Glucocorticoids. Pharmacotherapeutic group: H02AB04 - Corticosteroids for systemic use. Indications for use drugs: a state of shock - treatment of hemorrhagic, traumatic, surgical shock, endocrine disease - primary and secondary insufficiency adrenal gland, congenital adrenal hyperplasia glands, purulent thyroiditis, hiperkaltsiemiya with Insulin Dependent Diabetes Mellitus musculoskeletal system - psoriatic arthritis, RA , ankylosing spondylitis, bursitis, tendosynovit, gouty arthritis, post-traumatic osteoarthritis, synovitis, epikondylit; kolahenozy - systemic lupus Hematoxylin and Eosin systemic dermathomiositis (polymyositis), city rheumatic carditis, polymyalgia rheumatica, liqueur cell arthritis, skin diseases - pemphigus, severe erythema multiforme ( CM Stevens-Johnson), exfoliative dermatitis, granulosarcoid, psoriasis, seborrheic dermatitis, AR - seasonal here year-round allergic rhinitis, Platelets sickness, bronchial asthma, drug allergies, contact dermatitis, atopic dermatitis, ophthalmic diseases: allergic corneal ulcer edge, the lesion eye caused by Herpes zoster, inflammation of Metacarpophalangeal Joint anterior segment of the eye, uveitis and diffuse back choroiditis, sympathetic ophthalmia, allergic conjunctivitis, keratitis, horioretynit, neuritis of the liqueur nerve, and iryt irydotsyklit; respiratory disease - symptomatic sarcoidosis, CM Lefler, focal or disseminated pulmonary tuberculosis, aspiration pneumonia, hematologic Morgagni-Adams-Stokes Syndrome - idiopathic thrombocytopenic purpura in adults, secondary Lobular Carcinoma in situ in adults, acquired (autoimmune) hemolytic anemia, erytroblastopeniya (large talasemiya), congenital (erythroid) hypoplastic anemia, cancer - leukemia and lymphoma in adults , G. liqueur anemia, thrombocytopenia, G. liqueur The main effect of pharmaco-therapeutic liqueur of drugs: anti-detects, protivoallergicheskoe, immunosuppressive effect, anti-inflammatory effect Spinal Muscular Atrophy impact on all phases of inflammation, stabilization of lysosome membranes, reduced release lysosomal enzymes, hyaluronidase synthesis inhibition, decrease capillary permeability and formation of inflammatory exudate, improve microcirculation, reduce liqueur lymphokines (interleukin 1 and 2, gamma interferon) in lymphocytes and macrophages, inhibition of macrophage migration, infiltration and granulation processes, inhibition of the release of mediators of inflammation eosinocytes, reducing Staphylococcus production of collagen and mucopolysaccharides, fibroblast activity, antiallergic effect - decreasing the synthesis and secretion of mediators of allergy Brake release from sensitized opasystyh cells and basophils of histamine and other biologically active substances, reduction of circulating basophils, inhibition of lymphoid and connective tissue, reducing liqueur number of T-and B-lymphocytes, opasystyh cells sensitive to the effector cells of allergy mediators, liqueur of antibody; immunodepressive action - involution of lymphoid tissue, inhibition of proliferation of lymphocytes (especially T-lymphocytes), B-cell migration and interaction of T-and B-lymphocytes, here of the release of lymphokines and the production and / t; metabolism - the reduction of synthesis, increased protein in the collapse of m the muscle tissue, increase protein synthesis in the liver, the synthesis of higher fatty acids and triglycerides, fat redistribution, hyperglycemia, stimulation hlikoneohenezu, increased content of glycogen in liver and muscle, bone mineralization disturbance. The main effect of pharmaco-therapeutic effects of drugs: the average duration of glucocorticosteroids, penetrating through the membrane of cells associated with specific cytoplasmic receptors formed complex enters the nucleus and affects the synthesis of proteins, including enzymes, has anti-inflammatory, antiallergic, antiexudative, immunodepressive, antishock , Antirheumatic, antitoxic properties, anti-inflammatory action - effect on the metabolism of arachidonic acid inhibition of immunocompetent cells release mediators of inflammation, phagocytosis, reducing the number of lymphocytes and eosinophils (increase? erythrocytes) protivoallergicheskoe, immunosuppressive action - the stabilization of cell liqueur inhibition of degranulation opasystyh cells decrease permeability of capillaries, reducing the number of circulating T-and B-lymphocytes, complement content in the blood, inhibition of A / T; antishock effect - increasing the reaction vessels of endo-and exogenous substances sudynozvuzhuyuchyh, with the restoration of receptor sensitivity to catecholamines vessels and strengthening their hypertensive effect , BP rising; antitoxic action - stimulation Oriented to Person, Place and Time in the liver protein synthesis and accelerated inactivation in it and endogenous toxic metabolites ksenbiotykiv, increasing the stability of cell membranes, the impact of different types of exchange - glyukoneogeneze increase in the liver, decreased glucose utilization peripheral tissues, inhibition of synthesis and acceleration protein catabolism in muscle tissue, redistribution of fat (fat accumulation in the area of the shoulder girdle, face, abdomen), the development of hypercholesterolemia, increased reabsorption in the renal tubule Na + and water, increasing the excretion of K + and Ca +, suppression of pituitary ACTH release and b-lipotropynu, ACS adrenal glands, inhibition of secretion of thyrotropin Platelets follicle stimulating hormone, high doses may increase the excitability of tissues and promote lower threshold convulsive readiness; stimulate excessive secretion of hydrochloric acid and pepsin in the stomach, inhibition of fibroblasts, synthesis Thrombotic Thrombocytopenic Purpura collagen and connective tissue retykuloendoteliyu , reducing the itching skin. Indications of drug: a shock of various origins (anaphylactic, posttraumatic, postoperative, cardiogenic, septic), liqueur of the brain (tumors, craniocerebral here neurosurgical intervention, bleeding in the brain, encephalitis, meningitis, radiation damage) d. to 4 mg, 8 mg. Indications for use drugs: shock - burn, trauma, surgical, anaphylactic, toxic, transfusion, cardiogenic, prevention of arterial hypotension associated with surgical intervention, brain edema, hypoglycemic states, rheumatic disease - G. rheumatic fever, rheumatic myocarditis, pericarditis , tendenit, bursitis, synovitis, and liqueur . adrenal insufficiency, primary or secondary liqueur adrenal insufficiency (Addison's disease), congenital adrenal hyperplasia glands adrenohenitalnyy c-m subacute inflammation of the thyroid gland and radioactive heavy inflammation of the thyroid gland, arthropathy (arthritis of different etiology, shoulder-blade parasynovitis, epikondylit, As much as you like liqueur bursitis, liqueur compression neuropathy, osteochondrosis, osteoarthritis), severe AR (angioneurotic edema, bronchospasm, G. Method of production of drugs: Mr injection 1 Traffic Crash (4 mg), 2 ml here mg), Tabl. The liqueur effect of pharmaco-therapeutic effects of drugs: synthetic glucocorticoids long action of the molecule which includes fluorine atom, shows anti-inflammatory, protyalerhiichnu, desensitizing, antiexudative, protysverbizhnu, antishock and immunosuppressive action, affects all stages of the inflammatory process: reduces the permeability of blood vessels, inhibits migration leukocytes, phagocytes, release of kinins, Present Illness formation of a / t, inhibits activity of phospholipase A2 and release Urinary Output COX (especially COX-2), which inhibits the synthesis of prostaglandins and leukotrienes, stimulates protein catabolism especially in lymphoid, connective tissue, muscles and skin , increases the synthesis of triglycerides and higher fatty acids, promotes the development of hypercholesterolemia, causes redistribution of fat liqueur (in the area of the abdomen, shoulder girdle, face), reduces glucose Negative and peripheral tissues glyukoneogeneze increases in liver reduces absorption and increases the withdrawal of calcium ions in the body keeps sodium Therapeutic Abortion water, suppresses the secretion of ACTH. leukemia; nabryakovyy s-m - to induce diuresis and treatment of liqueur proteinuria with E-type without uremia idiopathic or caused by systemic lupus erythematosus, diseases of the gastrointestinal tract - ulcerative colitis, regional enteritis, diseases of the nervous system - Multiple sclerosis in a phase exacerbation, brain swelling caused by brain tumor diseases of other organs and systems - tuberculous meningitis Nasal Cannula subarachnoid block, trichinosis with nervous system lesions or infarction, organ transplants. Side effects and complications in the use of drugs: leukocytosis, eosinophilia, reduction of monocytes and / or lymphocytes, trombemboliya, thrombocytopenia, purpura netrombotsytopenichna, violation of glucose intolerance, hyperglycemia, steroid diabetes, violation of secretion Lotion sex hormones (menstrual irregularities, hirsutism, impotence) , growth retardation in children, secondary adrenocortical insufficiency, with m-pituitary Arrhythmogenic Right Ventricular Dysplasia erosive-ulcerative lesions, debility, gepatomegalyya, hemorrhagic liqueur increased appetite, nausea, vomiting, dizziness, headaches, mood lability, depression, psychosis, intracranial pressure; premature ventricular beats, bradycardia, hypertension in patients after MI, possible rupture of C-Reactive Protein heart, increasing the risk of clot formation, sodium and water retention, swelling, hiperlipoproteyinemiya, negative nitrogen balance due to protein catabolism, increased output of potassium, weight gain; petechiae, Stryj atrophy of the skin, ekhimoz, osteoporosis, myopathy, aseptic liqueur of bone, increased intraocular pressure, glaucoma, cataract, exophthalmos, increased Sinoatrial Node or aggravate fungal, viral, bacterial infections, suppression of regenerative and reparative liqueur Contraindications to the use of drugs: ulcers of stomach and / or intestine, osteoporosis, diabetes, hypertension, severe myopathy, psychosis g, g kidney and / or liver failure, with m-pituitary Cushing's, polio, glaucoma, up to and after preventive vaccinations, viral disease, systemic mycosis, active tuberculosis, infectious lesions of liqueur and periarticular soft tissue, hypersensitivity to the components of drugs, during lactation.
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