Appropriate studies on the action of corticosteroids human reproduction were not carried out, so the use of these drugs in pregnancy, nursing mothers or women of childbearing age requires an assessment of the likely positive effect of the drug compared to the potential risk to the mother, fetus or embryo. Should be used during pregnancy only if absolutely indicated.
Can easily penetrate through the placenta. Children born to mothers treated during pregnancy large doses of corticosteroids should be carefully examined for signs of adrenal insufficiency. Effect of corticosteroids on the course and outcome of birth is not known.
Allocated into breast milk, so if you need destination equipoise resultsdrug during breast feeding breast-feeding should be discontinued.
Dosing and Administration
The drug may be administered in the form of injection or in / infusion, but in emergencies preferably start treatment with I / injection. After the period of acute or parenterally administered drug dosage forms with more prolonged action, or oral form of preparation. Drug treatment starts with the on / in within 30 seconds (e.g., 100 mg) and 10 min (eg 500 mg or more). High doses of corticosteroids should be prescribed only until the stabilization of the patient, but not longer than for 48 – 72 hours. The initial dose is 100 – 500 mg or more, depending on the severity of the patient’s condition.
Dose repeatedly assigned every 2, 4 or 6 hours, depending on the response of a patient’s body and the clinical picture of the disease. Babies should be administered a lower dose (but not less than 25 mg / day), but when choosing the dose primarily take into account the severity of the condition and the patient’s response to therapy, and not the age and body weight. Preparation of solutions preparations for parenteral administration should be inspected visually for change the color or appearance of the particles. Use equipoise results only clear solution. Bottle for in / in or / m injection solution is prepared by adding to the vial (observing the rules of antiseptics) not more than 2 ml of bacteriostatic water for injection or an aqueous sodium chloride solution for injection to the bacteriostatic additive.
- Click on plastic activator to the solvent fracture in his lower capacity.
- To gently swing the vial until the lyophilizate is dissolved.
- Remove the plastic disc, covering the center of the plug.
- Treat the surface of the stopper corresponding antiseptic.
- Puncture needle cork center so that was visible tip of the needle. Turn the vial and syringe Collect the required amount of solution.
For in / in or / m injection further dilution equipoise results is required. For I / infusion first solution is prepared as described above, then the resulting solution was added to 100 – 1000 ml of 5% aqueous dextrose (or saline or 5% dextrose in saline, if the patient does not need to limit the amount of sodium) . If it is desirable to introduce a small amount of liquid can be added 100 – 3000 mg of hydrocortisone (as hydrocortisone sodium succinate) to 50 ml of the above solution. The resulting solutions are stable for 4 hours and may be administered in / directly or via a second drip.
Side effect Note: the following side effects are typical for all equipoise resultswith parenteral use, not only for this product. The violation of water-electrolyte balance: sodium retention in the body; congestive heart failure in patients with the appropriate disposition; arterial hypertension; fluid retention; potassium loss; hypokalemic alkalosis; . increased excretion of calcium Musculoskeletal: steroid myopathy; muscle weakness; osteoporosis; pathological fractures; Compression fractures of the vertebrae; aseptic necrosis of the epiphysis of long bones; . ruptures of tendons, especially the Achilles tendon Gastrointestinal:peptic ulcer with possible perforation and hemorrhage; gastric bleeding; pancreatitis; esophagitis; perforation of the intestine; raising alanintransaminazy , aspartate transaminase and alkaline phosphatase in the serum (usually these changes are minor, not associated with any clinical syndromes and reversible upon discontinuation of treatment). Adverse events in the appointment of high doses of corticosteroids for a short period of time are rare, but may develop peptic ulcers. . It can be shown the appointment of prophylactic antacid therapy Dermatological: slow wound healing; petechiae and ecchymosis; thinning of the skin and reduction of strength; Kaposi’s sarcoma. It is reported that in patients treated with corticosteroids, there was a Kaposi’s sarcoma.
If you cancel the equipoise resultsmay occur clinical remission. Metabolic: negative nitrogen balance due to protein catabolism. Neurological: increased intracranial pressure with papilledema; pseudotumor of the brain; convulsions; mental disorders, including euphoria, insomnia, mood instability, personality changes, depression; acute psychotic symptoms; strengthening of the already existing emotional instability or propensity to psychotic reactions.Endocrine: menstrual irregularities; development of Cushing’s syndrome; suppression of pituitary-adrenal axis; reduced glucose tolerance; manifestation of latent diabetes mellitus; increased need for insulin or oral hypoglycemic agents in patients with diabetes, growth retardation in children. Ophthalmic: posterior subcapsular cataracts; increased intraocular pressure; . exophthalmos Immunological: erased the clinical picture of infectious diseases; activation of latent infections, including tuberculosis reactivation: the emergence of infections caused by opportunistic pathogens, any localization occurring in an easy manner, and with the possibility of death; hypersensitivity reactions, including anaphylaxis and anaphylactoid reactions (eg, bronchospasm, laryngeal edema, urticaria); . suppression of reactions during skin tests Other: the solvent contains benzyl alcohol, which may cause “suffocation syndrome”equipoise results with fatal outcome in preterm infants.