Betamethasone

Chemical name

(11бета,16бета)-9-Фтор-11,17 ,21-тригидрокси-16-метил прегна-1,4-диен-3,20-дион (and in the form of dipropionata, dinatria phosphate, valerate, etc.)

Gross

C22-H29-F-O5

Characteristics

Fluoride homologs hydrocortisone. White or kremovo-bely powder odourless, virtually nerastvorim in water, easily soluble in acetone, a moderate in ethanol and chloroform.

Of drugs

Drugs, the anti-inflammatory, glukokortikoidne, protiwallergicescoe, protivozudnoe. When a local big receptacles withdraws feature reduces the mediators of inflammation (of Eosinophils and fat cells), interleukin 1 and 2, gamma-interferon (of lymphocytes and macrophages), down gialuronidasy activity and decreased permeability of vascular wall. Interacts with specific receptors in zitoplazme cells stimulates synthesis Mrnk, education inducing proteins, including lipokortina, oposreduth cell effects. Lipokortin oppressing fosfolipazu A_2, blocking liberatiou arahidonova acid biosynthesis and endoperekisey, NG, lakotrienov (to the development of inflammation, allergies and other pathological processes). Increases the level of glucose in the blood, accelerates catabolised protein, sodium delayed and Vodu.posle liver (in / m) and the enteralnogo rapidly absorbed maximum effect (the ingestion) develops in 1-2 hours A local software intensity removal depends on several factors : the solvent (polypropylene components improve diffusion), the эпидермального barrier (inflammation and skin diseases increase the intake). The plasma is associated with proteins. Easily passes gistogematicalkie barriers, including placental. Биотрансформируется in the liver (mostly), resulting metabolites not active. Excreted kidneys; Partly out of breast milk.

Indications

Inherent gipoplasia napochechnikov, napochechnikovaya deficiency (usually in combination with mineralokortikoidami); Shock (anaphylactic, endotoksicski, gemodinamicheski); Tireoidit (acute, chronic), tireotoksicski kriz, gipercalziemia by malignant neoplasms; Rheumatoid arthritis in the phase of deterioration, acute revmocardit, systemic lupus red, sklerodermia and other systemic diseases connective tissue, inflammatory destruction of joints and soft tissues, including okolosustaveh (traumatic arthritis, acute gouty etc. genesis, arthritis, osteohondrit, bursitis, fibrosit, tendonitis tendowaginit, tendoshinovit, acute illness, GACVS); prevention of rejection reactions transplant; argued syndrome; severe allergic, incl. anaphylactoidnye reaction (from drugs associated with transfusions, allergic rinita, swelling Kwinke, savorotocnaya disease, etc.); bronchial asthma (including asthma status), sarkoidoz, berillios, Leffler syndrome, aspirazionny pnevmonit; brain edema (traumatic, posleoperazionny, metstaticski, postinsultny); neirodermit, dermatitis (simple exfoliativei, sunny, seborainey, radiation, bullezny gerpetiformny contact, atopic, lower limbs to circulatory failure, etc.), eczema (child, atopical, monetovidnaya), psoriasis, oprelosti, gnezdnaya pleshivosti, colloid scars, uzlovataya pocesuha Gajda, itching (aged, anoguenitalny) mnogoformnaya ekssoudatus erythema, eritrodermia, vesicular disease, Mycobacterium shaped etc. skin diseases; recurrent mouth disease; Baby Ulcerative Colitis, ulcerative disease; Anemia (Autoimmune Hemolytic, congenital gipoplastical) idiopathic and secondary anaemia in adults, acute leukaemia in children, lymphomas (hodgkinskaya, lymphoma), lymphoblastic (chronic); allergic conjunctivitis and corneal ulcers, keratit, iridotsyklit, irit, horioretinit, diffuse horioidit, retrobulbarnyi rapid, prevention distress-sindroma in newborns, croup and diphtheria, tuberculosis meningitis, tetanus (in combination with antimicrobial means); breast cancer and prostate.

Contraindications

Hypersensitivity, mikozy system, the HIV / AIDS epidemic, the active form of tuberculosis, chickenpox, herpes simple, incl. eyes, mouth and other viral diseases, the vaccination pepticalkie ulcer syndrome, a disease hospital of stomach and duodenal ulcer (in the phase of deterioration), divertikulit, ezofagit, gastritis, intestinal fresh anastomozy, long cardiac insufficiency, throm, arterial hypertension, diabetes mellitus, a disease Itsenko - Kushinga, osteoporosis, male, gipoalbuminemia, heavy human liver and kidneys, psychoses, открытоугольная glaucoma, pregnancy (including eclampsia, eclampsia), breast-feeding (especially at high doses preparation); vnutrisustavno, a hotbed of defeat : unstable joints prior Arthroplasty, okolosustaus disease infected areas affected, the blood clotting; naruzhno : acne (pink, ordinary), the primary viral, fungal, bacterial, incl. tuberculosis, infections of the skin and nails of the head; children under 1 year of fine (in the background oprelosti), dermatitis and Medicine.

Side-Effects

Gipokaliemia, muscle weakness, miopatia, osteoporosis, spontaneous fractures, arterial hypertension, miocardiodistrofia, witness, and labor tromboembolia, erosivno-azwenne shock syndrome, steroidnyi diabetes, lower immunity and activates infectious diseases suprescia гипоталамо-гипофизар��о-адреналовой system, the emergence of girsutisme and teens, the regularity of menstruation, Itsenko syndrome - Kushinga, increasing weight, sleep disturbance, euphoria commencement or depression, anxiety, psychosis, glaucoma, cataract, steroidnyi exofthalm, lifting syndrome (with a sharp cut in long-term therapy); rarely Delay sodium and water (swelling); Local-itch, hyperemia, heat, dryness, pigmentation, dermatitis (perioralny, allergic), mazeration and atrophy of skin, scars, potnica secondary infections of the skin and mucous membranes.

Specific guidance

To avoid an overdose of dose calculations predict on the basis of square metre surface area.

Patient interaction

Therapeutic, toxic effects reduce индукторы liver enzymes reinforce - эстрогены and oral contraceptive methods, the likelihood of arrhythmias and гипокалиемии - glycosides lapidary, диуретики (lack of potassium), amphotericin B, карбоангидразы inhibitors, the risk of losses язвенно-эрозивных or bleeding in the stomach, alcohol and НПВС; likely infections and the development of cancer and other diseases limfoproliferativeh - immunosuppressants possibility of a light pain in pregnant-ritodrin. Ters гипогликемическую противодиабетических activity and insulin, and натрийуретическую диуретическую - мочегонных activity vaccines (because of the decline in the production of antibodies); Antikoagulyazionnuu-coumarin derivatives and indandiona, heparin, and streptokinaza urokinaza. Increases gepatotoksicnosti paracetamol. Impact concentration in the blood salicilatov, mexiletina.

Overdosing

Symptoms : nausea, vomiting, sleep disorders, euphoria, agitation depression. With long-term use at high doses, osteoporosis, the delay fluid in the body, the AD and other signs гиперкортицизма, including syndrome Иценко - Кушинга, secondary надпочечниковая недостаточность.Лечение : in the face of the gradual elimination of drug maintenance of the vital functions, correction электролитного balance антациды, фенотиазины, drugs lithium; In the Gulf Itsenko - Kushinga - aminoglutetimid.

Precautions

To use caution diabetes, a simple aciclovir cornea with Red volchanke (the risk of aseptic necrosis), osteoporosis, in patients with a risk of thrombosis (appointed in the face of anti-), the older (increased risk of hypertension, osteoporosis, especially among women in post-menopausal stages), in children, only in the context of antimicrobial therapy, with abszessah, grand infections, tuberculosis. There is a need to take into account an increase in the gipotireoze, cirrhosis of the liver, the probability of development (especially in long-term use) napochechnikova relative failure (in the months following the product). In long-term care should carefully monitor the growth and development of children periodically optical survey (to detect glaucoma, cataracts, etc.), regularly monitor the гипоталамо-гипофизар��о-адреналовой system, the glucose in the blood and urine (especially in patients with diabetes mellitus), electrolytes in whey hidden blood in the faeces. During therapy avoid immunization, the use of alcoholic beverages.

Dosing and Administration

Inside, parenteral Mestno.vnutri, at the time of delivery; Adults and juveniles-one, preferably morning (small dose) or reception 2-3 (large dose), from 0,25-0,6 mg to 7,2-8 mg / day; After a lengthy dose therapy reduces gradually to 0.25 mg every 2-3 Sutok.pri rheumatic diseases, the initial dose of 1-2.5 mg, supporting-0.5-1.5 mg / day, bronchial asthma, 3.5 mg, then 0.25 mg / day, astmaticescom status-3.5-4.5 mg / day, pollinozah, 1.5-2.5 mg / day, adrenoguenitalnom syndrome - 1-1.5 mg / day; supporting dose picked individually. For children 0,0625-0,2 mg / kg or 1,975-7,5 mg / m ^ 2 surface area of the body in Sutki.parenteralno : adults and adolescents in / in struino slowly or drip at the 4-8 mg / day (if necessary, until 9-20 mg), followed by maintenance dose of 2-4 mg; In / m-4-6 mg (9 mg) a day. In oteke brain-in / 2 to 4 mg, once, coma-2-4 mg four times a day. The rejection reactions kidney allotransplantata in / in the drip, 60 mg for 24-C.detam in / m, 0,021-0,125 mg / kg / day or 0,625-3,75 mg / m ^ 2 every 24 hours Vnutrisustavno and periartikulyarno (adults), in large joints from 2 to 4 mg (9 mg), the small-0,8-2 mg not more than one every three weeks. In the area of destruction, sinovialnuu bag - 2-3 mg, sukhojile vagina, 0.4 mg; Soft tissue 2-6 mg; Ganglia - 1-2 mg; Spot - 0.4 mg; In / to a hotbed of defeat - 0.1 mg / cm ^ 2 (not more), not more than 2 mg in one dose; if necessary mix with the local anaesthetics (1% lidocaine solution, procaine). Subkongungualno in average dose of 2 mg. Наружно - наносят тонким слоем (мазь, крем) или несколько капель (лосьон) на пораженные участки кожи от 2 до 6 раз в сутки до клинического улучшения, затем - не более 1-2 раза в сутки (возможно использование герметичной повязки); treatment of children and patients with a lesion of no more than five days.

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