Treatment of adult conditions and diseases in which corticosteroids therapy allows to achieve the desired clinical effect (be aware that in certain diseases of GCS therapy is a complementary and not a substitute for standard therapy):
- Diseases of the musculoskeletal system and soft tissue in the t. H. Rheumatoid arthritis, osteoarthritis, bursitis, ankylosing spondylitis, sciatica epicondylitis, buy trenbolone acetate coccygodynia, sciatica, lumbago, torticollis, ganglion cyst exostosis, fasciitis, foot disease.
- Allergic diseases , in t. Ch. Bronchial asthma, hay fever (hay fever), allergic bronchitis, seasonal or perennial rhinitis, drug allergy, serum sickness, reactions to insect stings.
- Circulatory system diseases , in t. Ch. Atopic dermatitis, nummular eczema, neurodermatitis, contact dermatitis, expressed fotodermatit, urticaria, lichen planus, insulin lipodystrophy, alopecia areata, discoid lupus erythematosus, psoriasis, keloids, pemphigus vulgaris, herpes dermatitis, cystic acne.
- Systemic connective tissue diseases , including systemic lupus erythematosus, scleroderma, dermatomyositis, periarteritis nodosa.
- Hemoblastosis (palliative therapy of leukemia and lymphomas in adults, acute leukemia in children).
- Primary or secondary adrenocortical insufficiency (with obligatory simultaneous use of mineralocorticoid).
- Other diseases and pathological conditions requiring systemic corticosteroids therapy (congenital adrenal hyperplasia, ulcerative colitis, regional ileitis, sprue, lesions of the mucous eye, if necessary, the introduction of the drug in the conjunctival sac, pathological changes in the blood, if necessary, the use of corticosteroids, nephritis, nephrotic syndrome).
- Hypersensitivity to or any other components of the drug, or other corticosteroids,
- systemic mycoses,
- intravenous or subcutaneous administration,
- with intraarticular injection: an unstable joint, infectious arthritis,
- introducing into the infected surface and in the intervertebral space.
Hypothyroidism, cirrhosis, diseases of the eye, caused by Herpes simplex (due to the risk of perforation of the cornea), ulcerative colitis, with the threat of perforation, abscess or other purulent infections, diverticulitis, recent intestinal anastomoses, active or latent peptic ulcer and duodenal colon, renal insufficiency, hypertension, osteoporosis, myasthenia gravis, thrombocytopenic purpura (intramuscular injection).
Use during pregnancy and lactation
In the absence of controlled studies safety of Diprospan during pregnancy, use of the drug in pregnant women or women of childbearing age requires a preliminary assessment of the expected benefits and potential risks for the mother and fetus. Newborns whose mothers received therapeutic doses of corticosteroids during pregnancy should be under medical supervision (for early detection of adrenal insufficiency)
The appointment Diprospan during lactation should decide the issue of termination of breastfeeding, taking into account the importance of therapy for the mother (because possible side effects in children).
Dosage and administration
Intramuscular, intraarticular, periarticular, intrabursalnye intradermal, interstitial, and intralesional injection.
Slight crystal size of dipropionate allow the use of smaller diameter needles (up to 26-gauge) for intradermal injection, and directly into the lesion
not be administered intravenously! NOT administered subcutaneously
Strict adherence to aseptic technique when applying Diprospan sure.
Dosage and method of administration set individually, depending on the indication, the severity of the disease and the patient’s response.
If systemic therapy initial dose Diprospan in most cases is 1-2 ml. Introduction repeated as necessary, depending on the condition of the patient.
The intramuscular (i / m) administration of corticosteroids should be carried deep into the muscle and select a large muscles and avoiding contact with other tissues (to prevent atrophy of tissue).
The drug is administered / m:
- under severe conditions that require urgent action; Initial dose is 2 ml
- at various dermatological diseases ; is generally sufficient injection of 1 ml of the suspension Diprospan,
- in diseases of the respiratory system . Onset of action occurs within a few hours after the / th injection suspensions. In bronchial asthma, hay fever, allergic bronchitis and allergic rhinitis significant improvement is achieved after the introduction of 1-2 ml Diprospan.
- with acute and chronic bursitis initial dose for i / m administration of 12 mL of suspension. If necessary, a number of repeated injections.
If a satisfactory clinical response does not occur after a certain period of time, Diprospan should be withdrawn and other therapy. The local administration of the simultaneous use of local anesthetics is necessary only in rare cases. If it is desired, buy trenbolone acetate using 1% or 2% solutions of lidocaine or procaine hydrochloride not containing methylparaben, propylparaben, phenol and other similar substances. When this mixing is produced in the syringe, the syringe is first dialing the desired dose from the vial Diprospan suspension. Then, in the same syringe ampoules are removed from the required amount of local anesthetic and shaken for a short period of time.
In acute bursitis (subdeltovidnom, subscapularis, and elbow prepatellar) administering 2.1 ml of the suspension in the bag synovial relieves pain and restores mobility of the joint for a few hours. After the relief of acute lower doses of the drug used for chronic bursitis.
In acute tenosynovitis, tendinitis and peritendinitah one Diprospan injection improves the condition of the patient; when chronic – repeat injection depending on the patient response. Avoid injection of the drug directly into the tendon.
Intra Diprospan at a dose of 0.5-2 ml relieves pain, limited mobility of the joints in rheumatoid arthritis and osteoarthritis within 2-4 hours after administration. The duration of therapeutic effect varies considerably and may be four or more weeks.
The recommended dose of the drug when administered in large joints are from 1 to 2 ml; in the Middle – 0.5-1 ml; in small -. 0.25-0.5 ml
Under certain dermatological diseases effectively intradermal Diprospan directly into the lesion, the dose is 0.2 ml / cm 2 . Hearth uniformly cut away, using a tuberculin syringe and a needle with a diameter of about 0.9 mm. The total amount of drug on all areas should not exceed 1 ml for 1 week. For an introduction to the lesion is recommended to use tuberculin syringe with a needle gauge 26.
Recommended single dose (with an interval between doses 1 week) for bursitis: callosity at 0.25-0.5 ml (usually effective 2 injections), and spur – 0.5 ml, by limiting the mobility of the big toe – 0.5 ml, with synovial cyst – 0.25-0.5 ml, with tenosynovitis – 0.5 ml, for acute gouty arthritis – 0.5-1, 0 ml. For most suitable injection tuberculin syringe with a 25-gauge needle.
After reaching a maintenance dose of a therapeutic effect selected by gradually reducing doses administered at appropriate intervals. Lowering continues until the minimum effective dose.
At the occurrence, or threat of stress (non-disease) may be a need to increase the dose Diprospan. Abolition of the drug after long-term treatment is carried out by gradual dose reduction.
The observation of the patient is carried out, at least for a year at the end of long-term therapy or the use of high doses.
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The frequency and severity of side effects, as in the application and other corticosteroids, depend on the used dose and duration of use of the drug.
These effects are usually reversible and can be eliminated or reduced at lower doses. From the water-electrolyte balance : hypernatremia, increased release of potassium, increased calcium excretion, hypokalemic alkalosis, fluid retention in the tissues. cardio-vascular system : congestive heart failure (in predisposed patients), increased blood pressure. from the musculoskeletal system : muscle weakness, steroid myopathy, loss of muscle weight gain myasthenic symptoms in myasthenia gravis, osteoporosis, compression fracture of the spine, aseptic necrosis of the femoral head or shoulder bone, pathologic fracture of long bones, tendon rupture, joint laxity (with repeated intra-articular administration). From the digestive system : erosive and ulcerative lesions gastrointestinal tract with possible subsequent perforation and hemorrhage, pancreatitis, flatulence, hiccups. with the skin side and mucous membranes : violation of healing atrophy and thinning of the skin, petechiae, ecchymosis, increased sweating, dermatitis steroid acne, striae, susceptibility to the development of pyoderma and candidiasis, reduced reaction during skin tests CNS and peripheral nervous system : convulsions, increased intracranial pressure with papilledema (usually at the end of therapy), dizziness, headache; euphoria, mood changes, depression (with severe psychotic reactions), personality disorders, irritability, insomnia.From the Endocrine : menstrual irregularities, secondary adrenocortical insufficiency (especially in times of stress in the disease, trauma, surgery), Itsenko- syndrome Cushing, decreased carbohydrate tolerance, steroid diabetes or a manifestation of latent diabetes mellitus, increased requirements for insulin or oral hypoglycemic drugs, violation of fetal development, delayed growth and sexual development in children. from a sight organ : posterior subcapsular cataracts, increased intraocular pressure, glaucoma , exophthalmos; in rare cases – blindness (with the introduction of the drug in the face and scalp).From the Metabolic : negative nitrogen balance (due to protein catabolism), lipomatosis buy trenbolone acetate (including mediastinal and epidural lipomatosis, which can cause neurological complications) , increased body weight.Allergic reactions : anaphylactic reactions, shock, angioneurotic edema, decreased blood pressure. Other reactions associated with the parenteral administration of the drug : rarely – hyper or hypopigmentation, subcutaneous and cutaneous atrophy, sterile abscess, facial flushing after injection (or intra-articular injection), neurogenic arthropathy. how much to inject for weight loss
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