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понедельник, 19 июля 2010 г.

Levitra



Levitra ™ (LEVITRA)

VARDENAFILUM G04B E09
Bayer Schering Pharma

COMPOSITION AND FORM:

Table. n / a 5 mg blister, № 1
Vardenafil 5 mg

Other ingredients: krospovidon, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica, macrogol 400, gipromelloza, titanium dioxide (E171), iron oxide red (E172).

№ UA/0226/01/01 from 22.10.2008 to 22.10.2013

Table. n / a 10 mg blister, № 1, № 4
Vardenafil 10 mg

Other ingredients: krospovidon, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica, macrogol 400, gipromelloza, titanium dioxide (E171), iron oxide red (E172).

№ UA/0226/01/02 from 22.10.2008 to 22.10.2013

Table. n / a 20 mg blister, № 1, № 4
Vardenafil 20 mg

Other ingredients: krospovidon, magnesium stearate, microcrystalline cellulose, colloidal anhydrous silica, macrogol 400, gipromelloza, titanium dioxide (E171), iron oxide red (E172).

№ UA/0226/01/03 from 22.10.2008 to 22.10.2013

Pharmacological properties: a tool for the treatment of erection. The physiological mechanism of erection of the penis is the relaxation of smooth muscles of cavernous bodies and arterioles. When sexual stimulation of the cavernous nerves of the body released nitric oxide (NO), activates the enzyme guanylate cyclase, and in enhancing the content of cyclic Guanosine monophosphate (cGMP), resulting in relaxation of smooth muscle is cavernous body, causing an increase in blood flow to the penis.
Vardenafil blocks specific fosfodiesterazu 5-th type (PDE-5), under the influence of which is split cGMP. This enhances action of endogenous NO in the cavernous body during sexual arousal. Thus, the use of Levitra erectile dysfunction is restored and provides a natural reaction to sexual stimulation.
Vardenafil is rapidly absorbed after oral administration. The concentration in blood plasma after administration of fasting reaches its maximum value for 30-120 min (mean 60 min). The absolute bioavailability of approximately 15%. When receiving vardenafil with fatty foods speed the absorption decreases, the period of maximum concentration increases up to 60 minutes, the maximum plasma concentration is reduced by an average of 20%, but significant change in AUC is not happening. When receiving vardenafil with food containing no more than 30% fat, pharmacokinetic parameters of the drug did not change.
Vardenafil and its major metabolite by approximately 95% bound to plasma proteins, and this process is reversible and not dependent on the concentration of the drug. In the sperm of healthy men after 90 minutes after taking vardenafil determined not more than 0.00012% of applied dose. Vardenafil is metabolized predominantly under the influence of hepatic enzyme CYP 3A4 (major route), CYP 3A5 and CYP 2C9 (non-essential way). The total clearance of vardenafil is 56 L / h. After oral vardenafil displayed in the form of metabolites, mainly in the faeces (91-95% of the administered dose), to a lesser extent - in the urine (2-6% dose). Half-life of vardenafil on average 4-5 hours, the major metabolite M1 - about 4 hours
In healthy men aged 65 years and older compared with patients of younger age (45 years) observed rate increase AUC by an average of 52%, but a significant reduction in hepatic clearance of vardenafil is not indicated. The frequency of adverse side effects of the drug does not depend on age.
In individuals with mild, moderate and severe renal insufficiency (creatinine clearance 55-80, respectively, 30-50 and ≤ 30 mL / min) the pharmacokinetics of vardenafil virtually unchanged. In patients with mild and moderate contractile function of the liver clearance of vardenafil is reduced, and rates of AUC and maximum concentration increased in proportion to the degree of dysfunction of the liver.

Indications: Erectile dysfunction (inability to achieve and maintain an erection necessary for sexual intercourse).

APPLICATION: inside, regardless of the meal. The recommended starting dose is 10 mg. The tablet should be taken for 15-25 minutes prior to sexual intercourse, but can be taken for 4-5 hours to achieve the desired effect when using Levitra requires adequate sexual stimulation. Given the efficacy and tolerability of the drug dose can be increased to 20 mg or decrease to 5 mg. The maximum recommended dose of Levitra - 20 mg, the multiplicity of reception - no more than 1 time per day.
There is no need to correct the dosage regimen in elderly patients, patients with renal failure or minor violations of liver function. In patients with moderate hepatic impairment decreased clearance of vardenafil, so the initial dose should not exceed 5 mg / day. Given the efficacy and tolerability in the future daily dose of Levitra can be increased to 10-20 mg.

CONTRAINDICATIONS: Hypersensitivity to the drug's components, the simultaneous application of nitrate or any donators NO (drugs that produce NO), the age of 16 years, the simultaneous use of HIV protease inhibitors indinavir and ritonavir, because they are potent inhibitors of 3A4 SYR.

SIDE EFFECTS: generally well tolerated, side effects are transient and only slightly expressed.
The most frequent (10%): headache, flushing (flushing person);
frequent (1-10%): dizziness, dyspepsia, nausea, nasal congestion;
infrequent (0,1-1%): photosensitivity of skin, hypertension, back pain, lacrimation;
unit (0,01-0,1%): hypotension, myalgia, priapism.
Were noted isolated cases of anterior ischemic optic neuropathy (as a result there is a reduction of up to counter its loss), which is presumed to be associated with the use of inhibitors of PDE-5, which belongs to the group, and Levitra. Most of the surveyed patients were subjected to vascular risk (pronounced congestion of the optic nerve, the age of 50 years and over, diabetes, hypertension, cardiovascular disease, hyperlipidemia and smoking). However, not determined whether these single cases directly to the use of PDE-5 inhibitors in patients undergoing vascular risk, or they should be attributed to other factors.

Cautions: preparations for the removal of erectile dysfunction with particular caution is prescribed for the anatomical deformation of the penis, such as triangulation, cavernous fibrosis (Peyronie's disease), as well as in diseases that contribute to the development of priapism (sickle cell anemia, multiple myeloma, leukemia, or leukemia) .
Due to the lack of security information Levitra in patients receiving the drug groups listed are not recommended for severe liver problems, kidney disease in the terminal stage (if required dialysis), severe arterial hypotension (systolic blood pressure at rest ≤ 90 mmHg. Cent.) , unstable angina, after suffering a hemorrhagic stroke, or myocardial infarction (within the last 6 months), as well as in hereditary degenerative diseases of the retina (retinitis pigmentosa).
Since Levitra is not used in patients with a propensity for bleeding in patients with peptic ulcer or duodenal ulcer, appoint a drug in such cases is possible only after a careful comparison of expected benefits and potential risks.
Before using vardenafil necessary to assess the state of the cardiovascular system of the patient, because sexual activity is associated with certain cardiac risk. Patients with congenital prolonged interval of Q-T, the receiving class Ia antiarrhythmic drugs (quinidine, procainamide) or class III (amiodarone, sotalol), the appointment of Levitra is contraindicated.
Patients older than 65 years is not recommended exceed the dose of 5 mg in connection with a reduction in clearance of vardenafil.
Levitra is not intended for infants, children and women.

INTERACTIONS: The safety and effectiveness of vardenafil in combination with other means to deal with erectile dysfunction are not installed, so use these combinations is not recommended.
Reduced clearance of vardenafil was happening while the application of selective enzyme inhibitors of cytochrome P450 CYP 3A4 (such as cimetidine, ketoconazole, itraconazole, indinavir, ritonavir, erythromycin). If necessary, a combination with any of these medications daily dose of Levitra should not exceed 5 mg.
Simultaneous reception vardenafil blocker with α-adrenergic receptors may cause the development of symptomatic hypotension, therefore Levitra should apply no earlier than 6 hours after their admission.
Inhibitors of CYP 2C9 (tolbutamide, warfarin), CYP 2D6 (selective inhibitors of reverse neuronal serotonin, tricyclic antidepressants), thiazides and tiazidopodobnye diuretics, loop and Potassium-sparing diuretics, ACE inhibitors, calcium antagonists, β-adrenoceptor blockers and inducers of CYP 450 metabolism (rifampin , barbiturates) do not affect the pharmacokinetics of vardenafil.
No evidence of clinically significant interactions vardenafil with tolbutamide (250 mg) or warfarin (40 mg), which are metabolized by CYP 2C9, were revealed.
Single dose antacid (magnesium / aluminum hydroxide) did not affect the bioavailability of vardenafil.
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OVERDOSE: Symptoms - pain in the back; treatment: symptomatic and supportive therapy (respectively, clinical status). Application of hemodialysis does not increase the clearance of vardenafil, because he was actively associated with plasma proteins and not singled out by the kidneys.

Storage: Store in a dry place at a temperature of 30 ° C.

The drug is a diuretic, is a mixture of Aldaktona



Aldaktazid (Aldactazide: spironolactone and hydrochlorothiazide)
The drug is a diuretic, is a mixture of Aldaktona
cialis buy
(Aldactone) and thiazides (thiazide). Often used by athletes before competition for sgonki excess water. In some works quite effectively. Most often used for 3-5 days before competition.

The drug impedes the allocation aldosterona, the hormone the adrenal gland. This hormone is responsible for the level of electrolytes and water reserves in the body. The presence of the diuretic drugs such as thiazide, makes an ideal preparation for many athletes combination. Average dose - one tablet a few times a day for three days before the competition.


Aldakton (Aldactone: spironolactone)
Product - Tablets 25 mg, 50 pieces in the package. This - diuretic average force, which works through inhibition of aldosterona in the body. In the form aldaktazida often used for high blood pressure. Many athletes find the drug useful to Fight reception before the event to remove excess water caused by increased levels of estrogen in the body. Last time used by women as an anti-androgen. The drug has the ability to suppress the action of androgens in the female body. This makes it popular among zhenschinatletov using steroids and suffer from virilization. In this case, reception of steroids ceases and one to three weeks taken aldakton up until androgen levels did not fall to an acceptable value. The drug, like all diuretics, causing a number of serious side effects: muscle sudorgi, heart problems, dizziness. Because of the anti-androgenic properties, the male athletes use the drug only a few days in a row. The drug lowers androgens are so low that there is a risk of gynecomastia. Usual dosage - one tablet a few times a day.

Glukofag (Glucophage)
Famous brand neymy: Glucophage, Mellitron. Glukofag available in tablets of 850 mg, 40 tablets per pack. Glukofag - brand neym under which comes metformin, oral hypoglycemic drug. Glukofag designed to prevent the development of diabetes in adults. The drug increases the body's ability to transport glucose into muscle cells by enhancing insulin sensitivity. The drug also reduces the ability of the body to form glucose in the liver, through which lowers the secretion of insulin. The drug is very similar to fenformin, as oral hypoglycemic drug, but fenformin employs more rudely. Fenformin is stronger Glukofaga 5-10 times, the ratio of the effect of the same amount of both drugs. Glukofag causes significantly fewer side effects than Fenformin. Possibility of overdose and as a consequence of this, the program separate Glukofaga hypoglycemia depends on the correlation characteristics of the organism and received dose. It is considered that the drug improves the function of insulin in the body. It provides the best recovery of glycogen reserves and a decrease in blood glucose levels. The most common side effects of Glukofaga - metallic taste in the mouth, nausea and vomiting. Effective dose - 1700 mg per day, divided into equal parts. Taking the drug together with the necessary food and water to avoid stomach upset.

Gonadotropin (HCG - Human chorionic gonadotropin)
The human gonadotropin - a glycoprotein, a drug obtained from the urine of pregnant women. Come in the form of injections and produced in many countries. Pregnil from Organon, Prophase from Serono, are intended for the treatment of undescended (? Undescended) testes in children at an early age, gipogonadimizma (low testosterone by the body) and in infertility in women. Among athletes, HCG is used to stimulate natural testosterone production during or after a steroid cycle. If the cycle is terminated abruptly, especially when endogenous androgens If not applicable, it can cause very rapid loss of newly acquired muscle mass. If you use HCG the loss can be prevented. Fakes are not very common. Some athletes celebrated unpleasant side effects when used for forgery - fever and skin defects, from a lack of sterility of the drug, so be careful. The product is always packaged in two separate vials, one with powder and one - with a sterile solvent. The contents of vials before use is mixed and the mixture is frozen for later use.

GHB
GHB, or gamma hydroxybutyrate, a naturally occurring metabolite that participates in the formation of GABA (gamma-aminobutirat). GHB has been widely circulated widely to the prohibition in 1990. The product has many positive qualities, but is used mostly athletes because it promotes a significant increase in the level of growth hormone (16 times or more). Unfortunately, the increase in growth hormone is accompanied by rising levels of prolactin. Prolactin nullifies much of the positive results caused by increased levels of growth hormone. Perhaps this is causing a small increase in muscle mass when using GHB. On the other hand, many athletes have noted improvements in visual elaboration of muscles when using GHB. Some athletes marked increase in power rates, and "dry" muscle mass. Some do not have any allowances in force or in muscle mass, but note the loss of fat.

At higher levels of GR, there are also some other positive effects. First, GR is the perfect sleeping pill. Small doses cause a state of relaxation, euphoria and drowsiness. Increasing the dose increases the effect and receiving very quickly fall asleep. GR unlike other sleeping pills does not violate any of the stages of normal sleep. This is critical for achieving a normal sleep patterns needed for rest and recovery of muscles.

GHB is a state of euphoria, relaxation and sensuality, while lowering the level of anxiety. GHB also causes a number of proseksualnyh effects, improving tactility (sensitivity to touch), enhancing erections in men and increasing the intensity of orgasm. For these reasons, GHB has become a very popular "recreational" drug. And especially among athletes, because, unlike other recreational drugs, GHB does not harm the drill. GHB used by many athletes as a substitute for alcohol because it does not cause a hangover the next day. By the way, GHB is very effective as a treatment for alcoholism.
Many publications about the drug, by contrast, argue that it is extremely dangerous, and overdose is not a dream, and coma. About the deaths, but no one writes.

Diazid (Dyazide)
Combination diuretic, 50 mg of triamterene (triamterene) and 25 mg gidrohlorotiazeda (hydrochlorothiazede). The most frequently prescribed to control high blood pressure. A very large number of "chemists" are the drug to remove excess water or to deal with bloated view of the use of certain steroids, or simply for "dry" before the competition. This drug, unlike drugiz diuretics, cares for potassium, and not as bad effect on muscle tissue. Thus, when using this drug, use of salts or other drugs potassium optional. Average dose - one or two tablets a day technie short period of time, usually a day or two before a competition. The exact dosage is chosen individually for each and should take place under medical supervision, since the drug has some side effects, including - dizziness, cramps, in extreme cases - heart attacks.

DNP - did not apply under any circumstances!
The drug was originally developed as a replacement detonating a component of dynamite. The drug displays a fatty acid from the process of ATP formation and eliminates the formation of large amount of heat. Aspirin, klenbutenol and ephedrine are doing the same, but much less intensively. Therefore, the use of these drugs raises the body temperature. The drug began to be used as a fat burner in the 30 - s. In 1% of use in using the drug developed cataracts and was released from the open consumption. The reason for which the drug is held in such demand among bodybuilders, is that it accelerates the metabolism so than any other known drugs. Even in small doses, approximately 3-5 mg / kg, the drug accelerates the metabolism of 30%. If this dose is applied daily, the metabolism speeds up to 50%. In this mode, the body burns about 400 grams of fat per day. The drug is very dangerous. Increasing the dose of 4 times leads to death. The drug raises the body temperature, but an uncertain value, and if the temperature rises above 104F (57C), you can either die or make severe cerebral injuries (the drug may actually raise the temperature much higher ...). If you think this outcome is not the worst side effect for yourself, take into consideration the irreparable damage to the liver and kidneys, which occur during "normal" Long term use without overdose. The drug significantly reduces the processing of the liver thyroid hormone from T4 to T3. In humans, high-level and seated on a low calorie diet, medication run out of ATP within a few days. When this occurs, the body temperature returns to normal. The only thing in this case is left to do - start using Tsitomelom, 150 micrograms per day. Preapart sold only as a chemical for laboratory experiments. One of the variants of the drug - its use as an insecticide, if someone asks you where to buy it - say so.

Klenbutenol (Clenbuterol)
Pharmaceutical name: Klenbutenol (Clenbuterol)

Famous brand neymy and producer countries:

Broncodil 0.01 mg tab.; Von Boch I

Broncoterol 0.02 mg tab.; Quimedical PT

Cesbron 0.02 mg tab.; Fidelis PT

Clenasma 0.02 mg tab.; Biomedica Foscama

Clenbuter.Pharmachim 0.02 mg tab.; Sopharma Sofia BG

Contrasmina 0.02 mg tab.; Falqui I

Contraspasmina 0.02 mg tab.; Arzneimittel Werk Dresden G

Monores 0.01 mg tab.; Valeas I

Monores 0.02 mg tab.; Valeas I

Novegam 0.02 mg tab.; Chinoin Mexico

Prontovent 0.02 mg tab.; Salus I

Spiropent 0.02 mg tab.; Thomae G. Bender A, De

Angeli I, Europharma ES,

Promeco Mexico,

Boehringer BG, HU, CZ

Spiropent mite 0.01 mg tab.; Thomae G

Spasmo-Mucosolvan 0.02 mg tab.; Thomae G

Ventolase 0.02 mg tab.; Juste ES

Veterinary option: Ventipulmin 0.016 mg / gr.; Richter A, BL-Vetmedica G Description: Klenbutenol - a drug, usually issued by a people suffering from asthma. The body operates in parallel adrenaline (epinefrin), competing with him in the effects on receptors such as beta-2. The drug is katabolikom to fat and anabolic to muscle. Athletes use Klenbutenol as predsorevnovatelnoy preparation for burning fat.

Effective dosage: 60-120 mg per day, divided equally among all

day. Receive Mode: 2 days - reception, 2 days - no, and so 2 weeks 3 weeks

"Rest".

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Series: usually takes 6-12 weeks. Over 12 weeks of use of the drug is not recommended, you need to make a break for a couple of months. After two weeks of using beta-2 receptors in "hammered" and the anabolic effect of the drug disappears. Burning fat while not terminated. Studies show that the regime "two days after two days" can reduce the weakening effect of the drug. In this case, Klenbutenol has a half-life of 48 hours. This means that the mode of "Two by two" allows you to quickly save a number of tablets used in the cycle than completely prevent overloading of the receptors, which occurs in about two weeks. A three-week interval between doses as time allows you to restore the sensitivity of the receptors; mode "two two" furthermore reduces the side effects of the drug, since the maximum concentration is reached on the third day.

With what can be combined. Using Tsitomela (Cytomel) (25 mg / day) and Zaditena (Zaditen (ketotifene)) (10 mg / day), Klenbutenola dosage should be reduced by half, thermogenic effect is amplified. Tsitomel fights deiodinase deterioration. Zaditen restores beta-2 receptors. In a series Klenbutenola work well preparations potassium, potassium maintains electrolytic balance and reduces potential problems with muscle spasms.

Side effects: nervousness, tremors of hands, headaches, insomnia, palpitations sertsebienie, possible asthma. For different people maple work differently, some problems do not occur at all. If the electrolyte balance in normal, Maple usually does not cause problems. The most common - muscle cramps. If your work involves a lot of manual labor, Maple can be a problem. Tremor, which they called, making precise movements with his hands practically impossible. Fortunately, this effect stops after taking a week or two. In very high doses of maple can be dangerous, it is possible the so-called syndrome of sudden death. Results maple gives, but the organism is difficult to cope with the drug. You have to buy a good instrument for measuring the pressure and use it several times a day. To avoid most trouble, you need to base the dosage on blood pressure and pulse.

Fakes. The drug is almost not fake, because the work it is very easy to notice. We should avoid drugs such as Klenbutedrol and Maple RX.

Klostilbegit (clomifen citrate)
Product - tablets of 50 mg. "Clomid" - the commercial name of the drug "clomifen citrate, a synthetic estrogen, which is usually prescribed to women having difficulty conceiving. In men, the drug works as an anti-estrogen and gonadotropin simulator, the application of Clomid causes the rise in levels of hormones that stimulate the testes and luteinizing hormone. The drug acts directly on the pituitary gland. As a result, the natural production of testosterone. This effect is beneficial for athletes-chemists, especially at the end of the cycle, when the internal level of testosterone above normal. When an athlete stops using steroids, his own production of testosterone is reduced, and if the natural level of testosterone did not return to normal levels, we can expect significant losses in muscle volume and strength. To prevent this, use, in particular, Clomid. Studies show that daily reception clomifen citrate in the amount of 50-100 mg per day for two weeks or more returns a natural production of testosterone at an acceptable level. During the period of use Clomid gradually raise testosterone levels. Since you often need is not gradual, and sharp rise of the testosterone, athletes are mainly used HCG for a couple of weeks and continue the recovery cycle is Clomid. Clomid is also effective as an anti-estrogen. Most athletes at the end of the cycle are experiencing problems with the excess of estrogen. High levels of this hormone in combination with low testosterone significantly increases the risk of gynecomastia. By using Clomid, the athletes decide two problems - block unwanted effects of estrogen and raise the natural level of testosterone. Women use Clomid before the competition to lower estrogen levels and thereby giving the body more rigid look. In terms of toxicity and side effects of Clomid is considered a fairly safe product. Possible side effects include hot flashes and temporary disturbances of vision. Clomifen citrate is widely distributed on the black market. Among the derivatives need to mention clomifen citrate production company Anfarm, Greece.

Lasiks (Lasix, furosemide)
Product - tablets of 20 or 40 mg. Very strong diuretic. Often used by athletes to remove excess water from the body and make the body more relief. The drug acts very quickly, if taken orally, the effect is manifested in two hours. Most athletes appreciate this immediate effect, because it allows them to quickly assess their competetive form - where what is missing, or not enough relief. Depending on their own assessment, the athlete can take another dose of the drug or, conversely, have a drink of water. Many argue that avoid the side effects of the drug in the form of seizures, taking medications of mineral salts and potassium. This practice, being very effective, very dangerous. When used independently of diuretics and salt products greater risk of heart attacks. Fortunately, most athletes favor of the drug for only a day or two before a competition. Dosage - 40 mg per day. In general, drug use must take place under medical supervision.

Naprosin (Naprosyn, naproxen)
Product - tablets of 250 mg, 100 pieces in the package. This - a nonsteroidal antiinflammatory drug. Frequently isplzuetsya to treat people with rheumatoid arthritis. Reduces swelling of the joints, improves mobility, relieves pain in many patients. Also used in the treatment of ligament injuries, often with athletic training.

The drug works by delaying the allocation of a certain hormone, called Prostoglandin. The process of preparation - not degenerative, like corticosteroids, and well seen in most patients.
Diabetes and the heart - new approaches to prevention and treatment

Anticipated event of spring 2004 was an XI of the Russian National Congress "Man and medicine." Russian Academy of State Service under the President of Russia has traditionally been welcoming guests and participants of the Congress. In Congress, April 21, 2004 symposium, highlighting contemporary issues and developments in the field of cardiovascular disease in diabetes mellitus. The symposium was held in a supportive work environment due to sponsorship and participation in organizing activities of pharmaceutical company Nycomed.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium was chaired by Head of the Department of Endocrinology and Diabetology Medical Faculty of Moscow State Medical and Dental University, MD, professor Mkrtumyan Ashot Musaelovich, as well as director of systemic hypertension Complex, Public Health Ministry, MD, professor Chazova Irina .

Interest in the topic of the symposium was apparent and an explanation of this fact gave Professor Mkrtumyan. He explained that diabetes leads to severe coronary vessels, and 3-4 times increased mortality in patients with diabetes compared with patients without disorders of carbohydrate metabolism.

The first report "Prevention and treatment of complications in patients with type 2 diabetes mellitus from the viewpoint of the cardiologist" presented Ostroumova Olga, professor of Faculty Therapy and profbolezney Moscow State Medical University stomatologichesogo. She noted that 75 fatalities out of 100 in diabetes - a death related to cardiovascular causes, and therefore the need for their prevention and treatment of complications is obvious.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

What drugs are best suited for reducing the risk of heart attack? Studies show that a very good effect gives glyukofazh (Metformin) - a drug the pharmaceutical company Nycomed.

Professor Ostroumova presented the results of studies that have shown reduced risk of myocardial infarction when applying glyukofazha (metformin) for 39% and the risk of stroke by 41%.

There is also another problem: high blood pressure and diabetes. On the one hand, patients with hypertension, who may not have diabetes, have twice the risk of developing cancer compared with patients with normal blood pressure. On the other hand, elevated levels of glucose contributes to hypertension. Consequently, one disease contributes to the other and vice versa. But if the patient is monitored and hypertension, and diabetes, the risk of complications and death from heart attack or stroke doubles. In exactly the same level of systolic blood pressure in patients with diabetes, the risk of complications increases several times. That patients with the highest risk of developing cardiovascular complications. More than that, and the benefits of antihypertensive therapy in diabetics is more significant than in patients without diabetes. Domestic recommendations correspond to the level of blood pressure 130/85. New European recommendations are 130 to 80 and below. What drugs for the treatment of hypertension in diabetes is preferable? Of course, number one - ACE inhibitors or receptor antagonists of type 1 to angiotensin-II, they should be assigned to all patients, but given such a low target levels of pressure, practically 100% of patients should receive combination therapy. With better combination? From tiazidopodobnymi diuretics, calcium antagonist, and if a patient with a coronary heart disease, heart failure, the beta-blockers. Recent studies show that the risk of cardiovascular complications after treatment with captopril and atenolol were no differences, although it was believed that beta-blockers are contraindicated in diabetes. But beta-blockers in the pathogenesis of diabetes has its point of application: ventricular arrhythmia, myocardial damage, high blood pressure. That is why beta-blockers improve prognosis in diabetes mellitus.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The speaker noted that a patient with diabetes and myocardial ischemia began prognosis of disease and mortality similar to patients with postinfarction cardiosclerosis. If the patient has diabetes, coronary disease, the use of beta-blockers should be. And the higher the selectivity of beta-blockers, the less side effects. That is why the highly selective Beta-blocker Concor, manufactured by Nycomed, has a number of advantages for patients with diabetes. No adverse effect either on the carbohydrate or lipid metabolism. No masking of hypoglycemia. It has all the positive effects and significant reduction in the risk of cardiovascular complications.

The most important issue was addressed in the following report: "The choice of drug for the treatment of type 2 diabetes from the perspective of cardioprotection and evidence-based medicine." Professor Mkrtumyan Ashot Musaelovich gave the definition of evidence-based medicine as a reliable, accurate and meaningful use of the best results of clinical trials to cure a particular patient. He noted that one in five patients with clinically confirmed coronary heart disease and diabetes. Myocardial infarction in men without diabetes more frequently than women. But this fact is leveled with the accession of diabetes. What is different from other diabetic patients? The only factor that seemed to be chronic hyperglycemia. But some studies show that one of hyperglycemia pure enough for the development of the observed clinic, including diabetic macro-and microangiopathy. Chronic hyperglycaemia leads to activation of lipid peroxidation. In the end, is the accumulation of free radicals, leading to the defeat of the vascular endothelium.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

How successful can fight with hyperglycemia? Survey of more than 6,500 patients with diabetes in the UK showed that glycated hemoglobin 6.5% - the target. But there is evidence that if you reach 7%, it has already significantly reduced the risk of vascular complications of diabetes. As shown by the large-scale study, to achieve the targets and get the high efficiency of treatment allows it glyukofazh (metformin).

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo
Glyukofazh, struggling with diabetes, heart attack wins.
* Glyukofazh - high drug used to treat diabetes mellitus type 2. Recent studies have proven not only well tolerated and the drug metformin Glyukofazh. Recent clinical trials indicate that Glyukofazh is practically the only antidiabetic means that reduce the risk of death from diabetes and its serious complications. Europe, for example, about 60% of diabetic patients receiving monotherapy or combined treatment with drugs containing metformin. What are the advantages Glyukofazha? Glyukofazh begins to act at the level of the intestine, slowing the absorption of glucose and therefore reduces the peak concentration of glucose in the blood;
* Glyukofazh has anoreksigennoe effect due to the direct action of the drug on the gastrointestinal mucosa, reducing the consumption of food. This gives a dual positive effect: reducing the concentration of glucose in the blood, and reducing the degree of obesity, which is known to lead to further aggravation of insulin resistance in tissues;
* Glyukofazh reduces glucose production in the liver and increases the capture of glucose muscles;
* Glyukofazh normalizes the lipid profile, lowering triglycerides and low density lipoprotein, reduces the level of free fatty acids, increases the level of high density lipoprotein.
* Glyukofazh has angioprotective action by improving blood rheological properties (activation of fibrinolysis, inhibition of platelet aggregation, lowering blood viscosity)
* Glyukofazh does not lead to hypoglycemia and has no effect on blood glucose levels in healthy people. Of the above items can be concluded that Glyukofazh - ideal monotherapy for the treatment of diabetes type 2.

Professor Mkrtumyan noted that in obese individuals, patients with diabetes mellitus type 2 glyukofazh reduced risk of associated diseases in 32% of diabetes deaths by 42% and total mortality by 36%, myocardial infarction - 39%. Third report on the role of the sympatho-adrenal system in metabolic syndrome, was made a doctor of medical sciences, professor Chazov Irina.

Metabolic syndrome - a big problem associated with an increased risk of cardiovascular disease. He is responsible for the increased risk of cardiovascular complications. The speaker presented the results of Russia's national study on the effectiveness of treatment of metabolic syndrome, which involved about 2000 patients. Based on the study was to establish a link between the various components of the metabolic syndrome, as well as the link between type 2 diabetes, and these components.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

It is noted that obesity in 68% of typical patients with metabolic syndrome and hypertension. Type 2 diabetes mellitus is also very often, in 67% of cases, may precede hypertension and metabolic syndrome. Obesity in most patients precedes the development of type 2 diabetes and this requires about 8 years.

It was noted that according to WHO criteria in 1998 called the metabolic syndrome status in violation of glucose tolerance and the presence of two or more connecting factors. Listed criteria violation tolerance and additional factors. However, more modern feel American criteria of metabolic syndrome is established when there is more than the three following signs:

* Insulin resistance or central obesity (OT husband.> 102 cm, wives.> 88 cm)
* Dyslipidemia (HDL-cholesterol: wives. <45 mg / dL, her husband. <35 mg / dd, TGM50 mg / dl)
* Hypertension (BP> 130/85 mmHg. Cent.)
* Impaired glucose tolerance
* Hyperuricemia Additional criteria:
* Hypercoagulation
* Polycystic ovary
* Endothelial
* Microalbuminuria
* CHD

The main therapeutic measure in patients with metabolic syndrome is, of course, decrease body weight. It can be achieved by using low-calorie diet and increasing physical activity, if necessary, the use of special drugs and in extreme cases - surgical interventions.

For drug treatment of metabolic syndrome using drugs that increase the sensitivity of tissues to insulin. This methylidene derivatives, such troglitazon and biguanide, the most popular representative is glyukofazh. It is also hypolipidemic drugs - statins and fibrates and antihypertensive drugs.

Hot debate continues to be of use of beta-blockers in metabolic syndrome and diabetes. But today it is not contested the fact that today's highly selective beta-blockers, such as Concor, not only did not cause any adverse effects, but also very effective in combating metabolic syndrome. Proper research presented by Professor Chazov showed high efficiency of Concor in normalizing blood pressure values of cerebral perfusion according to computer tomography, as well as glucose and lipid metabolism in patients with metabolic syndrome.

The latest report, which is logical, focused on prevention of diabetes. Interest in the presentation by Professor Shestakova MV was not only a scientific and practical. It was noted that prevention of diabetes - is a big economic problem in the health of Russia and foreign countries, millions of dollars annually.

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

The symposium "Diabetes and the heart - new approaches to prevention and treatment" - Special Report RMS-Expo

Recent studies have shown that patients with subclinical forms of diabetes in the form of impaired glucose tolerance in 30% of cases quickly develops diabetes. But the most remarkable is the fact that the transition to hypocaloric diet on a background of regular and very active physical exercise can give to reduce the risk of diabetes by 58%.
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In this vein, was extremely interesting study comparing drug therapy with glyukofazh and active lifestyle. Glyukofazh 44% reduced risk of developing diabetes in the age group 25 to 44 years and 53% in those with a body mass index over 35 kg per sq.m. with quite modest changes in lifestyle. The study showed that glyukofazh and active lifestyles equally effective in these groups of persons to reduce the risk of diabetes, which means that this drug may be recommended in cases where there are difficulties with the organization of an active lifestyle. What is the economic efficiency of prevention? Prevention of diabetes in the U.S. can save about 20 thousand dollars per patient per year. Today the prevention of diabetes is not a utopia but a reality. To do this, physicians should motivate patients. Patients should be motivated by their health. Finally, a planned policy of the state to ensure a healthy lifestyle. At the conclusion of the symposium speakers answered questions from the audience. The symposium was held under the patronage of Nicomedes in a warm, working, friendly atmosphere.