Tag Archives: primo steroid

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primo steroid

Nausea, mucosal erosions of the gastrointestinal tract, confusion, dizziness, unconsciousness, hallucinations, tremors and seizures, prolongation of the interval primo steroid. Treatment: symptomatic; monitoring parameters; appointment of antacids. No specific antidote.

Interaction with other drugs

Salts of iron, zinc, antacids, salts containing magnesium or aluminum, didanosine (Only those preparations of didanosine which comprise as auxiliary substances magnesium and aluminum) significantly reduce the absorption of levofloxacin while receiving.
In an application of levofloxacin and iron salts, zinc salts, antacids containing magnesium or aluminum, didanosine recommended to assign the last 2 hours after administration of levofloxacin (or 2 hours before receiving levofloxacin).
calcium salts have little effect on the oral absorption of levofloxacin. Sucralfate significantly reduces the bioavailability of levofloxacin. With simultaneous use of levofloxacin and sucralfate are encouraged to nominate the last 2 hours after receiving levofloxacin. There were no pharmacokinetic interactions between levofloxacin and theophylline. However, the concomitant use of quinolones with theophylline, primo steroid and other drugs that reduce the seizure threshold may be lowered seizure threshold. in the presence of fenbufen levofloxacin concentration of about 13% higher than when used as monotherapy.when concomitant use levofloxacin  increased by 33%. In an application with indirect anticoagulants, coumarin derivatives (eg., Warfarin), there is an increase of indicators of coagulation (prothrombin time / international normalized ratio (INR)) and / or bleeding. Cimetidine and probenecid, as a result of blocking the renal tubular secretion, reduce the renal clearance of levofloxacin 24% and 34%, respectively, so levofloxacin should be used with caution in conjunction with drugs that affect the tubular secretion (such as probenecid and cimetidine), especially in patients with impaired renal function. levofloxacin may lengthen the interval , so be careful when the simultaneous use of antiarrhythmic drugs class IA and III, tricyclic antidepressants, macrolides and neuroleptics.Glucocorticoids increase the risk of tendon rupture. no clinically meaningful effect on the pharmacokinetics of levofloxacin had no concomitant use of calcium carbonate, glibenclamide, ranitidine, digoxin.

 

special instructions

The prevalence of acquired resistance strains of pathogens may vary depending on geographic region and over time. In connection with this required information on microbial resistance to the drug in a particular country. For treatment of severe infections or when treatment failure should be set microbiological diagnosis with the release of the pathogen and the determination of its sensitivity to levofloxacin.
There is a high probability that the methicillin-resistant staphylococcus aureus would be resistant to fluoroquinolones, including levofloxacin. Therefore levofloxacin is not recommended for the treatment of established or suspected infections causedaureus, if laboratory tests have not confirmed the sensitivity of the organism to levofloxacin. Levofloxacin can cause serious, potentially fatal hypersensitivity reactions (angioedema, anaphylactic shock), even when primo steroid using the initial . Patients should stop taking the drug and consult a doctor.
When receiving levofloxacin observed cases of severe bullous skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. In the case of any reaction on the part of the skin and the mucous membranes of the patient should seek medical advice immediately and continue treatment to his advice.
Reported cases of hepatic necrosis, including the development of fatal liver failure in the application of levofloxacin, primarily in patients with severe major diseases, such as sepsis (see. “Side effects” section). Patients should be warned about the need to stop treatment and urgent referral to a doctor in case of symptoms and liver disease symptoms such as anorexia, jaundice, dark urine, itching, and abdominal pain.
Should be taken 2 hours before or 2 hours after administration of iron salts, zinc salts, sucralfate or didanosine (only ddI formulations, which contain as excipients magnesium and aluminum), because there may be a decrease in its absorption.
patients concurrently taking indirect anticoagulants, coumarin derivatives, it is necessary to control parameters blood clotting.
In rare cases, observed during treatment with quinolones, tendinitis can lead to rupture of ligaments, especially the Achilles tendon. This side effect is apparent within 48 hours after initiation of therapy. For the elderly and patients taking steroids, there is an increased risk of developing tendinitis. Therefore, during treatment with levofloxacin should be closely monitored the status of such patients.
If there is a suspicion of tendonitis (to inform patients about its symptoms), reception primo steroid is necessary to stop and start the appropriate treatment immediately (eg., Immobilization).
Diarrhoea (especially in cases of severe resistant and / or mixed with blood) during or after reception  may be a symptom of disease caused by Clostridium difficile, the most severe form of which is pseudomembranous colitis. If there is a suspicion of pseudomembranous colitis,  should be discontinued immediately and symptomatic treatment of conduct (eg., Oral vancomycin).In this state, drugs that inhibit peristalsis are contraindicated.

primo steroid

Ambroxol is the active l metabolite of bromhexine. It has sekretomotornym, sekretoliticheskim and expectorant action. It stimulates serous cells of glands of bronchial mucosa by increasing mucin content and thus changes the disturbed ratio of serous and mucous components of phlegm. Ambroxol content increases mucous secretion and release of surfactant (surfactant) in the alveoli and primo steroid bronchi. Increases motor activity of ciliated epithelium, increases mucociliary phlegm transport. On average, orally effect occurs within 30 minutes, the duration – 6-12 hours.

 

After ingestion ambroxol rapidly and almost completely absorbed from the gastrointestinal tract. The maximum plasma concentration (C max ) is achieved after approximately 1-3 hours. The resulting metabolites (such as dibromantranilovaya acid glucuronide) excreted by the kidneys. Distribution . Binding to plasma proteins – about 85% (80-90%). Ambroxol penetrates through the blood-brain and placental barriers and is excreted in breast milk. Metabolism . Ambroxol is metabolized in the liver by conjugation to form a pharmacologically inactive metabolites. Excretion . Because of the high degree of binding to plasma proteins and large distribution volume, and slow reverse distribution of tissue elimination significantly ambroxol blood by dialysis or forced diuresis not be expected.

 

Indications
Acute and chronic diseases of the respiratory tract, accompanied by violation of the secretion and transport of sputum:

  • acute and chronic bronchitis;
  • pneumonia;
  • chronic obstructive pulmonary disease;
  • bronchial asthma with obstruction of primo steroid sputum discharge;
  • bronchiectasis.

Contraindications

  • Hypersensitivity to ambroxol or other components of the preparation.
  • Children up to age 6 years.

Precautions :

  • dysmotility bronchi and formation of secretions in large quantities (for example, a rare syndrome of fixed cilia);
  • renal failure or hepatic insufficiency;
  • peptic ulcer and 12 duodenal ulcer.

Pregnancy and lactation
Use of the drug in the I trimester of pregnancy is contraindicated. In II and III trimester of pregnancy, the drug should be taken with caution.
Use of the drug during lactation is possible only if the expected benefit of treatment to the mother outweighs the potential risk to the infant.

Dosage and administration:
Tablets for oral use.
Tablets are taken after a meal, without chewing and drinking plenty of fluids. It is recommended to observe the following dosages: Children aged 6 to 12 years old : 2-3 times daily 1/2 tablet (respectively, 2-3 times 15 mg of ambroxol hydrochloride). Adults and children over 12 years : during the first 2- 3 days, take 3 times a day 1 tablet (respectively, 3 times 30 mg of ambroxol hydrochloride), then – 2 times a day 1 tablet (or 2 x 30 mg of ambroxol hydrochloride). If necessary for enhancing the therapeutic effect can be given 2 tablets 2 times a day (corresponding to 120 mg ambroxol hydrochloride / day). In renal failure, or severe liver disease should increase the interval between doses, or reduce the dose while taking the drug. The duration of the application is installed on an individual basis depending on the evidence and the disease. Without a doctor’s primo steroid appointment should not take more than 4-5 days.

 

Side effects
Possible side effects are listed below in descending frequency of occurrence: Sometimes  including isolated reports. Allergic reactions : sometimes – skin rash, urticaria, angioedema edema, pyrexia, dyspnea; very rarely – anaphylactic shock. From the digestive system : sometimes – diarrhea, dry mouth, constipation; long-term use – abdominal pain, nausea, vomiting. For the skin : very rarely – toxic epidermal necrolysis, Stevens-Johnson syndrome. Other : rarely – weakness, headache, rash, dysuria.

Overdose
Symptoms of a person overdose have not been described.
There are: short-term anxiety, diarrhea, nausea, vomiting.
If a significant excess of the dose (more than 25 mg / kg / day) may decrease blood pressure, excessive salivation. Treatment : artificial vomiting, gastric lavage in the first 1 -2 hours after ingestion;reception of fat-containing products; symptomatic therapy.

Interaction with other drugs
the combined use ambroxol and antitussive drugs that suppress the cough reflex, due to the weakening of the cough reflex may be a risk of stagnation in the bronchi. Increases penetration in bronchial secretion of amoxicillin, cefuroxime, erythromycin and doxycycline.

Cautions
Patients with severe renal insufficiency primo steroid should take into account the possibility of cumulation of ambroxol metabolites formed in the liver.
Necessary to ensure entry to the body fluid in sufficient quantity to maintain sekretoliticheskim action Ambroxol during ingestion.