Rektodelt

Rectodelt is a drug from the GCS group (for systemic use), which has a non-fluorinated form.

[1]

Indications Rectodelta

It is used in children - with intensive combined treatment of false croup ( croup syndrome in the acute degree), and in addition the true croup (diphtheria form) and bronchial obstruction.

Release form

The release of the drug is in the form of rectal suppositories, which contain 0.1 g of prednisone. Inside a single pack - 2, 4 or 6 candles.

Pharmacodynamics

The drug has an effect, the severity of which depends on the size of the dose of drugs; In addition, it affects the processes of tissue metabolism. It can be used to maintain the processes of the homeostasis of the body during exercise and in a calm state. At the same time, the drug is a participant in the processes of immunoregulation.

When the portion used for substitution treatment is exceeded, the drug causes a potent anti-inflammatory effect (antiexudative and antiproliferative activity), and with it a delayed immunosuppressive effect. The substance inhibits the activity of cells of the immune system and chemotaxis, and in addition, the release of inflammatory agents and the body's immune response (leukotrienes, PG and lysosome enzymes).

When used during bronchial obstruction, the active drug element potentiates the strength of bronchodilation, which develops under the action of β-mimetics.

Prolonged administration in large portions leads to involution of the adrenal cortex with immunity.

The mineralocorticoid effect of Rectaudelta (less intense than when using hydrocortisone) requires tracking of plasma electrolyte values during therapy.

The active component of the drug helps to improve the patency of the respiratory ducts - reducing the intensity of inflammation, preventing the development of mucosal edema, slowing down the occurrence of bronchospasm and reducing the force of mucus secretion (while simultaneously weakening its viscosity). Similar effects are developed by strengthening the membranes of blood vessels and stabilizing the cell walls, and with it increasing the susceptibility of the muscles of the bronchi in relation to β2 sympathomimetics and suppression of immune responses of the 1st type (developed from the 2nd week of using drugs).

Pharmacokinetics

GCS blood parameters are observed rather quickly after the administration of the suppository, from which it can be concluded that the drug has a high level of bioavailability and active absorption.

Prednisone inside the body is quickly transformed into an active metabolic product - prednisone. Both of these elements can be mutually transformed, but prednisone is mostly contained within the human body. The bioavailability of drugs is about 29%.

Prednisolone is synthesized with transcortin and plasma protein. Drug clearance rates are about 1.5 ml / minute / kg. Approximately 2-5% of the substance is excreted unchanged with the urine, and up to 24% - in the form of prednisone. The residue is excreted in the form of other metabolic products.

Dosing and administration

The drug is prescribed to infants and children over 6 months of age, in the amount of the 1st suppository per day (the maximum daily dose is thus 0.1 g of the substance). The duration of such treatment is determined by the course of pathology.

To stop an acute lesion, a 2-day treatment cycle is required. If an emergency arises, the therapy can be repeated 1-fold. Longer courses of therapy are not recommended. For 2 days it is allowed to apply a maximum of 0.2 g of the medicinal substance.

Suppositories are inserted deep inside the rectum.

It is recommended to use the suppository in children who cannot perform IV, IM or oral drug use (due to stress, the inadmissibility of the use or development of complications).

If the optimal portion or deviation from the recommended treatment regimen is exceeded, complications may develop, resulting in severe negative manifestations.

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Use Rectodelta during pregnancy

Adequate appropriate testing of the use of drugs in pregnant women and breastfeeding was not conducted. Drug research was conducted only on animals. At the same time, the appearance of a teratogenic and embryotoxic effect was observed - an anomalous development of the skeletal structure, a slowdown in the development of the fetus inside the womb, and the death of the embryo.

In addition, there was an increase in the probability of development of deformities - in the case of the use of the drug in the first trimester.

The use of Rectodelt in animals has also shown that the introduction of subteratogenic portions increases the likelihood of intrauterine growth retardation, metabolic disorders in adults, and in addition to the appearance of pathologies in the CVS area and changes in the duration of the transmission of neural responses with impulses.

The introduction of drugs on the 3rd trimester in animals revealed that in this case the infant may develop atrophy of the adrenal cortex. In such cases, substitution treatment is required for the newborn.

The drug can be prescribed during pregnancy, but only in extreme cases and when it is determined that the probability of the risk to the fetus is lower than the benefit for the woman.

Prednisone with prednisone, which are components of the drug, pass inside the mother's milk, although there is no information that they harm the baby. But still, if there is an urgent need to use drugs in large portions, it is necessary to refuse breastfeeding for this period.

Contraindications

It is contraindicated to prescribe the drug if the patient is diagnosed with intolerance against its individual elements.

For short-term treatment in order to relieve urgent, acute and life-threatening conditions, there are no contraindications.

Side effects Rectodelta

In case of drug administration in case of emergency, the only negative symptom may be an immune reaction - the development of strong sensitivity.

Prolonged use of the medication may trigger the development of various side effects:

• endocrine function disorders: the appearance of a cushingoid of varying severity. Symptoms such as obesity, metabolic syndrome on the background of diabetes, moon face, growth retardation, hyperglycemia (resulting in steroid diabetes), sex hormone secretion disorder, depletion of adrenal cortex (may lead to atrophy), changes in indications hemograms and hirsutism;
• problems with metabolic processes: negative values of nitrogen balance, sodium retention and fluids inside the body, as well as hypokalemia;
• violations in the work of the cardiovascular system: the weakening of the strength of blood vessels and increased blood pressure indicators;
• damage to the blood system: increased blood coagulation;
• disorders of the musculoskeletal structure: muscular atrophy, osteoporosis, and in addition, bone necrosis of aseptic origin;
• lesions of the epidermis: acne, striae, skin atrophy, as well as telangiectasia;
• disorders affecting visual activity: cataracts of a steroid nature and manifestation of glaucoma proceeding in a latent form;
• problems with the work of the central nervous system: mental disorders;
• manifestations of the gastrointestinal tract: pancreatitis or ulcers in the gastrointestinal zone (associated with ulcerogenic effects on the gastrointestinal tract and an increase in gastric pH)
• symptoms associated with the immunosuppressive effect: slowing down the processes of wound healing and reducing the body's resistance to various infections.

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Overdose

There is no information about the development of acute overdose of any form of GCS. In case of poisoning, it is necessary to take into account the existing likelihood of the development of pronounced symptoms - mainly associated with endocrine function, as well as disorders of metabolic processes and salt balance.

The medication does not have an antidote, so when symptoms appear, symptomatic measures are taken.

Interactions with other drugs

A variety of enzyme inducers (among them phenytoin with barbiturates and rifampicin with primidone) reduce the therapeutic properties of Rectodelt.

Use with estrogen means leads to increased exposure to drugs.

Combination with atropine or other anticholinergics may lead to increased IOP.

Combination with salicylates or NSAIDs increases the likelihood of bleeding in the area of the gastrointestinal tract.

Using medication, it should be remembered that it reduces the effectiveness of insulin hypoglycemic substances and coumarin derivatives.

Combining with SG increases their therapeutic effect due to the loss of potassium, which is induced by the activity of steroids.

Simultaneous use with saluretics can lead to potentiation of potassium excretion.

When using the medication, the blood index of the substance praziquatel may decrease.

Introduction together with an ACE inhibitor significantly increases the likelihood of changes in hemogram readings.

Chlorocine and meflokine with hydrochloroquine, used together with the drug, increase the risk of cardiomyopathy and myopathy formation.

The drug weakens the medicinal effect of the substance GH.

Use in combination with protirelin leads to a slowdown in the process of excretion of rectodelt.

The drug increases the blood values of cyclosporine, and therefore increases the likelihood of a convulsive syndrome that has a central nature.

[4], [5]

Storage conditions

Rektodelt must be kept in a place protected from moisture and sunlight. Temperature indicators - maximum 25 ° С.

[6]

Shelf life

Rectodelt is allowed to use within 36 months from the date of manufacture of the therapeutic agent.

Application for children

The drug is not used for therapy in infants up to 6 months of age.

Analogs

Analogues of drugs are medicines such as Betaspan, Medrol, Dexon and Hydrocortisone Acetate with Metipred, and in addition, Dexamethasone, Celeston, Depo-Medrol, Primacort with Diprospan, Prednisolone with Kenalog and Solu-Medrol. Also on the list are Court-s, Floisterone with Polcortolone and Methylprednisolone with Solu-Cortef.

Reviews

Rectodelt is considered to be a very effective drug, but the reviews also state that you need to take into account the presence of a large number of adverse symptoms - this is the main drawback of the drug, because otherwise the commentators agree that it really quickly and qualitatively improves the patient's condition.