methenolone enanthate

Derivative of adamantane, positively influencing the performance of physical and mental performance. The spectrum of action of the drug combination of activating, anxiolytic, immunostimulant actions and elements actoprotective activity. In methenolone enanthate no gipnosedativny and muscle relaxant properties of the drug does not have the potential adtsiktivnym. In its application, as opposed to actions typical psychostimulants, practically do not develop the phenomenon hyperstimulation and aftereffect of depletion functionality of the organism.
The therapeutic effect ladastena patients with asthenia, anxiety, asthenia disorders manifested from the very first days of its use as a distinct reduction asthenic symptoms, indicators of emotional stress, somatovegetativnyh manifestations; drug helps to restore the activity and increase endurance.
Mechanism of action ladastena associated with increased release of dopamine from presynaptic terminals, blockade of its re-uptake and biosynthesis enhancement caused gene expression of tyrosine hydroxylase, as well as its modulatory effect on the GABA-benzodiazepine-hlorionoformny receptor complex, eliminating decrease benzodiazepine reception, developing under stress , methenolone enanthate enhances GABA-ergic mediation, reducing the expression of the gene controlling the synthesis of GABA transporter, carrying the reuptake of the neurotransmitter.
Methenolone enanthate is non-toxic (LD50 in rats is greater than 10,000 mg / kg or more than 100 times higher than the effective dose). Pharmacokinetics Time to reach the maximum concentration (T max ) is 4.2 hours, the maximum concentration (C max ) of 363.3 ng / mL, the drug elimination half-life (T 1/2 ) – 11.21 hours.

testimony

Asthenic conditions of various origins, including at somatic diseases and after infectious methenolone enanthate diseases.
Neurasthenia.

Dosing and Administration

Used inside, regardless of the meal. The optimal single dose – 50-100 mg; DSA – 100-200 mg, distributed into 2 doses throughout the day. The drug should not be used after 16 hours methenolone enanthate of the day. The duration of a course of the drug is 2-4 weeks.

Side effects

Manifestations may include the excessive activation and sleep disorders, which do not require discontinuation of the drug, it is advisable to decrease the dose. With increased individual sensitivity to the drug may develop allergic reactions.

Overdose

With substantial overdose may develop sedation. Treatment: nonspecific detoxification therapy.

Interaction with other drugs

Ladasten reduces the hypnotic methenolone enanthate effect of thiopental sodium, does not weaken the anxiolytic effect of benzodiazepines.

primobolan depot

Stimulates the body’s α, β and γ-interferons. Major producers of interferon in response to primobolan depot are intestinal epithelial cells, hepatocytes, T-lymphocytes, and neutrophils. After oral administration, maximum production of interferon is defined in the sequence gut-liver-blood through the 4-24 hours,primobolan depot has immunomodulatory and antiviral effect. It stimulates bone marrow stem cells, in a dose dependent increases antibody reduces the degree of immunosuppression, restores ratio of T-helpers / T-suppressors. It is effective against a variety of viral infections, including influenza virus, and other acute respiratory viral infections, hepatitis viruses and herpes viruses. The mechanism of antiviral action due to inhibition of translation of virus-specific proteins in the infected cells, whereby virus replication is inhibited.

Indications

In adults, for the treatment of viral hepatitis A, B, C, herpes infection, cytomegalovirus infection, in the complex therapy of infectious-allergic and viral encephalomyelitis (multiple sclerosis, leykoentsefality, uveoentsefality et al.), In the primobolan depot complex therapy of urogenital and respiratory chlamydia, for treatment and prevention of influenza and other acute respiratory viral infections.

Contraindications

Hypersensitivity to the drug. Pregnancy and lactation.
Children’s age (up to 7 years).

Dosing and Administration

The drug is taken orally after a meal. For a non-specific prevention of hepatitis A -. 0.125 g per week for 6 weeks for the treatment of viral hepatitis A – the first day to 0,125 g, 2 times, and then to 0,125 gcherez 48 hours. The course of treatment of 1.25 g (10 tablets). For the treatment of acute hepatitis B – the first and second days of 0,125 g, followed by 0.125 g in 48 hours. The treatment of 2 g (16 tablets), with a protracted course of hepatitis B – 0.125 g of 2 times a day on the first day, followed by 0.125 g in 48 hours. The treatment of 2.5 g (20 tablets). In chronic hepatitis B – initial phase of treatment (2.5 g – 20 tablets) – the first two days of 0.25 g, then 0.125 g in 48 hours. Continuation phase (1.25 g – 10 2.5 g tablets 20 tablets) – 0,125 g per week. Heading dose Lavomaksa® from 3.75 g to 5 g, duration of treatment 3,5-6 months, depending on the results of biochemical, immunological, morphological studies, reflecting the degree of activity of the process. In acute hepatitis C – the first and second days of 0,125 g, then to 0,125 g in 48 hours. The treatment of 2.5 g (20 tablets). In chronic hepatitis C – initial phase of treatment (2.5 g – 20 tablets) – the first two days of 0.25 g, then 0.125 g in 48 hours.Continuation phase (2.5 g, 20 tablets) – 0,125 g per week. Heading dose Lavomaksa® – 5 g, duration of treatment – 6 months depending on the results of biochemical, immunological, morphological markers of activity of the process. In the treatment of influenza and other acute respiratory viral infections – in the first two days of illness to 0,125 g, then after 48 hours at 0,125 g in the course of treatment primobolan depot of 0.750 for the prevention of influenza and other acute respiratory viral infections – 0,125 g once a week for 6 weeks. For treatment of herpes, cytomegalovirus infection – the first two days of 0,125 g, then after 48 hours at 0,125 g heading dose of 2, 5 of urogenital and respiratory chlamydia – the first two days of 0,125 g, then after 48 hours at 0,125 g heading dose of 1.25 g When the complex treatment of infections neyrovirusnyh dose set individually, a course of treatment is 4 weeks.

primobolan depot dosage

Antibacterial drug, a new class of antimicrobial agents, oxazolidinones, active in vitro against aerobic gram-positive bacteria, some gram-negative bacteria and anaerobes. The mechanism of action is due to selective inhibition of protein synthesis in bacteria. By binding to the bacterial ribosome linezolid primobolan depot dosage prevents the formation of a functional 70S initiation complex, which is an essential component of the translation process of protein synthesis.

Is active in vitro and in vivo against primobolan depot dosage Gram-positive aerobes: Enterococcus faecium (including strains resistant to vancomycin), Staphylococcus aureus (including methicillin-resistant strains), Streptococcus agalactiae, Streptococcus pneumoniae (including multidrug-resistant strains), Streptococcus pyogenes.

Is active in vitro against Gram-positive aerobes: Enterococcus faecalis (including strains resistant to vancomycin), Enterococcus faecium (strains sensitive to vancomycin), Staphylococcus epidermidis (including methicillin-resistant strains), Staphylococcus haemolyticus, Streptococcus spp. viridans group; Gram-negative aerobes: Pasteurella multocida.

Resistance to linezolid bacteria: Haemophilus influenzae, Moraxella catarrhalis, Neisseria spp, Enterobacteriaceae spp, Pseudomonas spp…

He mentioned cross-resistance between linezolid and antimicrobial agents of the following classes: primobolan depot dosage aminoglycosides, beta-lactams, folic acid antagonists, glycopeptides, lincosamides, quinolones, rifamycins, streptogramins, tetracycline and chloramphenicol, because of the action of linezolid and differences of these classes of drugs mechanisms. Linezolid is active against pathogenic microorganisms both sensitive and resistant to these drugs. Resistance towards linezolid develops slowly by the multistep mutation 23S ribosomal RNA occurs c frequency of less than 1×10 -9 -1 × 10 11 .

Pharmacokinetics
Absorption
After oral linezolid is rapidly and extensively absorbed from the gastrointestinal tract. The maximum concentration of linezolid in the blood plasma (Cmax) -21.2 mg / l, the median time to reach maximum concentration in the blood of linezolid (TSmah) – 2 hours, the absolute bioavailability of approximately 100%. Food intake does not affect absorption of linezolid. The equilibrium concentration of linezolid in the blood is reached on the second day of admission.

Distribution
The volume of distribution of primobolan depot dosage linezolid when the equilibrium concentration in a healthy adult is an average of 40-50 liters. Binding to plasma proteins is 31% and is independent of the concentration of linezolid in the blood.

Metabolism
was established that P450 isoenzymes are not involved in the metabolism of linezolid in vitro. Linezolid does not inhibit or potentiate the activity of a clinically significant cytochrome P450 isoenzymes (1A2, 2C9, 2C19, 2D6, 2E1, ZA4).

Metabolic oxidation leads to the formation of two inactive metabolites -gidroksietilglitsina (the major metabolite in humans, formed as a result of non-enzymatic process) and aminoetoksiuksusnoy acid (produced in smaller quantities). other inactive metabolites are also described.

 

Pharmacokinetics in specific patient populations Patients with renal insufficiency. After a single dose of 600 mg of linezolid in patients with severe renal insufficiency (creatinine clearance <30 mL / min), the concentration of its two main metabolites increased 7-8 times. However, larger AUC (area under “concentration-time” curve) of the initial preparation was not observed. Although the hemodialysis deduced that a number of major metabolites, their concentration in the blood plasma after administration of 600 mg of linezolid and dialysis procedures remained significantly higher blood concentrations in patients with normal renal function, renal failure with mild or moderate.

Patients with hepatic insufficiency. There is limited evidence that in patients with hepatic insufficiency, mild or moderate (Class A and B for the classification of Child-Pugh), the pharmacokinetics of linezolid and its two main metabolites does not change. The pharmacokinetics of linezolid in patients with severe hepatic insufficiency (class C Child-Pugh classification) has not been studied. However, as linezolid is metabolised by non-enzymatic, it is not expected to significant violations of its metabolism in liver failure.

Children. Children (12 years and older) the pharmacokinetics of linezolid, taken at a dose of 600 mg did not differ from adult kinetics. When assigning adolescents linezolid 600 mg every 12 hours, the concentration will be the same as in adults with assignment of the same dose.

Elderly patients. In elderly patients aged 65 years and older pharmacokinetics of linezolid are not significantly altered.

. Women In women, the amount of linezolid slightly lower allocation than in men; they also reduced by 20% when the average clearance per body weight. The half-life of linezolid is not significantly different in men and women, a dose adjustment is required.

Indications for use:

Treatment of infectious and inflammatory diseases caused by susceptible to linezolid aerobic and anaerobic Gram-positive organisms (including infection, accompanied by bacteremia):

– Community-acquired pneumonia caused by Streptococcus pneumoniae (including multidrug-resistant strains), including cases accompanied by bacteremia, or Staphylococcus aureus (only metitsillinchuvstvitelnye strains);
– nosocomial pneumonia caused by Staphylococcus aureus (including metitsillinchuvstvitelnye and methicillin-resistant strains) or Streptococcus pneumoniae (including multidrug-resistant strains) ;
– complicated skin and soft tissue infections, including infections in diabetic foot syndrome is not accompanied by osteomyelitis, caused by Staphylococcus aureus (including metitsillinchuvstvitelnye and methicillin-resistant strains), Streptococcus pyogenes, or of Streptococcus agalactiae;
– uncomplicated skin and soft tissue infections caused by Staphylococcus aureus (only metitsillinchuvstvitelnye strains) pyogenes or Streptococcus;
– infections caused by vancomycin-resistant strains of Enterococcus faecium, including accompanied by bacteremia.

Contraindications:

Hypersensitivity to linezolid or any other components of the preparation. Children age under 12 years (due to the impossibility of an adequate selection of the dose). The simultaneous use of inhibitors of monoamine oxidase (MAO) A and B (e.g., phenelzine, isocarboxazid), and two weeks after discontinuation of these drugs.

In the absence of blood pressure monitoring should not be administered linezolid in patients with uncontrolled hypertension, pheochromocytoma, thyrotoxicosis and / or patients receiving agonists (eg, pseudoephedrine, phenylpropanolamine, epinephrine, norepinephrine, dobutamine), Dofaminomimetiki (eg, dopamine).

In the absence of close monitoring of patients with possible development of serotonin syndrome should not be administered linezolid people with carcinoid syndrome and / or patients receiving these medications: serotonin reuptake inhibitors, tricyclic antidepressants, agonists of 5-HT1 receptors (triptans), meperidine or buspirone.

Precautions
Hepatic failure, severe renal failure (if the expected benefit outweighs the potential risk). Systemic infections, pose a risk to life, such as infection associated with venous catheters in intensive care units.

Application of pregnancy and during breastfeeding

Safety trials of linezolid during pregnancy was conducted. The use of Linezolid-Acre drug ® during pregnancy is possible only when the intended benefits of the therapy for the mother outweighs the potential risk to the fetus.

The appointment Linezolid drug-acre ® during lactation should stop breastfeeding.

Dosing and Administration

Inside. The drug can be taken during meals or between meals. The duration of therapy depends on the pathogen, location and severity of the infection and the clinical effect.

Community-acquired pneumonia caused by Streptococcus pneumoniae (including multidrug-resistant strains), including cases accompanied by bacteremia, or Staphylococcus aureus (only metitsillinchuvstvitelnye strains)
Adults and children (12 years and older.): 600 mg every 12 hours, the recommended duration of treatment – 10-14 days.

Hospital pneumonia _vyzvannaya Staphylococcus aureus (including methicillin-resistant strains and metiiillinchuvstvitelnye) or Streptococcus pneumoniae (including multidrug-resistant strains)
Adults and children (12 years and older): 600 mg every 12 hours, the recommended duration of treatment – 10-14 days..

Complicated skin and soft tissue infections, including infections in diabetic foot syndrome is not accompanied by osteomyelitis, caused by Staphylococcus aureus (including metitsillinchuvstvitelnye and methicillin-resistant strains), Streptococcus pyogenes, or Streptococcus agalactiae
Adults and children (12 years and older): 600 mg every 12 hours. The recommended duration of treatment – 10-14 days.

Uncomplicated skin and soft tissue infections caused by Staphylococcus aureus (only metitsillinchuvstvitelnye strains) or Streptococcus pyogenes
Adults and children over 12 years old. 600 mg every 12 hours, the recommended duration of treatment – 10-14 days.

Infections caused by resistant to Vancomycin Enterococcus faecium, including bacteremia accompanied by
adults and children (12 years and older.): 600 mg every 12 hours, the recommended duration of treatment – 14-28 days.

Elderly patients: dose adjustment is required.

Patients with renal impairment: dose adjustment is required. Due to the fact that 30% of linezolid removed by hemodialysis for 3 hours, linezolid be taken after dialysis patients in need of it.

Patients with hepatic impairment: dose adjustment is required.

Side effect

The frequency of side effects is classified in accordance with the recommendations of the World Health Organization (WHO): very often ‘(≥ 10%); often (≥ 1%, <10%); infrequently (≥0,1%, <1%); rare (≥ 0,01%, <0,1%); very rare (<0.01%), including isolated cases. Adverse events associated with taking linezolid, are usually mild or moderate severity. Most others are marked headache, diarrhea and nausea.

Adult patients From the digestive system: often – diarrhea, nausea, vomiting, constipation, abdominal pain (including spastic), flatulence, candidiasis of the oral mucosa; infrequently – to change the language of staining. Laboratory tests: often – thrombocytopenia; infrequently – increasing the concentration of triglycerides in the blood, the increase in “liver” enzymes (including alaninaminotranoferazy (ALT), aspartate aminotransferase (ACT), alkaline phosphatase (ALP), lactate dehydrogenase (LDH), lipase, amylase, the concentration of total bilirubin and creatinine) increased concentration of prolactin. From the nervous system: often – headache, dizziness, convulsions; infrequently – dysgeusia. On the part of the central nervous system: often – insomnia. With the genitourinary system: often – vaginal candidiasis.For the skin: often – a rash. Other: . often – fever, rarely – opportunistic fungal infections have also been marked by an increase blood pressure, indigestion, itching.

Children (12 years and older) From the digestive system: often – diarrhea, nausea, vomiting, abdominal pain (local or generalized), loose stools. Laboratory findings: infrequently – eosinophilia, an increased concentration of triglycerides in the blood, increased ALT, lipase , creatinine concentration. From the nervous system: often – headache, vertigo. For the skin: often – a rash, rarely – itching. The respiratory system: often – upper respiratory tract infection, pharyngitis, cough. Other: often – fever , unspecified pain.

Post-marketing data (the frequency is unknown) Laboratory findings: reversible myelosuppression (thrombocytopenia, anemia, leukopenia, pancytopenia). From the senses: . Cases of optic neuropathy, sometimes leading to loss of vision Allergic reactions: anaphylaxis. For the skin: rash, angioedema edema, bullous skin lesions similar to Stevens-Johnson syndrome. On the part of metabolism: lactic acidosis. From the nervous system: peripheral neuropathy, seizures. From the digestive system: discoloration of tooth enamel. Other: chills, fatigue, serotonin syndrome.

Overdose

Cases of overdose of linezolid have not been reported.
Recommended symptomatic treatment (including the need to maintain the glomerular filtration rate). About 30% of the dose is excreted within three hours in hemodialysis.
The specific antidote is unknown.

Interaction with other drugs

Linezolid is a reversible non-selective MAO inhibitor, so some patients can cause moderate reversible increase in the pressor action of pseudoephedrine and phenylpropanolamine. In a joint application is recommended to reduce the initial dose of agonists (eg, pseudoephedrine, phenylpropanolamine, epinephrine, norepinephrine, dobutamine), dopamine receptor agonists (eg, dopamine) in the future to carry out the titration of the dose.

There was no development of serotonin syndrome in patients receiving linezolid in conjunction with serotonergic drugs. However, there are few reports about the development of serotonin syndrome during treatment with linezolid and antidepressants -selective reuptake inhibitors serototonina.

While the use of aztreonam and gentamicin pharmacokinetics of linezolid changes were noted.

Rifampicin caused decrease Cmax and AUC linezolid an average of 21% and 32%, respectively.

special instructions

In established infection (or suspected infection) caused by a concomitant Gram-negative organisms, shows the use of additional funds, acting on Gram-negative flora.

Some patients receiving linezolid may develop reversible myelosuppression (anemia, thrombocytopenia, leukopenia, and pancytopenia), depending on the duration of therapy. In this regard, in the treatment necessary to monitor blood parameters in patients with increased bleeding risk, myelosuppression history, and while the use of drugs that reduce hemoglobin or platelet count and / or their functional properties, as well as in patients receiving linezolid for more than 2 weeks.

Patients taking antibiotics, including linezolid, should take into account the risk of pseudomembranous colitis of varying severity.

Cases of diarrhea associated with Clostridium difficile, reported in association with use of nearly all antibacterial agents, including linezolid. The severity of the diarrhea may range from mild to severe.Treatment of antibacterial drugs disrupts the normal intestinal flora, which leads to overgrowth of Clostridium difficile. Clostridium difficile produces toxins A and B, which lead to the development of diarrhea.Excessive amounts of the toxins produced by strains of Clostridium difficile, can cause high mortality among patients, such as the infection may be resistant to antimicrobial therapy, and may need kolonektomiya. The possibility of diarrhea associated with Clostridium difficile, should be considered in all patients with diarrhea following the use of antibiotics. Patients who have had diarrhea associated with Clostridium difficile after the administration of antibacterial agents need careful medical observation for 2 months.

If you have symptoms of deterioration of visual function, such as changes in visual acuity, changes in color vision, blurred, visual field defects, it is recommended to address urgently to the ophthalmologist for consultation. Should monitor visual function in all patients receiving linezolid for a long time (more than 28 days), and all patients with newly emerging vision impairment symptoms, regardless of the duration of therapy. In the case of peripheral neuropathy and optic neuropathy, should evaluate the risk / benefit of continuing therapy with linezolid in these patients.

In connection with the use of linezolid reported lactic acidosis. Patients in patients receiving linezolid appears repeated nausea or vomiting, unexplained acidosis, or a marked reduction in the concentration of carbonate anions, require careful medical supervision.

Convulsions have been reported in patients treated with linezolid, and in most cases had a history of seizures or an indication of the presence of risk factors for their development. If necessary, use of the drug in combination with the selective serotonin reuptake inhibitors should continuously monitor patients for signs and symptoms of serotonin syndrome such as cognitive impairment, hyperpyrexia, hyperreflexia and incoordination. In the case of the appearance of these symptoms should be discontinued one or both of taking the drug. Symptoms “cancellation” syndrome may occur when you stopped taking serotonergic agents.

buy primobolan depot

The active drug component Lavasept is polyhexamethylene biguanide hydrochloride, which has buy primobolan depot the effect of broad spectrum bactericidal action, active against Pseudomonas aeruginosa, E. Coli, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, and others. In the presence of blood and purulent discharge, bactericidal and fungicidal activity attenuated slightly.

Indications for use .

1. Treatment of infected wounds and superficial soft tissue injuries.
2. Washing of the cavities through the drainage tube using active drainage.
3. Irrigation of the surgical field during surgery at reconstructive operations, immediately before transplantation of bone and soft tissue.
4. Irrigation of the surgical field buy primobolan depot during the operation, during which there is a real threat of infection.
5. Treatment of infected wounds during hip replacement surgery (according to Schneider).
6. Antiseptic treatment of wounds, left completely or partially open after the operation, using napkins or Longuet.
7. Treatment of burn surfaces.
8. Disinfection of surgical instruments, moistening wipes, washing implants.

Contraindications.

Lavasept is intended for topical use and is only used in diluted form. Application Lavasepta contraindicated:

  • Pregnancy, lactation, children’s age.
  • In case of hypersensitivity buy primobolan depot to the drug.
  • In operations on the brain.
  • In operations on the eyes, the middle and inner ear.
  • For intraperitoneal lavage.

Precautions during operations on the undamaged cartilage.

Dosage and administration.

Locally. Lavasept only be used diluted in a concentration of 0.1% or 0.2%. A solution with a concentration of 0.1% or 0.2% is prepared by diluting a concentrated solution. To a solution of 1000 ml of Ringer’s lactate or without

0.9% sodium chloride solution, 1.0 ml or 2.0 ml of concentrated Lavasepta respectively. The solution should be prepared only by specially trained personnel. When mixed with other solutions to avoid haze and precipitates. Precipitated Polihexanide at low temperatures can be dissolved by heating the solution to 60º C.

For washing wounds, the active wound drainage using 0.1% Lavasepta solution. In the case of infection with gram-negative flora healing used 0.2% solution.

Side effects.

When using Lavasepta may cause increased sensitivity to the drug reaction (hives, skin rash). In buy primobolan depot this case, the use of Lavasepta should be discontinued immediately and symptomatic treatment appoint (antihistamines).

The interaction with other drugs and other interactions.

Currently cases of such interactions are not known.

Special instructions.

Lavasept is intended for topical use and can only be used in diluted form.

Lavavsept like other antiseptics, by buy primobolan depot experimental data on animals inhibits the growth of cartilage tissue embryos. Prolonged use Lavasept can also cause damage to the intact cartilage. To avoid complications, it is not recommended to use for washing Lavasept uninfected joints.

bayer primobolan depot

Has a mild bayer primobolan depot anti-inflammatory, anti-edema and anti-thrombotic effects.
thrombophlebitis of superficial veins; localized infiltrates and soft tissue swelling; injuries of tendons and joints, soft tissue injuries and joints.
Known hypersensitivity to the drug, ulcer-necrotic lesions of the skin in places intended application of the gel, traumatic violation of integrity of the skin, increased blood clotting, thrombocytopenia.

Dosage and administration:
Outwardly, the gel is applied thinly to the affected area at the rate of 3-5 cm of gel on the skin 3-5 cm in diameter, and gently rubbed into the skin.
Apply 1-3 times a day every day until the disappearance of inflammation, an average of 3 to 7 days. Timing of treatment determined by the doctor.

Side effects:
allergic skin reactions, flushing of the skin.

Overdose
Overdose is unlikely due to the low absorbability of the gel component.

Cautions
Not recommended for bayer primobolan depot bleeding, as well as on open wounds, mucous membranes, and in the presence of local purulent processes. Use with extreme caution in increased vascular permeability. The use of the gel is not recommended for deep venous thrombosis.

Interaction with other medicinal products
is not recommended to bayer primobolan depot mix with other products for external use, do not prescribe topically concurrently with nonsteroidal anti-inflammatory drugs, tetracycline, antihistamines.