Conditions that shows testosterone suspension gains the parenteral administration of corticosteroids:A state of shock (burns, traumatic, operational, toxic, cardiogenic) – the ineffectiveness vasoconstrictor, plasma-drugs and other symptomatic therapy.Allergic reactions (acute severe), transfusion shock, anaphylactic shock, anaphylactoid reactions.Bronchial asthma (severe), asthmatic testosterone suspension gains status.Intoxication in infectious diseases (with prolonged use of corticosteroids at the same time prescribe antibiotics).Acute and chronic insufficiency of the adrenal cortex (in combination with a mineralocorticoid).Hepatic encephalopathy.
For short-term use for health reasons only contraindication is hypersensitivity to Testosterone suspension gainsu or components of the drug.
The children in the period of growth GCS should be used only if absolutely indicated and under particularly close supervision of your doctor.
With careful preparation should be administered in the following diseases and conditions:
- Diseases of the digestive tract – stomach ulcer and duodenal ulcer, esophagitis, gastritis, acute or latent peptic ulcer, recently established intestinal anastomosis, ulcerative colitis, with the threat of perforation or abscess, diverticulitis.
- Parasitic and infectious diseases of viral, fungal or bacterial origin (currently or recently transferred, including the recent contact with a patient) – herpes simplex, herpes zoster (viremicheskaya phase), chicken pox, measles; amoebiasis, strongyloidiasis; systemic mycosis; active and latent tuberculosis. Application for serious infectious diseases is admissible only against the background of specific therapy.
- Pre- and post-vaccination period (8 weeks before and 2 weeks after vaccination), lymphadenitis after BCG vaccination.
- Immunodeficiency states (including AIDS or HIV infection).
- Diseases of the cardiovascular system (including recent myocardial infarction – in patients with acute and subacute myocardial infarction may spread necrosis, slowing the formation of scar tissue and, as a consequence – the gap of the heart muscle), severe chronic heart failure, arterial hypertension, hyperlipidemia).
- Endocrine diseases – diabetes (including impaired glucose tolerance), hyperthyroidism, hypothyroidism, Cushing’s disease, obesity (W-IV cent.).
- Severe chronic renal and / or hepatic insufficiency, nefrourolitiaz.
- Hypoalbuminemia and conditions predisposing to its occurrence.
- Systemic osteoporosis, myasthenia gravis, acute psychosis, polio (excluding the bulbar form of encephalitis), open-and-closure glaucoma.
Use during pregnancy and lactation
During pregnancy (especially in I trimester) apply only for health reasons. When long-term therapy in pregnancy does not exclude the possibility of fetal growth. In the case of applications III trimester of pregnancy there is a risk of atrophy of the fetal adrenal cortex, which may necessitate replacement therapy in the newborn. Because corticosteroids penetrate into breast milk, if necessary, use during breast-feeding, breast-feeding is recommended to stop.
DOSAGE AND ADMINISTRATION Adults: in shock resistant to standard therapy, a single dose of 30-90 mg intravenously slowly (~ 3 min) or drip. The maximum daily dose-150-300 mg.
If unable to intravenous administration can be administered deeply into the gluteal muscle, with action comes later.
If necessary, an additional 30-60 mg administered intravenously or intramuscularly.
In other testimony single dose – 30-45 mg slow intravenous or intramuscular (into the gluteal muscle). While improving the condition, the treatment should continue decreasing doses of prednisone tablets.
Children: aged 2-12 months: a single dose of 2-3 mg / kg body weight intravenously or deep in the buttock; aged 1-14 – 1.2 mg / kg body weight intravenously slowly (~ 3 minutes) or a deep gluteal muscle. If necessary, after 20-30 minutes, a dose can be repeated.
The frequency and severity of side effects depend on the duration of application, size of the dosage used and the possibility of compliance circadian rhythm deperzolon destination. When using deperzolon may occur:
From endocrine system: reduction of glucose tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, adrenal suppression, Cushing’s syndrome (moon face, obesity, pituitary type, hirsutism, increased blood pressure, dysmenorrhea, amenorrhea, muscle weakness, striae) , delayed sexual development in children.
From the digestive system: nausea, vomiting, pancreatitis, steroid stomach ulcers and duodenal ulcers, erosive esophagitis, gastrointestinal bleeding and perforation of the wall of the gastrointestinal tract, increased or decreased appetite, indigestion, flatulence, hiccups. In rare cases – increased activity of “liver” transaminases and alkaline phosphatase.
Cardio-vascular system: arrhythmia, bradycardia (up to cardiac arrest); development (in predisposed patients) or increased severity of heart failure, electrocardiographic changes typical of hypokalemia, increased blood pressure, hypercoagulation, thrombosis. Patients with acute and subacute myocardial infarction – the spread necrosis, slowing the formation of scar tissue, which can lead to rupture of the heart muscle.
From the nervous system: delirium, disorientation, euphoria, hallucinations, manic-depressive psychosis, depression, paranoia, increased intracranial pressure, nervousness or anxiety, insomnia, dizziness, vertigo, pseudotumor cerebellum, headache, convulsions.
From the senses: posterior subcapsular cataracts, increased intraocular pressure with possible damage to the optic nerve, the propensity to develop secondary bacterial, fungal or viral eye infections, trophic changes of the cornea, exophthalmos, sudden loss of vision (for parenteral administration in the area of the head, neck, nose shells, the scalp may be the deposition of crystals of the drug in the blood vessels of the eye).
On the part of metabolism: increased excretion of calcium, hypocalcemia, increased body weight, negative nitrogen balance (increased protein breakdown), increased sweating.
Conditional mineralocorticoid activity – delay of fluid and sodium (peripheral edema), hypernatremia, hypokalemic syndrome (hypokalemia, arrhythmia, myalgia or muscle spasm, unusual weakness and fatigue).
From the musculoskeletal dvigatelnogo system: slowing growth and ossification in children (premature closure of epiphyseal growth zones), osteoporosis (very rare – pathological fractures, aseptic necrosis of the humeral head and femur), rupture of tendons of muscles, steroid myopathy, reduced muscle mass (atrophy).
For the skin and mucous membranes: delayed wound healing, petechiae, ecchymosis, thinning of the skin, hyper- or hypopigmentation, steroid acne, striae, susceptibility to the development of pyoderma and candidiasis.
Allergic reactions: skin rash, pruritus, anaphylactic shock, local allergic reactions.
Local when administered parenterally: burning, numbness, pain, tingling in the introduction, infection at the injection site, rarely – necrosis of surrounding tissue, scarring at the injection site; atrophy of the skin and subcutaneous tissue with the / m introduction (especially dangerous administration in the deltoid muscle).
Other: development or exacerbation of infection (the appearance of this side effect contribute jointly used immunosuppressants and vaccination), leucocyturia, “cancellation” syndrome.
may be increased side effects described above. It is necessary to reduce the dose deperzolon. Treatment – symptomatic.
INTERACTION WITH OTHER DRUGS
children with asthma is contraindicated use of Testosterone suspension gainsa concurrently with sympathomimetic aerosol. When concomitant administration of anticoagulants and Testosterone suspension gainsa anticoagulative last action can be weakened, at least – to grow; require dose adjustment.
Testosterone suspension gainsa combination with anticoagulants and thrombolytics increases the risk of ulcer bleeding from the gastrointestinal tract. It increases the likelihood
Simultaneous treatment with salicylates is accompanied by acceleration of excretion and decreased concentration, and the abolition Testosterone suspension gainsa – an increase in the concentration of salicylates in the blood with the probability of side effects, including – Occurrence of gastrointestinal bleeding.
Testosterone suspension gainsa combination with diuretics, especially thiazide derivatives, and carbonic anhydrase inhibitors, amphotericin B can lead to increased excretion of K + and increased risk of heart failure; with a sodium-containing drugs – leading to edema and high blood pressure.
Concomitant use with antihypertensive agents Testosterone suspension gainsa. with oral hypoglycemic agents and insulin reduces their effectiveness; with cardiac glycosides – increases the risk of glycoside intoxication with the development of ventricular asystole extras as a result of hypokalemia.
Hormonal contraceptives increase the effect Testosterone suspension gainsa.
Concomitant use Testosterone suspension gainsa and ethanol or non-steroidal anti-inflammatory drugs increase the risk of erozivno- ulcerative lesions and bleeding from the gastrointestinal tract (may require a reduction in dose).
The appearance of hirsutism, acne and edema contributes to the simultaneous use of Testosterone suspension gainsa with other steroid hormones (androgens, estrogens, oral contraceptives, and anabolic steroid).
In addition, the simultaneous use of hormonal contraceptives is accompanied by strengthening actions Testosterone suspension gainsa due to a decrease in clearance of the latter.
The risk of developing cataracts increases with concomitant use with antipsychotics Testosterone suspension gainsa, karbutamida and azathioprine. Concomitant use of inducers of liver enzymes mikrosomalnyh (phenytoin and barbiturates, ephedrine, rifampicin, theophylline) reduces the concentration and weakening Testosterone suspension gainsa effect.
Simultaneous application Testosterone suspension gainsa M-holinoblokatorami, including antihistamines, tricyclic antidepressants, and nitrates promotes intraocular pressure.
Admission Testosterone suspension gainsa pazikvatelem during the treatment reduces the concentration of the latter.
Simultaneous treatment with paracetamol increases the hepatotoxic effect as a result of the induction of hepatic enzymes and formation of toxic metabolite of paracetamol.
Simultaneous treatment with vitamin D reduces the impact of the latter on calcium absorption in the intestine.
At simultaneous reception with growth hormone reduced the effectiveness of the latter.
Intensifies metabolism and decrease blood concentrations of isoniazid and mekselitina while reception Testosterone suspension gainsom them, especially in slow acetylators.
Carbonic anhydrase inhibitors and loop diuretics may contribute to the development of osteoporosis.
Indomethacin Testosterone suspension gains displaces from its association with albumin and contributes to the development of osteoporosis.
Ergocalciferol and parathyroid hormone hinder the development of glucocorticosteroid osteopathy.
ACTH increases the effects Testosterone suspension gainsa.
Cyclosporine and ketoconazole, slowing metabolism Testosterone suspension gainsa, in some cases increasing its toxicity.
At simultaneous reception with mitotanom and other inhibitors of adrenocortical function may require increasing doses Testosterone suspension gainsa.
Concomitant use with live virus vaccines and other types of immunization contributes to the activation of virus with the development of infectious diseases.
Antititireoidnye preparty reduce and thyroid hormones increase Testosterone suspension gainsa clearance.
During treatment deperzolon (especially long) must be monitored ophthalmologist, blood pressure control, the state of water and electrolyte balance, as well as patterns of peripheral blood and the blood glucose level.
In order to reduce the side effects can be administered antacids and increase the flow of K + in the body (diet, potassium supplements). Food should be rich in proteins, vitamins, with the restriction of fat, carbohydrates and salt.
The drug is enhanced in patients with hypothyroidism and liver cirrhosis.
The drug may exacerbate existing emotional instability or psychotic disorders. When referring to the history of psychoses in deperzolon in high doses administered under strict medical supervision.
Caution should be used in acute and subacute myocardial infarction – may spread necrosis, slowing the formation of scar tissue and rupture of the heart muscle.
In stressful situations during maintenance therapy (eg, surgery, trauma, or infectious diseases) should be carried out correction dose due to an increase in the SCS needs. With the sudden cancellation, particularly in the case of the prior use of high doses may develop the syndrome of “cancellation” (anorexia, nausea, lethargy, generalized musculoskeletal pain, general weakness), as well as exacerbation of the disease, about which he was appointed deperzolon.
During treatment deperzolon should not be vaccinated due to the reduction of its effectiveness (immune response).
Appointing deperzolon during intercurrent infections, septic conditions, and tuberculosis, treatment with antibiotics is necessary to simultaneously bactericidal action.
In children, during long-term treatment deperzolon careful observation of the dynamics of growth and development. Children who during the treatment period were in contact with patients with measles or chickenpox, prophylaxis prescribe specific immunoglobulins.
Due to the weak mineralocorticoid effect for replacement therapy in adrenal insufficiency deperzolon used in combination with a mineralocorticoid.
In patients with diabetes should monitor the glucose content of the blood and correct therapy if necessary.
Showed radiological control of bone and joint system (spine images, brushes).
Deperzolon in patients with latent infectious diseases of kidneys and the urinary tract can cause pyuria, which may be of diagnostic value.
Deperzolon increases the content of metabolites 11- and 17-oksiketokortikosteroidov. Running low dose t3 clen cycle trying to lose bodyfat isn’t a real hot idea imo.