Trenbolone acetate powderrenders anxiolytic, central muscle relaxant, anticonvulsant, sedative-hypnotic and anti-panic effects. It has a depressant effect on the central nervous system (CNS), realized mainly in the thalamus, the hypothalamus and the limbic system. It enhances the inhibitory action of gamma-aminobutyric acid (GABA), which is one of the major mediators of the pre- and post-synaptic inhibition of transmission of nerve impulses in the central nervous system. It has also anxiolytic, sedative, muscle relaxant and anticonvulsant effects.
The mechanism of action of alprazolam is determined by the stimulation of benzodiazepine receptors supramolecular GABA-benzodiazepine-hlorionofor prescription complex, resulting in the activation of GABA receptor, causes a decrease in the excitability of the subcortical brain structures, braking polysynaptic spinal reflexes.
The anxiolytic effect is to . reduction of emotional stress, easing symptoms of anxiety, fear
Expressed anxiolytic activity combined with a mild sedative effect; shortens the period of sleep, increases sleep duration, reduces the number of nighttime awakenings. The mechanism of hypnotic action is inhibition of the cells of the reticular formation of the brain. It reduces the impact of emotional, autonomic and motor stimuli that disturb sleep.
Almost no effect on the cardiovascular and respiratory system.
About 80% of the drug binds to plasma proteins. It may pass through the placenta, the blood-brain barrier (BBB), passes into breast milk. Stable concentration is usually reached within a few (2-3) days in plasma. Alprazolam actively metabolized in the liver, the major metabolite is an alpha-hydroxy metabolite that has biological activity. Elimination of the drug from the body is mainly through the kidneys in the form of compounds with glyukorunovoy acid. The half-life accumulation ~11-16 hours at re-appointment -. Minimum (refers to benzodiazepines with short or medium T1 / 2), elimination after discontinuation of treatment -Fast.
Indications for use.
The treatment of anxiety disorders. Anxiety associated with depression. Neurotic depression at an alarming symptoms of various origins. Panic disorder.
Hypersensitivity to alprazolam or other benzodiazepines. Coma, shock, angle-closure glaucoma, myasthenia gravis, acute alcohol poisoning, drug, drugs and psychotropic substances, severe course of chronic obstructive pulmonary disease, severe depression (suicide attempts), sleep apnea syndrome, the expressed disturbances of function of kidneys and liver; pregnancy trenbolone acetate powder (especially the I trimester), see. “Special instructions”, the period of lactation.
Precautions: cerebral and spinal ataxia, drug dependency history, the propensity to abuse of psychotropic drugs, hyperkinesia, organic brain disease, psychosis (possible paradoxical reactions), hypoproteinemia, advanced age.
The safety of alprazolam in children and adolescents (under 18 years) not installed.
Inside, 2-3 times a day, regardless of the meal. The dose is adjusted individually and corrected in the course of treatment depending on the effect and tolerability of the individual. It is recommended to use the lowest effective dose. When alarm conditions the initial dose is 0.25 mg – 0.5 mg three times a day. If necessary, this dose may be increased to 4 mg / day (divided into several doses).
In elderly initial dose of 0.25 mg of 2 -. 3 times daily
with anxiety associated with depression initial dose 0.5 mg three times a day.
Side effects usually occur early in treatment and gradually disappear with further use of the drug or dose reduction. On the part of the central nervous system: at the beginning of treatment (particularly in elderly patients) – drowsiness, fatigue, dizziness, impaired concentration, ataxia, disorientation, mental retardation and motor responses; rarely – headache, euphoria, decreased mood, tremors, memory loss, impaired coordination of movements, confusion, dystonic extrapyramidal reactions (uncontrolled movements, including eye), muscle weakness, slurring of speech; very rarely – paradoxical reaction (aggressive outbursts, confusion, agitation, anxiety, suicidal tendencies, muscle spasms, hallucinations, anxiety, insomnia). From the side of hematopoiesis: leukopenia, neutropenia, agranulocytosis (chills, pyrexia, sore throat, unusual tiredness or weakness), anemia, thrombocytopenia. From the digestive system: dry mouth or salivation, heartburn, nausea, vomiting, anorexia, constipation, diarrhea; abnormal liver function, increased activity of “liver” transaminases and alkaline phosphatase (ALP), jaundice. From the urogenital system: urinary incontinence, urinary retention, renal dysfunction, decreased or increased libido, dysmenorrhea. Allergic reactions: skin rash, itching. Influence on the fetus: teratogenicity (especially the I trimester), CNS depression, respiratory failure and suppression of sucking reflex in infants whose mothers used the drug. Other: addiction, drug dependency; lowering blood pressure (the blood pressure); rarely – blurred vision (diplopia), weight loss, tachycardia. With a sharp decrease in trenbolone acetate powder dose or cessation of reception – syndrome “cancel” (irritability, sleep disturbances, dysphoria, a spasm of smooth muscles of internal organs and skeletal muscles, depersonalization, increased sweating, depressed mood, nausea, vomiting, tremors, disorders of perception, ie. h hyperacusis, paresthesia, photophobia, tachycardia, seizures, rare – acute psychosis)..
Overdose (intake of 500-600 mg). Symptoms: drowsiness, confusion, decreased reflexes, nystagmus, tremor, bradycardia, dyspnea or shortness of breath, decreased blood pressure, coma. Treatment:gastric lavage, activated charcoal. Symptomatic therapy (maintenance of respiration and blood pressure), administration of flumazenil (in the hospital). Hemodialysis – is ineffective.
. Interaction of
Alprazolam increases the effects of other psychotropic medications, anticonvulsants, and antihistamines, ethanol and drugs that have a depressant effect on the central nervous system.
Inhibitors of microsomal oxidation – increase the risk of toxic effects.
Inductors microsomal liver enzymes – reduce efficiency. Antihypertensive agents may increase the severity of blood pressure lowering.
Clozapine – may increase the respiratory depression. Reduces the effectiveness of levodopa in patients with Parkinson’s disease. Potentially may increase the toxicity of zidovudine. Alprazolam 4 mg / day increases the plasma concentrations of imipramine and desipramine (31% and 20% respectively) while receiving. Metabolic clearance of alprazolam reduced while receiving usual therapeutic doses of cimetidine and macrolide antibiotics. Be careful and think about reducing the dose of alprazolam when taken with cimetidine, macrolides, nefazodone, fluvoxamine, fluoxetine, propoxyphenyl, sertraline, diltiazem, digoxin, and oral contraceptives.
In the treatment of alprazolam patients is strictly prohibited the use of alcohol (ethanol).
In renal / hepatic failure and prolonged treatment is necessary to monitor the pattern of peripheral blood and “liver” enzymes (transaminases).
Patients who did not take earlier psychotropic drugs, “meet” the drug at lower doses, compared with patients previously treated with antidepressants, anxiolytics or suffering from alcoholism.
in endogenous depression alprazolam can be used in combination with antidepressants.
in the application of alprazolam patients with depression were cases of hypomania and mania.
Like the others. benzodiazepines, alprazolam has the ability to cause drug dependence during chronic administration in high doses (more than 4 mg / day).
if you have patients with such unusual reactions such as increased aggression, acute state of excitement, anxiety, suicidal thoughts, hallucinations, increased muscle cramps, difficult falling asleep, shallow sleep, treatment should be discontinued.
in the period of pregnancy is used only in exceptional cases and only for health reasons. It has a toxic effect on the fetus and increase the risk of birth defects when trenbolone acetate powder used in the I trimester of pregnancy.Therapeutic dose in the later stages of pregnancy can cause depression of the central nervous system of the newborn. The constant use during pregnancy may lead to physical dependence with the development of the syndrome of “cancellation” of the newborn.
Children, especially at a younger age, are very sensitive to the central depressant effects of benzodiazepines.
Using just before birth or during labor may cause neonatal respiratory depression, decreased muscle tone, hypotension, hypothermia and a weak act of sucking (the so-called “flaccid baby syndrome”).