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dianabol before and after

Dianabol before and after – selective beta1-blocker without intrinsic sympathomimetic activity. It has no membrane stabilizing (local anesthetic) activity.
When topically applied dianabol before and after reduces both elevated and normal intraocular pressure, due to reduced production of intraocular fluid. The onset of the antihypertensive effect generally occurs within 30 minutes after instillation, and the maximum reduction of intraocular pressure occurs approximately 2 hours.After a single impact on the installation ophthalmotonus maintained for 12 hours. dianabol before and after, compared with other beta-blockers, do not cause a decrease in blood flow in the optic nerve.
dianabol before and after causes miosis, accommodation spasm, night blindness, the effect of “veil” before the eyes (unlike miotikov).

Pharmacokinetics dianabol before and after highly lipophilic, resulting in good penetration through the cornea into the anterior chamber, anterior chamber Cmax determined 20 minutes after instillation. When applied topically, systemic absorption is low, the plasma concentration is below the threshold (2 ng / ml) detected. Excretion mainly through the kidneys.

Indications

Reduction of intraocular pressure as monotherapy or in combination with other drugs:
– at elevated intraocular pressure,
– with open-angle glaucoma.

Contraindications

Individual hypersensitivity to the drug.
Sinus bradycardia, atrioventricular block II-III degree, cardiogenic shock, heart failure, heart failure, a history of sick sinus syndrome in patients with artificial pacemaker, children up to 18 years.

Carefully

Thyrotoxicosis, myasthenia gravis, diabetes, Raynaud’s syndrome, pheochromocytoma, concomitant use of oral beta-blockers.

Pregnancy and breast-feeding

Fertility
Data on the effect of the drug Betoptik ® C on human fertility are not available. Pregnancy should not be used during pregnancy except in cases where it is really necessary. Sufficient experience of use of the drug during pregnancy is not. According to the results of epidemiological studies, malformativnyh effects have been identified, but with oral β-blockers there is risk of delay fetal development. In addition, signs and symptoms of .beta.-blockade (such as bradycardia, hypotension, respiratory distress and hypoglycaemia) were detected in the neonatal period in cases where the .beta.-blockers adopted mother before giving birth. It is necessary to carry out careful monitoring of babies during the first days of life if the drug Betoptik ® C, used by the mother during pregnancy. Information on the reduction of systemic absorption, see. in the “dosage and Administration”. breastfeeding β-blockers are excreted in breast milk and may cause serious adverse reactions in breast-fed infants. However, it is unlikely that the application of therapeutic doses Betoptik drug ® C, a sufficient amount of the drug to be present in breast milk to cause the development of clinical symptoms of β-blockade in the newborn. Can be used for the treatment of nursing mothers prescribed by a doctor, if the expected therapeutic benefits exceed the risk development of possible side effects. Information on the reduction of systemic absorption, see. in the “Dosing and administration”.

Dosing and Administration

Locally. Before use, the vial shaken!
According 1-2 eye drops into the conjunctival sac 2 times per day.
Recommended after instillation of the preparation the lacrimal canaliculi clamped at the inner corner of the eye (1-2 minutes). To reduce the risk of systemic side effects
in some patients the intraocular stabilization pressure occurs within a few weeks, so it is recommended to control intraocular pressure within the first month of treatment.
If the desired level of intraocular pressure is not achieved during monotherapy, combination therapy should be assigned.

Side effect

Violations of the organ of vision
is very common in 10% of cases there is discomfort in the eyes.
Often, in 1-10% of cases, there is a blurred vision, increased lacrimation.
Infrequently, in 0.1-1% of cases, punctate keratitis, keratitis, conjunctivitis , blepharitis, blurred vision, photophobia, eye pain, dry eye, asthenopia, blepharospasm, itching of the eye, eye discharge, crusting on the edges of the eyelids, inflammation, eye irritation, a violation of the conjunctiva, conjunctival edema, hyperemia of the eye.
Rarely, in 0.01-0.1% of the cases, there was a cataract.
The frequency is not known: redness of the eyelids.

Disorders of the nervous system
. Often, a headache
. Occasionally, syncope
is unknown frequency: dizziness

Violations of the heart
. It is not often, bradycardia, tachycardia
Frequency not known: arrhythmia

Violations by vessels
Rare: hypotension.

Disorders of the respiratory system, organs, thoracic and mediastinal disorders
Uncommon: asthma, dyspnea, rhinitis.
Rare: cough, rhinorrhea.

Disorders of the gastrointestinal tract
Uncommon: nausea.
Rare: dysgeusia.

Disorders of the skin and subcutaneous tissue disorders
Rare:. Dermatitis, rash
Frequency not known: Alopecia

Violations of the genital and breast
Rare: loss of libido.

Mental disorders
Rare:. Anxiety
unknown frequency: Insomnia, depression.

Violations by the immune system
Frequency unknown: hypersensitivity

General disorders and administration site reactions
Frequency unknown: asthenia.

In the application of β-blockers (eye drops) were observed, and other adverse reactions, that may develop during use of the drug and Betoptik ® C:

Violations of the immune system: systemic allergic reactions, including angioedema, urticaria, local and generalized rash, pruritus, anaphylactic reaction.

Violations of the Metabolism and nutrition:
Hypoglycemia

Mental disorders
nightmares, memory loss.

Disorders of the nervous system
cerebrovascular disorders, cerebral ischemia, worsening of symptoms of signs and symptoms of myasthenia gravis, paresthesia.

Violations by the authority of
detachment choroidal after filtration surgery, decreased corneal sensitivity, corneal erosion, ptosis, diplopia.

Disturbances of cardiac
chest pain, palpitations, edema, congestive heart failure, AV block, cardiac arrest, heart failure.

Violations of the vessels:
Raynaud’s phenomenon, cold hands and feet.

Disorders of the respiratory system, organs, thoracic and mediastinal disorders
bronchospasm (predominantly in patients with bronchospastic disease in history)

Violations of the gastrointestinal
dyspepsia, diarrhea, dry mouth, abdominal pain, vomiting

Violations of the track and subcutaneous tissue
psoriazoformnaya rash or exacerbation of psoriasis

Violations of the genital and breast
sexual dysfunction

General disorders and administration site reactions
Fatigue

Overdose

When injected into an excess amount of the drug is recommended eyes flush eyes with warm water.
If accidentally taking the drug inside the symptoms of β1-blocker overdose are: bradycardia, hypotension, acute cardiac insufficiency and bronchospasm. Treatment is symptomatic and supportive.

Interaction with other drugs

Patients receiving the drug Betoptik ® C and at the same time taking other β-blockers are administered orally, the risk of adverse reactions (both system and local) may be higher due to possible additive effects. These patients should be under close medical supervision.
When concomitant administration of β-blockers for topical ophthalmic use with oral forms of calcium channel blockers, β-blockers, anti-arrhythmic drugs (including amiodarone), digitalis glycosides, parasympathomimetics, guanethidine and drugs deplete catecholamines such as reserpine, may be observed amplification effects such as lowering blood pressure and bradycardia.
in some cases, as a result of the simultaneous application of β-blockers and adrenaline (epinephrine) may develop mydriasis.
When concomitant administration of muscle relaxants and hypoglycemic agents may be a strengthening of their actions .
.beta.-blockers may impair the effect of adrenaline, used in anaphylactic reactions. It should be used with extreme caution in patients with atopy or anaphylaxis in history.
In a joint application with sympathomimetics -. Strengthening their vasoconstrictor effect
should be taken when the joint application of dianabol before and after and adrenergic psychotropic drugs as a result of the possible increase in their actions.
Can be used in combination with other, if necessary topical ophthalmic preparations. In this case, the interval between their use should be at least 10 minutes.

special instructions

Diabetes: .beta.-blockers should be used with caution in patients with a tendency to spontaneous hypoglycemia and diabetics labile currents, since these drugs may mask the signs and symptoms of acute hypoglycemia. Thyrotoxicosis: .beta.-blockers may mask some of the symptoms of hyperthyroidism (eg, tachycardia). In patients with suspected hyperthyroidism should not be abruptly cancel β-blockers, as this may cause increase in symptoms. Myasthenia gravis: β-blockers may cause signs and symptoms similar to those in infants (eg, diplopia, ptosis, generalized weakness). Surgery : the anesthetist should be advised that the patient takes dianabol before and after. Before elective surgery β-blockers should be gradually (not simultaneously!) Canceled 48 hours prior to general anesthesia because during general anesthesia may reduce myocardial sensitivity to sympathetic stimulation necessary for the operation of the heart (for example, they can block the effect of systemic β-agonist adrenaline). Pulmonary: Caution should be exercised in the appointment of β-blockers in patients with severely reduced function of the respiratory system. Despite the fact that clinical studies have shown no effect of dianabol before and after on respiratory function, should not exclude the possibility of hypersensitivity to the drug. The risk of an anaphylactic reaction: patients taking β-blockers may have a history of atopy or anaphylactic reactions. In the case of repeated reactions, such patients may be sensitive to the usual doses of adrenaline needed for the relief of anaphylaxis. dianabol before and after should be used with caution in patients with severely impaired peripheral circulation (ie with Raynaud’s syndrome and pheochromocytoma). The local assignment β-blockers can enter the systemic circulation. Thus, .beta.-blockers can cause cardiovascular, pulmonary and other adverse reactions, as well as by intravenous and parenteral administration. Cases of severe respiratory and cardiovascular disorders, including the death of bronchospasm in patients with asthma and death from heart failure. Violations of the heart: in patients with cardiovascular diseases (eg, coronary heart disease, Prinzmetal angina, heart failure) and hypotension .beta.-blocker therapy should be critically assessed and considered the possibility of the treatment of other active substances. It is necessary to closely monitor for signs of worsening disease and adverse reactions in patients suffering from cardiovascular diseases. Corneal diseases: .beta.-blockers can cause dry eyes. It should be used with caution in patients with corneal diseases. Detachment of the choroid: . Described cases of detachment of the choroid with the use of drugs that prevent the formation of intraocular fluid (eg, timolol, acetazolamide) after filtration operations preparation Betoptik ® C contains the preservative benzalkonium chloride, which can cause eye irritation and discoloration of soft contact lenses. Avoid direct contact of the product with soft contact lenses. Patients who use contact lenses, the lenses before applying the drug should be removed and set them back no earlier than 15 minutes after instillation of the drug. Do not touch the tip of the dropper bottle to any surface to avoid contamination of the vial and its contents. The vial must be closed after each use.

Effects on ability to drive vehicles and management mechanisms

Patients who after instillation of the drug is temporarily reduced sharpness of vision or other visual disturbances occur, it is not recommended to engage in activities that require attention and response to its recovery.

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