate inflammation.

Bachelors in danger.

Great risk of developing prostatitis in men who do not keep a regular sex life. In the prostate are tiny tubules that produce a special secret, which is part of semen. Content is released into the prostate ducts genito-urinary tract during ejaculation. Therefore, the absence of regular ejaculations and erectile dysfunction, ejaculation does not end can lead to stagnation of secretion and the development of inflammation of the prostate gland.

Lot - does not mean good.

However, excessive "faithfulness", especially the frequent change of sexual partner in the health plan also does not bode well - one of the major risk factors for chronic prostatitis - is transferred (and especially untreated) urethritis - a disease transmitted through sexual contact. Among the best known gonorrhea urethritis. However, this disease is so pronounced symptoms that rarely goes unnoticed. However, in recent years, so-called spread nonspecific urethritis, urinary tract inflammation, which are caused by viruses or other microorganisms. Most manifestations of urethritis are less pronounced than for gonorrhea. Therefore, there is a risk that the man did not notice the slight burning sensation when urinating and "pulling" pain in the abdomen, which ultimately will result in chronic urethritis.In addition, non-specific urethritis in women can occur with little or no symptoms and the infection can "pick up" even through unprotected sex with a regular partner.

Office problems.

The probability of getting sick and prostatitis in men, spending much of his time in a sitting position. Today at risk, alas, gets most of the professions, from programmers and office workers to professional drivers. When we sit, blood circulation in the pelvic organs somewhat worse. Over time, this leads to difficulty of venous outflow of blood, swelling and inflammation of the prostate.

Therefore, all men, leading a sedentary lifestyle is useful to do special exercises that improve blood flow to the pelvic organs - should involve the anus muscles, keep them busy for a few seconds, then relax. This exercise should be done every hour for a few dozen times (it would seem that it is almost impossible, but very soon the habit, and the exercises are performed almost automatically.) In addition to the above exercise should not try not to forget about once an hour warm-up for a few minutes.

At risk for prostatitis and men suffering from varicose veins (this is predominantly "female" disease, but occurs in men). Varicose and blood circulation in the pelvic organs.

Coffee and Cigarettes

One of the major risk factors for prostatitis - smoking and alcohol abuse, strong coffee and greasy, spicy and fried food. Their decomposition products irritate the genito-urinary tract, increasing the risk of prostatitis.

Keep your feet warm.

Under the threat of men, often gets cold and with chronic inflammation. A constant source of inflammation in the body increases the risk of inflammation of the prostate gland. Furthermore, in the "at risk" are all men aged over 35 years.Bullish prostate and lion heart .

However, the risk of prostatitis can be significantly reduced if from time to time to start taking preventive purposes Bioregulators prostate cancer. This class of pharmaceutical drugs of natural origin (of the active pharmaceutical ingredient - extract from prostate bull), designed for long term use.

Their action is based on the fact that the delivery of biologically active substances from a healthy animal prostate recovers improves metabolism in the human prostate, preventing the development of disease.

We Bioregulators prostate no side effects and contraindications, so they can be used without a doctor's prescription. Such preparations are available in the form of injections and suppositories, it is clear that the prophylactic use should be chosen precisely candles.

For example, candles Prostatilen Zinc addition to extracts from prostate bull contains a complex of zinc and vitamin E. Zinc is vital for the normal functioning of the prostate, helps to maintain the integrity of sperm, increases sex drive. Zinc deficiency leads to impotence, the regression of male sex glands and testes. And vitamin E is essential for the normal absorption of zinc, without a trace element present simply not be acquired in addition has an antioxidant effect, supports the biological activity of sperm. Some types of male infertility is associated with lack of zinc in the diet or problems with his assimilation.

Therefore Prostatilen Zinc has a complex effect on the prostate, effectively preventing the development of inflammation and cancer growth, and at the same time preventing the development, prostatitis often associated sexual dysfunction, as well as used for the prevention and treatment of male infertility.

Prostatitis and impotence

Prostatitis - disease spread almost like a common cold. According to statistics, about 50% of men at least once in life ill with inflammation of the prostate gland. In addition, the disease is quite "unpleasant," one of the most frequent complications of prostatitis - premature ejaculation and potency disorders.

What is prostatitis?

Prostatitis, or simply put, an inflammation of the prostate - is the most common disease of the urogenital system in men. The causes of prostatitis are many: it is an infection caused by bacteria transferred venereal diseases, hypothermia, sedentary lifestyle ... Most prostate arises from a combination of several factors. However, with whatever was associated prostatitis, inflammation of the prostate gland is manifested in the feeling of heaviness and dull abdominal pain and problems with urination, especially in the morning. If, immediately after the appearance of these symptoms, seek medical advice and do not start treatment, prostate can become chronic. After some time, the symptoms subside "by themselves", but fuzzy prostatitis will periodically be felt exacerbations. Furthermore, at this stage of the disease may develop one of the most unpleasant complications of the disease - erectile dysfunction.Prostatitis - the first step to impotence. The most common erectile dysfunction occurs in chronic prostatitis caused by a bacterial infection, but such a complication can occur in any type of prostatitis, regardless of the cause of the disease. According to statistics, from problems with premature ejaculation and erectile dysfunction affects up to 30% of men with chronic prostatitis. At that erectile dysfunction in prostate grows gradually, over many years. First, there is a premature ejaculation, then it is added to the actual erection problems, and then emerges and decreased libido - that is sexual activity. There are a number of reasons that contribute to the development of sexual problems in the prostate. The first - the so-called violation of the neuro-humoral regulation. As an erection, and the activities of the prostate is regulated by a complex mix of hormones and nerve impulses in the brain that is involved, and the nerves leading to the muscles and blood vessels of the pelvic organs. Therefore, the violation of the regulation of neuro-inflammation of the prostate gland can "recoil" and erections.

Furthermore, chronic prostatitis in certain cases lead to abnormalities in muscle in the lower part of the pelvis, while participating in erection.

Do not forget about the purely psychological factors. Symptoms of prostatitis such as persistent pain in the lower abdomen and urinary problems can cause fear of failure on the love front, a sense of weakness and old age (which is especially true for men who are experiencing "midlife crisis"), and this, of course, also affects the potency is not the best way. 

Features of treatment

However, whatever was called erectile dysfunction, it is necessary to remember that, regardless of age and the reasons that led to problems with potency, this condition can be cured. The main thing - do not be ashamed to admit to himself in the problem and seek medical advice.

Most often the treatment of erectile dysfunction associated with chronic prostatitis is comprehensive: it is the treatment of the underlying disease, psychotherapy and the appointment of the so-called PDE-5 inhibitors, drugs that cause increased blood flow to the genitals. However, be aware that these drugs have a number of dangerous side effects, so they can be taken only on prescription in the recommended doses it! Very well established as the treatment for erectile dysfunction associated with chronic prostatitis, and so-called Bioregulators prostate cancer, such as candles Prostatilen Zinc. The main advantage of this tool is that the main active ingredient of the drug - Prostatilen (this extract from bovine prostate) combined in a complex with zinc and vitamin E itself has prostatilen Organotropnye effect on the prostate gland, improves microcirculation, has anti-inflammatory action. Zinc - is a trace mineral that is vital for maintaining potency and normal semen quality (not for nothing that a suspected male infertility is one of the first analyzes of the concentration of zinc in semen). Zinc prevents the development of good and malignant processes in the prostate gland, helps to preserve the integrity of the sperm increases the sex drive is a factor of the immune defense. Zinc deficiency leads to regression of the male sex glands and testicles, reduced sperm count and other abnormalities. Therefore, problems with potency that is often associated with lack of zinc in the diet.

A vitamin E is needed for normal digestion of zinc - zinc without it just does not learn. In addition, Vitamin E maintains biological activity of spermatozoa.

Thus Prostatilen Zinc treating erectile dysfunction in a complex: it eliminates the causes associated with prostatitis, and contributes to improving the overall potency.

By the way, the very creation of this drug is associated with the legend. Prostatilen Zinc was developed in the late 80s. in the Leningrad Military Medical Academy, a scientific institution, which in those days were collected the best physicians of the country. It was found that the combination of extracts from prostate bull with zinc and vitamin E acts much better than just one hood. At the time, the collapse of the country is not allowed to start production of military development, and only today Prostatilen Zinc production was set up at the Kharkov plant "Lekhim." However, since the development of the past years, the drug did not prevent Prostatilen-Zinc to become one of the most reliable and safe for the treatment of erectile dysfunction.

Healthy eating has become the female value

U.S. company to sell organic products surveyed 1,500 women and received unexpected results: 61% of Americans believe that a healthy body is more important than a healthy relationship.It turned out that now many are paying attention to a healthy lifestyle, nutrition, diet include superfoods. The diet took the first place in the list of values ​​in life.It is therefore not surprising that 70% of respondents would be willing to exchange good grades at the child on the correct diet. 60% considered: a healthy diet is more important than saving money. When it came to clothes, 83% to easily choose a healthy body, but not perfect wardrobe. And 54% said they would be better to eat right than have a chance at something in this life.Modern women understand how important it is to eat healthy foods. But it appears that for many it is, almost the most important thing in life.

I notice a decrease in erection - what do I do?

Constantly changing, and not in a positive way, growth statistics the problem of erectile dysfunction, can not remain indifferent doctors. Medical professionals have long been sounding the alarm bell in an attempt to attract men's attention to the fact that the potency problems are not a joke and the highly publicized "horror story." Men's carelessness and specific attitude towards their health complement the already bleak picture.

Doctors are sounding the alarm ...

Continuing studies and surveys conducted among the male population, clearly revealed the dimensions and the danger of erectile dysfunction. Regardless of the place of residence, region, and traditional way of life, erectile dysfunction begin to pursue a growing number of men. This kind of problem can not and should not remain in the shadows, and do not receive adequate coverage. That's why medical practitioners in the field of men's health and have created a web site "UaMen", entirely devoted to men's health. On the resource everyone can get complete and accurate information about intimate issues first hand.

Is the problem of erectile dysfunction so serious?

The problem of erectile dysfunction today touched a huge layer of the male population. Polls confirm the findings of physicians, and point to the fact that almost half of the men anyway faced with erectile dysfunction, such as the fall of its hardness or decrease in the time duration of an erection. As a result - there is a dissatisfaction with their sex lives. And, of course, we should not ignore the latest research on the causes of erectile dysfunction and its impact on the body of men in general. Quite often, the loss of male power is not an isolated problem, and one of the signs of a more serious condition, such as diabetes, cardiovascular failure, atherosclerosis.

Why at the present level of medicine erectile dysfunction is so common?

It would seem, what difficulties may arise in the prevention and treatment of erectile dysfunction at the present level of development of modern medicine? First, the main problem is always in the plane of the male psychology. The stubborn refusal to accept the fact of men have problems with erection causes the disease that goes into the stage of "neglect" and treat it is much more difficult.Secondly, a lot of bad habits, promotes erectile dysfunction. The most detrimental effect on the potency of tobacco smoking, alcohol, drugs and food high in cholesterol.Third, the failure to comply with the requirements of medical men, especially after surgeries, or neglect to receive the recommendations of pharmacological agents.Fourth, and this is quite tangible and important problem - lack of awareness of the male population. As a consequence, a complete disregard for preventing disease, which complicates the lives of not only the patient, but also the work of a doctor who takes the already "running" event.

What to do?

I want to enjoy the joy of a long intimate relationshipIn more detail, not only on the basic factors of erectile dysfunction, but also with other components of the problem can be found on a dedicated resource "UaMen." Anonymous a consultation and to be informed, and therefore protected. On the Internet site "UaMen" answers given by practitioners, urologists, sexologists, people, every day faced with the problem of erectile dysfunction while taking patients. The most reliable and complete information on the resource, designed to help a man get timely answers and know exactly what should be taken at the first signs of erectile dysfunction.

Bi-Xikam

Release form, composition and packing Bi-Xikam 
 
Pill light yellow, Valium. 1 tab. meloxicam 7.5 mg. Excipients: sodium citrate dihydrate, anhydrous lactose, microcrystalline cellulose, povidone (Kollidon, polyvinylpyrrolidone 25 000), colloidal silicon dioxide (Aerosil), crospovidone (poliplasdon VIC EL-10), magnesium stearate.

Pill light yellow, Valium. 1 tab. meloxicam 15 mg. Excipients: sodium citrate dihydrate, anhydrous lactose, microcrystalline cellulose, povidone (Kollidon, polyvinylpyrrolidone 25 000), colloidal silicon dioxide (Aerosil), crospovidone (poliplasdon VIC EL-10), magnesium stearate. Clinico-pharmacological group: NSAID. Selective COX-2 inhibitor.

Pharmacological action

NSAIDs. Has anti-inflammatory, analgesic and antipyretic effect. The mechanism of action is selective inhibition of enzymatic activity of COX-2 involved in the biosynthesis of prostaglandins in inflammation. In appointing the high-dose, long-term use and individual characteristics of the organism of COX-2 selectivity may be reduced. Inhibits the synthesis of prostaglandins in inflammation to a greater extent than in the mucosa of the gastrointestinal tract and kidneys.

Pharmacokinetics

Suction

After oral administration, is well absorbed from the gastrointestinal tract. The absolute bioavailability of meloxicam - 89%. Simultaneous ingestion does not alter absorption. While taking the drug orally at doses of 7.5 mg and 15 mg meloxicam concentration in plasma is proportional to dose. The vast differences between the Cmax and Cmin in plasma after a single dose is relatively small and at a dose of 7.5 mg of 0.4-1 mg / ml, a dose of 15 mg - 0.8-2 mg / ml, (presented, respectively, values and Cmin and Cmax ).

Distribution

Css achieved within 3-5 days. With prolonged use of the drug (more than 1 year) concentrations are similar to those that have been reported after first reaching an equilibrium state. Plasma protein binding of more than 99%. Vd is small and amounts to an average of 11 liters. Meloxicam crosses gistogematicheskie barriers, the concentration in the synovial fluid reaches 50% Cmax of the drug in blood plasma.

Metabolism

Meloxicam is almost completely metabolized in the liver with the formation of four pharmacologically inactive metabolites.

Breeding

T1 / 2 of meloxicam is 15-20 hours is derived equally from feces and urine, mostly as metabolites. With the feces as unchanged output of less than 5% of the daily dose in the urine as unchanged drug is found only in trace amounts. Plasma clearance is an average of 8 ml / min.

Pharmacokinetics in special clinical situations

In the elderly clearance of the drug decreases. Hepatic or renal failure of moderate severity did not significantly affect the pharmacokinetics of meloxicam.

Statement

Inflammatory and degenerative diseases of joints, accompanied by pain syndrome:
rheumatoid arthritis;
osteoarthritis;
Ankylosing spondylitis (ankylosing spondylitis).

Dosing regimen

The drug is taken orally during a meal one time per day. In rheumatoid arthritis the recommended dose is 15 mg / day. Depending on the therapeutic effect of the dose can be reduced to 7.5 mg / day. Osteoarthritis: The recommended dose - 7.5 mg / day. With the ineffectiveness of the dose may be increased to 15 mg / day.

If ankylosing spondylitis dose is 15 mg / day. The maximum daily dose should not exceed 15 mg. In patients with increased risk of side effects, as well as in patients with severe renal insufficiency on hemodialysis, the dose should not exceed 7.5 mg / day.

Side effect
From the digestive system: nausea, vomiting, abdominal pain, diarrhea, constipation, flatulence, erosive and ulcerative lesions of the gastrointestinal tract, perforation of stomach or intestinal ulcers, gastrointestinal bleeding (implicit or explicit), elevated liver enzymes, hepatitis, colitis, stomatitis , dry mouth, esophagitis, hyperbilirubinemia, belching.
Cardio-vascular system: tachycardia, increased blood pressure, feeling the tides.
With the respiratory system: exacerbation of bronchial asthma, cough.
CNS: headache, dizziness, tinnitus, disorientation, confusion, thoughts, sleep disturbance, drowsiness, emotional lability.
With the urinary system: edema, interstitial nephritis, renal medullary necrosis, urinary tract infection, proteinurniya, hematuria, renal failure, hypercreatininemia and / or an increase of urea in the blood serum.
On the part of the vision: conjunctivitis, blurred vision.
From the hemopoietic system: anemia, leukopenia, thrombocytopenia.
Dermatological reactions: itching, skin rash, increased photosensitivity.

Allergic reactions: urticaria, anaphylactoid reactions (including anaphylactic shock), angioedema, allergic vasculitis, erythema multiforme eksudativnaya (including Stevens-Johnson syndrome), toxic epidermal necrolysis (Lyell's syndrome).

Other: fever.

Contraindications
"Aspirin" asthma;
gastric ulcer and duodenal ulcer in acute phase;
gastrointestinal, cerebrovascular or other bleeding;
severe renal insufficiency (unless hemodialysis);
severe hepatic impairment;
severe congestive heart failure;
Children up to age 15 years;
pregnancy;
Lactation (breastfeeding);
hypersensitivity to the drug.

Caution should be used on patients of advanced age, with erosive and ulcerative lesions of the gastrointestinal tract in history.

Pregnancy and lactation

The drug is contraindicated during pregnancy and lactation.

Use in hepatic dysfunction

Contraindicated in severe liver failure.

Use in renal impairment

In renal failure, if the spacecraft more than 25 ml / min correction dosing regimen is not required. In patients with increased risk of side effects, as well as in patients with severe renal insufficiency on hemodialysis, the dose should not exceed 7.5 mg / day. Contraindicated in severe renal failure if left hemodialysis.

Cautions

It should be used with caution on patients with an indication of a history of peptic ulcer of the stomach and duodenum, as well as in patients receiving anticoagulation therapy. In these patients at increased risk of erosive and ulcerative lesions of the gastrointestinal tract.

With care and control of indicators of kidney function should use the drug in elderly patients, patients with chronic heart failure with signs of circulatory failure in patients with cirrhosis and in patients with hypovolemia due to surgical interventions.

In renal failure, if CC> 25 ml / min correction dosing regimen is not required.

In patients on dialysis, the maximum dose is 7.5 mg / day.

Patients taking both diuretics and meloxicam, should get plenty of fluids.

If in the course of treatment have an allergic reaction (including itching, skin rash, urticaria) and photosensitivity, the patient should consult a doctor to solve the issue of termination of treatment.

Effects on ability to drive vehicles and management mechanisms

Use of the drug may cause unwanted effects in the form of headaches and dizziness, sleepiness. If you experience these phenomena should be abandoned vehicle, maintenance of machines and mechanisms.

Overdose

Symptoms: increased side effects.

Treatment: gastric lavage, activated charcoal reception (during the next hours after admission), the holding of symptomatic therapy. Kolestiramin accelerates the removal of meloxicam from the body. A specific antidote does not exist.

Drug Interactions

In an application with other NSAIDs (as well as of acetylsalicylic acid) and increased risk of erosive and ulcerative lesions and bleeding from the gastrointestinal tract. In an application with antihypertensive drugs may reduce the effectiveness of the latter.

In an application with lithium therapy may develop accumulation of lithium and increase its toxicity (recommended to control the concentration of lithium in the blood).

In an application with methotrexate increases the side effects of the latter on the hematopoietic system (risk of anemia and leukopenia, shows a periodic monitoring of blood count).

Betoptic

Release form, composition and packing Betoptic 

Eye drops 0.5% in a clear, colorless or slightly yellow solution. 1 ml of betaxolol hydrochloride 5.6 mg, which corresponds to the content betaxolol 5 mg Excipients: benzalkonium chloride, hydrochloric acid and / or sodium hydroxide solution (to maintain the pH), purified water.

Clinico-pharmacological group: antiglaucoma medication - beta-blocker.

Pharmacological action

Antiglaucoma medication. Selective beta1-blocker without intrinsic sympathomimetic activity. Has no membrane stabilizing (local-anesthetic) action. When topically applied betaxolol reduces intraocular pressure by decreasing production of intraocular fluid. The onset of hypotensive action observed within 30 min after instillation, the maximum effect develops in 2 hours

After a single instillation of an impact on ophthalmotonus stored for 12 hours betaxolol (compared with other beta-blockers) did not induce reduction of blood flow to the optic nerve. Application Betoptika did not cause miosis, spasm of accommodation, night blindness, the effect of "veil" in front of the eyes (unlike miotikov).

Pharmacokinetics

When topical treatment is possible systemic absorption of betaxolol hydrochloride.

Statement

The drug is used to reduce intraocular pressure as monotherapy or in combination with other medications for:
open-angle glaucoma;
ocular hypertension.

Betoptik be used to treat open-angle glaucoma or ocular hypertension in patients with diseases of the respiratory system.

Dosing regimen

The drug is instilled into the conjunctival sac 1-2 drops 2 times a day. In some patients, stabilization of intraocular pressure occurs within a few weeks, so it is recommended to control intraocular pressure during the first month of treatment. In case of insufficient clinical efficacy of monotherapy prescribe additional therapy.

Side effect
On the part of the vision: often - short-term discomfort in the eyes after instillation, tearing, and in some cases - reducing the sensitivity of the cornea, redness of the eye, point keratitis, photophobia, anisocoria, photophobia, itching, dryness of the eyes.
CNS: Rarely - insomnia, depressive neurosis.

Contraindications
hypersensitivity to the drug.

Precautions should be prescribed the drug for sinus bradycardia, AV-block II and III degree of cardiac failure, cardiogenic shock, myasthenia gravis, diabetes mellitus.

Pregnancy and lactation

Enough experience with the drug Betoptik during pregnancy and lactation no. Use of the drug during pregnancy and lactation (breastfeeding) is possible only when the intended benefits to the mother outweighs the potential risk to the fetus or child.

Cautions

With carefully administered to patients with diabetes, because beta-blockers may mask the symptoms of acute hypoglycemia.

With carefully administered to patients with thyrotoxicosis, because Beta-blockers may mask the symptoms of hyperthyroidism (eg tachycardia). In patients with suspected thyrotoxicosis should not be abruptly canceled beta-blockers, as it may cause increased symptoms.

Keep in mind that beta-blockers can cause symptoms similar to those in infants (diplopia, ptosis, generalized weakness). Precautions should be prescribed beta-blockers in patients with severe impairment of respiratory system.

Despite the fact that clinical studies have shown no effect of betaxolol on lung function, we can not exclude the possibility of hypersensitivity to the drug. Before elective surgery should be phased out of beta-blockers for 48 hours before general anesthesia because during general anesthesia, they can reduce the sensitivity of the myocardium to sympathetic stimulation. Patients who used beta-blockers, may have a history of atopy or anaphylactic reactions. In the case of repeated hypersensitivity reactions, such patients may not be sensitive to the usual doses of epinephrine (adrenaline), required for relief of anaphylaxis.

The drug should be administered with caution in patients with Raynaud's syndrome or pheochromocytoma. When backfilling in the eye of beta-blockers may be absorbed into the systemic circulation.

At the same time may experience the same side effects as in the system application. There are cases of severe respiratory and cardiovascular disorders, including fatal bronchospasm in patients with bronchial asthma and death from heart failure. Betoptik has minimal effect on blood pressure and heart rate. However, caution should be exercised in the appointment of the drug to patients with AV-block or heart failure.

Treatment Betoptikom should immediately stop when the first symptoms of decompensation of the cardiovascular system.

Use caution when sharing application Betoptika and adrenergic psychotropic drugs. Eye drops Betoptik contain preservatives that may be deposited in soft contact lenses and have a damaging effect on the tissue of the eye. Therefore, patients who wear contact lenses should remove them before applying the drops and set back no earlier than 20 minutes after instillation.

Use in pediatrics

Enough experience with the drug Betoptik have no children.

Effects on ability to drive vehicles and management mechanisms

If, after drops in patients temporarily reduced clarity of vision, until its reconstruction is not recommended to drive and engage in activities that require attention and response.

Overdose

In eyes of excess drug should be flush eyes with lukewarm water.

Drug Interactions

With the simultaneous application of the drug Betoptik and beta-blockers for intake increases the risk of side effects (both local and systemic) due to the additive effect (so patients receiving this combination of drugs should be under medical supervision).

In applying Betoptika in combination with drugs, depletes catecholamines (such as reserpine), may see the decline of blood pressure and bradycardia.

Conditions and terms of

List B. The drug should be stored at a temperature of 8 ° to 30 ° C in places inaccessible to children. Shelf life - 3 years. After opening the bottle of medication must be used within 1 month.

Betaferon

Release form, composition and packing Betaferon 

Valium for a solution for subcutaneous injection in the form of freeze-dried mass of a white enclosed solvent transparent, almost colorless; prepared solution of slightly opalescent to opalescent, colorless or pale yellow. 1 vial. 1 ml of p-pa recombinant interferon beta-1b 9.6 mln.ME (300 mcg) 8 mln.ME (250 mcg). Excipients: human albumin, mannitol. Solvent: sterile rr sodium chloride 0.54% - 1.2 ml.

Clinico-pharmacological group: Interferon. Drug used in multiple sclerosis.

Pharmacological action

Interferon beta-1b, used in multiple sclerosis, has antiviral and immunoregulatory activity. Mechanisms of action of interferon beta-1b in multiple sclerosis is not definitely established. However, it is known that the biological effect of interferon beta-1b is mediated by its interaction with specific receptors that are found on the surface of human cells.

Binding of interferon beta-1b to these receptors induces the expression of a number of substances which are considered as mediators of biological effects of interferon beta-1b. The content of some of these substances were determined in serum and fractions of blood cells of patients treated with interferon beta-1b. Interferon beta-1b decreases the binding capacity and expression of receptors of gamma interferon enhances their dissolution. The drug increases the suppressive activity of peripheral blood mononuclear cells.

As for remitting, and at the secondary-progressive multiple sclerosis treatment Betaferon reduces the frequency (30%) and severity of clinical exacerbations of the disease, the number of hospitalizations and the need for steroid treatment, and lengthens the duration of remission.

In patients with secondary-progressive multiple sclerosis use of Betaseron will delay further progression of disease and disability (including severe when patients are forced to always use a wheelchair) for up to 12 months.

This effect was observed in patients with both acute exacerbations of the disease, with or without exacerbations, as well as with any index of disability (in the study included patients with an estimate from 3.0 to 6.5 points on the expanded disability scale, EDSS).

The results of magnetic resonance imaging (MRI) brain of patients with remitting and secondary-progressive multiple sclerosis patients receiving Betaferon showed a significant positive effect of the drug on the severity of the pathological process, as well as a significant decrease in the formation of new active lesions.

Pharmacokinetics

After subcutaneous injection of Betaseron at a dose of 0.25 mg concentration of interferon beta-1b in serum are low or not determined. In this regard, information on the pharmacokinetics of the drug in patients with multiple sclerosis treated with Betaferon ® at the recommended dose, no.

After subcutaneous injection of 0.5 mg dose to healthy volunteers Cmax is about 40 IU / ml achieved after 8.1 h after injection. The absolute bioavailability of Betaseron when s / c infusion was approximately 50%. With / in the introduction of interferon beta-1b serum clearance, and T1 / 2 are an average of 30 ml / min / kg and 5 h, respectively.

The introduction of Betaseron every other day does not lead to increased concentrations of interferon beta-1b in serum and its pharmacokinetic processes during the course of therapy, apparently, do not change.

When s / c infusion at a dose of Betaseron 0.25 mg a day in healthy volunteers, levels of biological response markers (neopterin, beta2-microglobulin and the immunosuppressive cytokine IL-10) significantly increased compared to benchmarks 6-12 hours after the first dose of the drug.

They reached a peak after 40-124 h and remained elevated throughout the 7-day (168 h) study period.

Statement
clinically isolated syndrome (CIS) (the only clinical demyelinating event suggestive of multiple sclerosis, subject to exclusion of alternative diagnoses) with sufficient severity of the inflammatory process for appointment / to SCS - for slowing the transition to a clinically reliable multiple sclerosis (KDRS) in patients with high risk of KDRS.

Universally accepted definition of high risk do not. According to a study by a group at high risk for KDRS include patients with monoochagovym CIS (clinical manifestations of a lesion in the CNS) and ≥ T2 foci on MRI and / or accumulated contrast agent centers.

Patients with multifocal CIS (clinical manifestations of> 1 lesion in the CNS) are at high risk of developing KDRS regardless of the number of lesions on MRI;
remitting multiple sclerosis - to reduce the frequency and severity of exacerbations of multiple sclerosis in ambulatory patients (ie patients could walk unaided) with a history of at least two exacerbations of the disease over the past 2 years and followed by complete or incomplete recovery of neurological symptoms;
secondary-progressive multiple sclerosis with active disease course characterized by relapses or marked deterioration of neurological functions during the last 2 years - to reduce the frequency and severity of exacerbations, as well as to slow the progression of the disease.

Dosing regimen

Betaseron treatment should be started under the supervision of a physician with experience treating this disease. At present, the question remains about the duration of treatment Betaferon. In clinical studies, the duration of therapy in patients with remitting and secondary-progressive multiple sclerosis as high as 5 and 3 years respectively.

The duration of therapy is determined by your doctor. Recommended dose of Betaseron 0.25 mg (8 mln.ME), which is contained in 1 ml of prepared solution, administered sc every other day. The patient should be informed that in case of missing injections, the drug should be introduced immediately, as soon as he remembers. Following an injection of doing in 48 hours

Rules for preparation of the solution:
A package containing vials and syringes with solvent. To dissolve the lyophilized powder for injection using a syringe attached finished with a solvent and a needle.
A package containing vials, syringes with solvent, the adapter with a needle to the vial and alcohol wipes. To dissolve the lyophilized powder for injection using a syringe made ready with a solvent and an adapter with a needle to the vial. 1.2 ml of solvent (sodium chloride 0.54%) injected into the vial with Betaseron.

The powder should dissolve completely without shaking. Before use, inspect a ready solution. In the presence of particles or changes in color of the solution can not be applied. 1 ml of final solution contains 0.25 mg (8 mln.ME) interferon beta-1b. The drug should be administered sc immediately after the preparation of the solution. If an injection is delayed, the solution should be refrigerated and used within 3 h. The solution must not be frozen.

Side effect

Below are the side effects observed with a frequency of 2% and higher than in the placebo group, patients who in the course of controlled clinical trials received Betaferon dose 0.25 mg / m 2 or 0.16 mg / m 2 every other day for up to 3 years.
From the body as a whole: the reaction at the injection site, fatigue, complex flu-like symptoms, headache, fever, chills, abdominal pain, chest pain, malaise, necrosis at the injection site, pain of various locations.
With the cardiovascular system: peripheral edema, vasodilatation, hypertension, peripheral vascular disease, palpitations, tachycardia.
From the digestive system: nausea, constipation, diarrhea, increased AST and ALT levels 5 times the original level, dyspepsia.
From the hematopoietic system: lymphocytes <1500/mkl, neutrophils <1500/mkl, leukocytes <3000/mkl, lymphadenopathy.
From a metabolism: an increase in body weight.
From the musculoskeletal system: myasthenia, myalgia, arthralgia, leg cramps.
The nervous system: hypertonicity, dizziness, insomnia, loss of coordination, anxiety, nervousness.
With the respiratory system: dyspnea.

Dermatological reactions: rash, skin diseases, increased sweating, alopecia.
With the urinary system: the imperative need to urinate, frequent urination.
From the sexual system: metrorrhagia (acyclic bleeding), menorrhagia, dysmenorrhea, in men - impotence, prostate diseases.

The following side effects are based on postmarketing monitoring the use of Betaferon, grouped by organs and systems are presented with the following frequency of occurrence: Very common (≥ 10%), relatively frequent (<10% - ≥ 1%), infrequent (<1% - ≥ 0.1%), rarely (<0.1% - ≥ 0.01%), very rare (<0.01%). General reaction: very often - flu-like symptoms (fever, chills, myalgia, headache, excessive sweating), the frequency of these symptoms decreased over time, rarely - malaise, chest pain.
From the hematopoietic system: Infrequent - leukopenia, anemia, thrombocytopenia, rarely - lymphadenopathy.
Cardio-vascular system: Infrequent - hypertension, rarely - cardiomyopathy, tachycardia, palpitations.
On the part of the endocrine system: rarely - dysfunction of the thyroid gland, hyperthyroidism, hypothyroidism.
CNS: Infrequent - muscular hypertonicity, depression, rarely - seizures, confusion, agitation, emotional lability, suicidal attempts.
Part of the respiratory system: rarely - dyspnea, bronchospasm.
From the digestive system: Infrequent: - nausea, vomiting, increased activity of ACT, ALT, rarely - increased levels of bilirubin and GGT activity, pancreatitis, anorexia.
From the musculoskeletal system: Infrequent - myalgia.
From the reproductive system: rarely - menstrual irregularities.

Allergic reactions: seldom - anaphylactic reactions.

Local reactions: very common - congestion, local swelling, inflammation, pain, rarely - skin necrosis (with time with continued treatment the frequency of reactions at the site of injection usually decreases).

Betaserc

Release form, composition and packing Betaserc 

The tablets are round, flat, white or nearly white, with beveled edges, labeled "256" on one side and "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 8 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

The tablets are round, biconvex, white or nearly white, with beveled edges, scored on one side and marked "267" on both sides of the risks and marked "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 16 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

The tablets are round, biconvex, white or nearly white, with beveled edges, scored on one side and marked "289" on both sides of the risks and marked "S" over "∇" - on the other side of the tablet. 1 tab. betahistine dihydrochloride 24 mg. Excipients: microcrystalline cellulose, mannitol, citric acid monohydrate, colloidal silicon dioxide, talc.

Clinico-pharmacological group: drug improving the microcirculation of the labyrinth that is used in the pathology of the vestibular apparatus.

Pharmacological action

Synthetic analogue of histamine. Acts primarily on the histamine H1-and H3-receptors of the inner ear and vestibular nuclei of the CNS. By direct agonistic effects on histamine H1-receptors in blood vessels of the inner ear, as well as indirectly through effects on the histamine H3-receptors improves microcirculation and capillary permeability of the inner ear, normalizes blood pressure of the endolymph in the labyrinth and cochlea.

Along with that betahistine increases blood flow in the basilar artery. Betaserc also has a strong central effect, as an inhibitor of histamine H3-receptors of the vestibular nerve nuclei. Normalizes conduction in neurons of the vestibular nuclei at the brainstem.

Clinical manifestations of these properties are to reduce the frequency and intensity of vertigo, noise reduction and tinnitus, improvement of hearing in the case of his slides.

Pharmacokinetics

Absorption and distribution

After oral betahistine dihydrochloride rapidly and almost completely absorbed from the gastrointestinal tract. Cmax in plasma is reached after 3 h. Plasma protein binding is low.

Breeding

T1 / 2 of 3-4 hours almost completely excreted by the kidneys as metabolites (2-peridiluksusnoy acid) for 24 h.

Statement
treatment and prophylaxis of vestibular vertigo of various origins;
syndromes characterized by dizziness, headache, tinnitus, progressive hearing loss, nausea and vomiting;
disease and Meniere's syndrome.

Dosing regimen

Drug is prescribed inside during the meal. Improving the condition stated in the beginning of therapy. Stable therapeutic effect is achieved within 2 weeks of Betaserc and can grow while taking the drug for several months.

Treatment of long-term. Duration of therapy set individually.

Side effect

Probably: violations of the gastrointestinal tract. In very rare cases: cutaneous manifestations of allergic reactions (skin rash, itching, hives), angioedema.

Contraindications
hypersensitivity to the drug.

Pregnancy and lactation

Insufficient data to assess the impact of the drug during pregnancy and lactation.

Use in hepatic dysfunction

Cautions

Precautions should be prescribed the drug to patients with gastric ulcer or duodenal ulcer history. During treatment, patients with pheochromocytoma and asthma should be under medical supervision.

Effects on ability to drive vehicles and management mechanisms

Betaserc has no sedative effect and does not affect ability to drive vehicles or operate machinery.

Overdose

Symptoms: nausea, vomiting at a dose of 728 mg, there were reports about the appearance of convulsions.

Treatment: symptomatic therapy.

Drug Interactions

Drug interactions drug Betaserc with other drugs has not been described. Incompatibilities are unknown.

Conditions and terms of

The drug should be stored in a dry place inaccessible to children at or above 25 ° C. Shelf life - 5 years.

Betaloc

Release form, composition and packing Betaloc 
 
Solution for injection in a clear, colorless. 1 ml 1 amp. metoprolol tartrate 1 mg 5 mg. Excipients: sodium chloride, water, d / and.

Clinico-pharmacological group: Beta1-blocker.

Pharmacological action

Cardioselective beta1-blocker without intrinsic sympathomimetic activity. Has little membrane-stabilizing action and does not exhibit partial agonist activity. Metoprolol suppresses or inhibits the stimulatory effect exerted by catecholamines on cardiac activity resulting from the nervous and physical stress.

This means that metoprolol has the ability to prevent an increase in heart rate, cardiac output and myocardial contractility, and increased blood pressure caused a sharp release of catecholamines. Patients with symptoms of obstructive lung disease and if you want to assign metoprolol in combination with beta2-adrenomimetikami.

In a joint application with the beta2-adrenomimetikami Betaloc in therapeutic doses, to a lesser extent affects they cause bronchodilation than nonselective beta-blockers. Metoprolol to a lesser extent than nonselective beta-blockers, affects the production of insulin and carbohydrate metabolism. The influence of the drug Betaloc on the reaction of the cardiovascular system in conditions of hypoglycemia is much less pronounced compared with nonselective beta-blockers.

In patients with myocardial infarction at high / vvvedenii metoprolol reduced chest pain, and reduced risk of developing atrial and atrial flutter. In the intravenous metoprolol at the first sign (within 24 hours after symptom onset) reduces the risk of myocardial infarction. Early treatment with metoprolol leads to further improvement of prognosis of myocardial infarction.

Improving quality of life in the treatment of drug Betaloc observed in patients after myocardial infarction. In paroxysmal tachycardia and atrial flutter () atrial Betaloc reduces heart rate.

Pharmacokinetics

Metabolism

Metoprolol undergoes oxidative metabolism in the liver with the formation of three major metabolites, none of which has no clinically significant beta-blocking effect.

Breeding

The average T1 / 2 of metoprolol from plasma is about 3-5 hours about 5% of the administered dose excreted in the urine in unchanged form.

Statement
supraventricular tachycardia;
Prevention and treatment of myocardial ischemia, tachycardia, and pain in myocardial infarction or suspected it.

Dosing regimen

When supraventricular tachycardia drug is administered IV at an initial dose of 5 mg (5 ml) at 1 - 2 mg / min. You can repeat administration with an interval of 5 min to achieve a therapeutic effect. Usually the total dose of 10-15 mg (10-15 ml). The recommended maximum dose of iv administration of 20 mg (20 ml). With a view to preventing and treating myocardial ischemia, tachycardia, and pain in myocardial infarction or suspected drug he administered iv at a dose of 5 mg (5 ml).

You can repeat administration with an interval of 2 min. The maximum dose - 15 mg (15 ml). 15 min after the last injection prescribed metoprolol (Betaloc ZOK) oral dose of 50 mg every 6 h for 48 h. In patients with impaired renal function, dosage adjustment is required.

Patients with impaired liver function is usually due to a low degree of binding to plasma proteins, dosage adjustment is required.

However, in severe liver dysfunction (patients with portokavalnymi anastomosis) may require a reduction in dose. Elderly patients dosage adjustment is required.

Side effect

To estimate the incidence used the following criteria: very common -> 10%, often - 1-9.9%, sometimes - 0.1-0.9%, rare - 0.01-0.09%, very rare - 0.01%.
With the cardiovascular system: often - bradycardia, postural hypotension (very rarely accompanied by fainting), cold extremities, a feeling the heartbeat, and sometimes - a temporary boost in heart failure symptoms, AV-block I degree, cardiogenic shock in patients with acute myocardial infarction; rarely - other conduction abnormalities, arrhythmias, very rarely - gangrene in patients with previous severe disorders of peripheral circulation.
CNS and peripheral nervous system: Very common - fatigue, often - dizziness, headache, and sometimes - paresthesia, cramps, depression, decreased ability to concentrate, drowsiness or insomnia, nightmares, rarely - increased nervous irritability, anxiety; very rare - impaired memory / amnesia, depression, hallucinations.
From the digestive system: frequent - nausea, abdominal pain, diarrhea, constipation, and sometimes - vomiting, rarely - dry mouth, liver function abnormalities.
From the hematopoietic system: very rarely - thrombocytopenia.
Part of the respiratory system: often - shortness of breath on exertion, and sometimes - bronchospasm in patients with asthma, rarely - rhinitis.
From the musculoskeletal system: very rarely - arthralgia.
From the sensory organs: rarely - blurred vision, dryness and / or eye irritation, conjunctivitis, is very rare - tinnitus, disorders of taste sensations.

Dermatological reactions: sometimes - a rash (in the form of hives), increased sweating, rarely - hair loss, very rarely - photosensitivity, exacerbation of psoriasis.

Other: rarely - impotence / sexual dysfunction, and sometimes - an increase of body weight. Betaloc is well tolerated, side effects are mostly mild and reversible.

In many cases, a causal relationship with the drug has not been established.

Contraindications
AV-block grade II and III;
heart failure in the stage of decompensation;
clinically significant sinus bradycardia;
SSS;
cardiogenic shock;
expressed by peripheral blood circulation disorders (including the threat of gangrene);
hypotension;
patients with acute myocardial infarction with heart rate below 45 beats / min, an interval of more than 0.24 with PQ or systolic blood pressure less than 100 mm Hg;
in the treatment of supraventricular tachycardia in patients with systolic blood pressure less than 110 mm Hg;
patients receiving beta-blockers were contraindicated in intravenous calcium channel blockers (including verapamil);
childhood and adolescence to 18 years (the effectiveness and safety of the drug not established);
hypersensitivity to the drug or other beta-blockers.

Be wary of a drug at AV-blockade of I degree, Prinzmetal angina, COPD (emphysema, chronic obstructive bronchitis, bronchial asthma), diabetes, kidney failure, severe.

Pregnancy and lactation

Like most medicines, Betaloc should not be administered during pregnancy and lactation (breastfeeding), except in cases where the expected benefit duration the mother outweighs the potential risk to the fetus. Like other antihypertensive drugs, beta-blockers can cause side effects such as bradycardia in the fetus, infants or children who are breastfed, and therefore require special care in the appointment of beta-blockers in the III trimester of pregnancy and immediately before delivery. When you receive the mother during lactation metoprolol in therapeutic doses of metoprolol, is excreted in breast milk, and beta-blocking effect of a child who is breastfed, are negligible. Use in hepatic dysfunction in patients with impaired liver function is usually due to a low degree of binding to plasma proteins, dosage adjustment is required.

However, in severe liver dysfunction (patients with portokavalnymi anastomosis) may require a reduction in dose.

Use in renal impairment

Patients with impaired renal function, dosage adjustment is required.

Cautions

Patients suffering from bronchial asthma or obstructive lung disease, should appoint a concomitant bronchodilatory therapy. If necessary, increase the dose of beta 2-adrenomimetic.

In applying the beta1-adrenergic blockers the risk of their influence on carbohydrate metabolism or the possibility of masking of hypoglycemia is much less than the nonselective beta-blockers. In patients with chronic heart failure in decompensated need to get the compensation stage, both before and during drug treatment.

Patients suffering from angina, Prinzmetal, not advisable to appoint non-selective beta-blockers. It is very rare in patients with impaired AV-conduction can occur impairment (a possible outcome - AV-block). If during treatment developed bradycardia, a dose of Betaloc should be reduced. Metoprolol can worsen the symptoms of disorders of the peripheral arterial circulation is mainly due to the reduction of blood pressure. Should be prescribed with care to patients suffering from severe renal insufficiency, metabolic acidosis, together with cardiac glycosides.

Patients taking beta-blockers, anaphylactic shock occurs in a more severe form. Patients suffering from pheochromocytoma, in parallel with the drug Betaloc should appoint an alpha-blocker. In the case of surgical intervention should inform the doctor-anesthesiologist that the patient takes a beta-blocker. Should not appoint a second dose of the drug (second or third) in heart rate below 40 beats / min, with a PQ interval of 0.26 s and systolic blood pressure less than 90 mm Hg

Betaleukin

Release form, composition and packing Betaleukin 

Powder for injection 1 amp. / 1 fl. interleukin-1β 0.05 mg - - 0.5 mg - - 1 mg.

Stabilizer: PVP low molecular weight.

Clinico-pharmacological group: Stimulant leykopoeza. Immunostimulating drug.

Pharmacological action

Stimulant leykopoeza. Has gemostimuliruyuschee and immunostimulatory effects. The drug increases leykopoez and restores the bone marrow hemopoiesis after the damaging effect of cytotoxic drugs and radiation, due to its ability to induce production of colony-stimulating factor and increase proliferation and differentiation of hematopoietic cells of various germs.

Immunostimulatory effect of the drug due to increased functional activity of neutrophils, induction of differentiation of precursors of immune cells, increased lymphocyte proliferation, activation of cytokine production and increased production of antibodies.

Pharmacokinetics

Data on the pharmacokinetics of the drug Betaleukin not given.

Statement
stimulation leykopoeza with toxic leukopenia 2.4 degree, complicating chemo-and radiotherapy of malignant tumors;
patronage leykopoeza when the need for chemotherapy for leukopenia (leukocyte count of peripheral blood at least 3h109 / l);
secondary immunodeficiency that develops after severe trauma, extensive surgery, resulting in septic, purulent-destructive, chronic septic processes.

Dosing regimen

Betaleukin injected sc or iv infusion. To stimulate leykopoeza drug is used at a dose of 15-20 ng / kg body weight, to stimulate the immune system - 5.8 ng / kg body weight. Course of treatment - 5 daily drip intravenous infusion or subcutaneous injection. If necessary to repeat treatments at intervals of 2 weeks. The duration of infusion - 120-180 min.

Rules for the preparation of solutions

For solution for IV infusion contents of the ampoule (vial) was dissolved immediately before use in 1 ml of sterile 0.9% p-ra sodium chloride or water, d / and and bring the total volume of 100 ml 0.9% p-rum sodium chloride.

To achieve the estimated dose infusion the solution was diluted in the required amount (depending on the initial dose of the drug in the vial or bottle, and, accordingly, its concentration in the resulting solution) in 500 ml of 0.9% p-ra sodium chloride or 5% dextrose p-pa .

To obtain a solution for subcutaneous injection contents ampoule (vial) is dissolved in 0.5-1 ml of sterile 0.9% p-ra sodium chloride or water, d / and.

Side effect

Systemic reactions: in some cases - fever, headache, increased body temperature. These reactions continue for 2-3 h after injection, after which the temperature drops and side effects disappear.

Listed side effects are not a contraindication for continuation of treatment. In isolated cases: possible allergic reactions.

Contraindications
hypersensitivity to the drug;
septic shock;
severe fever;
pregnancy.

Pregnancy and lactation

The drug is contraindicated in pregnancy.

Cautions

If you experience severe side effects prescribed paracetamol, metamizol sodium, diphenhydramine, or a combination, you can choose to use corticosteroids.

Overdose

Currently, cases of drug overdose Betaleukin were reported.

Drug Interactions

Drug interactions drug Betaleukin not described.

Conditions and terms of

List B. The drug must be stored and transported at a temperature not exceeding 15 ° C. Shelf life - 2 years.

Betalgon

Release form, composition and packing Betalgon 

Ointment for external use only white or white with a tinge of yellow to light brown in color, with a specific smell.

1 g nikoboksil (β-butoksietilovy ester of nicotinic acid) 25 mg nonivamid (vanililamid pelargonic acid) 4 mg.

Excipients: citral, purified water, beeswax, petroleum jelly.

Clinico-pharmacological group: preparation of local irritant and analgesic effect.

Pharmacological action

Combined preparation for topical use, contains 2 highly vasodilator component. Provides local irritating, distracting and antispasmodic effect, and also has anti-inflammatory, analgesic and warming effect and stimulates local blood circulation.

Improvement of blood circulation in the skin accompanied by increased blood flow in underlying tissues. Effect occurs within minutes after treatment and reaches a maximum within 20-30 min.

Pharmacokinetics

Data on the pharmacokinetics Betalgon not given.

Statement
myalgia and arthralgia;
contusions;
damage to muscles and ligaments;
neuralgia;
osteochondrosis with radicular syndrome;
lumbago;
sciatica;
sports injuries;
disorders of peripheral circulation.

Dosing regimen

Use of the drug Betalgon should begin with the use of very small quantities of ointments. Column ointment no longer than 0.5 cm (size of a pea) with the applicator is applied to the appropriate area of skin (area approximately corresponds to the area of the palm).

To enhance the therapeutic effect of the drug section of the application of ointment can be covered by a woolen cloth. The patient should be warned about the inadmissibility of the use of the drug for more than 10 days without consulting a doctor.

Side effect

Possible: an allergic reaction.

Contraindications
hypersensitivity to the drug. Betalgon should not be applied to the area of open wounds, as well as on irritated or damaged skin.

Pregnancy and lactation

With careful use of medication during pregnancy and lactation (breastfeeding).

Cautions

Avoid getting Betalgona the eyes and mucous membranes (nose and mouth), since when hit causes an unpleasant burning sensation (otherwise harmless). Patients with sensitive skin should not take a hot shower or bath before and after applying Betalgona. After applying Betalgona should wash your hands thoroughly with soap and water.

Use in pediatrics

Not intended for use in children. The appointment of the drug to children decided individually.

Overdose

When applying too much Betalgona effect of the drug can be relaxed, rubbing the skin with a tissue dampened with vegetable oil or nourishing cream.

Drug Interactions

Drug interactions drug Betalgon not described.

Conditions and terms of

The drug should be stored in a dry place, protected from light and away from children, at a temperature above 20 ° C. Shelf life - 2 years.

Betac

Release form, composition and packing Betac 
Tablets, coated in white or almost white, round, biconvex, with Valium on one side on a break - the core of a white or nearly white. 1 tab. betaxolol (as hydrochloride) 20 mg. Excipients: lactose monohydrate, microcrystalline cellulose, sodium starch glycolate, silica colloidal anhydrous, magnesium stearate, hydroxypropyl methylcellulose, titanium oxide, polyethylene glycol 400.

Clinico-pharmacological group: Beta1-blocker.

Pharmacological action

Cardioselective beta1-blocker without intrinsic sympathomimetic activity. Has a weak membrane stabilizing activity. Exerts antihypertensive effects due to reduced cardiac output and a decrease in sympathetic stimulation of peripheral vessels.

When used in therapeutic doses of drug has not expressed cardiodepressive action does not affect the exchange of glucose, does not diminish bronhorasshiryayuschego-acting beta-agonists, does not cause retention of sodium and water in the body.

Effect of the drug begins after 1-2 h, duration - 24 hours antihypertensive effect occurs within 2-5 days, maximum effect develops in 1-2 months.

Pharmacokinetics

Suction

After oral administration is completely absorbed from the gastrointestinal tract (100%). Bioavailability is 90%. Cmax achieved within 2-4 hours

Distribution

Associated with blood proteins by 55%. Vd - from 4.9 to 9.8 L / kg. Slightly penetrates the blood-brain barrier and placental barrier, little is excreted in breast milk.

Breeding

T1 / 2 of 14-22 hours is excreted in urine (15% unchanged). Ground clearance is 4.7 ml / min, clearance increases with age.

Statement
hypertension;
Coronary heart disease: angina and rest myocardial infarction (combined therapy);
hypertrophic cardiomyopathy;
cardiac arrhythmias (sinus tachycardia, supraventricular and ventricular tachyarrhythmia and beats, arrhythmia, combined mitral valve prolapse, hyperthyroidism).

Dosing regimen

Betacam take 1 time per day, regardless of the meal, washed down with water. Hypertension the initial dose is 5-10 mg / day. 1-2 weeks if necessary it was increased to 20 mg.

Side effect
Cardio-vascular system: bradycardia, AV-block, heart failure, orthostatic hypotension, deterioration of peripheral circulation (cold extremities, paresthesias, Raynaud's syndrome).
With the respiratory system: bronchospasm. Allergic reactions: skin rash, urticaria.
CNS: fatigue, depression, fatigue, drowsiness, confusion, hallucinations, dizziness, headache.
From the digestive system: nausea, rarely - vomiting, diarrhea or constipation, cholestasis.
By the authority of: dry eyes.
From the hemopoietic system: leucopenia, thrombocytopenia.

Other: exacerbation of psoriasis, impotency.

Contraindications
chronic heart failure II-III stage;
cardiogenic shock;
AV-block II or III degree;
sinoatrial block;
bradycardia;
Prinzmetal angina;
cardiomegaly;
hypotension (systolic blood pressure less than 100 mm Hg);
diabetes mellitus;
myasthenia gravis;
psoriasis;
Raynaud's syndrome;
endarteritis obliterans;
marked renal dysfunction;
bronchial asthma;
emphysema;
chronic obstructive bronchitis;
increased sensitivity to betaxolol and other ingredients.

Pregnancy and lactation

Use of the drug Betacam during pregnancy and lactation (breastfeeding) is possible with caution and only when the potential benefits of its application to the mother justifies the potential risk to the fetus.

Use in renal impairment

The drug is contraindicated in marked renal impairment.

Cautions

Precautions should be used in the preparation for pheochromocytoma. In the case of the need for routine surgical treatment of the abolition of the preparation is carried out for 48 hours before general anesthesia. Should take into account the possibility of heart failure in the first days of treatment with Betacam in patients with an appropriate disposition. Betaxolol may mask symptoms of hypoglycemia (eg, tachycardia), so that when applied to patients with diabetes should regularly monitor blood glucose levels.

Betacam drug use under control of HR. With the development of bradycardia dose reduce or cancel the product. Upon the termination of therapy with Betacam recommend a gradual reduction in dose (5 mg every 3-4 days) for 1-2 weeks in order to avoid withdrawal symptoms. The drug is not recommended concurrently with MAO inhibitors.

Use in pediatrics

It is not recommended to use the drug in children.

Effects on ability to drive vehicles and management mechanisms

Precautions should be administered to patients whose activities require increased attention and rapid psychomotor reactions.

Overdose

Symptoms: bradycardia, AV-block, falling blood pressure, fainting, heart failure, bronchospasm, seizures.

Treatment: symptomatic. When AV-blockade was shown to intravenous atropine alupenta or epinephrine (adrenaline), a temporary pacemaker. In arterial hypotension, if there are no signs of pulmonary edema, we recommend IV drip infusion of plasma substitutes, and inefficiency - epinephrine (adrenaline), dopamine, dobutamine. In the event of bronchospasm - an inhaled beta 2-adrenoceptor agonists, with cramps - diazepam.

Drug Interactions

In an application with Betacam amiodarone, calcium channel blockers (verapamil, diltiazem) and beta-blockers, used as eye drops for glaucoma, may increase the inhibitory effect of betaxolol on cardiac contractility and cardiac conduction.

In an application with Betacam cardiac glycosides increase the probability of AV-block. Antihypertensive drugs in a joint application with Betacam enhance its hypotensive action.

While the application Betacam with preparations for inhalation anesthesia increases the risk of depression of the myocardium and the development of arterial hypotension. Duration of action of nondepolarizing muscle relaxants may be increased against the background of the simultaneous reception of Betacam. NSAIDs, while the application weaken the hypotensive effect Betacam by retention of sodium and water and inhibition of prostaglandin synthesis in the kidneys. Estrogen also reduces the hypotensive effect Betacam (due to sodium retention). Cocaine, while the application may reduce the therapeutic effects of betaxolol.

The combined use of Betacam and agonists or xanthine their therapeutic effects are relatively weaker. Concomitant use of phenothiazines with Betacam leads to increased concentrations of each drug in blood plasma. Betaxolol slows the excretion of lidocaine and theophylline. Sulfasalazine improves betaxolol in blood serum.

Conditions and terms of

The drug should be stored in a dry place, protected from light and away from children at or above 25 ° C. Shelf life - 2 years.