trenbolone enanthate

It has expressed the alpha-adrenergic trenbolone enanthate activity.
The local application in ophthalmology causes mydriasis, improves the outflow of intraocular fluid and constricts blood vessels of the conjunctiva.
Phenylephrine has a strong stimulating effect on the postsynaptic alpha-adrenergic receptors, has very little effect on the beta-adrenergic receptors of the heart.The drug has vasoconstrictor action similar to the action of norepinephrine (noradrenaline), while it has practically no chronotropic and inotropic effect on the heart.Phenylephrine pressor effect is weaker than that of norepinephrine, but is longer. Causes vasoconstriction after 30-90 seconds after installation, the duration of 2-6 hours.
After the installation of phenylephrine reduces the iris dilator muscle and smooth muscle of the arterioles of the conjunctiva, thereby causing mydriasis. Mydriasis occurs within 10-60 minutes after a single trenbolone enanthate instillation. Continues after instillation of 2.5% solution and maintained for 2 hours. Mydriasis, called phenylephrine, is not accompanied by cycloplegic.

Pharmacokinetics of
Phenylephrine easily penetrates the ocular tissue, the peak plasma concentration occurs within 10-20 minutes after topical application. Phenylephrine is excreted by the kidneys as unchanged (<20%) or in the form of inactive metabolites.

Indications

  1. Iridocyclitis (for the prevention of adhesions and rear reduce exudation of the iris).
  2. Pupil dilation during ophthalmoscopy and other diagnostic procedures necessary to monitor the state of the rear segment of the eye, during laser interventions in the fundus and vitreoretinal surgery.
  3. Conducting provocative test in patients with narrow profile of anterior chamber angle and suspected closure glaucoma.
  4. Differential diagnosis of superficial and deep injection of the eyeball.
  5. “Red-eye” syndrome (to reduce redness and irritated mucous membrane of the eye).
  6. Preventing eyestrain and accommodation spasm in patients with high visual load.
  7. Treatment of false myopia (spasm of accommodation) and prevention of the progression of the true myopia patients with a high visual load.

 

Contraindications

  1. Hypersensitivity to the drug.
  2. Narrow-angle or angle-closure glaucoma.
  3. Arterial hypertension in combination with ischemic heart disease, aortic aneurysm, atrioventricular block I – III degree, arrhythmia.
  4. Tachycardia.
  5. I type I diabetes history.
  6. Continuous intake of monoamine oxidase inhibitors, tricyclic antidepressants, antihypertensive drugs.
  7. Additional mydriasis during surgery in patients with trenbolone enanthate impaired integrity of the eyeball, as well as in violation of tear production.
  8. Reduced body weight in newborns.
  9. Hyperthyroidism.
  10. Hepatic porphyria.
  11. Congenital deficiency of glucose-6-phosphate dehydrogenase.
  12. The period of lactation.

 

Precautions
In patients with trenbolone enanthate type II diabetes – increased blood pressure increase the risk. Elderly patients – increased risk of reactive miosis. Exceeding the recommended dose of a 2.5% solution in patients with injuries, diseases of the eye or its appendages, postoperative, or with decreased tear production can lead to increased absorption of phenylephrine and the development of systemic side effects.
Because the conjunctiva causes hypoxia – in patients with sickle cell anemia, while wearing contact lenses after surgery (healing reduction).
when cerebral arteriosclerosis, a long-term asthma. Pregnancy and lactation In animals in late pregnancy phenylephrine caused fetal growth retardation, and stimulated the early onset of labor.
Action Irifrin ® in pregnant women are poorly understood, so to use the drug in these patients should be only if the expected benefit to the mother outweighs the risk of possible side effects to the fetus. In the case of the appointment of the drug during lactation, breast-feeding should be discontinued.

Dosing and Administration
During the one-time installation ophthalmoscopy using a 2.5% solution Irifrin ® . Typically, enough to create mydriasis administration of 1 drop of 2.5% solution Irifrin ® in the conjunctival sac.
The maximal mydriasis achieved after 15-30 minutes, and remains at a sufficient level for 1-3 hours. If necessary, maintaining mydriasis for a long time after 1 Hour Possibility of re-install Irifrin ® .
To carry out diagnostic procedures:

  • as a provocative test in patients with narrow profile of the anterior chamber angle and angle-closure glaucoma suspected buried 1 drop once the drug. If the difference between the values ??of intraocular pressure before instillation Irifrin ® after pupil dilation is 3 to 5 mm Hg. . Art, the provocative test is considered positive;
  • for the differential diagnosis of injection-type eyeball buried 1 drop of the drug once: if 5 minutes after instillation marked vasoconstriction of the eyeball, the injection is classified as surface, while maintaining the redness of the eyes should be carefully examine the trenbolone enanthate patient for the presence of iridocyclitis or scleritis, as it shows expanding more deep lying vessels.

When iridotsiklitah to prevent the development and tear already formed posterior synechiae and to reduce the exudation into the anterior chamber of the eye drop formulation 1 is dug in the conjunctival sac of the patient’s eyes 2-3 times a day 5-10 days depending on the severity trenbolone enanthate of the disease.
Pupils with mild myopia for the prevention of spasm of accommodation during the period of high visual load 1 drop Irifrin ® buried the evening before bedtime, with progressive myopia moderate, 3 times a week in the evening before going to bed, when emmetropia – during the day, depending on the load.
when hyperopia with a tendency to spasm of accommodation with high visual load bury evening Irifrin ® in combination with a 1% solution of cyclopentolate. In normal visual load bury Irifrin ® 3 times a week in the evening before bedtime. In the treatment of false and true myopia 1 drop Irifrin ® buried the evening before going to bed 2-3 times a week for a month.

 

Side effect Local Conjunctivitis, Keratitis, periorbital edema, eye pain, burning during installation, tearing, blurred vision, irritation, discomfort, increased intraocular pressure, blockage of the angle of the anterior chamber (by narrowing the angle), allergic reactions, reactive hyperemia. Phenylephrine may cause jet cramps the day after the application. Re-installation of the drug at this time can give less pronounced mydriasis than the day before. This effect is often seen in elderly patients. As a result of a significant reduction in iris dilator muscle under the influence of phenylephrine 30-45 minutes after installation the moisture anterior chamber can be detected from the particles of the pigment of the pigment of the iris leaf. The slurry in the chamber moisture must be differentiated manifestations of anterior uveitis or to exposure to blood cells in the moisture of the anterior chamber. Systemic contact dermatitis is the part of the cardiovascular system: heart palpitations, tachycardia, arrhythmia, increased blood pressure, ventricular arrhythmia, reflex bradycardia, occlusion of the coronary arteries, pulmonary embolism.

Overdose
Overdose symptoms are anxiety, nervousness, dizziness, sweating, vomiting, heart palpitations, weak or shallow breathing.
In the event of systemic effects of phenylephrine to stop undesirable effects can be achieved by the use of alpha-adrenoceptor blocking agents, for example, from 5 to 10 mg of phentolamine intravenously. If necessary, the injection can be repeated.

Interaction with other drugs
Midriatichesky phenylephrine effect is enhanced when used in combination with topical application of atropine. Due to the strengthening of vasopressor action may develop tachycardia.
Application Irifrin ® within 21 days after discontinuation of a monoamine oxidase inhibitor patients and tricyclic antidepressants should be administered with caution, as in this case, there is the possibility of an uncontrolled rise in blood pressure.
Pressor effect of adrenergic agents may potentiate when combined with tricyclic antidepressants, beta-blockers, reserpine, guanethidine, methyldopa and m-holinoblokatorami.
Irifrin ® may trenbolone enanthate potentiate the inhibition of cardiovascular activity during inhalation anesthesia by increasing the sensitivity of the myocardium to sympathomimetics and occurrence of ventricular fibrillation.
The use in conjunction with other sympathomimetic may increase the cardiovascular effects of phenylephrine. The use of phenylephrine may cause weakening of concomitant antihypertensive therapy and lead to an increase in blood pressure, tachycardia. Pre-installation of local anesthetics may increase the systemic absorption and prolong mydriasis.

Product form
Eye drops 2.5% (without preservative). In a 0.4 ml disposable tubes dropper. On 5 tubes, droppers in the package of laminated paper. On 3 packages of laminated paper in the stack of cardboard together with instructions for use.

Shelf life
2 years.
Do not use stated on the package after the expiration date.

Storage:
In the dark place at a temperature no higher than 25 ° C.
Do not freeze.
Keep out of the reach of children.

 

Conditions of supply of pharmacies:

on prescription.

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