KENALOG PILLS 4MG

GCS, inhibits the release of interleukin - 1, 2, gamma Interferon from lymphocytes and macrophages. Induces the formation of lipocortins, inhibits the release of inflammatory mediators by eosinophils, reduces the number and stabilizes the membranes of mast cells. It has anti-inflammatory, anti-allergic, anti-edema, anti-proliferative and immunosuppressive effects. Reduces bronchial hyperreactivity, restores the sensitivity of receptors to beta-adrenostimulyatorov. Stabilizes the membranes of mast cells, inhibits the activity of phospholipase A2, reduces the release of arachidonic acid from the phospholipids of cell membranes and the formation of its metabolic products (Pg, Tx, leukotrienes). Antiallergic effect develops as a result of suppression of the synthesis and secretion of allergy mediators, inhibition of release from sensitized mast cells and histamine basophils and other biologically active substances, reduction in the number of circulating basophils, suppression of the development of lymphoid and connective tissue, reduction in the number of T and B lymphocytes, fat cells, reducing the sensitivity of effector cells to mediators of allergy, inhibition of antibody production, changes in the immune response of the body.Anti-shock and anti-toxic effects are associated with an increase in blood pressure (by increasing the concentration of circulating catecholamines and restoring sensitivity of adrenoreceptors to them, as well as vasoconstriction), reducing vascular permeability, membrane-protective properties, activation of liver enzymes involved in endo-and xenobiotic metabolism. Suppresses the release of pituitary ACTH and beta-lipotropin, but does not reduce the level of circulating beta-endorphin. It inhibits the secretion of TSH and FSH. Increases the excitability of the central nervous system, reduces the number of lymphocytes and eosinophils, increases - red blood cells (stimulates the production of erythropoietin). It has a pronounced dose-dependent effect on the metabolism of carbohydrates, proteins and fats. Increases glycogenesis, enhances the breakdown of fat, retains Na + and water, promotes the excretion of K +, reduces the absorption of Ca2 +, induces the secretion of parathyroid hormone that mobilizes Ca2 + from bone tissue. Activates catabolic processes. Triamcinolone is close to Hydrocortisone in anti-inflammatory activity, triamcinolone acetonide is 6 times more active. Mineralocorticoid activity is practically absent. The maximum effect is observed after 1-2 hours, the duration of action is 2.5 days.

Indications and usage

Rheumatism, rheumatoid arthritis, simple and allergic dermatitis, erythema multiforme exudative, SLE and other systemic diseases of the connective tissue, bronchial asthma, fibrotic changes in the lungs, hemorrhagic diathesis, hemolytic anemia, lymphoma, leukemia.

Contraindications

Hypersensitivity, systemic mycoses, glaucoma, history of acute psychosis, tuberculosis (the active syndrome), myasthenia gravis, neoplasms with metastases, diverticulitis, gastric ulcer and duodenal ulcer, hypertension, Itsenko-Cushing syndrome, Chph. diabetes, hidden foci of infection, amyloidosis, syphilis, acute viral and bacterial infections, polio (with the exception of the bulbar-encephalitic form), gonococcal or tuberculosis arthritis, vaccination period, l imphadenitis after BCG vaccination, pregnancy (especially I trimester), lactation, child age (up to 6 years). With caution - obesity, edematous syndrome, mental illness, gastrointestinal diseases, children (6-12 years old)

Inside, after meals: the initial dose - 4-40 mg / day in 2-3 doses; after improvement, the daily dose is gradually reduced by 1-2 mg every 2-3 days in order to achieve the minimum maintenance dose (1 mg) or completely cancel. Adults and adolescents (over 12 years) with adrenal insufficiency - 4-12 mg / day once (in the morning) or in 2 doses (in the morning and at lunch). With Hodgkin's disease, lymphosarcoma, chronic leukemia, the initial dose is 30-60-75 mg / day.Children from 6 to 12 years with adrenal insufficiency - 0.117 mg / kg once in the morning or in 2 doses, in other cases - 0.416-1.7 mg / kg. For children weighing up to 25 kg - 0.1-0.5 mg / kg / day in 1 or several doses. The maximum daily dose is 12-14 mg.

Adverse reactions

On the part of the digestive system: nausea, vomiting, bulimia, steroid ulcers in the digestive tract, bleeding from ulcers, perforation of the intestinal wall, intestinal atony, pancreatitis, hepatomegaly. On the part of the cardiovascular system: bradycardia, increased blood pressure, arrhythmias, exacerbation of the phenomena of heart failure, myocardial dystrophy, steroid vasculitis. Nervous system disorders: epilepsy, convulsions, cranial hypertension, fatigue, sleep disorders, mood disorders, psychosis, dizziness, headache. On the part of the endocrine system: dysmenorrhea, Itsenko-Cushing syndrome, atrophy of the adrenal cortex, hyperglycemia, steroid diabetes, adrenal insufficiency (especially during stress - with trauma, surgery, concomitant diseases), "moon-shaped" face, hirsutism, stria, acne. On the part of the senses: visual impairment, posterior subcapsular cataract, steroid exophthalmos or increased intraocular pressure. On the part of metabolism: fluid retention, sodium, hypokalemia, hyperlipoproteinemia, impaired nitrogen metabolism (negative nitrogen balance), weight gain, catabolic effect, slower growth of children.On the part of the musculoskeletal system: muscle weakness, loss of muscle mass, myopathy, osteoporosis, aseptic necrosis of the femoral head, compression fractures of the vertebrae, pathological fractures of the tubular bones. On the part of the hemostasis system: hypercoagulation, thromboembolism. Effect on the fetus: with prolonged use during pregnancy - a violation of fetal growth, in the third trimester - atrophy of the adrenal cortex in the fetus. On the part of the skin: slow wound healing, sweating, flushing of the skin of the face, petechiae, ecchymosis, allergic dermatitis. Other: immunosuppression (exacerbation of infectious diseases), "cancellation" syndrome (not caused by hypocorticism): anorexia, nausea, lethargy, myalgia, ossalgia, general weakness, allergic reactions. Overdose. Symptoms: Itsenko-Cushing syndrome, hyperglycemia, glycosuria. Treatment: symptomatic therapy on the background of gradual cancellation.

Special notes

With oral use of a dose in excess of 4 mg / day, the suppression of the activity of the hypothalamic-pituitary system can develop after 6-12 weeks. The abolition of the drug is carried out gradually. Do not use within 8 weeks before vaccination and for 2 weeks after their implementation. In order to prevent adrenal insufficiency, at the end of treatment, corticotropin is prescribed for several days. During the treatment period, it is recommended to take vitamin D and eat foods rich in Ca2 +.

Drug interactions

Reduces the effectiveness of insulin, oral hypoglycemic drugs, antihypertensive drugs, anticoagulants; reduces the content of salicylates in the blood; reduces the concentration of praziquantel in the serum. Rifampicin, phenytoin, barbiturates - weaken the effect, hormonal contraceptives - increase efficiency. Increase the risk of side effects: NSAIDs (erosive and ulcerative lesions and bleeding from the gastrointestinal tract), androgens, estrogens, oral contraceptives, steroid anabolics (hirsutism, acne), antipsychotics, bucarban, azathioprine (cataract); holinoblokatory, antihistamines, tricyclic antidepressants, nitrates (glaucoma); saluretics (hypokalemia); cardiac glycosides (digitalis intoxication).