Berocca calcium and magnesium

Release form, composition and packing Berocca calcium and magnesium 

Effervescent tablets 1 tab. ascorbic acid, 1 g of thiamine, riboflavin 15 mg 15 mg Pantothenic Acid 23 mg pyridoxine 10 mg Cyanocobalamin 10 mcg Nicotinamide 50 mg Biotin 150 mcg Calcium (in the form of carbonate and pantothenate) 100 mg of magnesium (in the form of heavy carbonate and sulfate) 100 mg. Inactive ingredients: citric acid anhydrous, sodium bicarbonate, sodium chloride, aspartame, red beet, betakaroten 1% CWS, orange flavoring, sodium lauryl sulfate, mannitol.

Clinico-pharmacological group: Multivitamins with macrocells.

Pharmacological action

Combined preparation containing a complex of vitamins and minerals, are important factors in metabolic processes. Vitamin B1 normalizes the activity of the heart and promotes normal functioning of the nervous system.

Vitamin B2 promotes the process of regeneration of tissues, including skin cells. Vitamin B6 helps maintain the structure and function of bones, teeth, gum disease, affects on erythropoiesis contributes to the normal functioning of the nervous system.

Vitamin B12 is involved in erythropoiesis, promotes normal functioning of the nervous system.

B vitamins are involved in the formation of various enzymes that regulate the different types of metabolism.

Vitamin C is involved in the oxidation of biologically active substances, the regulation of metabolism in the connective tissue, carbohydrate metabolism, blood coagulation and tissue regeneration, stimulates the formation of steroid hormones, normalize capillary permeability.

Vitamin C increases resistance to infections and reduces the inflammatory response. Calcium is involved in the formation of bone tissue, blood clotting, transmission of nerve impulses, reduced skeletal and smooth muscle, normal heart function. It also promotes iron absorption. Magnesium is involved in the formation of muscle and bone tissues, and also participates in protein synthesis.

Statement

Prevention of states, leading to enhanced body's need for vitamins and minerals: increased physical and psychical load, irregular, defective, or the monotonous diet, and during recovery from an illness, to improve the body's resistance to infection and colds. Receiving the drug for 10-15 days leads to improved health, increased activity and improve mood.

Dosing regimen

Adults: 1-2 tablets per day. Pre-dissolve 1 tablet in a glass of water. The course of the drug 10-15 days. The drug can be repeated after a break (1-3 months), or on doctor's advice.

Side effect

Allergic reactions. Do not exceed recommended daily dose at random receiving high-dose, immediately consult a doctor.

Contraindications

Hypersensitivity to the drug. Should not be used for serious violations of the functions of the liver, kidney stone disease.

Pregnancy and lactation

Can be taken during pregnancy and breastfeeding period, subject to the recommended daily dose.

Use in hepatic dysfunction

Should not be used for serious liver problems.

Drug Interactions

Oral contraceptives reduce the level of vitamin C in the body. The product contains calcium and therefore delays the intestinal absorption of antibiotics from the tetracycline group, as well as antimicrobial agents - derivatives of fluoroquinolones.

Vitamin C increases the effects and side effects of antimicrobial agents from the group of sulfonamides (including the appearance of crystals in urine). When concomitant administration of diuretics from the group of thiazides increases the likelihood of hypercalcemia. While others do not take multivitamin preparations.

Conditions and terms of

At temperatures below 30 ° C, protected from heat and moisture. Keep out of reach of children. Godzhnosti term - 3 years. Do not use a later date on the package.

Berodual

Release form, composition and packing Berodual 

Solution for inhalation transparent, colorless or nearly colorless, free from suspended particles, with an almost imperceptible odor. 1 ml of fenoterol hydrobromide 500 mcg ipratropium bromide anhydrous, 250 mcg. Excipients: benzalkonium chloride, disodium edetate dihydrate, sodium chloride, hydrochloric acid, purified water. Clinico-pharmacological group: bronchodilator drug.

Pharmacological action

Combined bronchodilator drug. Fenoterol hydrobromide is a selective beta2-agonists. Binding to β2-adrenoceptors, activates adenylyl cyclase via Gs-protein stimulyatorny with subsequent increase of cAMP formation, which in turn activates protein kinase A. The latter phosphorylates the target protein in the cells of smooth muscles, which in turn leads to phosphorylation of myosin light chain kinase, inhibition fosfoinozina hydrolysis and opening of calcium-activated potassium channels fast.

Thus, fenoterol, relaxes smooth muscles of the bronchi and vessels, and also prevents the development of bronchospasm due to the influence of bronhokonstriktornyh factors, such as histamine, methacholine, cold air and allergies (immediate type reaction). After taking the drug inhibited the release of mast cell inflammatory mediators.

In addition, after receiving fenoterol at high doses there is increasing mucociliary transport. Fenoterol also shows properties of a stimulator of respiration. Beta-adrenergic effect of fenoterol on cardiac activity, such as increasing the frequency and strength of heart contractions, due to the vascular action of fenoterol, stimulation of β2-adrenergic receptors of heart, and with the use of doses higher than therapeutic, the stimulation of β1-adrenergic receptors.

When receiving fenoterol at high doses the effect is observed at the level of metabolism: lipolysis, glycogenolysis, hyperglycemia, and hypokalemia (the latter is due to increased absorption of potassium of skeletal muscle).

Fenoterol (at high concentrations) inhibits the contractile activity of the uterus. There is insufficient data on the impact of fenoterol hydrobromide on metabolism in diabetes mellitus. Ipratropium bromide is a blocker of m-cholinergic receptors. Effectively eliminates bronchospasm associated with the influence of the vagus nerve decreases the secretion of glands (including bronchial). When inhaled causes bronchodilation, mostly attributed to local rather than systemic anticholinergic effects.

No negative influence on the secretion of mucus in the airways, mucociliary clearance and gas exchange. Together, fenoterol hydrobromide and ipratropium bromide in the form of metered aerosol bronchodilator effect is achieved by different mechanisms. Consequently, it is increasing and provides greater breadth of therapeutic action in bronchopulmonary diseases involving airway constriction.

To achieve therapeutic effects require a lower dose of beta-agonist, which allows an individual to choose an effective dose with little side effects.

In patients with bronchospasm associated with COPD (chronic bronchitis and emphysema) significant improvements in lung function (increase in forced expiratory volume in 1 sec / FEV 1 / and the maximum expiratory flow rate / MSV25-75% / 15% or more) notes for 15 min after inhalation of the drug, the maximum effect is achieved in 1-2 hours and lasts most of the patients up to 6 hours in 40% of patients with bronchospasm associated with asthma, showed a significant improvement in lung function (FEV1 increase of 15% or more).

Pharmacokinetics

Concentration of active components in plasma, detected after inhalation application to correlate with their therapeutic effect.

Plasma concentrations after inhalation were 500-1000 times lower than the concentrations observed after administration of equivalent doses of therapeutic effect of the drug inside. Effect of the drug after inhalation application comes quickly.

Statement
prevention and symptomatic treatment of chronic obstructive airways disease with reversible bronchospasm, such as bronchial asthma and especially chronic obstructive pulmonary disease (chronic bronchitis, emphysema).

Dosing regimen

Adults (including elderly) and adolescents over 12 years with acute lung and moderate attacks of asthma medication is prescribed in doses of 1 ml (20 drops).

In severe cases, such patients are in intensive care units, the drug is prescribed in higher doses, up to 2.5 ml (50 drops). In extreme cases it is possible to use the drug (provided medical supervision) to a maximum dose of 4 ml (80 drops).

In children aged 6-12 years with acute attacks of bronchial asthma for quick relief of symptoms is recommended to appoint a drug at a dose of 0.5-1 ml (10-20 drops), and in severe cases - up to 2 ml (40 drops), and in severe cases may use of the drug (provided medical supervision) to a maximum dose of 3 ml (60 drops).

For course and long-term treatment for adults (including elderly) and adolescents over 12 years of preparation is administered at a dose of 1-2 ml (20-40 drops) 4 times / day. The maximum daily dose - 8 ml.

Children aged 6-12 years are designated by 0.5-1 ml (10-20 drops) 4 times / day. The maximum daily dose - 4 mL. In the case of mild bronchospasm, or as an aid in the implementation of mechanical ventilation for adults (including elderly), adolescents aged 12 years and children aged 6-12 years recommended dose of 0.5 ml (10 drops).

In children under 6 years (body weight less than 22 kg) due to the fact that information about the use of the drug in this age group is limited, we recommend the use of the next dose (only provided medical supervision): 25 micrograms ipratropium bromide and 50 mcg fenoterol hydrobromide / kg body weight (per dose) = 0.5 ml (10 drops) up to 3 times per day. The maximum daily dose - 1.5 ml. Treatment should usually begin with the lowest recommended dose.

Terms of use of the drug

The recommended dose should be diluted with saline to a final volume of 3-4 mL, and apply (in full) by nebulizer. Solution for inhalation should not be diluted with distilled water. Dilution of the solution should be carried out each time before use; residues diluted solution should be destroyed.

Dosing may depend on the method of inhalation and type of nebulizer. The duration of inhalation can be controlled by spending diluted volume. Solution for inhalation can be applied using different business models nebulizers. In those cases where there are wall-mounted oxygen, the solution is best applied at a flow rate of 6.8 l / min. If necessary, the use of this dose may be repeated at intervals of not less than 4 hours

Side effect

The most common adverse effects are fine tremor of skeletal muscles, nervousness, dry mouth and changes in taste, less marked headache, dizziness, tachycardia and palpitations, especially in patients with aggravating factors.
With the respiratory system: cough, respiratory tract irritation, rarely - paradoxical bronchospasm.
From the digestive system: nausea, vomiting, gastrointestinal dysmotility (especially in patients with cystic fibrosis).
Cardio-vascular system: reduction of diastolic blood pressure, increased systolic blood pressure, arrhythmia.
On the part of the vision: When the product enters the eye - reversible accommodation disturbances, mydriasis, increased intraocular pressure (pain or discomfort in the eyeball, blurry vision, a sense of ghosting and color spots before the eyes, redness of the conjunctiva).

Allergic reactions: seldom - a skin rash, angioedema tongue, lips and face, urticaria.

Other: hypokalemia, excessive sweating, a feeling of general weakness, myalgia, muscle cramps, mental changes, urinary retention.

Contraindications
hypertrophic obstructive cardiomyopathy;
tachyarrhythmia;
Hypersensitivity to fenoterol hydrobromide, or atropinopodobnym drugs or other drug compounds.

Precautions should be prescribed drug in angle-closure glaucoma, coronary insufficiency, hypertension, diabetes, recent myocardial infarction, severe organic diseases of the heart and blood vessels, hyperthyroidism, pheochromocytoma, prostatic hyperplasia, bladder neck obstruction, cystic fibrosis, pregnancy, during breast feeding, children under the age of 6 years.

Pregnancy and lactation

Necessary to observe the usual precautions associated with the use of drugs during pregnancy, especially in the I trimester. Should take into account the possibility of inhibitory effect Berodual on contractile activity of the uterus.

Fenoterol hydrobromide passes into breast milk. Evidence that ipratropium bromide passes into breast milk is not received.

However, given that many of the drugs get into breast milk, should be prescribed with care Berodual nursing mothers.

Cautions

The patient should be informed that in the event of unexpected rapid amplification of shortness of breath should see a doctor immediately. Keep in mind that patients with asthma or mild to moderate forms of chronic obstructive pulmonary disease symptomatic treatment may be preferable to regular use. In patients with bronchial asthma or severe chronic obstructive pulmonary disease should be mindful of the need for amplification or anti-inflammatory therapy to control inflammation of the airways and the disease course.

Regular use of increasing doses of products containing beta2-adrenoceptor agonists, such as Berodual, for relief of bronchial obstruction can cause uncontrolled deterioration of the disease. In the event the bronchial obstruction simply increasing doses of beta 2-agonists (including Berodual) is greater than recommended for a long time, not only justified, but also dangerous.

To prevent life-threatening deterioration of the disease should consider reviewing the patient's treatment plan and adequate anti-inflammatory therapy with inhaled corticosteroids. Other sympathomimetic bronchodilators should be administered simultaneously with berodual only under medical supervision.

Berlithion 300

Release form, composition and packing Berlithion 300 

Film-coated tablets pale yellow, round, with risk on one side. 1 tab. thioctic (α-lipoic) acid 300 mg Excipients: lactose monohydrate, magnesium stearate, microcrystalline cellulose, croscarmellose sodium, povidone (K-30), colloidal silicon dioxide, anhydrous. The composition of the shell: Opadry OY-S-22898 yellow (hypromellose, titanium dioxide (E171), sodium dodecyl sulphate, liquid paraffin, quinoline yellow (E104), yellow-orange dye (E110), liquid paraffin).

Concentrate for solution for infusion is transparent, greenish-yellow. 1 ml 1 amp. ethylenediamine salt of thioctic (α-lipoic acid) 32.33 mg 388 mg, which resp. content of thioctic (α-lipoic acid) 25 mg 300 mg Excipients: Propylene glycol, ethylene diamine, water, d / and.

Clinico-pharmacological group: drug with antioxidant action, regulating carbohydrate and lipid metabolism. Hepatoprotector.

Pharmacological action

The drug, which regulates metabolism. Thioctic (α-lipoic) acid - an endogenous antioxidant, is formed in the body in the oxidative decarboxylation of α-keto acid and pyruvic acid. Helps reduce blood glucose and increased glycogen content in the liver, as well as to overcome insulin resistance.

By the nature of the biochemical actions similar to vitamin B. Participates in the regulation of lipid and carbohydrate metabolism, stimulates cholesterol metabolism, improves liver function. Exerts hepatoprotective, hypolipidemic, hypocholesterolemic, hypoglycemic effect.

The use of ethylenediamine salt of thioctic acid in solution for iv administration (which has a neutral reaction) can reduce the severity of adverse reactions.

Pharmacokinetics

Absorption and distribution

After oral thioctic (α-lipoic) acid is rapidly and completely absorbed from the gastrointestinal tract. Reception with food reduces the absorption.

Time to reach Cmax - 40-60 min. Bioavailability - 30%. At iv administration Cmax is 25-38 ug / ml and is reached through 10.11 min, AUC - about 5 ug x hr / ml. Vd - about 450 ml / kg.

Metabolism and Elimination

Has the effect of "first passage" through the liver. The formation of metabolites occurs as a result of oxidation of the side chain and conjugation. Thioctic acid and its metabolites are excreted in the urine (80-90%). T1 / 2 - 20-50 min. The total plasma clearance - 10-15 ml / min.

Statement
diabetic polyneuropathy;
alcoholic polyneuropathy.

Dosing regimen

Inside the adult prescribe 600 mg 1 time per day. Tablets are taken on an empty stomach, approximately 30 minutes before the first meal, without chewing and drinking plenty of fluids. Duration of treatment is determined by the physician individually. In severe forms of polyneuropathy in the beginning of the treatment drug is prescribed IV to 300-600 mg (12-24 ml, respectively) per day for 2-4 weeks. Later moving to supportive therapy and prescribe Valium 300 in the form of tablets of 300-600 mg / day.

Rules for preparation and storage solution infuzionnnogo

To prepare the infusion solution 1-2 ampoules Valium 300 diluted with 250 ml 0.9% sodium chloride solution and injected iv infusion over 30 min. Because of the sensitivity of the active substance infusion solution should be prepared immediately before use. Solution of the drug must be protected from exposure to light, for example, using aluminum foil. Protected from light, the solution can be stored for approximately 6 hours

Side effect
From the digestive system: it is possible (after ingestion) - dyspepsia, including nausea, vomiting, heartburn.
CNS: in some cases (after iv administration) - seizures, diplopia, with the rapid IV administration may be the feeling of heaviness in the head and breathing difficulties, which are alone.
From the hemopoietic system: in some cases (after iv injection) - petechiae on the skin and mucous membranes, thrombocytopathies, hemorrhagic rash (purpura).
From the metabolic: hypoglycemia (due to improved glucose uptake).

Allergic reactions: in some cases - urticaria, systemic allergic reactions up to anaphylactic shock.

Local reactions: sometimes - a burning sensation at the injection site.

Contraindications
children's age (efficacy and safety have not been established);
pregnancy;
Lactation (breastfeeding);
hypersensitivity to the drug.

Pregnancy and lactation

Application Valium 300 during pregnancy and lactation is contraindicated because of the lack of sufficient clinical data supporting the safety and efficacy of its application in this category of patients.

Cautions

In patients with diabetes requires constant monitoring of blood glucose levels, especially at the initial stage of therapy.

In some cases it is necessary to reduce the dose of insulin or oral hypoglycemic agents to avoid hypoglycemia. After taking the drug Valium 300 in the morning, apply the product of iron, magnesium, and also consume dairy products (due to their content of calcium) is recommended in the afternoon or evening.

Patients taking the drug Valium 300 should abstain from alcohol.

Use in pediatrics

Valium 300 should not be prescribed for children and adolescents due to lack of clinical experience with the drug in these patients.

Overdose

Symptoms: headache, nausea, and vomiting.

Treatment: symptomatic. No specific antidote.

Drug Interactions

In vitro thioctic (α-lipoic) acid reacts with complexes containing metal ions (eg, cisplatin). Therefore, for simultaneous administration may weaken the effect of cisplatin.

With the simultaneous application of ethanol and its metabolites may reduce the therapeutic activity of Valium 300. Valium 300 enhances the hypoglycemic action of insulin and oral hypoglycemic agents.

Pharmaceutical interactions

Thioctic (α-lipoic) acid forms with the molecules of dextrose (including with solutions levulozy) soluble complex compounds. Valium 300 IU is incompatible with dextrose solution, Ringer's solution, as well as with solutions, which are known to react with SH-groups or disulfide bridges.

Conditions and terms of

List B. The drug should be kept in the dark, place inaccessible to children at or above 25 ° C. Shelf Life tablets - 2 year shelf life of concentrate for solution for infusion - 3 years.