Metilone 16mg Davipharm anti-inflamasi, gangguan endokrin, arthritis (2 blister x 14 tablet)

Bentuk sediaan Kothak 2 blister x 14 tablet
Spesifikasi Methylprednisolone

Komposisi

Informasi komposisi	Isi
Methylprednisolone	16 mg

Migunakake

Indikasi

Obat metilone dituduhake kanggo perawatan kanggo pasien sing mbutuhake efek glukokortikoid kayata:

Kelainan endokrin: gangguan adrenal primer lan sekunder, kelenjar adrenal kongenital.

rematik: arthritis reumatoid , arthritis kronis remaja, radang sendi.

Penyakit kolagen/arteri: Sistemik eritematosus lupus, dermatitis awak, demam reumatoid kanthi inflamasi jantung sing abot, arteritis sel raksasa/nyeri otot amarga rematik.

Penyakit dermatologis: pemfigus biasanipun.

Alergi: Rinitis alergi musiman lan tahan suwe, reaksi hipersensitivitas obat, penyakit serum, dermatitis kontak alergi , asma bronkial.

Mripat oftalmologi: Ivanitis (iritis, iriditis), inflamasi post-peach dug, neuritis optik.

Penyakit pernapasan: sarcoid paru , tuberkulosis akut utawa nyebar (kanthi kemoterapi anti-tuberkulosis sing cocog), inhalasi jus lambung.

Kelainan hemorrhagic hemorrhagic (TPI hemorrhagic hemorrhage) (autoimun).

Kanker: leukemia (akut lan limfoma), limfoma ganas.

Penyakit gastrointestinal: kolitis ulcerative, penyakit Crohn.

Kondisi liyane: tuberkulosis, organ.

Farmakokologi

Methylprednisolone yaiku glukokortikoid sintetik, turunan 6-alfa-metil saka prednisolon. Obat kasebut utamane digunakake kanggo nyegah inflamasi, utawa imunosupresif. Obat kasebut asring digunakake ing wangun esterifikasi utawa ora ana esterifikasi kanggo nambani penyakit sing diwenehake kortikosteroid.

Amarga metilasi Prednisolone, methylprednisolone mung nduweni efek mineralokortikoid (metabolisme uyah sithik banget), ora cocok kanggo nambani insufisiensi adrenal. Yen nggunakake methylprednisolone ing kasus iki, iku kudu digunakake dening mineralocorticoids.

Methylprednisolone nduweni efek anti-inflamasi, imunosupresif lan anti-sel anti-proliferasi. Efek anti-inflamasi disebabake methylprednisolone sing nyuda produksi, pelepasan lan aktivitas intermediet inflamasi (kayata histamin, prostaglandin, leucotrien, lan liya-liyane), amarga nyuda manifestasi awal proses inflamasi.

methylprednisolone nyegah leukosit nempel ing tembok pembuluh darah saka karusakan lan imigrasi ing wilayah sing rusak, kanthi cepet nyuda sifat penyerap ing wilayah kasebut, nyebabake leukosit arang teka ing wilayah kasebut. Efek iki nyuda uwal saka prau, dadi gedhe, busung, pain.

Sifat imunosupresif nyuda respon kanggo reaksi alon lan cepet (tabung III lan tabung IV), amarga inhibisi beracun saka kompleks antigen - antibodi sing nyebabake vaskulitis alergi ing kulit. Kanthi nyandhet efek limfokin, sel target lan makrofag, kortikosteroid nyuda reaksi dermatitis kontak amarga alergi. Kajaba iku, kortikosteroid uga nyegah limfosit sel T lan makrofag sing sensitif marang sel target. Efek proliferasi anti-sel nyuda karakteristik psoriasis.

Farmakokinetik

penyerapan

Lair kira-kira 80%. Konsentrasi plasma tekan maksimal 1-2 jam sawise obat oral, wektu tekan udakara 30 jam.

Distribusi

Methylprednisolone disambungake banget karo protein plasma. Volume distribusi kira-kira 1,4 l/kg.

Metabolisme

Methylprednisolone metabolizes utamane ing ati liwat CYP 3A4, methylprednisolone bisa dadi substrat saka ABC (ATP-binding Cassette) P-Glycoprotein, sing mengaruhi distribusi ing jaringan lan interaksi obat liyane.

Eliminasi

Metabolit sing berlebihan liwat urin. Wektu adol kira-kira 3 jam, suda kanggo wong lemu. Reresik total methylprednisolone kira-kira 5 - 6 ml / jam.

Sadurunge njupuk Metilone 16mg Davipharm anti-inflamasi, gangguan endokrin, arthritis (2 blister x 14 tablet)

How to use recommendations of daily daily daily dumps and are used as treatment instructions. Total daily dose recommended can be taken once or divided into several times (except Japanese insertion: Double daily minimum daily doses and daily drink at 8 am). Unwanted effects can be reduced by using the lowest doses effectively in the shortest time. The starting dose may vary depending on the condition being treated. This dose is continued until the clinical response is achieved, usually after 3-7 days for patients with rheumatism (except for acute rheumatitis), allergies affect skin or respiratory tract and ophthalmology. If not meet the response after 7 days, it is necessary to conduct a re -evaluation to confirm the initial diagnosis. Immediately after the clinical response, should gradually reduce the daily dose to stop the lowest treatment effectively for chronic diseases (such as seasonal bronchial asthma, flaky dermatitis, acute inflammation in the eye), or gradually decreased daily daily doses to the lowest doses that are effective for chronic diseases (rheumatoid arthritis, systemic lupus erythematosus, bronchial asthma, atopic dermatitis). For chronic diseases such as rheumatoid arthritis, reducing the initial dose to the maintenance dose, it should be done appropriately. Dose reduction should not exceed 2 mg every 7-10 days. In rheumatoid arthritis, steroid maintenance should be at the lowest possible. When using methylprednisolone for a long time, we must consider taking Japan. After long -term treatment must stop gradually. In Japan, the minimum daily corticoid dose is doubled and drink once a day single at 8 am. Dosage depends on the patient's condition and response. Elderly: For a long time, it is necessary to pay attention to the serious consequences than unwanted side effects, especially when osteoporosis, diabetes, hypertension, sensitive infections, thin skin. Children: The dosage is based on the severity of the disease and the patient's response, according to age, weight, skin surface area, minimum doses effectively in the shortest time. Use Japanese -doseed therapy if possible. Dosage recommended dose: Disease recommended starting dose. Very heavy Heavy Average Children 12 - 16 mg 8 - 12 mg 4 - 8 mg 4 - 8 mg Systemic dermatitis 48 mg Application 12 - 40 mg Mg malignant lymphoma 16 - 100 mg Quan up to 3.6 mg/kg/day. Usually. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.What to do when overdose? Symptoms Expression of Cushing syndrome, muscle weakness (body), and osteoporosis (systemic), all occur when using long -term glucocorticoids. When taking high doses for a long time, increasing adrenal gland energy and adrenal inhibition may occur, it is necessary to suspend or stop using glucocorticoids. Symptomatic treatment and supportive treatment in the case of overseas methylprednisolon, there is no specific antidote. Methylprednisolon is separated. What to do when forgetting 1 dose? Not recorded.

Efek sisih

Nalika nggunakake Metilone, sampeyan bisa ngalami efek sing ora dikarepake (ADR), asring kedadeyan nalika dosis dhuwur, dosis jangka panjang.

Umum, ADR> 1/100

Parasit lan infeksi.

Endokrin: Sindrom Cushing .

Metabolisme lan nutrisi: Tetep natrium, retensi banyu.

Mental: kelainan emosi, depresi, kasenengan.

mripat: katarak .

Hipertensi: Hipertensi.

pencernaan: borok.

Kulit lan jaringan subkutan: Atrofi kulit, Jerawat . otot - balung lan jaringan ikat: kekirangan otot, retardasi perkembangan.

Badan lan papan panggunaan: cacat kemampuan marasake awak dhewe.

Pengujian: Ngurangi kalium.

Frekuensi ora dingerteni

Infèksi lan parasit: infèksi oportunistik, Potensi TB kambuh , peritonitis.

jinak lan ora dingerteni: Sarcom Kaposi.

Hematologi: sel darah putih. kekebalan: Reaksi hipersensitivitas amarga obat.

Endokrin: insufisiensi adrenal, sindrom suspensi steroid.

metabolisme lan nutrisi: Infeksi alkalin hipotensi, asidosis metabolik, nyuda toleransi glukosa, nambah kabutuhan insulin utawa diabetes oral, nambah napsu.

Kejiwaan: Psikosis, prilaku mental, gangguan emosi, gangguan mental, owah-owahan pribadine, kebingungan, prilaku abnormal, kuatir, insomnia, jengkel.

Neurologi: konvulsi, tambah tekanan intrakranial, demensia, gangguan kognitif, pusing, sirah.

mripat: glaucom, mripat cembung, kornea tipis, nyembah tipis, vena - retina.

jantung: gagal jantung kongestif, pecah otot jantung sawise infark miokard. getih vaskular: Hipotensi, trombosis arteri, trombosis.
ambegan - dada - mediastinum: emboli paru, cegukan.
Pencernaan: Perforasi usus, pendarahan lambung, pankreatitis, ulcer esofagus, kembung, esofagitis, nyeri weteng, diare, gangguan pencernaan, mual. ati - empedu: nambah enzim ati.
Kulit lan membran mukus: ruam abang, angioedema, gatal, urtikaria, bruising, pendarahan, ruam, wulu, kringet, stretch mark, kapiler ing kulit.
otot - balung - sendi: fraktur patologis, nekrosis balung, atrofi otot, penyakit sendi neurologis, penyakit otot, nyeri sendi, nyeri tendon.
Sistem reproduksi lan kelenjar susu: titik akupunktur sing ora teratur.

Sistemik lan panggonan panggunaan: lemes, rasa ora nyaman, gejala kondensasi obat, nyuda dosis kortikosteroid kanthi cepet banget nyebabake insufisiensi adrenal akut, nyuda tekanan getih, pati.
Petunjuk babagan cara nangani ADR
Pengurangan metilprednisolon langkah demi langkah tinimbang mandheg kanthi tiba-tiba.
Siji-sijine dosis dina kurang saka bagean dosis tinimbang dosis saben dina, ukuran sing apik yaiku ukuran sing apik kanggo nyuda inhibisi kelenjar adrenal lan ADR liyane. Ing terapi saben dina, gunakake mung saben 2 dina, ing wayah esuk.
Ngawasi paramèter osteoporosis, pendarahan, toleransi glukosa, efek ing mripat, tekanan getih.
Preventia ulkus lambung, duodenum karo H2 - obat anti-reseptor histamin nalika dosis dhuwur.
Kabeh pasien sing nggunakake methylprednisolone jangka panjang mbutuhake kalsium tambahan kanggo nyegah osteoporosis.
Wong-wong sing cenderung kena pengaruh imunosupresan kudu ngevaluasi infeksi.
Nalika ngalami efek samping obat kasebut, sampeyan kudu mandheg nggunakake lan ngandhani dhokter utawa menyang fasilitas medis sing paling cedhak kanggo perawatan pas wektune.

Pènget

Sadurunge nggunakake obat kasebut, sampeyan kudu maca instruksi kasebut kanthi teliti lan deleng informasi ing ngisor iki.

Kontraindikasi

Obat metilone Kontraindikasi ing kasus ing ngisor iki:

Hipersensitivitas kanggo methylprednisolone utawa bahan liyane saka tamba.

Infeksi sing abot, kajaba kejut bakteri lan meningitis.

Lesi kulit virus, jamur utawa tuberkulosis.

nggunakake vaksin virus sing urip.

Ati-ati nalika nggunakake

Efek saka efek imunosupresif / nambah sensitivitas kanggo infeksi

Singidaken pratandha infèksi lan infèksi anyar bisa katon nalika njupuk tamba. Nyandhet respon inflamasi lan fungsi kekebalan nambah sensitivitas kanggo infeksi jamur, virus, bakteri. Manifestasi klinis bisa uga ora khas, bisa tekan tahap kemajuan sadurunge dideteksi.

Wong sing nggunakake obat sing luwih sensitif tinimbang wong normal kayata campak utawa cacar bisa uga luwih serius.

Kortikosteroid kudu digunakake kanthi ati-ati ing pasien sing kena infeksi utawa sing dicurigai kena infeksi parasit kayata Strongyloides (cacing belut), sing bisa nyebabake infeksi tambah lan nyebarake Strongyloides kanthi gerakan larva sing nyebar, asring diiringi inflamasi usus sing abot lan infeksi gram negatif, bisa mati.

Kontraindikasi kanggo vaksin urip ing pasien sing njupuk kortikosteroid amarga bisa nyuda respon antigen antibodi.

Kejut infeksi: Dosis sing sithik sajrone 5 - 11 dina bisa nyuda kematian.

sistem kekebalan

Amarga reaksi kulit lan reaksi anafilaksis, kejutan anaphoid nalika nggunakake kortikosteroid, perlu kanggo njupuk langkah-langkah pencegahan sing cocog sadurunge digunakake, utamane ing pasien sing duwe riwayat alergi marang obat apa wae.

Efek Hormon

Perawatan sing luwih dawa: atrofi adrenal bisa kedadeyan lan ana nganti pirang-pirang wulan sawise mandheg nggunakake, pasien sing njupuk obat sing luwih dhuwur tinimbang dosis fisiologis (6 mg methylprednisolone) luwih saka 3 minggu ora kudu mandhegake obat kasebut kanthi tiba-tiba. Sampeyan perlu kanggo netepake kahanan klinis ing proses mungkasi obat kasebut. Yen penyakit kasebut ora bisa kedadeyan maneh nalika mungkasi kortikosteroid awak nanging ora yakin babagan inhibisi HPA (sumbu hipotalamus - pituitary - kelenjar adrenal), dosis kortikosteroid bisa dikurangi dadi dosis fisiologis. Nalika tekan dosis 6 mg / dina, pangurangan dosis kudu luwih alon kanggo mulihake HPA.

Kortikosteroid mandheg kanthi dadakan sawise nggunakake terus-terusan ≤ 3 minggu, mung nalika nemtokake manawa pasien ora bakal kambuh. Mungkasi dumadakan sawise nggunakake dosis nganti 32 mg / dina kanggo 3 minggu ora bisa nimbulaké inhibisi HPA. Pasien ing ngisor iki kudu mungkasi obat kasebut kanthi alon nalika digunakake ≤ 3 minggu:

wis nggunakake akeh kortikosteroid awak, utamane yen digunakake luwih saka 3 minggu.

Gunakake jangka pendek sajrone 1 taun sawise perawatan sing dawa.

Ana risiko gangguan adrenal saliyane perawatan kortikosteroid eksternal. Gagal adrenal akut uga bisa nyebabake fatal yen kortikosteroid mandheg mandheg.

Pasien njupuk obat ing wayah sore lan bola-bali kaping pirang-pirang.

Methylprednisolone> 32 mg.

Nalika gagal adrenal amarga obat bisa nyuda sekresi mineralokortikoid, nambah uyah utawa mineralokortikoid.

Sindrom kondensasi bisa kedadeyan: anoreksia, mual, koma, sirah, mriyang, nyeri sendi, kulit, mundhut bobot, nyeri otot, hipotensi.

Tambah sindrom Cushing sing saya tambah parah, kudu dihindari ing pasien iki.

Gangguan metabolik lan nutrisi

Hiperglikemia mundhak, nyebabake diabetes sajrone perawatan sing suwe.

Efek mental

Depresi, kasenengan.

Gejala biasane katon sawise sawetara dina perawatan lan biasane ilang nalika mungkasi tamba. Nanging, yen gejala kasebut langsung kuwatir.

Efek ing mripat

Nimbulake katarak, kulit retina yen digunakake kanggo panggunaan sing dawa, risiko infeksi jamur lan tambah virus.

Kedadean kardiovaskular

Kelainan lipid getih lan hipertensi sajrone perawatan sing dawa. Mula, kudu ati-ati banget lan mung nggunakake obat yen pancen perlu kanggo pasien gagal jantung kongesti.

Ngawasi efek ing ati kortikosteroid, otot muskuloskeletal ing pasien sing duwe masalah ati, utawa pasien osteoporosis.

Bocah-bocah

kortikosteroid bisa nyebabake perkembangan embrio, bocah cilik lan bocah cilik.

Bayi lan bocah cilik sing diobati nganggo kortikosteroid sing berpanjangan beresiko nambah tekanan intrakranial.

Kemampuan kanggo nyopir lan ngoperasikake mesin

Amarga efek sing ora dikarepake kayata pusing, pusing, gangguan visual, lemes, kudu ati-ati nalika nyopir lan ngoperasikake mesin.

meteng

mung digunakake yen perlu. Nggunakake obat iki yen wis ngevaluasi keuntungan sing luwih gedhe tinimbang risiko kanggo janin.

periode nyusoni

kortikosteroid diekskresikan ing jumlah cilik saka susu ibu. Nanging, methylprednisolon 40 mg / dina ora mbebayani kanggo bocah-bocah, yen dosis sing luwih dhuwur bisa nyebabake inhibisi adrenal bocah kasebut. Mulane mung digunakake nalika pancen perlu lan keuntungan luwih dhuwur tinimbang resiko.

Interaksi obat

interaktif liwat CYP 3A4

Inhibitor CYP 3A4

Antibakteri Macrolid, jus jeruk bali, antihistamin H1, Isoniazid nambah konsentrasi methylprednisolone ing getih nambah efek, tambah keracunan.

Induksi CYP 3A4

Antibiotik, antibiotik rifampisin, anti-konvulsi kayata carbamazepin, obat anti-muntah, kontrasepsi oral, obat antivirus ... nyuda tingkat methylprednisolone, nyuda efek perawatan saka methylprednisolone.

ora liwat CYP 3A4

NSAID: Tambah risiko tukak lambung.

obat anti-kolinergik, obat maple saraf, otot.

anti-cholinininusterase: Nambah efek myasthenia gravis.

Perawatan diabetes: kortikosteroid nambah gula getih, mula dosis diabetes kudu ditambah.

Obat-obatan sing nyebabake hipokalemia: Risiko mundhake hipokalemia.

Panyimpenan

Ing panggonan sing garing, aja nganti cahya, suhu ora ngluwihi 30ºC.

Obat liyane

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