In patients with myocardial infarction intravenous dianabol side effects reduces chest pain and reduce the risk of atrial fibrillation and atrial flutter. Intravenous administration of dianabol side effects at the first symptoms (within 24 hours after onset of symptoms) reduces the risk of myocardial infarction. Early treatment with dianabol side effects leads to better forecast future treatment of myocardial infarction.
It achieved a reduction in heart rate (HR) in paroxysmal tachycardia and blink (flutter) of the atria. dianabol side effects- β 1 adrenoblokator blocking β 1 receptors at much lower doses than the doses required to block β 2 – receptors. dianabol side effects has an insignificant membrane-stabilizing effect and does not exhibit partial agonist activity. dianabol side effects reduces or inhibits the agonistic effect. exerted on cardiac function catecholamines resulting from the nervous and physical stress. This means that dianabol side effects has the ability dianabol reviews to prevent an increase in heart rate, cardiac output and increased myocardial contractility and blood pressure lifting (BP), caused by a sharp release of catecholamines. Patients with symptoms of obstructive pulmonary disease, if necessary, can be assigned to dianabol side effects in combination with β 2 -adrenomimetikami. When combined with .beta. 2 – Betalok agonists in therapeutic doses, to a lesser extent, affects the induced .beta. 2 – agonists bronchodilation than nonselective β-blockers.
dianabol side effects less than nonselective β-blockers affect the production of insulin, and carbohydrate metabolism. Effect of the drug on the reaction Betalok cardiovascular system under conditions of hypoglycemia is much less pronounced when compared to non-selective β-blockers. Improving the quality of life in the treatment of drug Betalok observed in patients after myocardial infarction.
dianabol side effects undergoes oxidative metabolism in the liver to form the three major metabolites, none of which has no clinically significant β- blocking effect. About 5% of the dose is excreted in the urine in unchanged form. The average half-life of dianabol side effects from plasma is about 3 to 5 hours.
Indications for use
dianabol side effects is contraindicated in patients with acute myocardial infarction with heart rate less than 45 beats per minute, PQ interval of more than 0.24 seconds or systolic blood pressure less than 100 mmHg
Known hypersensitivity to dianabol side effects and its components or to other β-adrsnoblokatoram.
In severe peripheral vascular disease with gangrene threat.
In the treatment of supraventricular tachycardia in patients with a systolic blood pressure less than 110 mm Hg
Patients receiving β-blockers are contraindicated intravenous blockers “slow” calcium channels such as verapamil.
Age 18 years (effectiveness and safety have been established)
Precautions: atrioventricular block I degree, Prinzmetal angina, chronic obstructive pulmonary disease (emphysema, chronic obstructive bronchitis, bronchial asthma), diabetes, severe renal insufficiency.
Pregnancy and lactation
Pregnancy As with most drugs, Betaloc should not be administered during pregnancy and during breast-feeding unless the expected benefit to the mother outweighs the potential risk to the fetus. As with other antihypertensive agents, β-blockers may cause side effects such as bradycardia in the fetus, infants or children who are breastfed, and therefore must be especially careful when assigning β-blockers in the last trimester of pregnancy and just before birth .
Lactation The amount of dianabol side effects, liberated into breast milk, and β- blocking action in a child who is breastfed (when taking the mother of dianabol side effects in therapeutic doses), are minor.
Dosing and Administration
Supraventricular tachycardia. Begin with the introduction of 5 mg (5 ml) of the drug Betalok at a rate of 1 to 2 mg / min. You can repeat the introduction of 5-minute intervals to achieve a therapeutic effect. Typically, the total dose of 10-15 mg (10-15 ml). Recommended maximum dose intravenous administration of 20 mg (20 ml).
Prevention and treatment of myocardial ischemia, and pain tachycardia myocardial infarction or suspected it. Intravenous 5 mg (5 ml) of the drug. You can repeat the introduction of a 2-minute intervals, the maximum dose-15 mg (15 ml). 15 minutes after the last injection administered dianabol side effects for oral administration at a dose of 50 mg (Betalok) every 6 hours for 48 hours.
Renal impairment There is no need to adjust the dose in patients with impaired renal function.
Abnormal liver function usually due to the low degree of connection to plasma proteins, dose adjustment is not required. However, if severe liver dysfunction (patients with portocaval anastomosis) may require dose reduction.
Advanced age Peter need to adjust the dose in elderly patients.
Children Experience with Betalok drug in children is limited.
Betalok well tolerated, and side effects are generally mild and reversible.
As a result of clinical trials or application Betalok drug (dianabol side effects tartrate), the following undesirable side effects have been described in clinical practice. In many instances, a causal relationship with drug treatment Betaloc has not been established. To assess the frequency of cases we used the following criteria: very common (> 10%), often (1-9,9%), rarely (0.1-0.9%), rarely (0,01-0,09%) and very rare (<0.01%).
Cardiovascular system Common: bradycardia, postural disorders (very rarely accompanied by syncope), cold extremities, palpitations. Uncommon: temporary increase of symptoms of heart failure, cardiogenic shock in patients with acute myocardial infarction; . The AV blockade degree I rarely:. Other disturbances of cardiac conduction, arrhythmias Very rare: Gangrene in patients dianabol before and after with previous severe impairment of the peripheral circulation.
Central nervous system Very common:. Fatigue Common: dizziness, headache. Rare: increased nervous irritability, anxiety, impotence / sexual dysfunction is not common: paraesthesia, convulsions, depression, weakening of attention, drowsiness or insomnia, nightmares. Very rare: amnesia / memory impairment, depression, hallucinations
Gastrointestinal tract Common: nausea, abdominal pain, diarrhea, constipation. Uncommon: vomiting. Rare: dry PTY.
Liver Rare: liver function abnormalities.
Skin Not often:. Rash (in the form of urticaria), increased sweating Rare:. Hair loss Very rare: photosensitivity, exacerbation of psoriasis.
Respiratory system often:. Shortness of breath during physical effort is not often:. Bronchospasm in patients with asthma Rare: Rhinitis.
Sense organs Rare:. Blurred vision, dry and / or irritated eyes, conjunctivitis Very rare: Tinnitus, taste disturbance.
Metabolism Uncommon: weight gain.
From the musculoskeletal system: Very rare: arthralgia
Blood Very rare: thrombocytopenia.
Toxicity of dianabol side effects at a dose of 7.5 g in an adult caused lethal intoxication with. At the 5-year-old child, who took 100 mg of dianabol side effects, after gastric lavage were observed signs of intoxication. Receiving 450 mg dianabol side effects teenager 12 years has led to a moderate intoxication. Receiving 1.4 g and 2.5 g dianabol side effects adults caused moderate to severe intoxication, respectively. Admission for adults 7.5 g resulted in extremely severe intoxication.
Symptoms In case of overdose of dianabol side effects are the most serious symptoms of the cardiovascular system, but sometimes, especially in children and adolescents, may predominate symptoms of the central nervous system and the suppression of lung function. Bradycardia, atrioventricular block I-III degree, asystole, marked reduction in blood pressure, poor peripheral perfusion, cardiac failure, cardiogenic shock.Inhibition of lung function, sleep apnea. As well, increased fatigue, impaired consciousness, loss of consciousness, tremors, convulsions, sweating, paresthesia, bronchospasm, nausea, vomiting, possible esophageal spasm, hypoglycaemia (especially in children), or hyperglycaemia, hyperkalaemia. To the kidneys. Transient myasthenic syndrome. Concomitant use of alcohol, antihypertensives, quinidine or barbiturates may aggravate the patient’s condition. The first signs of overdose can be observed 20 minutes – 2 hours after ingestion.
Treatment Assignment of activated charcoal, if necessary gastric lavage. IMPORTANT! Atropine (0.25-0.5 mg / in adults, 10-20 mg / kg for children) must be assigned to gastric lavage (the risk of stimulation of the vagus nerve). If necessary, maintain the airway (intubation), and adequate ventilation of the lungs. Restores the volume of circulating blood and glucose infusion. ECG monitoring. Atropine 1.0-2.0 mg / in repeated administration (particularly in the case of vagal symptoms) as needed. In the case of (suppression), depression of the myocardium shown infusion dobutamine or dopami. Glucagon can also be used 50 to 150 mg / kg / in intervals of 1 minute. In some cases, it may be effective to add epinephrine therapy. When arrhythmias and increasing the ventricular complex (the QRS) infusion solutions administered sodium (chloride or bicarbonate). Installation of an artificial pacemaker. During cardiac arrest due to overdose may require resuscitation for several hours. Terbutaline can be used for the relief of bronchospasm (by injection or via inhalation). Symptomatic treatment.
The interaction with other drugs and other interactions
Avoid concomitant administration of the drug Betalok with the following medications:
Barbituric acid derivatives: Barbiturates (the study was conducted with phenobarbital) slightly increase the metabolism of dianabol side effects, resulting enzyme induction.
Propafenone: the appointment of propafenone to four patients treated with dianabol side effects, showed an increase in plasma concentrations of dianabol side effects by 2-5 times, while two patients had side effects that are typical of dianabol side effects. This interaction was confirmed in a study of 8 volunteers. Probably due to inhibition of the interaction of propafenone, like quinidine, dianabol side effects metabolism by cytochrome P4502D6 system. Taking into account the fact that propafenone has the properties of β-blocker, co-administration of dianabol side effects and propafenone does not seem appropriate.
Verepamil: a combination of β-blockers (atenolol, propranolol and pindolol) and verapamil may cause bradycardia and lead to a reduction in blood pressure. Verapamil and β-blockers are mutually inhibitory effect on atrioventricular conduction and sinus node function.
Betalok combination with the following drugs the drug may require dose adjustment:
Class I antiarrhythmic agents: antiarrhythmics class I and β-blockers may lead to the summation of negative inotropic effect, which may result in serious haemodynamic side effects in patients with impaired left ventricular function. Also avoid such a combination in patients with sick sinus syndrome and atrioventricular conduction violation. The interaction is described by the example of disopyramide.
Amiodarone: The combined use of amiodarone and dianabol side effects may lead to severe sinus bradycardia. Taking into account the extremely long half-life of amiodarone (50 days), to consider the possible interaction after a long time after the abolition of amiodarone.
Diltiazem: Diltiazem and β-blockers reinforce inhibitory effect on atrioventricular conduction and sinus node function. When combined with dianabol side effects diltiazem were cases of severe bradycardia.
Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs weaken the antihypertensive effect of β-blockers. This reaction is the most documented of indomethacin. There was no interaction described for sulindac. In studies with diclofenac described reactions were noted.
Diphenhydramine: Diphenhydramine reduces the clearance of dianabol side effects to α- gidroksidianabol side effectsa 2.5 times. At the same time strengthening the dianabol side effects action observed.
Epinephrine (adrenaline) has been reported 10 cases of severe hypertension and bradycardia in patients treated with non-selective β- blockers (including pindolol and proprapolol) and treated with epinephrine (adrenaline). Interaction observed in the group of healthy volunteers. It is assumed that these reactions can also occur when using epinephrine in conjunction with local anesthetics Accidental contact with the bloodstream. It is expected that this risk is much lower with cardioselective β-blockers.
Phenylpropanolamine: Phenylpropanolamine (norephedrine) in single doses of 50 mg may cause an increase in diastolic blood pressure to pathological values in healthy volunteers. Propranolol generally prevents the increase in blood pressure caused by phenylpropanolamine. However, β-blockers can cause paradoxical reaction of hypertension in patients receiving high doses of phenylpropanolamine. A few cases of hypertensive crisis in patients receiving phenylpropanolamine.
Quinidine: quinidine inhibited the metabolism of dianabol side effects have a special group of patients with fast hydroxylation (in Sweden about 90% of the population), causing mostly a significant increase in plasma concentrations of dianabol side effects and increased β-blockade. It is believed that such interaction is characteristic of other β-blockers in the metabolism involving cytochrome P4502D6.
Clonidine: Hypertensive reaction at a sharp lifting of clonidine may be increased at the joint reception of β-blockers. In a joint application, in the case of clonidine, the termination of receiving β-blockers should start several days before clonidine.
Rifampicin: Rifampicin may enhance the metabolism of dianabol side effects by reducing the plasma concentration of dianabol side effects. The concentration of dianabol side effects in the blood plasma can be increased with concomitant use of cimetidine, hydralazine, selective serotonin inhibitors such as paroxetine, fluoxetine and sertraline. Patients simultaneously receiving dianabol side effects and other β-blockers (eye drops), or monoamine oxidase inhibitors (MAOIs) should be monitored carefully. Pa patients receiving β-blockers inhalation anesthetics enhance cardiodepressive action. In patients receiving β-blockers in patients receiving oral hypoglycemic agents may require dose correction last. Cardiac glycosides when combined with β-blockers may increase atrioventricular conduction time and induce bradycardia.
Patients taking β-blockers should not be administered intravenously blockers “slow” calcium channels such as verapamil. Patients suffering from bronchial asthma or obstructive pulmonary disease. It must be assigned to concomitant bronchodilator therapy. When necessary to increase the dose of β 2 -adrenomimetika. When using .beta. 1 adrenoblokatorov risk of their influence on carbohydrate metabolism or masking hypoglycaemia is significantly less than with nonselective β-blockers.
In patients with chronic heart failure decompensation is necessary to achieve the stage of compensation, both before and during drug treatment. Patients suffering from angina Prinzmetal, is not recommended for non-selective β-blockers.
Very rarely in patients with impaired atrioventricular conduction deterioration may occur (possible outcome of atrioventricular block). If during treatment developed bradycardia, Betaloc dose should be reduced. dianabol side effects may aggravate the symptoms of peripheral arterial circulation mainly due to blood pressure reduction. Caution should be exercised when administering the drug to patients with severe renal insufficiency, metabolic acidosis, concomitant use with cardiac glycosides. Patients taking β-blockers, anaphylactic shock occurs in more severe. Patients suffering from pheochromocytoma, in parallel with the preparation Betaloc should be given an alpha-blocker. In the case of surgery should inform the anesthetist that the patient receives the .beta.-blocker. Do not re-appoint dozu- second or third at a heart rate less than 40 beats per minute, the PQ interval of more than 0.26 seconds, and systolic blood pressure less than 90 mmHg