Dexamethasone solution for intravenous and intramuscular administration of 4 mg ampoules 1 ml 10 pcs
Condition: New product
1000 Items
Rating:
Be the first to write a review!
More info
Active ingredients
Dexamethasone
Composition
1 ml of dexamethasone phosphate (in the form of sodium salt) 4 mg. Excipients: glycerol - 22.
Pharmacological effect
GKS. Suppresses the function of leukocytes and tissue macrophages. Limits the migration of leukocytes to the area of inflammation. Violates the ability of macrophages to phagocytosis, as well as the formation of interleukin-1. It contributes to the stabilization of lysosomal membranes, thereby reducing the concentration of proteolytic enzymes in the area of inflammation. Reduces capillary permeability due to histamine release. Suppresses the activity of fibroblasts and the formation of collagen. Inhibits the activity of phospholipase A2, which leads to the suppression of the synthesis of prostaglandins and leukotrienes. Suppresses the release of COX (mainly COX-2), which also helps to reduce the production of prostaglandins. Reduces the number of circulating lymphocytes (T-and B-cells), monocytes, eosinophils and basophils due to their movement from the vascular bed to the lymphoid tissue. inhibits the formation of antibodies. Dexamethasone suppresses the release of pituitary ACTH and &. 946.-Lipotropin, but does not reduce the level of circulating & # 946.-Endorphin. It inhibits the secretion of TSH and FSH. With the direct application of the vessels has a vasoconstrictor effect. Dexamethasone has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Stimulates gluconeogenesis, promotes the uptake of amino acids by the liver and kidneys, increases the activity of gluconeogenesis enzymes. In the liver, dexamethasone enhances the deposition of glycogen, stimulating the activity of glycogen synthetase and the synthesis of glucose from the products of protein metabolism. An increase in blood glucose activates insulin secretion. Dexamethasone inhibits glucose uptake by fat cells, which leads to the activation of lipolysis. However, due to an increase in insulin secretion, lipogenesis is stimulated, which leads to fat accumulation. It has a catabolic effect in the lymphoid and connective tissue, muscles, adipose tissue, skin, bone tissue. Osteoporosis and Itsenko-Cushing syndrome are the main factors limiting long-term therapy of corticosteroids. As a result of the catabolic effect, growth can be suppressed in childrenIn high doses, dexamethasone may increase the excitability of brain tissue and help lower the threshold of convulsive readiness. Stimulates excessive production of hydrochloric acid and pepsin in the stomach, which contributes to the development of peptic ulcers. With systemic use, the therapeutic activity of dexamethasone is due to the anti-inflammatory, anti-allergic, immunosuppressive and anti-proliferative effects. When applied topically and locally, the therapeutic activity of dexamethasone is due to the anti-inflammatory, antiallergic and anti-exudative (due to the vasoconstrictor effect) action. On anti-inflammatory activity exceeds hydrocortisone 30 times, does not possess mineralocorticoid activity.
Indications
For the reception of the disease pemphigus (normal), acute eczema (at the beginning of treatment), malignant tumors (as palliative therapy), congenital adrenogenital syndrome to the brain (usually after prior parenteral administration of GCS). For parenteral administration: shock of various genesis of cerebral edema (with a brain tumor, traumatic brain injury, neurosurgical intervention, cerebral hemorrhage, encephalitis, meningitis, radiation damage), severe allergic reactions (edema, bronchospasm, arthritis, arthropathy, asthma), asthmatic status, severe allergic reactions (edema, bronchospasm, rheumatoid arthritis), asthmatic status; reaction to drugs, serum transfusions, pyrogenic reactions) acute hemolytic anemia, thrombocytopenia, acute lymphoblastic leukemia, agranulocytosis severe infectious diseases anija (in conjunction with antibiotics), acute adrenal insufficiency cereals acute joint disease (scapulohumeral periarthritis, epicondylitis, styloiditis, bursitis, tenosynovitis, compression neuropathy, low back pain, arthritis of various etiologies, osteoarthritis).For use in ophthalmic practice: non-purulent and allergic conjunctivitis, keratitis, keratoconjunctivitis without damage to the epithelium, iritis, iridocyclitis, blepharoconjunctivitis, blepharitis, episculitis, scleritis, inflammatory process after eye injuries and surgical procedures, sympathetic ophthalmus, scleritis, inflammatory process after eye injuries and surgical interventions, sympathetic ophthalmus, scleritis, inflammation after eye injuries and surgical procedures, sympathetic ophthalmus, sylmatitis
Contraindications
For short-term use for health reasons - hypersensitivity to dexamethasone. For intra-articular administration and administration directly to the lesion: previous arthroplasty, abnormal bleeding (endogenous or caused by the use of anticoagulants), intra-articular bone fracture, infectious (septic) inflammation in the joint and periarticular infections (including history), as well as general infectious disease, marked periarticular osteoporosis, no signs of inflammation in the joint ("dry" joint, for example, in osteoarthritis without synovitis), severe bone destruction and joint deformity (sharp narrowing of the joint space, ankylosis), joint instability as an outcome of arthritis, aseptic necrosis of the epiphysis of the bones forming the joint. For external use: bacterial, viral, fungal skin diseases, skin tuberculosis, skin manifestations of syphilis, skin tumors, post-vaccination period, violation of the integrity of the skin (ulcers, wounds), children (up to 2 years, with itching in the anus - up to 12 years), rosacea, acne vulgaris, perioral dermatitis. For use in ophthalmology: bacterial, viral, fungal diseases of the eye, tuberculosis of the eyes, violation of the integrity of the eye epithelium, an acute form of purulent eye infection in the absence of specific therapy, corneal diseases associated with epithelial defects, trachoma, glaucoma.
Use during pregnancy and lactation
During pregnancy (especially in the first trimester), as well as during lactation, dexamethasone is used taking into account the expected therapeutic effect and the negative effect on the fetus. With prolonged therapy during pregnancy does not exclude the possibility of fetal growth disorders. In the case of use at the end of pregnancy there is a risk of atrophy of the adrenal cortex in the fetus, which may require replacement therapy in the newborn.
Side effects
From endocrine system: reduction of glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, adrenal suppression, Cushing's syndrome (including moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis , striae), delayed sexual development in children. On the part of metabolism: increased excretion of calcium ions, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating, hypernatremia, hypokalemia. CNS: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, cerebellar pseudo-tumor, headache, convulsions. Since the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest). development (in susceptible patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. with intracranial administration - nosebleeds. On the part of the digestive system: nausea, vomiting, pancreatitis, steroid gastric and duodenal ulcers, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. rarely, increased activity of hepatic transaminases and alkaline phosphatase. On the part of the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral infections of the eye, trophic changes of the cornea, exophthalmos. On the part of the musculoskeletal system: growth retardation and ossification processes in children (premature closure of the epiphyseal growth zones), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), muscle tendon rupture, steroid myopathy, muscle mass reduction (atrophy).Dermatological reactions: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to the development of pyoderma and candidiasis. Allergic reactions: generalized (including skin rash, itchy skin, anaphylactic shock) and when applied topically. Effects associated with the immunosuppressive effect: the development or exacerbation of infections (the joint use of immunosuppressants and vaccination contribute to the occurrence of this side effect). Local reactions: with parenteral administration - tissue necrosis. When applied topically: rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stria, strep. With prolonged use or application to large areas of skin may develop systemic side effects characteristic of GCS.
special instructions
From endocrine system: reduction of glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, adrenal suppression, Cushing's syndrome (including moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, myasthenia gravis , striae), delayed sexual development in children. On the part of metabolism: increased excretion of calcium ions, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating, hypernatremia, hypokalemia. CNS: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, cerebellar pseudo-tumor, headache, convulsions. Since the cardiovascular system: arrhythmias, bradycardia (up to cardiac arrest). development (in susceptible patients) or increased severity of chronic heart failure, ECG changes characteristic of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. In patients with acute and subacute myocardial infarction - the spread of necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle. with intracranial administration - nosebleeds.On the part of the digestive system: nausea, vomiting, pancreatitis, steroid gastric and duodenal ulcers, erosive esophagitis, bleeding and perforation of the gastrointestinal tract, increased or decreased appetite, flatulence, hiccups. rarely, increased activity of hepatic transaminases and alkaline phosphatase. On the part of the senses: posterior subcapsular cataract, increased intraocular pressure with possible damage to the optic nerve, a tendency to develop secondary bacterial, fungal or viral infections of the eye, trophic changes of the cornea, exophthalmos. On the part of the musculoskeletal system: growth retardation and ossification processes in children (premature closure of the epiphyseal growth zones), osteoporosis (very rarely - pathological bone fractures, aseptic necrosis of the head of the humerus and femur), muscle tendon rupture, steroid myopathy, muscle mass reduction (atrophy). Dermatological reactions: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, stretch marks, tendency to the development of pyoderma and candidiasis. Allergic reactions: generalized (including skin rash, itchy skin, anaphylactic shock) and when applied topically. Effects associated with the immunosuppressive effect: the development or exacerbation of infections (the joint use of immunosuppressants and vaccination contribute to the occurrence of this side effect). Local reactions: with parenteral administration - tissue necrosis. When applied topically: rarely - itching, hyperemia, burning, dryness, folliculitis, acne, hypopigmentation, perioral dermatitis, allergic dermatitis, skin maceration, secondary infection, skin atrophy, stria, strep. With prolonged use or application to large areas of skin may develop systemic side effects characteristic of GCS.