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andriol tc

Warfarin (or 4-hydroxycoumarin) – anticoagulant which prevents the vitamin K-dependent blood clotting factor synthesis. Of the existing isomers potency warfarin andriol tc S-isomer in about 5 times higher than R-isomer of warfarin.

The pharmacological effect of warfarin is based on ability to prevent the action of vitamin K in synthesis of clotting factors II, VII, IX and X. In therapeutic warfarin doses reduces the rate of synthesis of clotting factors by 30 – 50%, and decreases their biological activity. The full effect is 2 – 7 day (in the already circulating in the blood clotting factors during this time removed from the body).

Pharmacokinetics
Following oral administration of warfarin bioavailability of> 90%, the maximum concentration achieved within 3-9 hours in plasma. Simultaneous food intake delays absorption, but it does not reduce the absorption quantitatively. There is some enterohepatic recycling. Warfarin is almost completely bound to serum albumin-free fraction content varies from 0.5 to 3%. The volume of distribution is approximately 0.14 l / kg. Warfarin crosses the placenta but not excreted in breast milk.Warfarin is metabolized in the liver. By catalysis CYP2C9 (S-isomer) and CYP1A2 and CYP1A3 (R-isomer) of warfarin becomes inactive metabolites that are excreted in urine. Half-life of S-isomer is 18-35 hours warfarin, R-isomer warfarin – 20-70 hours.

Indications.
– Treatment and prevention of deep vein thrombosis and pulmonary embolism.
– Secondary prevention of myocardial infarction and prevention of thromboembolic complications after myocardial infarction.
– Prophylaxis of thromboembolic complications in patients with atrial fibrillation, lesions of the heart valves or prosthetic heart valves.
– Treatment and Prevention transient ischemic attacks and strokes.

Contraindications.
– Pregnancy I and III trimesters.
– Bleeding tendency (von Willebrand disease, hemophilia, thrombocytopenia, platelet dysfunction, hemorrhagic diathesis).
– Severe liver or kidney failure, severe liver or kidney disease; obstructive jaundice.
– Infective endocarditis or pericardial effusion.
– Diabetes.
– Hypersensitivity and / or individual intolerance of components.
– Acute DIC.
– Conditions that predispose to gastrointestinal bleeding or renal (such as the previously observed with gastrointestinal complications intestinal bleeding, peptic ulcer and duodenal ulcer in the acute stage, diverticulosis, malignant tumor).
– Severe hypertension.
– A recent intracranial hemorrhage, such as an aneurysm of cerebral arteries. Tendency to fall.
– Newly transferred or implied complicated operations on the central nervous system, ophthalmic surgery and diagnostic procedures.
– Dementia, psychoses, alcoholism, and other andriol tc conditions where marked lack of opportunity to assess the state of the blood coagulation system by laboratory methods.

Pregnancy and lactation.
Marevan crosses the placenta, has teratogenic effects (nasal hypoplasia and chondrodysplasia) 6 – 12 weeks of pregnancy. The drug can cause bleeding in the fetus in late pregnancy and during labor.Marevan is absolutely contraindicated in I and III trimester of pregnancy. The remaining phases of pregnancy, use of the drug for anticoagulant therapy should be carried out with careful assessment of the likely benefits the mother and fetus on purpose / fails to appoint the drug.

The drug is not excreted in breast milk and can be used during lactation, however, advisable to abstain from breast-feeding in the first 3 days of therapy Marevanom.

Dosage and administration. Adults: Patients with normal weight and spontaneous international normalized ratio (MHO) of less than 1.2 mg of warfarin is prescribed to 10.5 for three consecutive days. Then, the dose is calculated in accordance with the table below, based on the measurement of MHO on the fourth day of therapy.

In the outpatient setting and in patients with hereditary protein C or S deficiency recommended initial dose is 4.5 mg of warfarin for three consecutive days. Then, the dose is calculated in accordance with the table below, based on the measurement of MHO on the fourth day of therapy.

For older patients, patients with low body weight, with a spontaneous MHO more than 1.2 or with co-morbidities (see. Section “Special Instructions”), or receiving any medicines that affect the effectiveness of anticoagulant therapy, the recommended initial dose of warfarin is 4.5 mg for two consecutive days. Then, the dose is calculated in accordance with the table below, based on the MHO measured on the andriol tc third day of treatment. pt-141 for sale

andriol testocaps

The tablets are taken andriol testocaps orally, every day, at about the same time, with a little water.
Follow in the direction of the arrows until all the tablets have been taken. Over the next 7 days, do not take pills. During this period, should start menstruating (bleeding after discontinuation of the drug).Normally, menstruation starts on day 2-3 after the last tablet. On the 8th day even if your period continues, start taking the pill from the next pack.How to start taking Marvelon drug

  • If you have not used oral contraceptives in the past month: Start taking Marvelon on the first day of the menstrual cycle (the first day of menstruation). Take a pill, which specified the day of the week, and then continue taking one pill a day in order. You can also start taking Marvelon for 2-5 days after the beginning of the menstrual cycle, but in this case it is necessary to use additional non-hormonal methods of contraception during the first 7 days of tablet-taking in the first cycle.
  • In the transition to the other combination pill: You can start taking Marvelon on the next day after taking the last tablet of the drug that you are using, without any interruption. If the package also contains inactive contraceptive pills (without hormones), you can start taking Marvelon on the next day after taking the last pill with hormones. You can start taking pills Marvelon and later, but not later than the day after the tablet-free interval (or the next day after the last inactive tablet).
  • When switching from pills containing progestogen only (minipill) You can stop taking the “mini-pill” in any day and start taking Marvelon the next day at the same time. However, during the first seven days of taking the pills Marvelon is necessary to use additional methods of contraception.
  • In the transition from the injection or implant: start using Marvelon on the day when the next injection should be, or on the day of implant removal. During the first seven days of taking the pills Marvelon is necessary to use additional methods of contraception.
  • After the birth of the child: it is recommended to wait until the first occurrence of a normal menstrual period before starting to take Marvelon. If you are breastfeeding, you should consult with your doctor.
  • After miscarriage or abortion: Follow the doctor’s recommendations.If you want to stop taking the drug Marvelon
    you can do it at any time whenever you want. If you stop taking the drug because you want to get pregnant, then before you try to conceive a child, it is usually recommended to wait for the natural occurrence of the first menstruation. This will allow you to predict the period of birth.What to do in case of missing the next dose
    if you are late with taking the next pill less than 12 hours, the effectiveness of the drug is maintained.
    Take the missed tablet as soon as you remember and the next tablet is taken at the usual time.
    If you are late with taking the next tablet more than 12 hours, the effectiveness of the drug can be reduced. . The more pills you have missed, the higher the risk of reduced contraceptive efficacy
    . Especially at high risk of becoming pregnant if you miss tablets at the beginning or end of the stack
    is therefore necessary to follow these rules.
    More than one missed pills in the pack – refer to the doctor. 1 missed tablet in the 1st week take the missed pill as soon as you remember (even if it will have to take two tablets at the same time) and take the next pill at the usual time. Use additional methods of contraception for the next seven days. If you have had sexual intercourse during the week before skipping pills, it may cause pregnancy. Tell your doctor immediately. 1 missed pill during the 2nd week Take the missed tablet as recall only (even if it will have to take two tablets at the same time) and take the next pill at the usual time. Efficacy is maintained, so additional methods of contraception are not required. 1 tablet missed in the third week, you can choose one of the following schemes without resorting to additional measures of contraception.1. Take the missed tablet as soon as you remember (even if it will have to take two tablets at the same time) and take the next pill at the usual time. Start the next pack as soon as the current one, without making a break in taking the drug. Bleeding at the cancellation can not be before the end of the second pack of the drug, but there may be spotting or unexpectedly heavy bleeding in the days of taking the pills. 2. Stop taking tablets from the currently used packaging, take a break for 7 days or less (including the day that you missed a pill) and start taking pills from the next burst. In this case, you can always start taking the pill from the next pack on the same day of the week, as usual.

 

 

References in the event of vomiting or diarrhea
If vomiting or diarrhea occurs within 3-4 hours following ingestion, absorption may be incomplete. In this case, you should use the recommendations for skipping the next dose.

If you want to delay the onset of menstruation
, you can postpone menstruation, if you start taking pills of the next pack as soon as the previous (non-stop).
You can take the tablets from the next pack until they run out. If you want to start menstruating, stop taking the tablets. When receiving the tablets of the second pack, you may experience a sudden profuse bleeding or spotting. Taking the pills from the next pack should be started after a 7-day break.

If you want to change the first day of menstruation
when using the drug in accordance with the recommendations of menstruation begins in the same day every 4 weeks. If you want to change the first day of menstruation, make shorter the next tablet-free interval.
For example, if your period usually starts on a Friday and you want it to be started on Tuesday (three days earlier), you should start taking the pill from the next pack 3 days earlier than usual.
If you make too short a tablet-free interval (eg, 3 days or less), then during the break, you may not be bleeding. During the reception of the next pack of pills may experience spotting or unusually heavy bleeding.

If you have unexpected bleeding
As with other oral contraceptives, during the first few months there may be irregular vaginal bleeding (spotting or sudden vaginal bleeding) between periods. The drug in this case it is necessary to continue as usual.
The emergence of intermenstrual bleeding during the first three months of reception does not mean that the contraceptive effect is reduced or that the drug is not suitable for you.
Irregular vaginal bleeding andriol testocaps usually stops once your body adjusts to the drug ( usually after three cycles of pills reception). If bleeding continues, becomes heavy, contact your doctor.

If you do not have your period
if you take all the pills in a timely manner, you have not had vomiting or diarrhea, you do not take other medicines, it is unlikely that you are pregnant. Continue to take Marvelon as usual.
If you have two times in a row was not menstruating, you may be pregnant. Do not start a new pack until the doctor rule out pregnancy.

Side effects
have been reported following adverse reactions in patients taking Marvelon. They can occur in the first few months of using the drug, and usually diminish over time.
Headache, gastralgia, nausea, vomiting; tenderness and engorgement; weight gain, glucose intolerance, fluid retention in the body, changes in libido, depressed mood, swelling of the eyelids, skin rash, nodular erythema, conjunctivitis, discomfort while wearing contact lenses, thrombophlebitis, thromboembolism (may show impaired perception: visual disturbances, hearing loss), generalized pruritus, cholestatic jaundice, cholelithiasis, increased blood pressure, intermenstrual bleeding, a change in vaginal secretion may develop vaginal candidiasis.
With prolonged use (rare) – chloasma, hepatocellular adenoma.

Overdose
of the serious consequences of hosting large number of pills Marvelon were reported. If you have taken several tablets at once, you may experience nausea, vomiting, vaginal bleeding. If you discover that a child swallows the pill, contact your doctor.

Interaction with other drugs and other forms of interaction
Interactions with certain drugs can lead to excessive bleeding and inefficiency of oral contraceptives. Such cases were observed when receiving hydantoins, barbiturates, primidone, carbamazepine, rifampicin, isoniazid; they are possible in the appointment oxcarbamazapine, topiramate, felbamate and griseofulvin. Reduced efficacy of oral contraceptives was also observed when taking certain antibiotics such as ampicillin, tetracycline, neomycin, penicillin, chloramphenicol, and activated carbon, laxatives.
Marvelon reduces the effectiveness of oral anticoagulants, anxiolytics (diazepam), the tricyclic antidepressants, theophylline, caffeine, hypoglycemic drugs, clofibrate, corticosteroids.
Always tell the doctor, who appoints you to the pill, which medicines you are already using. If the doctor prescribes you other medicines, tell him that you are taking Marvelon.

When you should contact your doctor

For regular inspection
If you are taking birth control pills, you need to have regular annual check-ups.

Consult your doctor immediately if:

  • Have you noticed any change in health status (see section “Contraindications”, “Side Effects.”);
  • You seal in the breast;
  • You are going to take other medications;
  • You are forced to comply with bed rest (during illness, after an injury), or you have an operation;
  • you have a very heavy or prolonged vaginal bleeding;
  • You missed a pill in the first week, and you have had sexual intercourse in the seven days before;
  • Do you suspect that you are pregnant.Stop taking the drug and contact your doctor immediately if you notice possible signs of thrombosis:
  • an unusual cough,
  • severe chest pain, which may be given in the left hand;
  • shortness of breath;
  • unusual, severe pain, or prolonged headache or migraine attack;
  • partial or complete loss of vision or double vision;
  • speech impairment or loss of speech;
  • a sudden change in hearing, smell or taste;
  • dizziness or fainting;
  • weakness or loss of sensation in a part of the body;
  • severe abdominal pain;
  • severe pain or swelling andriol testocaps of the legs.Effects on ability to drive and other machines
    The effect of the drug Marvelon on ability to drive and operate with mechanisms were observed.

 

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andriol testocaps bodybuilding

Maraslavin is a combined herbal preparation for topical application in dentistry with an antiseptic, disinfectant, anti-inflammatory, anti-allergic, irritant, astringent, stimulating regeneration and local anesthetic action. At the beginning of treatment the drug causes irritation, congestion and swelling of the mucous membrane of the gums. By hypertonicity maraslavina are removed from the tissues of the gums and the gum pockets of toxic degradation products. Then the increase in the number of collagen fibers observed andriol testocaps bodybuilding their seal, formation of new epithelium and the restoration of normal gingival structures and strengthening the binding periodontal cement of the tooth root.
In the treatment of hemorrhagic form of periodontal disease occurs first decrease swelling and bleeding gums, which become first pale and then pale pink color and compacted, gingival papillae are flat out and gradually pressed against the neck of the tooth to podemalevo-cement border. Gingival pockets are reduced or disappear. When pioreynoy form in the early days of an increase in the amount of purulent exudate, then gradually the amount is reduced to extinction. Papilla resolve, gum edges aligned and tightly pressed to the teeth. There stabilize loose teeth.

Indications
haemorrhagic form of gum disease with alveolar pockets. Combined therapy pioreynoy form of periodontal disease. The postoperative period in surgical treatment of periodontal disease.

Contraindications
: Hypersensitivity to the drug.

Dosing and Administration
Locally. Treatment is carried out and the dentist begins with the removal of supragingival calculus. At the same time measures are taken to venting gums spray or a jet of warm water.
Then carry out installation Maraslavina through loose cotton swab into the alveolar bone and pockets with a probe. For this poured into a glass vial 20-25 mL Maraslavina who richly moistened cotton swabs, the size of which depends on the width of the alveolar bone or pocket. Tampons are left in their pockets for 5-6 minutes, and at this time put pads on the other side of the teeth or in the pockets of the adjacent teeth. This procedure is repeated 5-6 times in andriol testocaps bodybuilding a single session (sequentially in each pocket). At each change of the tampon easier and it penetrates deeper into the alveolar pocket. Recent tampons are left loose to lie in the pockets, the patient is released until the next day with the recommendation to remove the most tampons in the case of temperature increase (due to purulent exudate) or other violations of health and consult a dentist.
In the second session of treatment remove tampons, left after the first visit and remove the subgingival calculus. Consistently investing some tampons in each pocket as in the first session. Recent tampons also leave as much as possible for 24 hours.
The treatment is carried out at intervals of three months. 17-20 should conduct treatments by the above method, depending on the disease and condition of the patient. It is necessary that the first 5-6 sessions performed with 24 hours intervals. The following treatments are appointed by the dentist.
At the end of 5 – 6 months after treatment is carried out a control examination of the patient. Regardless of the state of the gums make 1 – 2 treatments (if necessary more) processing Maraslavinom the same places on the alveoli to eliminate possible microbial pathogens process. The final examination is carried out 12 months after the start of treatment.

Side effects
are possible allergic reactions. When imposing tight tampons possible low-grade fever, caused by a purulent exudation. These phenomena disappear after removal andriol testocaps bodybuilding of tampons. jintani labs

andriol

By increasing the osmotic pressure of plasma and subsequent reabsorption without filtering results in retention of water in the tubules and increases urine volume. Boosting plasma osmolarity, causing movement of fluid from the tissue (in particular, the eyeball, the brain) in the bloodstream. No effect on glomerular filtration. Urine output is accompanied by a moderate increase in natriuresis without substantially affecting the K + excretion. The andriol diuretic effect is higher, the higher the concentration (dose). Not effective for abuse filtration renal function, as well as azotemia in patients with liver cirrhosis and ascites. It causes an increase in blood volume.

Indications for use
of brain edema; cranial hypertension (in patients with renal or hepatic renal failure); acute attack of glaucoma; status epilepticus; oliguria acute renal hepatic or renal failure with preserved kidney filtration capacity (in combination therapy); post-transfusion complications after administration of incompatible blood; forced diuresis in poisoning by barbiturates and salicylates; for prevention of hemolysis during operations with extracorporeal circulation for the prevention of renal ischemia and associated acute renal failure.

Contraindications:
Hypersensitivity to the drug, anuria with acute tubular necrosis with severe kidney disease, hemorrhagic stroke, severe dehydration, subarachnoid hemorrhage (other than bleeding when performing craniotomy), pulmonary edema with acute left ventricular failure, congestive heart failure, hypokalemia, chloropenia , hyponatremia. Used with caution during pregnancy and lactation.

Dosing and Administration
Intravenous (slow jet or drip). Prophylactic dose is 0.5 g / kg body weight, therapeutic – 1-1.5 g / kg. The daily dose should not exceed 140-180 g In operations with extracorporeal circulation unit preparation is administered in a dose of 20-40 g immediately prior to perfusion. Patients with oliguria should first enter intravenously a test dose (200 mg / kg) for 3-5 minutes. If after 2-3 hours will not be marked diuresis increasing speed up to 30-50 ml / h, the further administration of the drug should be avoided.

Side effects
of violations of water-electrolyte metabolism (increased blood volume, hyponatremia, rarely – hyperkalemia), dehydration (indigestion, muscle weakness, dry skin, dry mouth, thirst, seizures, hallucinations, decreased blood pressure). Rarely -tahikardiya, chest pain, thrombophlebitis, skin rash.

Interaction with other drugs
is possible to increase the toxic effect andriol of cardiac glycosides (associated with hypokalemia).

Cautions
When left ventricular failure should be combined Mannitol with quick “loop” diuretics (because of the risk of pulmonary edema).
Need to monitor blood pressure, urine output, blood concentrations of serum electrolytes (potassium, sodium).
In the case of the introduction of the drug symptoms such as headache, vomiting, dizziness, visual disturbances should discontinue administration and eliminate the development of complications such as subdural and subarachnoid hemorrhage. When you see signs of dehydration is necessary to introduce into the body fluid. Can be used in heart failure (only in combination with the “loop” diuretics) and hypertensive crisis with encephalopathy.
Reintroducing Mannitol should be under the control of indicators of water and electrolyte balance of blood.
In the case of loss of the drug crystals andriol are heated in a water bath at a temperature of 50 to 70 ° C with shaking until complete dissolution of the crystals. When cooling to a temperature (36-38 °), the crystals will not fall again, the drug is fit for use. how much to inject for weight loss

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dr gerald andriole

Dr gerald andriole acts mainly in the proximal tubule, although the effect persists slightly downward in the loop of the nephron and collecting ducts. It permeates through the cellular and tissue barriers (for example, the blood-brain barrier) does not increase the content of residual nitrogen in the blood. Boosting plasma osmolarity, causing movement of fluid from the tissue (in particular, the eyeball, the brain) in the bloodstream. Urine output is accompanied by a moderate increase in natriuresis without substantially affecting the excretion of potassium. The diuretic effect is higher, the higher the concentration (dose). Ineffective filtration in violation of kidney function, as well as azotemia in patients with cirrhosis and ascites:. Causes an increase in blood volume pharmacokinetics Mannitol is poorly absorbed when taken orally and is therefore administered intravenously. The volume of distribution corresponds to the volume of mannitol extracellular fluid as it is distributed only in the extracellular sector. Mannitol may undergo minor metabolism in the liver with the formation of glycogen. The half-life of mannitol is about 100 minutes. The drug is excreted by the kidneys. Mannitol excretion is regulated by glomerular filtration, with no significant involvement of tubular reabsorption and secretion. If administer intravenously 100 g of mannitol, 80% of it is determined in urine during 3 hours. In patients with renal insufficiency mannitol half-life can be increased to 36 hours.

Indications for use
of brain edema, intracranial hypertension (in patients with renal or hepatic renal failure); oliguria acute renal hepatic or renal failure with preserved kidney filtration capacity (as part of combination therapy), post-transfusion complications after administration of incompatible blood, forced diuresis in poisoning barbiturates, salicylates; prevention of hemolysis during surgery using extracorporeal circulation with a view to preventing kidney ischemia and associated acute renal failure.

Contraindications:
Hypersensitivity to the drug, anuria with acute necrosis of renal tubules, left ventricular failure (especially accompanied by pulmonary edema), hemorrhagic stroke, subarachnoid hemorrhage (other than bleeding during craniotomy), dehydration, severe gravity, hyponatremia, hypo-hloremiya, hypokalemia .

Precautions
Pregnancy, lactation, old age.

Dosage and administration
. Intravenous (slow jet or drip)
prophylactic dose is 0.5 g / kg body weight, therapeutic 1.0-1.5 g / kg; the daily dose should not exceed 140-180 Before the introduction of the drug should be heated to a temperature of 37 ° C (may be in a water bath). When operations with cardiopulmonary bypass preparation is administered in unit dose 20-40 g immediately prior to perfusion. Patients with oliguria should first enter intravenously a test dose (200 mg / kg) for 3-5 minutes. If after 2-3 hours will not be marked increase in urine output speeds of up to 30-50 ml / h, the further administration of the drug should be discarded.

Side effects of
dehydration (dry skin, dry mouth, thirst, indigestion, muscle weakness, seizures, hallucinations, decreased blood pressure), dr gerald andriole violation of water-electrolyte metabolism (increased blood volume, hyponatremia, a rare – hypokalemia). Rarely – tachycardia, pain behind the breastbone, thrombophlebitis, skin rash.

Interaction with other drugs
is possible to increase the toxic effect of cardiac glycosides (in the background gipokalie-mission).

Cautions
When left ventricular failure (due to the risk of pulmonary edema) must be combined with mannitol quick “loop” diuretics. Necessary to control blood pressure, urine output, blood concentrations of serum electrolytes (potassium, sodium).
In the case of discontinue administration and eliminate the development of such complications as subdural and subarachnoid hemorrhage when administered drug headache, vomiting, dizziness, blurred vision.
When signs of dehydration is necessary to introduce into the body fluid. Can be used in heart failure (only in combination with the “loop” diuretics) and hypertensive crisis with encephalopathy.
Repeated administration of mannitol should be monitored indicators of water and electrolyte balance of blood.
The introduction of mannitol in anuria dr gerald andriole caused by organic diseases of kidneys, can lead to the development of pulmonary edema.

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