Anadrol results is a potassium-sparing diuretic, long-acting, competitive antagonist of aldosterone (a hormone of the adrenal cortex mineralokortikosteroidny). In the distal nephron anadrol results prevents aldosterone delay sodium and water and inhibits the effect of aldosterone kaliyvyvodyaschy, reduces the synthesis permeases in aldosterone-sensitive area of the collecting ducts and distal tubules. Aldosterone binding to receptors, increases the excretion of sodium, chloride and water excretion, reduces the excretion of potassium ion and urea reduces the acidity of urine.
The hypotensive effect of the drug effect due to the presence of a diuretic; diuretic effect appears 2-5 day of treatment.

Pharmacokinetics
When ingestion rapidly and completely absorbed from the gastrointestinal tract; almost 100% bioavailability and increases its food ca. 100%; connection to plasma proteins for about 98%. After receiving the daily dose of 100 mg for 15 days maximum concentration (Cmax) – 80 ng / ml, the time to reach maximum plasma concentration (TC max ) after receiving the next morning -. 6.2 hours
active sulfur-containing metabolites are formed in the process of biotransformation in the liver 7-alpha-tiometilspironolakton and kanrenon.Kanrenon reach the Cmax by 2-4 h, its relation to plasma proteins 90%.
anadrol results bad into the organs and tissues, with himself and its metabolites cross the placental barrier and canrenone – in breast milk.
distribution volume – 0.05 l / kg. The half-life (the T 1/2 .) -13-24 Hours
excreted by the kidneys: 50% – in the form of metabolites, 10% – unchanged and in part – through the intestines. Withdrawal of canrenone (mainly kidneys) biphasic T 1/2 in the first phase -. 2-3 hours, in the second -12-96 hours
in liver cirrhosis and heart failure duration T 1/2 increases with no signs of accumulation, the probability is higher at chronic renal failure and hyperkalemia.

INDICATIONS
– essential hypertension (as part of combination therapy);
– Edematous syndrome in patients with chronic heart failure (can be used as monotherapy and in combination with standard therapy)
– a condition in which secondary aldosteronism may be found, including cirrhosis of the liver, accompanied by ascites and / or edema, nephrotic syndrome, and other conditions accompanied by edema;
– hypokalemia / hypomagnesemia (as an aid for its prevention during treatment with diuretics and with the inability to use other methods of potassium concentration correction);
– primary hyperaldosteronism (Conn’s syndrome) – for a short pre-operative treatment;
– to establish the diagnosis of primary gaperaldosteronizma.

CONTRAINDICATIONS
Hypersensitivity to any component of the drug, lactose intolerance, lactase deficiency or glucose-galactose malabsorption, Addison’s disease, hyperkalemia, hyponatremia, severe renal insufficiency (creatinine clearance less than 10 ml / min), anuria, pregnancy, lactation, child (up to 3 years) for this dosage form.

WITH CARE
hypercalcemia, metabolic acidosis, atrioventricular block (hyperkalemia contributes to its strengthening); diabetes (with confirmed or suspected chronic renal failure); diabetic nephropathy; surgery; receiving drugs that cause gynecomastia; local and general anesthesia; old age, menstrual disorders, liver failure, cirrhosis of the liver.

Application of pregnancy and lactation
Veroshpiron contraindicated during pregnancy and lactation.

DOSAGE AND ADMINISTRATION
inside.

When essentsialyyuy hypertension
daily dose for adults is usually 50-100 mg once daily and may be increased to 200 mg, and the dose should be increased gradually, 1 every 2 weeks.
In order to achieve an adequate response to therapy, the drug should be taken at least 2 weeks. If necessary, a dose adjustment. In idiopathic hyperaldosteronism: 100-400 mg / day. In marked hypokalemia and hyperaldosteronism: 300 mg / day (maximum 400 mg) for 2-3 hours, while improving the state gradually reduce the dose to 25 mg / day.

Hypokalemia / hypomagnesemia
When hypokalemia and / or hypomagnesemia caused by diuretic therapy, prescribe a drug at a dose of 25-100 mg / day, once or in several stages. The maximum daily dose of 400 mg if oral potassium supplements or other methods of filling the deficit ineffective.

Diagnosis and treatment of primary hyperaldosteronism as a diagnostic tool with a short diagnostic test: for 4 days at 400 mg / day, spread over several receptions on the day. By increasing the concentration of potassium in the blood while taking the drug and decrease after cancellation it can assume the presence of primary hyperaldosteronism. With long-term diagnostic test: at the same dose for 3-4 weeks. Upon reaching the correction of hypokalemia and hypertension can assume the presence of primary hyperaldosteronism.

Preoperative course of therapy Short primary hyperaldosteronism
After diagnosis hyperaldosteronism set with more accurate diagnostic methods should take Veroshpiron 100-400 mg / day, divided into 1-4 daily reception during the period of preparation for surgery. If surgery is not indicated, then Veroshpiron used for long-term maintenance therapy, using the lowest effective dose, which is chosen individually for each patient.

Swelling on the background of nephrotic syndrome
daily dose for adults is usually 100-200 mg / day. There were no substantive effect on anadrol results pathological process, and therefore the use of this drug is recommended only when other therapies are ineffective.

When the edematous syndrome, chronic heart failure to background daily for 5 days at 100-200 mg / day for 2-3 hours, in combination with the “loop” or thiazide diuretic. Depending on the effect to reduce the daily dose of 25 mg. The maintenance dose is adjusted individually. The maximum dose of 200 mg / day.

Edema amid cirrhosis
If the ratio of urine sodium and potassium ions (Na + / K + ) exceeds 1.0, the daily intake for adults normally being 100 mg. If the ratio is less than 1.0, the daily dose for adults is usually 200-400 mg. The maintenance dose is adjusted individually.

In children
initial dose of 1-3,3 mg / kg body weight, or 30-90 mg / m 2 / day in 1-4 reception.
After 5 days, and the dose is adjusted as necessary to increase three-fold over the original.

ADVERSE EFFECTS From the digestive tract: nausea, vomiting, diarrhea, ulceration and bleeding from the gastrointestinal tract, gastritis, intestinal colic, abdominal pain, constipation. Liver: abnormal liver function. On the part of the central nervous system: ataxia , confusion, dizziness, headache, drowsiness, lethargy, confusion, muscle spasm. From the hematopoietic system: . agranulocytosis, thrombocytopenia, megaloblastoz From the laboratory parameters: hyperuricemia, hypercreatininemia, increasing concentrations of urea, a violation of water-salt metabolism (hyperkalemia, hyponatremia) and acid-base balance (metabolic hyperchloraemic acidosis or alkalosis). on the part of the endocrine system: brutalization vote, men – gynecomastia (the probability of development depends on the dose, duration of treatment and usually is reversible after discontinuation veroshpiron disappears only in rare cases, breast remains somewhat enlarged), reduced potency and erection; in women – menstrual disorders, dysmenorrhea, amenorrhea, metrorrhagia, menopause, hirsutism, pain in the breasts, breast cancer (an association with taking the drug is not available). Allergic reactions: urticaria, rarely makulopapulёznaya and erythematous rash, drug fever , itching. With the skin: alopecia, hypertrichosis. From the urinary system: acute renal failure. From the musculoskeletal system: leg cramps.

Overdose Symptoms: nausea, vomiting, dizziness, decreased blood pressure, diarrhea, skin rash, hyperkalemia (paresthesia, muscle weakness, arrhythmia), hyponatremia (dry mouth, thirst, drowsiness), hypercalcemia, dehydration, increase in urea concentration. Treatment: gastric lavage , symptomatic treatment of dehydration and hypotension. When hyperkalemia is necessary to normalize the water-electrolyte metabolism via kaliyvyvodyaschih diuretics, rapid parenteral administration of dextrose solution (5-20% solution) with insulin at the rate of 0.25-0.5 units per 1 g of dextrose; you can enter, if necessary repeatedly. In severe cases, hemodialysis. 

 

INTERACTION WITH OTHER DRUGS
Reduces the effect of anticoagulants, anticoagulants (heparin, coumarin derivatives, indandiona) and the toxicity of cardiac glycosides (because the normalization of the potassium level in the blood interferes with the development of toxicity).
Increases metabolism fenazola (antipyrine).
Reduces the sensitivity of vessels to norepinephrine (requires compliance with caution during anesthesia), increases T 1/2 digoxin -. digoxin intoxication can
increase the toxic effect of lithium due to the decrease in its clearance.
it accelerates the metabolism and excretion of carbenoxolone.
carbenoxolone contributes to the delay of sodium anadrol results.
glucocorticosteroids and diuretics (benzothiazine derivatives furosemide, ethacrynic acid) increase and accelerate the diuretic and natriuretic effects.
Enhances the effect of diuretics and antihypertensive drugs.
glucocorticosteroids enhance the diuretic and natriurichesky effect in hypoalbuminemia and / or hyponatremia.
The risk of hyperkalemia when taken with potassium supplements, potassium supplements and potassium-sparing diuretics, angiotensin-converting enzyme inhibitors (acidosis), antagonists of the angiotensin II of, aldosterone blockers, indomethacin, cyclosporin.
salicylate, indomethacin reduces the diuretic effect.
ammonium chloride, cholestyramine giperkaliemicheskogo contribute to the development of metabolic acidosis.
Fludrocortisone is a paradoxical increase in tubular secretion of potassium.
Reduces the effect of mitotane .
Enhance the effect of triptorelin, buserelin, gonadorelin.

Cautions
possible temporary increase in the level of urea nitrogen in serum, especially with reduced kidney function and hyperkalemia. Hyperchloraemic possible reversible metabolic acidosis.
In diseases of the kidneys and liver, as well as in the elderly requires regular monitoring of serum electrolytes indices and renal function.
The drug is difficult to determine digoxin, cortisol and adrenaline in the blood. Although there is no direct effect on carbohydrate metabolism, presence of diabetes, especially diabetic nephropathy, it requires special caution because of the possibility of hyperkalemia.
In the treatment of nonsteroidal anti-inflammatory drugs should monitor kidney function and blood electrolytes indicators. Avoid eating foods rich in potassium. During treatment, the use of alcohol is contraindicated.

Trade name Verrukatsid ®

International Non-Proprietary Name (INN) :

Dosage form : solution for outdoor applications.

Composition Active substance : phenol – 588 mg of meta-cresol – 392 mg. Excipients : ethyl alcohol 95% – 10 mg water to 1 g

Description
Mobile oily liquid from pinkish or light yellow to brown in color with a smell of phenol.

Pharmacotherapeutic group : antiseptic.

Pharmacological properties 

Verrukatsid ® has a cauterizing effect, coagulates the proteins of the skin.

Indications
Normal, threadlike, and plantar warts, papillomas, genital skin warts, corns, keratomas.

Contraindications
Individual hypersensitivity to the drug. Pigmented nevi (moles), rash, located on the red border of the lips and mucous membranes. Do not apply the drug to the skin surface area of 20cm 2 . Children up to 7 years.

Use during pregnancy and lactation
Use of the drug is possible in cases where the expected benefit to the mother outweighs the potential risk to the fetus or child. During the period of lactation is not recommended to remove the formations on the breast and hands.

Dosing and Administration
Verrukatsid ® is intended for external use only. The drug is applied exactly on the treated area a special applicator or a small thin wooden stick, not allowing him to enter the adjacent healthy areas of the skin and mucous membranes. On small papillomavirus (up to 2 mm) filamentous warts Verrukatsid ® is applied only once. Larger papilloma warts and small (size 2-3 mm) casting the drug 3-4 times, making breaks for drying the applied liquid. Before removing Verrukatsidom ®wart with a dense surface on chapped hands, plantar warts, keratitis, dry calluses must be removed from the surface horny layers. For this is applied for several hours keratolytic ointment (for example, 10% or salicylic al.), Covering the greased portion compress paper or plastic film, and then using a gauze bandage.Perhaps sealing the plaster. Then a bandage or adhesive plaster is removed, the skin steamed in hot water with soap and soda for 10-15 minutes and remove horny layers (cut with nail scissors or forceps).
On the dried skin is applied Verrukatsid ® several times, making a 3-4 minute breaks for the drying of the drug.
The warts on the hands and soles of the processed drug Verrukatsid ® 7-10 times with an interval of 3-4 minutes.
keratomas and dry corn enough to treat 3-4 times at intervals of 3-4 minutes. If necessary, multiple application of the drug to avoid burn the surrounding skin it is advisable to coat it with zinc paste. The paste is removed with dry gauze after drying the latter portion Verrukatsid ® . Genital warts is not recommended to remove yourself, handling Verrukatsidom ® conducted in the treatment room clinic dermatologist or urologist. Preparation Verrukatsid ® applied to each element separately 1-2 times at intervals of 3-4 minutes. Re-treatment, if necessary, carry out 6-8 days after the falling away of the crust. Allowed to conduct 4-5 procedures.

Side effects
Swelling and redness of the skin when applied to the eye area, going on their own. Allergic reactions.

Interaction with other medicinal products
Components preparation easily dissolve in the ointment base in connection with which to lubricate any ointments treated Verrukatsidom ® skin is not recommended.

Cautions
Do not allow contact with the drug on the mucous membranes, especially in the mucous membrane of eyes. In case of contact, rinse immediately with plenty of water and seek medical attention. It is unacceptable bandaging plots treated with the drug, gluing of plaster, smearing any ointments and removing crusts; can not be re-applied preparation before the terms specified above.
Clothing made ​​of synthetic fabrics should not touch the skin area treated with the drug. Do not apply Verrukatsid ® on education, located in the skin folds (inguinal folds, the anal region, interdigital spaces, etc.) And strongly sweating areas to avoid burns unaffected skin contacting surface or as a result of the spreading of the preparation on wet skin. Processed Verrukatsidom ® skin should be dry in the air, it can not be lubricated by any ointments, wash with water for the first day after treatment. In case of accidental contact with the drug on healthy skin must be immediately and carefully, not rubbing, remove it from the skin, and then treat the affected area 10-40% ethyl alcohol or alcohol-containing liquids (vodka, lotion, cologne) and wash thoroughly with warm water and soap. In the event of a burn Burns recommended and healing agent. When used properly, the drug does not leave scars. Extreme care and caution is required in the treatment of drug children

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