Pharmacological properties of polyene macrocyclic antibiotic with proviron 25mg activity. Is produced by Streptomyces nodosus. It has fungicidal or fungistatic effect depending on the concentration in biological fluids and the sensitivity of the pathogen. Associated with sterol (ergosterol) located in the cell membrane of the fungus sensitive to the drug. As a result of impaired permeability of the membrane, its barrier function is exited intracellular components into the extracellular space and the lysis of the fungus.
It is active against most strains of Histoplasma proviron 25mg capsulatum, Coccidioides immitis, Paracoccidioides brasiliensis , Candida spp., Blastomyces dermatitidis, Rhondotorula, Cryptococcus neoformans, Sporothrix schenckii, of Mucor mucedo, the Rhizopus, Absidia, Entomophthora, Basodiobolus, of Leishmania braziliensis, of Leishmania mexicana, Naegleria, of Aspergillus fumigatus.
the He is effective against bacteria, rickettsia, viruses. Communication with plasma proteins – more than 90%. Distributed in lungs, liver, spleen, kidneys, adrenals, muscle, and others. Fabrics. Concentration in pleural effusion, peritoneal, synovial fluid, aqueous humor reached approximately ⅔ concentration in plasma; Despite the delayed release, it accumulates weak. Virtually undergoing hemodialysis. After proviron 25mg the cancellation is detected in the body for several more weeks. When inhalation application content in pulmonary tissue reaches fungicidal concentration for most pathogenic fungi, fungistatic concentration contained in urine.
Fungal infections: disseminated cryptococcosis, cryptococcal meningitis; Meningitis caused by others. fungi, invasive and disseminated aspergillosis, North American blastomycosis, disseminated forms of candidiasis, intestinal kandidonositelstvo, coccidioidomycosis, paracoccidioidomycosis, histoplasmosis, phycomycosis, chromomycosis, mold mycosis, disseminated sporotrichosis, gialogifomikoz, chronic mycetoma, abdominal infections (ie. h. peritonitis), endocarditis, endophthalmitis, fungal septicemia, fungal infections of the proviron 25mg urinary tract.
visceral leishmaniasis (as primary therapy, including immunocompromised patients), skin-American visceral leishmaniasis.
Hypersensitivity, chronic renal failure.
With care – glomerulonephritis, amyloidosis, hepatitis, cirrhosis, anemia, agranulocytosis, diabetes, pregnancy, lactation.
Dosing and Administration
B / drip for 2-4 hours, the recommended concentration of the active substance – 0.1 mg / mL.
Test dose – 1 mg (base) diluted in 20-50 ml of 5% dextrose and is administered in / in for at least 20-30 minutes under the control of blood pressure, pulse, body temperature every 30 minutes for 4.2 hours.
With good tolerability recommended daily dose – 0.25-0.3 mg / kg, depending on the severity of the disease.
With increased sensitivity to the drug , diseases of the cardiovascular system, kidney failure treatment functions start with a low dose – 5-10 mg, and gradually increasing to 5-10 mg / day, adjusted to the recommended daily intake -. 0.5-0.7 mg / kg
selection of therapeutic doses is carried out individually depending on the type and severity of infection. When using the drug through day dose should not exceed 1.5 mg / kg (to avoid the development of cardio-pulmonary insufficiency).
In the case of interruption of therapy than renew it should for 7 days with the lowest dose and gradually increase to the desired level. Intracavitary instillation: in beginning 5 mg (base) in 10-20 ml of a 5% dextrose solution for 3-5 minutes, then 50 mg (base) in 10-20 ml of a 5% dextrose solution for 3-5 minutes every day. After 812 h after instillation injected 20 ml of 5% solution of N-acetylcysteine and overnight carried slow continuous suction. Washing of the bladder: 5 mg (base) are dissolved in 1000 ml of sterile water and rinsed with three-way catheter for 5-10 days . Babies: in / at the beginning of 0.25 mg / kg (base) per day in a 5% dextrose solution for 6 hours; taking into account the tolerance dose is gradually increased (usually 0.125-0.25 mg / kg every day or every other day) to a maximum dose of 1 mg / kg or 30 mg per 1 sq Sporotrichosis: course dose 2.5 g, duration of therapy – 9 months. aspergillosis: course dose – ZB g, duration of treatment -11 months. Rinotserebralny phycomycosis: course dose – 3-4 g Inhalation – solution is prepared immediately before use at the rate of 50,000 units in 10 mL of sterile water for injection. Inhalation spend 1-2 times per day, duration – 1520 m. When using inhalers, working only on inspiration, reduced to a single dose of 25,000 IU. The course of treatment – 10-14 days, a second course – 7-10 days.
From the digestive system: anorexia, dyspepsia (nausea, vomiting, diarrhea, gastralgia), hepatotoxicity (increased activity of “liver enzymes”). From the nervous system: headache, neuropathy, seizures. From the senses: hearing disorders and vision (blurred vision, diplopia). From the side of hematopoiesis: leukopenia, hemolytic anemia, thrombocytopenia. From the CCC: raising or lowering of blood pressure, arrhythmia, ECG changes. The respiratory system: inhalation – feeling “scratchy” throat , cough, rhinitis. From the urinary system: nephrotoxicity (hypercreatininemia, azotemia, acidosis).Allergic reactions: skin rash, pruritus, dyspnea, bronchospasm, fever, angioedema, anaphylaxis. Local reactions: thrombophlebitis at the injection site. Other: weight reduction body, myalgia, arthralgia, hypokalemia, hypomagnesemia.
. The likelihood of toxic effects increases with long-term treatment
During treatment is carried out check weighing of patients, complete blood count, urinalysis, control the level of K + in the blood, and the functional condition of the kidneys, liver, ECG. Patients taking potassium supplements, you should regularly monitor the level of K + and Mg 2+ in plasma.
The introduction of the drug to patients who are on hemodialysis, is possible only after the dialysis procedure.
All procedures should be carried out with a solution with strict aseptic, because the drug itself and all solutions are designed to his breeding, do not contain preservatives or bacteriostatic agents.
When using the system for on / in a previously established for others. goals must be a system of wash of 5% glucose solution for injection.
When the symptoms of anemia introduction of the drug should be discontinued.
The interaction with other drugs
.. Pharmaceutically compatible with heparin, saline and other solutions containing electrolytes,
presence of bacteriostatic additives (including benzyl alcohol) may result in drug proviron 25mg precipitation.
Synergism -. With nitrofurans
increases the toxicity and effect of anticoagulants, theophylline and sulfonylureas, flutsitozona (lengthens T ½ ); reduces the effect of ethinyl estradiol -. the risk of bleeding “breakthrough”
Inhibitors of microsomal oxidation in the liver (including cimetidine, non-narcotic analgesics, antidepressants) slow down the metabolic rate, increases in serum concentrations (increase toxicity).
Inductors microsomal oxidation in the liver (in including phenytoin, rifampin, barbiturates, carbamazepine) accelerate the metabolism in the liver (the effect of a decrease).
Enhances the toxic effects of cardiac glycosides (especially given the scarcity of K + in the body) and muscle relaxants curariform.
corticosteroids, carbonic anhydrase inhibitors, ACTH increases the risk of hypokalemia .
can not be administered concurrently with nephrotoxic antibiotics (increases the risk of renal dysfunction).
The antitumor drugs, radiotherapy and drugs that suppress bone marrow blood, increase the risk of anemia and other hematological disorders.
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