One Bisoprolol tablet contains 0.005 or 0.01 g bisoprolol fumarate, as well as auxiliary components: magnesium stearate (Magnesium stearate), colloidal silicon dioxide (Silicon dioxide colloidal), crospovidone (Crospovidone), corn starch (Amylum maydis), microcrystalline cellulose (Cellulose microcrystalline).

For the manufacture of film coating tablets, the following are used: polyvinyl alcohol, titanium dioxide, talc, macrogol, dyes (yellow iron oxide, quinoline yellow, orange yellow).

The drug is produced in the form of film-coated tablets, packaged in blister packs, 20, 30 or 50 pieces in a cardboard box.

The tablets are round, biconvex, their color varies from beige to beige with a yellowish tint, at the break - from white to almost white.

Bisoprolol (INN - Bisoprolol) belongs to the clinical-pharmacological group “ β1-blockers" Its action is aimed at relieving symptoms of myocardial ischemia(antianginal effect), normalization of the disturbed rhythm of contractions of the heart muscle(antiarrhythmic effect), as well as on decrease in blood pressure readings(antihypertensive effect).

Bisoprolol is selective β1-blocker and does not have internal sympathomimetic and membrane-stabilizing activity.

Under the influence of low doses of the active substance bisoprolol fumarate in a patient:

• plasma renin activity decreases(regulating blood pressure and water-salt homeostasis of a proteolytic enzyme);
• myocardial oxygen demand decreases;
• the excitability and conductivity of the myocardium decreases;
• the frequency of contractions of the heart muscle decreases(both at rest and under load);
• stimulated catecholamine and the formation of cyclic adenosine monophosphate are reduced from adenosine triphosphate;
• the flow of calcium ions into the intracellular space decreases;
• cardiac output decreases(despite the fact that there is no significant decrease in stroke volume);
• atrioventricular (AV) conduction is inhibited;
• pressure decreases;
• symptoms of myocardial ischemia are relieved.

According to the annotation, Bisoprolol in a dosage significantly higher than the therapeutic one (0.2 grams or more) can cause blockade, including β2-adrenergic receptors mainly in bronchi And smooth muscles of vascular walls.

The drug is absorbed by approximately 80-90%, and the level of absorption does not depend on food intake. The concentration of the active substance in plasma reaches its maximum value 60-180 minutes after taking the tablet.

Bisoprolol fumarate binds to blood plasma proteins by approximately 30%. The substance has the ability to a small extent:

• pass through the placental and blood-brain barriers;
• penetrate into the milk of a nursing woman.

Approximately half of the dose taken is metabolized into liver, resulting in the formation of inactive metabolites. The half-life varies from 10 to 12 hours. About 98% is eliminated from the body unchanged in the urine, up to 2% is excreted in bile.

What are Bisoprolol tablets for? Indications for the use of Bisoprolol are arterial hypertension(persistently elevated blood pressure), stable angina pectoris(IHD), chronic heart failure (CHF).

The drug Bisoprolol is produced by a fairly large number of pharmaceutical companies, however, regardless of where and by whom they are produced, the tablets have the same indications for use: that is, the indications for use of Bisoprolol-Pran are identical to the indications for use of the drug produced, for example, by Lugansk Chemical Pharmaceutical Plant or the Israeli company Teva.

The use of Bisoprolol is contraindicated for:

• hypersensitivity to the components of the drug;
• hypersensitivity to others β-blockers;
• acute heart failure(OSN);
• CHF in the stage of decompensation(if the patient requires inotropic therapy);
• shock (including cardiogenic shock);
• syndrome of weakness (dysfunction) of the sinus node;
• pulmonary edema;
• sinoatrial blockade;
• bradycardia(extremely low heart rate, in which the heart rate does not exceed 60 beats per minute);
• 2nd and 3rd degree AV block without a pacemaker;
• severe form of arterial hypotension, at which the indicator systolic blood pressure does not exceed 100 mm Hg. Art.);
• severe bronchial asthma;
• noted in the anamnesis COPD;
• pheochromocytoma(in cases where the patient is not simultaneously prescribed α-blockers);
• difficult to control diabetes mellitus;
• metabolic acidosis;
• peripheral circulatory disorders in later stages (for example, with Raynaud's syndrome);
• refractory hypokalemia, hypercalcemia or hyponatremia;
• hypolactasia;
• lactase deficiency;
• glucose-galactose malabsorption syndrome.

Due to the fact that there is not enough data on the safety and effectiveness of the drug for patients under 18 years of age, Bisoprolol is not used in pediatrics.

In addition, the drug is not prescribed to patients undergoing treatment MAO inhibitors(the exception is cases when the patient is prescribed B-type monoamine oxidase inhibitors).

Taking Bisoprolol may be accompanied by:

• dizzy And headaches;
• feeling fatigue;
• feeling of a rush of blood to the face;
• sleep disorders;
• mental disorders (usually depression, less often - hallucinations);
• paresthesia of the limbs and a feeling of cold in them;
• decreased secretion of tear fluid;
• development conjunctivitis;
• abdominal pain, nausea, vomiting;
• diarrhea or vice versa constipation;
• muscle weakness;
• increased convulsive muscle activity;
• symptoms of bronchial obstruction(in patients who have a predisposition to this);
• increased sweating;
• violation of potency;
• bradycardia;
• orthostatic hypotension;
• AV conduction disorders.

In some cases, the course may worsen heart failure with the development of peripheral edema.

In patients with impaired blood supply to the lower extremities, which is accompanied by intermittent claudication, as well as in patients diagnosed with Raynaud's syndrome, the main symptoms of these diseases may intensify.

Also, the possibility of decreased glucose tolerance cannot be ruled out, mainly in patients with concomitant diabetes mellitus(including but not limited to hidden (latent) diabetes, which is characterized by the complete absence of any manifestations of this disease).

The dosage of the drug is selected individually. The tablets are taken in the morning, before meals, without chewing. The course of treatment begins by prescribing 0.005 grams to the patient, which is taken once. Patients who have blood pressure increased slightly, the starting dose is 0.0025 grams per day.

In cases where this is necessary, the dose is doubled. The dosage regimen remains the same.

The highest daily dose is 0.02 grams; for patients with kidney dysfunction, which is characterized by a decrease in creatinine clearance (CC) below a level of 20 ml per minute, the highest dose should be half that (0.01 grams per day).

Exceeding the prescribed average daily dose is allowed in extreme cases. The drug is usually used for a long time.

Elderly patients do not need dose adjustment.

Instructions for use Bisoprolol-Ratiopharm identical to instructions for use Bisoprolol-Lugal and instructions for use Bisoprolol-Teva. According to the same scheme they take Bisoprolol-Prana and other bisoprolol preparations.

An overdose of the drug is accompanied by the following symptoms:

• expressed bradycardia;
• ventricular extrasystole;
• AV block;
• arrhythmia;
• pronounced decrease in blood pressure;
• HNS;
• cyanosis(blueness) of fingers or palms;
• difficulty breathing;
• dizzy;
• bronchospasm;
• syncope;
• convulsions.

Treatment involves performing a gastric lavage procedure, taking adsorbent drugs and prescription of symptomatic therapy:

• injection into a vein 1-2 grams atropine or epinephrine at AV block(in some patients, a temporary pacemaker is installed to solve the problem);
• injection into a vein lidocaine at ventricular extrasystole(class IA drugs should not be used);
• moving the patient to the Trendelenburg position with lowering blood pressure;
• intravenous administration of plasma replacement solutions(if there are no signs of the beginning pulmonary edema; if this does not give the expected effect, the patient to maintain the chrono- and inotropic effect and stop the pronounced decrease blood pressure should be entered epinephrine, dobutamine or dopamine);
• appointment cardiac glycosides, diuretics, and also glucagon at heart failure;
• intravenous diazepam for seizures;
• inhaled administration of β-agonists for bronchospasm.

Inadmissible combinations with Bisoprolol:

• Floctafenine;
• Sultopride.

• with calcium antagonists;
• with antihypertensive drugs, which are characterized by a central mechanism of action;
• with MAO inhibitors(except for MAO-B inhibitors).

The drug is prescribed with caution with:

• antiarrhythmic drugs class I and III;
• calcium antagonists, which relate to group of dihydropyridine derivatives;
• anticholinesterase drugs;
• Local β-blockers;
• insulin preparations And oral antidiabetic agents;
• cardiac glycosides(with digitalis preparations);
• anesthetics;
• non-steroidal anti-inflammatory drugs;
• ergotamine derivatives;
• β-sympathomimetics;
• sympathomimetics, which are characterized by the ability to activate α- and β-adrenergic receptors;
• increasing the risk of hypotension antihypertensive drugs(For example, tricyclic antidepressants, phenothiazines or barbiturates);
• Baclofen;
• Amifostin;
• parasympathomimetics.

Allowed combinations:

• Mefloquine;
• corticosteroid drugs.

To purchase the drug, a prescription in Latin is required.
Rp.: Tab. Bisoprololi 0.005 No. 20
D.S. 1 tab. per day (AH, IHD)

Bisoprolol is included in List B. It is recommended to store it in a dry place, protected from light, at room temperature (no more than 25 degrees Celsius). Keep away from children.

36 months.

The drug should be prescribed with caution:

• patients who have been diagnosed psoriasis, as well as patients whose family history indicates this disease;
• at diabetes mellitus in the stage of decompensation;
• patients who have predisposition to allergic reactions;
• patients whose work requires a high speed of psychomotor reactions or potentially threatens health and/or life (as a rule, the reaction speed may decrease in the initial stages of treatment, when changing the drug, as well as when Bisoprolol interacts with alcohol).

Patients who have been diagnosed with pheochromocytoma”, the drug is prescribed only after completing a course of treatment α-blockers.

Sudden withdrawal of the drug is unacceptable; the course of its use is completed gradually, gradually reducing the prescribed dose (it is considered optimal to reduce it by halving the dose daily).

Structural analogues of Bisoprolol (synonyms) are drugs Biprol, Bisogamma, Niperten, Bisoprolol-Prana, Bisoprolol-Lugal, Bisoprolol-Ratiopharm, Bisoprolol-Teva, Concor, Concor Cor, Bisomore, Bioscard, Corbis, Bidop, Aritel Kor, Bisomore.

Analogs of the drug according to the mechanism of action are Atenolol, Betacard, Betalok, Binelol, Cordanum, Lidalok, Lokren, Metozok, Metoprolol, Metocore, Nebivator, Nebilong, Nebilet, OD-Sky, Egilok, Estekor.

Which is better - Bisoprolol or Concor?

Concor is the brand name under which the original bisoprolol is produced. The manufacturer of the drug is the German pharmaceutical company Merck KGaA. However, the patent for this medicine has long expired, so there are currently a large number of more affordable generic bisoprolol on the market.

It is believed that all of them are not inferior in quality to the original drug, however, there is not enough official data to confirm this today.

Bisoprolol is not recommended for the treatment of pregnant and lactating women. However, in situations where the benefits to the mother potentially outweigh the likely risks to the developing fetus, the drug may still be prescribed.

In exceptional cases, when the medicine is used during pregnancy, it should be discontinued no later than 72 hours before the expected date of birth. Otherwise, there is a high likelihood that the newborn baby will develop hypoglycemia, arterial hypotension, bradycardia, and also respiratory depression.

When withdrawal is not possible, constant monitoring of the baby's condition is necessary during the first 72 hours after birth.

If it is necessary to prescribe Bisoprolol to a nursing woman, it is necessary to resolve the issue of cessation of lactation.

Most often, the topic of drug withdrawal is discussed on relevant forums. Reviews about Bisoprolol left by patients and doctors are mainly related to withdrawal syndrome, which occurs against the background of abrupt cessation of treatment with this drug.

Its particular manifestations are increased heart rate And attacks of arterial hypertension. Some patients note that during treatment with the drug they have significantly vision decreased.

However, since Bisoprolol is prescribed for a long period of time (for some patients even for life), visual impairment and medication intake may be unrelated phenomena.

Taking Bisoprolol may be accompanied by side effects. Some patients practically do not notice them in themselves, while in others, if you believe the reviews, they are quite pronounced.

In connection with all of the above, neither treatment nor discontinuation of the use of this drug should be an independent decision of the patient. In each specific case, the treatment regimen and dosage regimen are determined solely by the doctor who is caring for the patient.

The price of Bisoprolol depends on which pharmaceutical company produced the drug. So, for example, the average price of Bisoprolol-Ratiopharm 0.005 grams is 55 UAH (in Russian pharmacies you can buy it for about 345 rubles), but the price of Bisoprolol-Astrapharm starts from 8 UAH.

The price of analogues of the drug on the Russian pharmaceutical market is from 32 rubles (the average package of Bisoprolol-Prana 0.005 grams costs the buyer this amount).

Bisoprolol-Prana tablets 5 mg 30 pcs.Pranafarm

Bisoprolol-Teva tablets 10 mg 30 pcs. Teva

Bisoprolol-Teva tablets 5 mg 30 pcs. Teva

Bisoprolol tablets 2.5 mg 30 pcs.Vertex

Bisoprolol-Prana tablets 10 mg 30 pcs.Pranafarm

Bisoprolol 10 mg No. 30 tablets /ozone/Ozone LLC

Bisoprolol 5mg No. 30 tablets /ozone/Ozone LLC

Bisoprolol-prana 10 mg No. 30 tabletsPranafarm LLC

Bisoprolol-Teva 10 mg No. 30 tabletsTeva Pharmaceutical

Bisoprolol-Teva 10 mg No. 50 tabletsTeva Pharmaceutical

Bisoprolol-TevaTeva, Israel

Bisoprolol-TevaTeva, Israel

Bisoprolol-TevaTeva, Israel

Bisoprolol-TevaTeva, Israel

BisoprololSevernaya Zvezda JSC, Russia

Bisoprolol

Bisoprolol30

Bisoprolol30

Bisoprolol-Apo tablet. 10mg No. 30Apotex (Canada)

Bisoprolol-Apo tablet. 10mg No. 60Apotex (Canada)

Bisoprolol 10 mg No. 30 tablet p.o. Lekpharm LLC (Belarus)

Bisoprolol 5 mg No. 30 tablet p.o. Lekpharm LLC (Belarus)

Bisoprolol 10 mg No. 50 tablet p.o. Lekpharm LLC (Belarus)

Bisoprolol 5 mg No. 50 tablet p.o. Lekpharm LLC (Belarus)

Bisoprolol-ratiopharm 5 mg No. 50 tab.

Registration number:

LSR-007326/10-290710

Trade name: Bisoprolol -Teva

International nonproprietary name (INN): bisoprolol

film-coated tablets

Compound
1 film-coated tablet contains:
active substance: bisoprolol fumarate 5.00 or 10.00 mg;
excipients: microcrystalline cellulose, mannitol, croscarmellose sodium, magnesium stearate;
shell: hypromellose, titanium dioxide, macrogol-6000.

Round, biconvex, film-coated tablets, white or almost white, with engraving on one side: “BISOPROLOL 5” (dosage 5 mg) or “BISOPROLOL 10” (dosage 10 mg).

Beta1-adrenergic blocker selective

ATX code:С07АВ07

Pharmacological properties

Pharmacodynamics Bisoprolol is a selective beta 1-blocker, without its own sympathomimetic activity, and does not have a membrane-stabilizing effect. As with other beta1-blockers, the mechanism of action in hypertension is unclear. At the same time, it is known that bisoprolol reduces the activity of renin in the blood plasma, reduces the myocardial oxygen demand, and reduces the heart rate (HR). It has hypotensive, antiarrhythmic and antianginal effects.

By blocking beta 1-adrenergic receptors of the heart in low doses, it reduces the catecholamine-stimulated formation of cyclic adenosine monophosphate (cAMP) from adenosine triphosphate (ATP), reduces the intracellular current of calcium ions, inhibits all cardiac functions, reduces atrioventricular (AV) conductivity and excitability. When the therapeutic dose is exceeded, it has a beta2-adrenergic blocking effect. Total peripheral vascular resistance at the beginning of drug use, in the first 24 hours, increases (as a result of a reciprocal increase in the activity of alpha-adrenergic receptors and the elimination of stimulation of beta2-adrenergic receptors), after 1-3 days it returns to its original value, and with prolonged use it decreases.
The antihypertensive effect is associated with a decrease in minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the sympathoadrenal system (SAS) (of great importance for patients with initial renin hypersecretion), restoration of sensitivity in response to a decrease in blood pressure (BP) and an effect on the central nervous system (CNS). In case of arterial hypertension, the effect develops after 2-5 days, a stable effect is observed after 1-2 months.
The antianginal effect is due to a decrease in myocardial oxygen demand as a result of decreased contractility and other myocardial functions, prolongation of diastole, and improved myocardial perfusion. Due to increased end-diastolic pressure in the left ventricle and increased stretch of ventricular muscle fibers, oxygen demand may increase, especially in patients with chronic heart failure (CHF).
When used in average therapeutic doses, in contrast to non-selective beta-blockers, it has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscles, smooth muscles of peripheral arteries, bronchi and uterus) and on carbohydrate metabolism; does not cause sodium ion retention in the body; the severity of the atherogenic effect does not differ from the effect of propranolol.

Pharmacokinetics Bisoprolol is almost completely absorbed from the gastrointestinal tract; food intake does not affect absorption. The first pass effect through the liver is negligible, resulting in high bioavailability (90%).

Bisoprolol is metabolized via the oxidative pathway without subsequent conjugation. All metabolites have strong polarity and are excreted by the kidneys. The main metabolites found in blood plasma and urine do not exhibit pharmacological activity. Data obtained from in vitro experiments with human liver microsomes indicate that bisoprolol is metabolized primarily by the CYP3A4 isoenzyme (about 95%), with the CYP2D6 isoenzyme playing only a minor role.
Communication with blood plasma proteins is about 30%. Volume of distribution - 3.5 l/kg. Total ground clearance is approximately 15 l/h. The maximum concentration in blood plasma is determined after 2-3 hours. Permeability through the blood-brain barrier and placental barrier is low.
The plasma half-life (10-12 hours) ensures effectiveness for up to 24 hours after a single daily dose.
Bisoprolol is excreted from the body in two ways; 50% of the dose is metabolized in the liver with the formation of inactive metabolites. About 98% is excreted by the kidneys, of which 50% is excreted unchanged; less than 2% - through the intestines (with bile).
Since excretion occurs equally in the kidneys and liver, no dosage adjustment is required in patients with impaired liver function or renal failure. The pharmacokinetics of bisoprolol is linear and does not depend on age.
In patients with CHF, plasma concentrations of bisoprolol are higher and the half-life is longer compared to healthy volunteers.

Indications for use

• Arterial hypertension;
• coronary heart disease: prevention of attacks of stable angina.

Contraindications

• Hypersensitivity to the components of the drug and other beta-blockers;
• acute heart failure and CHF in the stage of decompensation, requiring inotropic therapy;
• cardiogenic shock;
• collapse;
• atrioventricular (AV) block II-III degree, without a pacemaker;
• sinoatrial block;
• sick sinus syndrome;
• bradycardia (heart rate before treatment less than 60 beats/min);
• severe arterial hypotension (systolic blood pressure less than 100 mmHg)
• cardiomegaly (without signs of heart failure);
• severe forms of bronchial asthma and a history of chronic obstructive pulmonary disease (COPD);
• severe peripheral circulatory disorders;
• Raynaud's syndrome;
• metabolic acidosis;
• pheochromocytoma (without simultaneous use of alpha-blockers);
• simultaneous use of monoamine oxidase inhibitors (MAO) (with the exception of MAO type B inhibitors);
• concomitant use of floctafenine and sultopride.
• age under 18 years (efficacy and safety have not been established).

With caution
Psoriasis, depression (including history), diabetes mellitus (may mask symptoms of hypoglycemia), allergic reactions (history), bronchospasm (history), desensitization therapy, Prinzmetal's angina, 1st degree AV block, severe renal dysfunction (creatinine clearance (CC) less than 20 ml/min); severe liver dysfunction; thyrotoxicosis, old age.

Use during pregnancy and breastfeeding

Pregnancy Bisoprolol does not have direct cytotoxic, mutagenic or teratogenic effects, but has pharmacological effects that may have a harmful effect on the course of pregnancy and/or on the fetus or newborn. Typically, beta blockers reduce placental perfusion, leading to reduced fetal growth, intrauterine fetal death, miscarriage, or premature birth. The fetus and newborn child may experience pathological reactions, such as intrauterine growth retardation, hypoglycemia, and bradycardia.

Bisoprolol-Teva should not be used during pregnancy; use is possible if the benefit to the mother outweighs the risk of side effects in the fetus and/or child. In the event that treatment with Bisoprolol-Teva is considered necessary, blood flow in the placenta and uterus should be monitored, as well as the growth and development of the unborn child should be monitored, and in the event of adverse events in relation to pregnancy and/or the fetus, alternative methods should be taken therapy. The newborn should be carefully examined after birth. Symptoms of hypoglycemia and bradycardia usually occur during the first 3 days of life.

Breastfeeding period There is no data on the penetration of bisoprolol into breast milk. Therefore, taking the drug Bisoprolol-Teva is not recommended for women during breastfeeding.

If it is necessary to use the drug during lactation, breastfeeding should be stopped.

Directions for use and doses
The drug Bisoprolol-Teva is taken orally, in the morning on an empty stomach, 1 time per day with a small amount of liquid, in the morning before, during or after breakfast. The tablets should not be chewed or crushed into powder.
In all cases, the doctor selects the regimen and dose for each patient individually, in particular, taking into account the heart rate and condition of the patient. For arterial hypertension and coronary heart disease, the drug is prescribed 5 mg once a day. If necessary, the dose is increased to 10 mg 1 time per day. In the treatment of arterial hypertension and angina pectoris, the maximum daily dose is 20 mg 1 time / day.
For patients with severely impaired renal function (creatinine clearance less than 20 ml/min.) or with severely impaired liver function, the maximum daily dose is 10 mg 1 time per day. Increasing the dose in such patients must be carried out with extreme caution. No dose adjustment is required in elderly patients.

Side effect
The frequency of the adverse reactions listed below was determined according to the following (World Health Organization classification): very often - at least 10%; often - at least 1%, but less than 10%; infrequently - not less than 0.1%, but less than 1%; rarely - not less than 0.01%, but less than 0.1%; very rarely - less than 0.01%, including individual messages.
From the heart and blood vessels: very often - decrease in heart rate (bradycardia, especially in patients with CHF); sensation of heartbeat, often - a pronounced decrease in blood pressure (especially in patients with CHF), manifestation of vasospasm (increased peripheral circulatory disorders, a feeling of cold in the extremities (paresthesia); infrequently - impaired AV conduction (up to the development of complete transverse block and cardiac arrest), arrhythmias , orthostatic hypotension, worsening CHF with the development of peripheral edema (swelling of the ankles, feet; shortness of breath), chest pain.
From the nervous system: often - dizziness, headache, asthenia, increased fatigue, sleep disturbances, depression, anxiety; rarely - confusion or short-term memory loss, nightmares, hallucinations, myasthenia gravis, tremors, muscle cramps. Typically, these phenomena are mild in nature and usually disappear within 1-2 weeks after the start of treatment.
From the senses: rarely - blurred vision, decreased lacrimation (should be taken into account when wearing contact lenses), tinnitus, hearing loss, ear pain; very rarely - dry and sore eyes, conjunctivitis, taste disturbances.
From the respiratory system: infrequently - bronchospasm in patients with bronchial asthma or obstructive airway diseases; rarely - allergic rhinitis; nasal congestion.
From the digestive system: often - nausea, vomiting, diarrhea, constipation, dry oral mucosa, abdominal pain; rarely - hepatitis, increased activity of liver enzymes (alanine aminotransferase, aspartate aminotransferase), increased bilirubin concentration, change in taste.
From the musculoskeletal system: infrequently - arthralgia, back pain.
From the genitourinary system: very rarely - impaired potency, weakened libido.
Laboratory indicators: rarely - increased concentration of triglycerides in the blood; in some cases - thrombocytopenia, agranulocytosis, leukopenia.
Allergic reactions: rarely - itching, rash, urticaria
From the skin: rarely - increased sweating, skin hyperemia, exanthema, psoriasis-like skin reactions; very rarely - alopecia; beta-blockers can aggravate the course of psoriasis.
Other: withdrawal syndrome (increased frequency of angina attacks, increased blood pressure).

Overdose
Symptoms: arrhythmia, ventricular extrasystole, severe bradycardia, AV block, marked decrease in blood pressure, acute heart failure, hypoglycemia, acrocyanosis, difficulty breathing, bronchospasm, dizziness, fainting, convulsions.
Treatment: if an overdose occurs, first of all you need to stop taking the drug, perform gastric lavage, prescribe adsorbents, and carry out symptomatic therapy.
For severe bradycardia, intravenous administration of atropine. If the effect is insufficient, a drug with a positive chronotropic effect can be administered with caution. Sometimes temporary placement of an artificial pacemaker may be necessary.
With a pronounced decrease in blood pressure, intravenous administration of plasma-substituting solutions and vasopressors.
For hypoglycemia, intravenous glucagon or intravenous dextrose (glucose) may be indicated.
For AV block: Patients should be closely monitored and treated with beta-agonists such as epinephrine. If necessary, install an artificial pacemaker.
In case of exacerbation of CHF, intravenous administration of diuretics, drugs with positive inotropic effects, as well as vasodilators. For bronchospasm, prescribe bronchodilators, including beta2-adrenergic agonists and/or aminophylline.

Interaction with other drugs
The effectiveness and tolerability of medicinal products may be affected by concomitant use of other medicinal products. This interaction can also occur when two drugs are taken within a short period of time. The doctor must be informed about the use of other medications, even if used without a prescription.
Class I antiarrhythmic drugs (for example, quinidine, disopyramide, lidocaine, phenytoin; flecainide, propafenone), when used simultaneously with bisoprolol, can reduce AV conduction and myocardial contractility.
Class III antiarrhythmic drugs (eg, amiodarone) may worsen AV conduction disturbances.
The effect of beta-blockers for topical use (for example, eye drops for the treatment of glaucoma) may enhance the systemic effects of bisoprolol (lowering blood pressure, lowering heart rate).
Parasympathomimetics, when used simultaneously with bisoprolol, may increase AV conduction disturbances and increase the risk of developing bradycardia. The simultaneous use of Bisoprolol-Teva with beta-agonists (for example, isoprenaline, dobutamine) may lead to a decrease in the effect of both drugs.
The combination of bisoprolol with adrenergic agonists that affect beta and alpha adrenergic receptors (for example, norepinephrine, epinephrine) may enhance the vasoconstrictor effects of these drugs that occur with the participation of alpha adrenergic receptors, leading to an increase in blood pressure. Such interactions are more likely when using non-selective beta-blockers. Mefloquine, when used simultaneously with bisoprolol, may increase the risk of bradycardia.
Allergens used for immunotherapy or allergen extracts for skin testing increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol. Iodine-containing radiopaque diagnostic agents for intravenous administration increase the risk of developing anaphylactic reactions. Phenytoin, when administered intravenously, and agents for inhalation anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressive effect and the likelihood of lowering blood pressure.
The effectiveness of insulin and hypoglycemic agents for oral administration may change during treatment with bisoprolol (masks the symptoms of developing hypoglycemia: tachycardia, increased blood pressure).
The clearance of lidocaine and xanthines (except theophylline) may be reduced due to a possible increase in their concentration in the blood plasma, especially in patients with an initially increased clearance of theophylline under the influence of smoking. The hypotensive effect is weakened by non-steroidal anti-inflammatory drugs (NSAIDs) (sodium ion retention and blockade of prostaglandin synthesis by the kidneys), glucocorticosteroids and estrogens (sodium ion retention). Cardiac glycosides, methyldopa, reserpine and guanfacine, blockers of “slow” calcium channels (verapamil, diltiazem), amiodarone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV block, cardiac arrest and heart failure. Nifedipine can lead to a significant decrease in blood pressure. Diuretics, clonidine, sympatholytics, hydralazine and other antihypertensive drugs can lead to an excessive decrease in blood pressure.
The effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins may be prolonged during treatment with bisoprolol. Tricyclic and tetracyclic antidepressants, antipsychotics (neuroleptics), ethanol, sedatives and hypnotics increase depression of the central nervous system.
Concomitant use with MAO inhibitors is not recommended due to a significant increase in the hypotensive effect. The treatment break between taking MAO inhibitors and bisoprolol should be at least 14 days. Non-hydrogenated ergot alkaloids increase the risk of developing peripheral circulatory disorders.
Ergotamine increases the risk of developing peripheral circulatory disorders. Sulfasalazine increases the concentration of bisoprolol in the blood plasma. Rifampin shortens the half-life of bisoprolol.

Special instructions
Monitoring the condition of patients taking the drug Bisoprolol-Teva should include measuring heart rate and blood pressure, conducting an ECG, and determining blood glucose concentrations in patients with diabetes mellitus (once every 4-5 months). In elderly patients, it is recommended to monitor renal function (once every 4-5 months).
The patient should be trained in the method of calculating heart rate and instructed about the need for medical consultation if the heart rate is less than 50 beats/min.
Before starting treatment, it is recommended to conduct a study of external respiratory function in patients with a burdened bronchopulmonary history.
Patients who use contact lenses should take into account that during treatment with the drug, the production of tear fluid may decrease.
When using the drug Bisoprolol-Teva in patients with pheochromocytoma, there is a risk of developing paradoxical arterial hypertension (if effective blockade of alpha-adrenergic receptors is not previously achieved).
In thyrotoxicosis, bisoprolol may mask certain clinical signs of thyrotoxicosis (for example, tachycardia). Abrupt withdrawal of the drug in patients with thyrotoxicosis is contraindicated, as it can increase symptoms.
In diabetes mellitus, it can mask tachycardia caused by hypoglycemia. Unlike non-selective beta-blockers, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentrations to normal values.
With simultaneous use of clonidine, its use can be discontinued only a few days after discontinuation of the drug Bisoprolol-Teva. It is possible that the severity of the hypersensitivity reaction may increase and the lack of effect from usual doses of epinephrine against the background of a burdened allergic history.
If planned surgical treatment is necessary, the drug should be discontinued 48 hours before general anesthesia. If the patient took the drug before surgery, he should choose a drug for general anesthesia with minimal negative inotropic effect.
Reciprocal activation of the vagus nerve can be eliminated by intravenous atropine (1-2 mg).
Drugs that deplete catecholamine stores (including reserpine) may enhance the effect of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision to detect a significant decrease in blood pressure or bradycardia.
Patients with bronchospastic diseases may be prescribed cardioselective beta-blockers with caution in case of intolerance and/or ineffectiveness of other antihypertensive drugs. While taking beta-blockers in patients with concomitant bronchial asthma, airway resistance may increase. If the dose of Bisoprolol-Teva is exceeded in such patients, there is a risk of developing bronchospasm. If increasing bradycardia (heart rate less than 50 beats/min), a pronounced decrease in blood pressure (systolic blood pressure less than 100 mmHg), or AV blockade is detected in patients, it is necessary to reduce the dose or stop treatment. It is recommended to discontinue therapy with Bisoprolol-Teva if depression develops.
Treatment should not be abruptly interrupted due to the risk of developing severe arrhythmias and myocardial infarction. The drug is discontinued gradually, reducing the dose over 2 weeks or more (reduce the dose by 25% in 3-4 days).
The drug should be discontinued before testing the concentrations of catecholamines, normetanephrine, vanillinmandelic acid, and antinuclear antibody titers in the blood and urine.

In smokers, the effectiveness of beta-blockers is lower. Impact on the ability to drive vehicles and work with equipment that requires increased concentration. The use of the drug Bisoprolol-Teva does not affect the ability to drive vehicles, according to the results of a study in patients with coronary artery disease. However, due to individual reactions, the ability to drive vehicles or operate technically complex mechanisms may be impaired. Particular attention should be paid to this at the beginning of treatment, after changing the dose, and also when consuming alcohol at the same time.

Release form
Film-coated tablets 5 mg and 10 mg 10 tablets in a PVC / aluminum blister. 3 or 5 blisters along with instructions for use in a cardboard box.

Storage conditions
At a temperature not exceeding 25° C. Keep out of the reach of children.

Best before date
2 years.
Do not use after the expiration date stated on the package.

Conditions for dispensing from pharmacies
According to the recipe.

Owner ru:
Teva Pharmaceutical Enterprises Ltd., Israel

Manufacturer Pharmaceutical plant Teva Private Co. Ltd., N-4042, Debrecen, st. Pallagi 13, Hungary

Address for receiving complaints: Russia, Moscow, 119049, st. Shabolovka, 10, Business Center "Concord"

Instructions for use, contraindications, composition, price, photo

Trade name of the drug: Bisoprolol

Active substance: Bisoprolol (Bisoprololum)

Attention! Below is a description of the active substance. The decision about the possibility of using the described drug cannot be made on the basis of this information.

Contraindications of the drugBisoprolol:

Hypersensitivity, sinus bradycardia (less than 45–50 beats/min), sick sinus syndrome, sinoatrial and AV block II–III degree, cardiogenic shock, acute and refractory to treatment severe heart failure, acute myocardial infarction, arterial hypotension (SBP below 90 mm Hg), severe obstructive respiratory failure, pregnancy, breastfeeding.

Bisoprololduring pregnancy and breastfeeding:

It is possible if the expected effect of therapy in the mother exceeds the potential risk to the fetus and child (adequate and strictly controlled studies of the safety of use in pregnant and lactating women have not been conducted). Since there is a risk of bradycardia, hypotension, hypoglycemia and respiratory distress (neonatal asphyxia) in newborns, treatment with bisoprolol fumarate should be discontinued 48–72 hours before delivery. If this cannot be done, the newborn should be under close medical observation for 48–72 hours after birth. The excretion of bisoprolol fumarate into human milk has not been studied, but since it is secreted into breast milk in rats (less than 2%), infants should be under medical supervision.

Side effect of the drugBisoprolol:

The frequency of side effects is indicated when prescribing doses not exceeding 40 mg.

From the nervous system and sensory organs: dizziness (3.5%), insomnia (2.5%), asthenia (1.5%), hypoesthesia (1.5%), depression (0.2%), drowsiness, anxiety, paresthesia (a feeling of coldness in the extremities), hallucinations, disturbances in thinking, concentration, orientation in time and space, balance, emotional lability, tinnitus, conjunctivitis, visual disturbances, decreased secretion of tear fluid, convulsions.

From the cardiovascular system and blood (hematopoiesis, hemostasis): bradycardia (0.5%), arrhythmia, palpitations, AV block, hypotension, heart failure, impaired microcirculation in the myocardium and extremities, intermittent claudication, vasculitis, agranulocytosis, thrombocytopenia, thrombocytopenic purpura.

From the gastrointestinal tract: diarrhea (3.5%), nausea (2.2%), vomiting (1.5%), dry mouth (1.3%), dyspeptic symptoms, constipation, ischemic colitis, mesenteric artery thrombosis .

From the respiratory system: cough (2.5%), shortness of breath (1.5%), broncho- and laryngospasm, pharyngitis (2.2%), rhinitis (4%), sinusitis (2.2%), respiratory infections pathways (5%), respiratory distress syndrome.

From the genitourinary system: peripheral edema (3%), decreased libido, impotence, Peyronie's disease, cystitis, renal colic.

From the skin: rash, acne, eczema-like reactions, prurigo, redness of the skin, hyperhidrosis, dermatitis, alopecia.

On the metabolic side: increased concentrations of liver enzymes (AST, ALT), hyperglycemia or increased glucose tolerance, hyperuricemia, changes in potassium concentration in the blood.

Other: pain syndrome (headache - 10.9%, arthralgia - 2.7%, myalgia, pain in the abdomen, chest - 1.5%, eyes, ears), weight gain.

Special instructions:

Test results may change during laboratory tests.

Precautions:

The possibility of masking the symptoms of hypoglycemia and thyrotoxicosis during treatment should be taken into account. It is possible that the severity of hypersensitivity reactions may increase and there will be no effect from normal doses of adrenaline against the background of a burdened allergic history. In case of severe liver dysfunction, acute renal failure (Cl creatinine less than 20 ml/min), patients on hemo- or peritoneal dialysis, the dose must be reduced. For pheochromocytoma, it should not be prescribed without additional administration of alpha-blockers. Bisoprolol reduces compensatory cardiovascular reactions in response to the use of general anesthetics and iodinated contrast agents. It is necessary to discontinue the drug 48 hours before anesthesia or select an anesthetic with the least negative inotropic effect. Treatment should be stopped gradually over a period of about 2 weeks (withdrawal syndrome is possible). Use with caution while working for vehicle drivers and people whose profession involves increased concentration of attention. It is necessary to avoid the consumption of alcoholic beverages during treatment (risk of orthostatic hypotension).

Storage conditions: In a dry place, protected from light, at a temperature not exceeding 25 °C.

Keep out of the reach of children.

Best before date: 3 years.

Attention: This information may not be current at the time of reading. Always look for the latest versions of the radar in the package with the drug.
It is prohibited to use site materials without consulting a specialist.

Clinical and pharmacological group

Beta1 blocker

Film-coated tablets from beige-yellow to beige, round, biconvex; on the fracture, white or almost white.

Excipients: croscarmellose sodium (primellose), povidone (medium molecular weight polyvinylpyrrolidone), pregelatinized starch (starch 1500), colloidal silicon dioxide (Aerosil), talc, microcrystalline cellulose, lactose (milk sugar), magnesium stearate.

Film shell composition: opadry II (polyvinyl alcohol, partially hydrolyzed, titanium dioxide, talc, macrogol (polyethylene glycol 3350), iron (II) oxide dye).

10 pcs. - contour cell packaging (3) - cardboard packs.
30 pcs. - dark glass jars (1) - cardboard packs.
30 pcs. - polymer jars (1) - cardboard packs.
30 pcs. - polymer bottles (1) - cardboard packs.

Pharmacological action

A selective beta1-blocker, without its own sympathomimetic activity, does not have a membrane-stabilizing effect. Reduces plasma renin activity, reduces myocardial oxygen demand, and reduces heart rate (at rest and during exercise).

It has hypotensive, antiarrhythmic and antianginal effects. By blocking beta1-adrenergic receptors of the heart in low doses, it reduces the formation of cAMP from ATP stimulated by catecholamines, reduces the intracellular current of calcium ions, has a negative chrono-, dromo-, bathmo- and inotropic effect, inhibits the conductivity and excitability of the myocardium, and reduces AV conductivity.

When increasing the dose above the therapeutic one, it has a beta2-adrenergic blocking effect.

OPSS at the beginning of drug use, in the first 24 hours, increases (as a result of a reciprocal increase in the activity of alpha-adrenergic receptors and the elimination of stimulation of beta2-adrenergic receptors), which after 1-3 days returns to the original level, and with long-term administration decreases.

The hypotensive effect is associated with a decrease in minute blood volume, sympathetic stimulation of peripheral vessels, a decrease in the activity of the renin-angiotensin system (of great importance for patients with initial hypersecretion of renin), restoration of sensitivity in response to a decrease in blood pressure and an effect on the central nervous system . In case of arterial hypertension, the effect occurs after 2-5 days, stable effect - after 1-2 months.

The antianginal effect is due to a decrease in myocardial oxygen demand as a result of a decrease in heart rate and decreased contractility, prolongation of diastole, and improved myocardial perfusion. By increasing the end-diastolic pressure in the left ventricle and increasing the stretch of ventricular muscle fibers, it can increase the need for oxygen, especially in patients with chronic heart failure.

The antiarrhythmic effect is due to the elimination of arrhythmogenic factors (tachycardia, increased activity of the sympathetic nervous system, increased cAMP content, arterial hypertension), a decrease in the rate of spontaneous excitation of sinus and ectopic pacemakers and a slowdown of AV conduction (mainly in the antegrade and, to a lesser extent, in the retrograde directions via the AV node) and along additional paths.

When used in average therapeutic doses, in contrast to non-selective beta-blockers, it has a less pronounced effect on organs containing beta2-adrenergic receptors (pancreas, skeletal muscles, smooth muscles of peripheral arteries, bronchi and uterus) and on carbohydrate metabolism, does not cause delay sodium ions (Na+) in the body; the severity of the atherogenic effect does not differ from the effect of propranolol.

Pharmacokinetics

Suction and distribution

Absorption - 80-90%, food intake does not affect absorption. Cmax in blood plasma is observed after 1-3 hours.

Communication with blood plasma proteins is about 30%. Passes through the BBB and the placental barrier to an insignificant extent, and is excreted in breast milk in small quantities.

Metabolism and excretion

50% of the dose is metabolized in the liver to form inactive metabolites.

T1/2 - 10-12 hours. About 98% is excreted in the urine - 50% unchanged, less than 2% - with bile.

Indications

Arterial hypertension;

IHD: prevention of angina attacks.

Contraindications

Shock (including cardiogenic);

Collapse;

Pulmonary edema;

Acute heart failure;

Chronic heart failure in the stage of decompensation;

AV block II and III degrees;

Sinoatrial block;

Severe bradycardia;

Prinzmetal's angina;

Cardiomegaly (without signs of heart failure);

Arterial hypotension (systolic blood pressure less than 100 mm Hg, especially with myocardial infarction);

History of severe forms of bronchial asthma and chronic obstructive pulmonary disease;

Concomitant use of MAO inhibitors (except MAO-B);

Late stages of peripheral circulatory disorders, Raynaud's disease;

Pheochromocytoma (without simultaneous use of alpha-blockers);

Metabolic acidosis;

Age up to 18 years (efficacy and safety have not been established);

Hypersensitivity to the components of the drug and other beta-blockers.

WITH caution the drug should be prescribed for liver failure, chronic renal failure, myasthenia gravis, thyrotoxicosis, diabetes mellitus, first degree AV blockade, depression (including a history), psoriasis, as well as for elderly patients.

Dosage

The drug is taken orally, in the morning, on an empty stomach, without chewing, at an initial dose of 5 mg 1 time/day. If necessary, the dose is increased to 10 mg 1 time/day. The maximum daily dose is 20 mg/day.

In patients with impaired renal function with CC less than 20 ml/min or with severe liver dysfunction the maximum daily dose should be 10 mg.

Dose adjustments for elderly patients not required.

Side effects

From the side of the central nervous system: increased fatigue, weakness, dizziness, headache, sleep disorders, depression, anxiety, confusion or short-term memory loss, hallucinations, asthenia, myasthenia, paresthesia in the limbs (in patients with intermittent claudication and Raynaud's syndrome), tremor.

From the senses: blurred vision, decreased secretion of tear fluid, dry and sore eyes, conjunctivitis.

From the cardiovascular system: sinus bradycardia, palpitations, myocardial conduction disturbances, AV block (up to the development of complete transverse block and cardiac arrest), arrhythmias, weakening of myocardial contractility, development (worsening) of chronic heart failure (swelling of the ankles, feet, shortness of breath), decreased blood pressure, orthostatic hypotension, manifestation of vasospasm (increased peripheral circulatory disorders, coldness of the lower extremities, Raynaud's syndrome), chest pain.

From the digestive system: dryness of the oral mucosa, nausea, vomiting, abdominal pain, constipation or diarrhea, liver dysfunction (dark urine, yellowness of the sclera or skin, cholestasis), changes in taste.

From the respiratory system: nasal congestion, difficulty breathing when prescribed in high doses (loss of selectivity) and/or in predisposed patients - laryngo- and bronchospasm.

From the endocrine system: hyperglycemia (in patients with non-insulin-dependent diabetes mellitus), hypoglycemia (in patients receiving insulin), hypothyroid state.

Allergic reactions: skin itching, rash, urticaria.

Dermatological reactions: increased sweating, skin hyperemia, exanthema, psoriasis-like skin reactions, exacerbation of psoriasis symptoms.

From the laboratory parameters: thrombocytopenia (unusual bleeding and hemorrhage), agranulocytosis, leukopenia, changes in the activity of liver enzymes (increased ALT, AST), bilirubin levels, triglycerides.

Effect on the fetus: intrauterine growth retardation, hypoglycemia, bradycardia.

Others: back pain, arthralgia, weakened libido, decreased potency, withdrawal syndrome (increased angina attacks, increased blood pressure).

Overdose

Symptoms: arrhythmia, ventricular extrasystole, severe bradycardia, AV block, marked decrease in blood pressure, chronic heart failure, cyanosis of fingernails or palms, difficulty breathing, bronchospasm, dizziness, fainting, convulsions.

Treatment: gastric lavage and administration of adsorbents; symptomatic therapy: in case of developed AV block - intravenous administration of 1-2 mg of atropine, epinephrine or installation of a temporary pacemaker; for ventricular extrasystole - lidocaine (class IA drugs are not used); when blood pressure decreases, the patient should be in the Trendelenburg position; if there are no signs of pulmonary edema - intravenous plasma-substituting solutions, if ineffective - administration of epinephrine, dopamine, dobutamine (to maintain chronotropic and inotropic effects and eliminate a pronounced decrease in blood pressure); for heart failure - cardiac glycosides, diuretics, glucagon; for convulsions - intravenous diazepam; for bronchospasm, beta-agonists by inhalation.

Drug interactions

Allergens used for immunotherapy or allergen extracts for skin testing increase the risk of severe systemic allergic reactions or anaphylaxis in patients receiving bisoprolol.

Phenytoin, when administered intravenously, and drugs for inhalation general anesthesia (hydrocarbon derivatives) increase the severity of the cardiodepressive effect and the likelihood of a decrease in blood pressure.

Changes the effectiveness of insulin and oral hypoglycemic drugs, masks the symptoms of developing hypoglycemia (tachycardia, increased blood pressure).

Reduces the clearance of lidocaine and xanthines (except diphylline) and increases their concentration in plasma, especially in patients with initially increased clearance of theophylline under the influence of smoking.

The hypotensive effect is weakened by NSAIDs (Na+ retention and blockade of prostaglandin synthesis by the kidneys), corticosteroids and estrogens (Na+ ion retention).

Cardiac glycosides, methyldopa, reserpine and guanfacine, slow calcium channel blockers (verapamil, diltiazem), amiodorone and other antiarrhythmic drugs increase the risk of developing or worsening bradycardia, AV block, cardiac arrest and heart failure.

Nifedipine can lead to a significant decrease in blood pressure.

Diuretics, clonidine, sympatholytics, hydralazine and other antihypertensive drugs can lead to an excessive decrease in blood pressure.

Prolongs the effect of non-depolarizing muscle relaxants and the anticoagulant effect of coumarins.

Tri- and tetracyclic antidepressants, antipsychotic drugs (neuroleptics), ethanol, sedatives and hypnotics increase CNS depression.

Concomitant use with MAO inhibitors is not recommended due to a significant increase in the hypotensive effect; the break in treatment between taking MAO inhibitors and bisoprolol should be at least 14 days.

Non-hydrogenated ergot alkaloids increase the risk of developing peripheral circulatory disorders.

Ergotamine increases the risk of developing peripheral circulatory disorders; sulfasalazine increases the concentration of bisoprolol in plasma; Rifampin shortens the half-life.

Special instructions

Monitoring of patients taking Bisoprolol should include measuring heart rate and blood pressure (at the beginning of treatment - daily, then once every 3-4 months), conducting an ECG, determining blood glucose levels in patients with diabetes mellitus (once every 4-5 months). months). In elderly patients, it is recommended to monitor renal function (once every 4-5 months).

The patient should be taught how to calculate heart rate and instructed about the need for medical consultation if the heart rate is less than 50 beats/min.

In approximately 20% of patients with angina, beta blockers are ineffective. The main reasons are severe coronary atherosclerosis with a low ischemic threshold (heart rate less than 100 beats/min) and increased end-diastolic volume of the left ventricle, disrupting subendocardial blood flow.

In smoking patients, the effectiveness of beta-blockers is lower.

Patients using contact lenses should take into account that during treatment the production of tear fluid may decrease.

When used in patients with pheochromocytoma, there is a risk of developing paradoxical arterial hypertension (if effective alpha-blockade is not previously achieved).

In case of thyrotoxicosis, Bisoprolol can mask certain clinical signs of thyrotoxicosis, for example, tachycardia. Abrupt withdrawal in patients with thyrotoxicosis is contraindicated because it can increase symptoms.

In diabetes mellitus, it can mask tachycardia caused by hypoglycemia. Unlike non-selective beta-blockers, it practically does not enhance insulin-induced hypoglycemia and does not delay the restoration of blood glucose concentrations to normal levels.

When taking clonidine simultaneously, it can be discontinued only a few days after discontinuation of Bisoprolol.

It is possible that the severity of the hypersensitivity reaction may increase and there will be no effect from the usual doses of zpinephrine against the background of a burdened allergy history. If planned surgical treatment is necessary, the drug should be discontinued 48 hours before the start of general anesthesia. If the patient took the drug before surgery, he should select a drug for general anesthesia with minimal negative inotropic effect.

Reciprocal activation of the vagus nerve can be eliminated by intravenous administration of atropine (1-2 mg).

Medicines that reduce the reserves of catecholamines (including reserpine) can enhance the effect of beta-blockers, so patients taking such combinations of drugs should be under constant medical supervision to detect a pronounced decrease in blood pressure or bradycardia.

Patients with bronchospastic diseases can be prescribed cardioselective adrenergic blockers in case of intolerance and/or ineffectiveness of other antihypertensive drugs. An overdose is dangerous due to the development of bronchospasm.

If increasing bradycardia (less than 50 beats/min), a pronounced decrease in blood pressure (systolic blood pressure below 100 mm Hg), or AV blockade is detected in elderly patients, it is necessary to reduce the dose or stop treatment.

Treatment should not be abruptly interrupted due to the risk of developing severe arrhythmias and myocardial infarction. Cancellation is carried out gradually, reducing the dose over 2 weeks or more (reduce the dose by 25% in 3-4 days). It should be discontinued before testing the content of catecholamines, normetanephrine and vanillinmandelic acid in the blood and urine, and titers of antinuclear antibodies.

Impact on the ability to drive vehicles and operate machinery

During the treatment period, care must be taken when driving vehicles and engaging in other potentially hazardous activities that require increased concentration and speed of psychomotor reactions.

Pregnancy and lactation

Use during pregnancy and lactation is possible if the benefit to the mother outweighs the risk of side effects in the fetus and child.

The drug is available with a prescription.

List B. The drug should be stored in a dry place, protected from light, out of reach of children, at a temperature not exceeding 25°C. Shelf life - 3 years.

Preparation Atarax - a Belgian-made tranquilizer, successfully used in psychiatry.

One of the few anxiolytic drugs whose use is approved for patients younger age group(from 12 months).

It has many contraindications and is dangerous for the development of severe adverse reactions. For this reason, it is released from pharmacies strictly according to a prescription in Latin.

Radar

According to the Register of Medicines it has an INN Hydroxyzine.

Compound

Drug based hydroxyzine. Has a sedative, antihistamine effect. It has a beneficial effect on cognitive functions and improves concentration.

Capable of facilitating itching for skin diseases.

In cases of severe anxiety and chronic insomnia, hydroxyzine reduces the regularity of night awakenings, increases the duration of sound, restful sleep, and the positive result is noticeable after the first dose of the tablet.

With long-term use of Atarax, hydroxyzine does not cause addiction, dependencies. The therapeutic effect is observed a maximum of 30 minutes after taking the drug.

The composition includes additional components - titanium dioxide, cellulose, lactose, magnesium stearate, macrogel, hydroxypropyl methylcellulose.

Why is Atarax prescribed?

Indications for use:

• anxiety states;
• feeling of internal tension;
• excessive irritability;
• withdrawal syndrome.

It can be used in the complex therapy of skin itching (used as a symptomatic treatment for eczema, psoriasis, dermatitis).

A similar symptom is often found in patients suffering from mental disorders.

Instructions for use and dosage

How to take the medicine is determined by the doctor depending on the patient’s diagnosis.

1. Treatment of withdrawal syndrome. Depending on the patient’s diagnosis and the severity of his illness, up to 100 mg is prescribed; the medicine should be taken during the day or once before bed (at the discretion of the attending physician). If necessary, the dosage can be increased to 300 mg.
2. Treatment of skin itching. Prescribed tablets up to 4 times a day. The maximum daily dosage is 300 mg.

For children after reaching 1 year, the dose of Atarax is prescribed according to age and weight, calculated from 1 to 2.5 mg per body weight.

The prescribed number of tablets is divided into several doses per day.

It is important to note that in patients with renal failure For moderate and severe forms, the dosage is determined by the minimum.

Prescribed with caution to patients elderly. In the event of a decrease in glomerular filtration, the initially prescribed number of tablets is halved.

Prescription restrictions

Contraindicated in case of individual intolerance to the elements included in the composition.

If it is necessary to take the drug during lactation, breastfeeding should be suspended during therapy.

Side effects

The medicine can provoke the appearance of undesirable reactions, which manifest themselves in the form of:

• drowsiness;
• migraines;
• dizziness;
• general weakness;
• rapid heartbeat;
• arterial hypotension;
• nausea;
• constipation;
• urinary retention;
• dry mouth;
• increased sweating;
• feverish condition;
• bronchospasms;
• allergic reactions.

In most patients, adverse reactions are observed mainly at the beginning of therapy or after adjustment (increase/decrease) of the dose.

Overdose symptoms

If the dose of Atarax prescribed by the doctor is not followed, there is a high probability of overdose, which manifests itself:

• depression of the central nervous system;
• involuntary motor activity;
• nausea;
• vomiting;
• disturbance of consciousness;
• hallucinations;
• arterial hypotension;
• arrhythmia;
• tremor, convulsions;
• disorientation in space.

If an overdose is detected, first of all it is necessary to rinse the stomach and induce vomiting. In case of serious condition of the patient, hospitalization is carried out.

Price

Average cost in Russia – 330 rubles for 25 tablets .

A tranquilizer belongs to group B drugs - potent drugs dispensed from pharmacies strictly according to a doctor’s prescription.

Therefore, to purchase Atarax, you must have a recipe in Latin.

Atarax and alcohol

It is unacceptable to take alcohol during therapy; compatibility is negative.

Atarax has a powerful effect on a person’s psycho-emotional state, and alcohol has the same effect. The duet of a drug and alcohol can cause not only serious disturbances in the patient’s mental adequacy, but also become deadly .

Even a minimal dose of alcohol will lead to adverse reactions that will manifest themselves in an intensified form.

There is a high risk of severe intoxication of the body. Known cases fatal outcome when combining Atarax and alcoholic beverages.

Reviews from patients who took the drug

Several real reviews from patients who have undergone Atarax therapy:

Vladimir, 29 years old, Yeysk:

I had problems with alcohol, which caused serious disturbances in my mental state - I became aggressive, irritable, and constantly felt tense and nervous. I passed the coding, but my psycho-emotional state did not return to normal.

The psychiatrist prescribed Atarax tablets. I noticed improvements quite quickly, after a couple of days of therapy I felt calm and improved mood. The only drawback of the pills is that I really wanted to sleep during the daytime. But I noticed this phenomenon only in the first days of treatment.

Katerina, 34 years old, Kaliningrad:

Constant stress at work, because of which I became nervous, irritable, slept poorly at night, and lashed out at loved ones. I turned to a specialist who prescribed me Atarax tablets.

Relief came after the first pill taken. I felt psycho-emotional balance, began to better perceive a large flow of information, memory improved, and sleep normalized.

Periodically I felt a headache, drowsiness, and rapid heartbeat. But malaise was observed mainly at the beginning of therapy. A good drug that really helps bring your psyche back to normal.

Do not forget that the positive effect of a tranquilizer on human health is possible only if the drug is taken correctly. You should not increase the dose of Atarax on your own initiative; this may cause adverse reactions and deterioration of well-being.

Arterial hypertension can be compensated by using antihypertensive drugs. Beta-1 blockers are widely used. A good medicine of this type is Metozok.

The active substance of the drug is metoprolol succinate. The substance has antiarrhythmic, hypotensive and antianginal effects. The release form of Metozok is tablets for oral use.

There are tablets of 25, 50 and 100 mg. They differ from each other in the amount of active substance. The estimated cost of the medicine is 250-400 rubles. The price is for 30 tablets. Metozok is available in pharmacies with a prescription. The manufacturer of the medicine is the Akrikhin company, Russia.

The principle of operation of the product

Beta-1 blockers are widely used in cardiology. These drugs are even used for preventive purposes. It has been established that the drugs will help prevent myocardial infarction and hypertensive crises.

Metozok is a good domestic beta-1 blocker. The active substance of the drug is metoprolol succinate. Metozok tablets also contain auxiliary components that do not have a pharmacological effect - lactose monohydrate, silicon dioxide, magnesium stearate, etc.

Metoprolol blocks beta-1 adrenergic receptors of the heart, reduces the synthesis of AMP from ATP, and reduces heart rate. Another substance helps reduce the intracellular current of calcium ions, reduce myocardial contractility, and prevent the development of a heart attack.

The hypotonic effect is also due to the fact that metoprolol succinate reduces the minute volume of blood flow and suppresses the production of renin. Metozok helps prevent arrhythmia, due to the fact that the active substance of the drug reduces the myocardial oxygen demand and prevents tachycardia.

When using this beta-1 adrenergic blocker, susceptibility to physical activity increases significantly and AV conduction slows down. The drug is well metabolized.

The maximum plasma concentration is observed after 6-12 hours, bioavailability increases during consumption of food, the drug binds to plasma proteins by 10%. The half-life is 3.5-7 hours, the drug is excreted through the liver and kidneys.

The hypotensive effect occurs within 1.5-2 hours. The effect lasts throughout the day.

Instructions for use of the drug

The drug Metozok is used in the treatment of arterial hypertension. The drug is equally effective for both hypertension and symptomatic hypertension.

Also indications for use are cardiac arrhythmias, cardiac dysfunction accompanied by tachycardia, coronary artery disease, and chronic heart failure.

Metozok tablet should be taken once a day. Cardiologists recommend taking it on an empty stomach. When treating hypertension, the starting dosage is 50 mg. If necessary, the dose is increased up to 100-200 mg.

For ischemic heart disease, CHF, tachycardia, heart rhythm disturbances, the starting dose is 12.5-25 mg. If necessary, the dosage can be increased to 100-200 mg. The daily dose should be increased progressively and only with the permission of the attending physician.

The duration of therapy is selected individually. Metozok can be taken for life if necessary.

Contraindications and side effects

Metozok has a number of contraindications for use. Firstly, the drug is contraindicated in patients with hypersensitivity to its components. Also, the medication is not prescribed to pregnant and lactating women.

The medicine is not used to treat people under age. The list of contraindications also includes cardiogenic shock, AV block of 2-3 degrees of severity, SSS (sick sinus syndrome), bradycardia, acute heart failure/decompensation of CHF, recent acute myocardial infarction, pheochromocytoma, taking MAO inhibitors, lactase deficiency, intolerance lactose, sinoatrial blockade, glucose/galactose malabsorption syndrome.

Side effects:

• Failures on the part of the SSS. Possible development of bradycardia, increased heart rate, cardiogenic shock, increased symptoms of heart failure, arrhythmia, impaired myocardial conduction.
• Disturbances in the functioning of the central nervous system. While taking pills, increased fatigue, decreased reaction speed, depression, insomnia/drowsiness may occur. When using high dosages - tremors of the limbs, anxiety, asthenia, memory impairment and hallucinations.
• Dry eyes, ringing in the ears, impaired taste. When using high dosages - conjunctivitis.
• Problems with the digestive system. They are manifested by a feeling of nausea, abdominal pain, vomiting, constipation/diarrhea, dry mouth, and liver dysfunction.
• Allergic reactions.
• Dyspnea.
• Increase in BMI.
• Rhinitis.
• Increased plasma bilirubin concentration.
• Sexual dysfunction.
• Arthralgia.
• Increased activity of liver enzymes.
• Hypoglycemia. This complication occurs in type 1 diabetes. In type 2 diabetes mellitus, hyperglycemia may develop.
• Leukopenia.
• Agranulocytosis.
• Dry cough.
• Thrombocytopenia.
• Bronchospasm.

In case of overdose - respiratory failure, coma, loss of consciousness, peripheral circulatory disorders, bradycardia, excessive drop in blood pressure, AV block.

Reviews and analogues

There are positive reviews about the drug Metozok. For most hypertensive patients, the drug helped stabilize systolic and diastolic pressure, as well as prevent a hypertensive crisis.

Patients suffering from coronary artery disease, tachycardia, cardiac arrhythmias, and chronic heart failure also respond positively to the medicine. People claim that while taking the pills they began to feel much better.

Substitutes for Metozok:

1. Metocard (350-500 rubles).
2. Betaxolol (95-120 rubles).
3. Cordinorm (250-300 rubles).
4. Vasocardin (80-120 rubles).
5. Betalok (270-350 rubles).
6. Nebilet (950-1100 rubles).
7. Egilok (170-200 rubles).

Reviews from doctors

Metozok is a good highly selective beta-1 blocker. The drug is effective for hypertension and other diseases of the cardiovascular system.

The drug has both advantages and disadvantages. Advantages - rapid onset of the hypotensive effect, the ability to take the medicine for life, low cost, normal compatibility with other antihypertensive drugs.

There are also a number of disadvantages. The most significant is withdrawal syndrome. After you stop taking it, your blood pressure may rise again. Another disadvantage of the drug is that it often causes hypo- and hyperglycemia in diabetics.

The drug is not very well tolerated. Most patients experience shortness of breath, dry cough, dyspeptic disorders, and headaches while taking Metozok.

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• How much pressure should be reduced in a person?

Instructions for use of the drug Lerkamen

Improper functioning of the cardiovascular system usually leads to problems with blood pressure. This has become a frequent ailment for almost every person, not only in old age, but also in young age. That is why many people who regularly experience such ailments are looking for the most effective method of influencing the body to bring this indicator back to normal. One of the most effective means that copes with this problem is Lerkamen - you need to carefully study the instructions for use, which is what we will do.

• Composition of the drug
• Directions for use
• Side effects
• Drug overdose
• Contraindications for use
• Lerkamen or Amlodipine: which is better?
• Other analogues

Cavinton: at what pressure can it be used?

Vinpocetine: instructions for use and contraindications

Composition of the drug

The form in which this medicine is produced is tablets. Their active substance is lercanidipine hydrochloride. In addition, the following additional ingredients are used in Lerkamen:

• lactose monohydrate;
• crystalline cellulose;
• sodium carboxymethyl;
• Magnesium stearate.

Lerkamen is a medicine for blood pressure that is commercially available. You can buy it in almost all pharmacies. The average price of the drug in Russia is 330 rubles. In Ukraine, the drug can be bought for about 40 UAH.

What pressure is Lerkamen used for? This is an effective medication that has a beneficial effect on the body with high blood pressure. Therefore, it is actively used for the treatment of arterial hypertension at any stage of its development. This drug has no other effects on the body.

Directions for use

The daily dose of Lerkamen is 1 tablet. This method of treating hypertension should last about 2 weeks. If after a period of time the patient does not experience improvement, the dosage is increased to 2 tablets per day. In situations where this amount of medication is not enough for a hypertensive patient, the attending physician should evaluate the advisability of further use of Lerkamen blood pressure tablets. Most likely, the patient needs to be prescribed a similar drug.

Side effects

Long-term use of this medicine, especially in excessive doses, can cause a number of ailments. The patient may experience the following side effects:

1. The central nervous system can cause minor migraines, confusion, and drowsiness.
2. The circulatory system exhibits the following symptoms: high pulse, a feeling of intense heat, pain in the chest area, and in extreme cases, loss of consciousness may occur.
3. The digestive system causes the following ailments: nausea, sometimes causing vomiting, diarrhea, bloating.
4. Allergic rashes may appear on the skin. This is especially true for people with an atypical reaction to some components of the drug.

Also, at the time of treatment with Lerkamen, the patient may feel very tired and quickly become overtired.

Drug overdose

Excessive use of Lerkamen tablets usually leads to a significant decrease in blood pressure. A person may experience clouding of reason, up to loss of consciousness. If such a situation occurs, the patient should be brought to consciousness, given activated charcoal to drink and call an ambulance.

Contraindications for use

There are a number of diseases for which it is not advisable to take this drug, since it may worsen the patient’s general condition. Contraindications to treatment with Lerkamen are:

• severe heart failure;
• improper functioning of the left ventricle;
• recovery period after a heart attack;
• severe liver or kidney disease;
• hypersensitivity or personal intolerance to certain components of the drug;
• pregnancy;
• women during the lactation period;
• childhood.

Lerkamen or Amlodipine: which is better?

Amlodipine is one of the analogues of Lerkamen. Which drug is more effective for hypertension? As for Amlodipine, this drug, in addition to lowering blood pressure, also improves the functioning of the cardiovascular system as a whole. It does not have many contraindications, and is also sold at a much lower price. At the same time, Amlodipine causes much more often ailments in the form of side effects. Therefore, which drug is better to use - Amlodipine or Lerkamen - it is better to consult with your doctor.

Other analogues

What can replace Lerkamen? Modern pharmacology does not stand still, so there are many similar drugs in such parameters as composition and effect on the body. The most common medications that lower blood pressure are:

1. Nifedipine. An inexpensive drug that is used not only for hypertension. Also promotes normal heartbeat and blood circulation. Nifedipine should not be used in patients with low blood pressure, insufficient functioning of the kidneys and liver, in elderly people, or in persons under 18 years of age.
2. Vaskopin. It has a beneficial effect on the body with high blood pressure and angina pectoris. It should not be used if there is an acute heart attack during pregnancy and lactation. It has a large number of pronounced side effects.
3. Tenox. It is used for arterial hypertension, as well as for angina pectoris. Stop use if there is a sharp drop in pressure. The drug is not suitable for people with acute heart disease and impaired functioning of the left ventricle of the heart. Side effects are minor and occur quite rarely in humans.
4. Azomex. It is prescribed not only for high blood pressure, but also for patients diagnosed with ischemia. There are almost no restrictions in treatment: it is not recommended to use Azomex for pregnant women, during lactation, as well as in childhood and adolescence. It has a large number of side effects, so during the period of therapy it is necessary to strictly adhere to the dosage prescribed by the attending physician.
5. Corinfar. This drug is actively used for angina pectoris and arterial hypertension. Causes many side effects, especially with prolonged use in excessive quantities. As for contraindications, Corinfar is not recommended for use during the recovery period after a heart attack, with a sharp decrease in blood pressure, during pregnancy and lactation, as well as under the age of 18 years.
6. Lacipil. It is an effective medication for complex therapy for hypertension. It does not have any other functional effects on the body. There are no special restrictions on use, except for allergic manifestations to the components of the drug and age less than 18 years. As for side effects, Lacipil only affects blood circulation. With long-term treatment, mild dizziness, headaches, rapid heartbeat, and a sharp rush of blood may occur.
7. Norvasc. The drug is highly effective not only for hypertension, but also for coronary heart disease and stable chronic angina. There are no restrictions in use, except for allergies or high sensitivity to components. Side effects are minor and do not cause any particular discomfort or trouble.

Regardless of the choice of medication for the treatment of arterial hypertension, your decision should be agreed with your doctor. He will help you choose the most effective and safe drug, and also prescribe the correct dosage, taking into account the individual characteristics of the course of the disease of each patient.

The 250 mg/125 mg tablets contain active ingredients amoxicillin(trihydrate form) and clavulanic acid(a form of potassium salt). The tablets also contain auxiliary components: MCC sodium croscarmellose.

Amoxiclav 2X tablets 625 mg and 1000 mg contain the active ingredients amoxicillin and clavulanic acid, as well as additional components: anhydrous colloidal silicon dioxide, flavorings, aspartame, yellow iron oxide, talc, hydrogenated castor oil, silicated MCC.

Amoxiclav Quiktab 500 mg and 875 mg tablets contain the active ingredients amoxicillin and clavulanic acid, as well as additional components: anhydrous colloidal silicon dioxide, flavorings, aspartame, yellow iron oxide, talc, hydrogenated castor oil, silicated MCC.

The powder from which the Amoxiclav suspension is prepared also contains amoxicillin and clavulanic acid, and also contains sodium citrate, MCC, sodium benzoate, mannitol, and sodium saccharin as inactive components.

The powder for preparing Amoxiclav IV infusion contains amoxicillin and clavulanic acid.

Release form

The drug is produced in the form of tablets. Amoxiclav 250 mg/125 mg – film-coated tablets, package contains 15 pieces.

Amoxiclav 2X (500 mg/125 mg; 875 mg/125 mg) - coated tablets, the package may contain 10 or 14 pieces.

Amoxiclav Quiktab (500 mg/125 mg; 875 mg/125 mg) is available in the form of dispersed tablets, 10 such tablets per package.

The product is also produced in the form of a powder from which a suspension is made; the bottle contains powder for preparing 100 ml of the product.

A powder is also produced, from which a solution is made, which is administered intravenously. The bottle holds 600 mg of the product (amoxicillin 500 mg, clavulanic acid 100 mg), 1.2 g bottles are also available (amoxicillin 1000 mg, clavulanic acid 200 mg), the package holds 5 bottles.

Pharmacological action

The abstract provides information that antibiotic Amoxiclav (INN Amoksiklav) is a broad-spectrum agent. Group of antibiotics: broad-spectrum penicillins. The medicine contains amoxicillin (semi-synthetic penicillin) and clavulanic acid (β-lactamase inhibitor). The presence of clavulanic acid in the composition of the drug ensures the resistance of amoxicillin to the action of β-lactamases produced by microorganisms.

The structure of clavulanic acid is similar to beta-lactam antibiotics, this substance also has an antibacterial effect. Amoxiclav is active against strains that demonstrate sensitivity to amoxicillin. This is a series gram-positive bacteria, aerobic gram-negative bacteria, gram-positive and gram-negative anaerobes.

Pharmacokinetics and pharmacodynamics

As the Vidal drug reference book informs, after oral administration, both substances are actively absorbed from the gastrointestinal tract; the absorption of the components is not affected by food intake, so it does not matter how to take it - before or after meals. Highest concentration in blood observed one hour after the drug was taken. Both active ingredients of the drug are distributed in fluids and tissues. Amoxicillin also enters the liver, synovial fluid, prostate, tonsils, gall bladder, muscle tissue, saliva, and bronchial secretions.

If the membranes of the brain are not inflamed, both active substances do not penetrate through the BBB. At the same time, the active components penetrate the placental barrier, and traces of them are detected in breast milk. They bind to blood proteins to a small extent.

In the body, amoxicillin undergoes partial metabolism, clavulanic acid is metabolized intensively. It is excreted from the body through the kidneys; small particles of active substances are excreted by the intestines and lungs. The half-life of amoxicillin and clavulanic acid is 1-1.5 hours.

Indications for use of Amoxiclav

Amoxiclav is prescribed for infectious and inflammatory diseases that develop due to the influence of microorganisms sensitive to this medicine. The following indications for the use of this drug are determined:

• infections of the ENT organs, as well as infectious diseases of the upper respiratory tract ( otitis media, retropharyngeal abscess, sinusitis, pharyngitis, tonsillitis);
• urinary tract infections (with cystitis, at prostatitis etc.);
• infectious diseases of the lower respiratory tract (pneumonia, bronchitis acute and chronic);
• gynecological diseases of an infectious nature;
• connective and bone tissue infections;
• infectious diseases of soft tissues, skin (including consequences of bites);
• biliary tract infections (cholangitis, cholecystitis);
• odontogenic infections.

What else Amoxiclav helps with, you should ask a specialist during an individual consultation.

Contraindications

When determining why tablets and other forms of the drug help, you should also take into account existing contraindications:

• infectious mononucleosis;
• previous liver disease or cholestatic jaundice when taking clavulanic acid or amoxicillin;
• lymphocytic leukemia;
• high sensitivity to antibiotic drugs from the group of cephalosporins, penicillins, as well as other beta-lactam antibiotics;
• high sensitivity to the active components of the drug.

It is prescribed with caution to people suffering from liver failure and people with severe kidney disease.

Side effects

When taking this antibiotic, patients may experience the following side effects:

• Digestive system: deterioration appetite, vomiting, nausea, diarrhea; in rare cases, abdominal pain and liver dysfunction may occur; isolated manifestations - hepatitis, jaundice, pseudomembranous colitis.
• Hematopoietic system: in rare cases - reversible leukopenia, thrombocytopenia; in very rare cases - eosinophilia, pancytopenia.
• Allergic manifestations: itching, erythematous rash, hives; in rare cases - anaphylactic shock, exudative erythema, edema, allergic vasculitis; isolated manifestations - Stevens-Johnson syndrome, pustulosis, exfoliative dermatitis.
• Functions of the nervous system: dizziness, headache; in rare cases - convulsions, anxiety, hyperactivity, insomnia.
• Urinary system: crystalluria, interstitial nephritis.
• In rare cases, superinfection may occur.

It is noted that such treatment, as a rule, does not provoke significant side effects.

Instructions for use of Amoxiclav (Method and dosage of Amoxiclav for adults)

Medicine in tablets is not prescribed to children under 12 years of age. When prescribing the drug, it should be taken into account that the permissible dose per day of clavulanic acid is 600 mg (adults) and 10 mg per 1 kg of weight (child). The permissible daily dose of amoxicillin is 6 g for an adult and 45 mg per 1 kg of weight for a child.

The agent for parenteral administration is prepared by dissolving the contents of the vial in water for injection. To dissolve 600 mg of the product, you need 10 mol of water, to dissolve 1.2 g of the product - 20 ml of water. The solution should be administered slowly over 3-4 minutes. The intravenous infusion should continue for 30-40 minutes. The solution must not be frozen.

Before anesthesia, to prevent purulent complications, 1.2 g of drugs should be administered intravenously. If there is a risk of complications, the drug is administered intravenously or taken orally in the period after surgery. The duration of the appointment is determined by the doctor.

Amoxiclav tablets, instructions for use

As a rule, adults and children (who weigh more than 40 kg) receive 1 tablet every eight hours. (375 mg), provided the infection is mild or moderate. Another acceptable treatment regimen in this case is to take 1 tablet every 12 hours. (500 mg+125 mg). For severe infectious diseases, as well as for infectious diseases of the respiratory tract, taking 1 tablet every eight hours is recommended. (500 mg+125 mg) or taken every 12 hours 1 tablet. (875 mg+125 mg). Depending on the disease, you need to take an antibiotic from five to fourteen days, but the doctor must individually prescribe a treatment regimen.

Patients with odontogenic infections should take 1 tablet every 8 hours. (250 mg + 125 mg) or once 12 hours, 1 tablet. (500 mg + 125 mg) for five days.

People suffering from moderate renal failure, the use of 1 table is indicated. (500 mg + 125 mg) every twelve hours. Severe renal failure is a reason to increase the interval between doses to 24 hours.

Amoxiclav suspension, instructions for use

The patient's childhood involves calculating the dose taking into account the child's weight. Before preparing the syrup, shake the bottle well. In two doses you need to add 86 ml of water to the bottle, each time you need to shake its contents well. Please note that the measuring spoon contains 5 ml of product. Prescribed in a dose depending on the age and weight of the child.

Instructions for use Amoxiclav for children

Children from birth to three months are prescribed the drug at the rate of 30 mg per 1 kg of weight (dose per day), this dose should be divided equally and administered at equal intervals. From the age of three months, Amoxiclav is prescribed at a dose of 25 mg per 1 kg of weight, which is similarly divided equally into two administrations. For infectious diseases of moderate severity, the dose is prescribed at the rate of 20 mg per 1 kg of weight, divided into three administrations. For severe infectious diseases, the dose is prescribed at the rate of 45 mg per 1 kg of weight, divided into two doses per day.

Instructions for use Amoxiclav Quiktab

Before taking, the tablet must be dissolved in 100 ml of water (the amount of water may be more). Before taking, you need to stir the contents well. You can also chew the tablet; it is better to take the drug before meals. Adults and children after reaching 12 years of age should take 1 tablet per day. 625 mg 2-3 times a day. For severe infectious diseases, 1 tablet is prescribed. 1000 mg 2 times a day. Treatment should not last more than 2 weeks.

Sometimes a doctor may prescribe analogues of the drug, for example, Flemoklav Solutab, etc.

Amoxiclav for sore throat

The drug Amoxiclav for sore throat an adult is prescribed 1 tablet. 325 mg once every 8 hours. Another treatment regimen involves taking 1 tablet once every 12 hours. The doctor may prescribe a higher dose of antibiotic if the disease in an adult is severe. Treatment of sore throat in children involves the use of a suspension. As a rule, 1 spoon is prescribed (a dosage spoon is 5 ml). The frequency of administration is determined by the doctor, whose recommendations are important to follow. How to take Amoxiclav for children with sore throat depends on the severity of the disease.

Dosage of Amoxiclav for sinusitis

Does Amoxiclav help with sinusitis, depends on the causes and characteristics of the course of the disease. The dosage is determined by the otolaryngologist. It is recommended to take 500 mg tablets three times a day. How many days to take the medicine depends on the severity of the disease. But after the symptoms disappear, you need to take the drug for two more days.

Overdose

To avoid overdose, the prescribed dosage for children and the dosage of Amoxiclav for adults must be strictly observed. It is recommended to carefully study the instructions or watch a video on how to dilute the suspension.

Wikipedia indicates that an overdose of the drug may result in a number of unpleasant symptoms, but there is no data on life-threatening conditions for the patient. Due to an overdose, the appearance of abdominal pain, vomiting, diarrhea, excitement. In severe cases, seizures may occur.

If the drug has been taken recently, gastric lavage is indicated. activated carbon. The patient must be monitored by a doctor. In this case it is effective hemodialysis.

Interaction

When taking the drug simultaneously with some drugs, undesirable manifestations may occur, which is why tablets, syrup and intravenous administration of the drug should not be used in parallel with a number of drugs.

Simultaneous use of drugs with Glucosamine, antacids, aminoglycosides, laxatives slow down the absorption of Amoxiclav when taken simultaneously with Ascorbic acid– absorption accelerates.

With simultaneous treatment with Phenylbutazone, diuretics, NSAIDs, Allopurinol and other drugs that block tubular secretion, the concentration of amoxicillin increases.

If anticoagulants and Amoxiclav are taken simultaneously, the prothrombin time increases. Therefore, drugs in such a combination must be prescribed with caution.

Amoxiclav increases toxicity Methotrexate when taken simultaneously.

When taking Amoxiclav and Allopurinol the likelihood of exanthema occurring increases.

Should not be taken at the same time Disulfiram and Amoxiclav.

Antagonists when taken together are amoxicillin and Rifampicin. The drugs mutually weaken the antibacterial effect.

You should not take Amoxiclav and bacteriostatic antibiotics (tetracyclines, macrolides), as well as sulfonamides at the same time, as these drugs can reduce the effectiveness of Amoxiclav.

Probenecid increases the concentration of amoxicillin and slows down its elimination.

When using Amoxiclav, the effectiveness of oral contraceptives may decrease.

Terms of sale

In pharmacies, Amoxiclav is sold by prescription; a specialist issues a prescription in Latin.

Storage conditions

The medicine belongs to list B. It must be stored in a place inaccessible to children, at a temperature of no more than 25°C.

Best before date

Special instructions

Since the majority of people suffering from lymphocytic leukemia and infectious mononucleosis and receiving Ampicillin, subsequently noted the manifestation of an erythematous rash; such people are not recommended to take ampicillin antibiotics.

Prescribed with caution to people with a tendency to allergies.

If a course of treatment with the drug is prescribed for adults or children, it is important to monitor the functions of the kidneys, liver, and the process of hematopoiesis.

People who have impaired renal function need to adjust the dose of the drug or increase the interval between taking the drug.

It is optimal to take the product during meals to reduce the likelihood of side effects from the digestive system.

Patients undergoing treatment with Amoxiclav may experience a false-positive reaction when determining glucose levels in urine when using Felling's solution or Benedict's reagent.

There is no data on the negative impact of Amoxiclav on the ability to drive vehicles and work with precision machinery.

Patients who are interested in whether Amoxiclav is an antibiotic or not should keep in mind that the product is an antibacterial drug.

If Amoxiclav is prescribed, the patient's childhood age must be taken into account when prescribing the medication form and dosage.

Analogues of Amoxiclav Level 4 ATX code matches:

There are a number of analogues of this drug. The price of analogues depends, first of all, on the manufacturer of the drug. There are analogues on sale that are cheaper than Amoxiclav. For patients interested in what can replace this antibiotic, experts offer a large list of medications. These are the means Moxiclave, Co-Amoxiclav, Augmentin, Clavocin, Flemoklav, Honeyclave, Bactoclav, Ranklav, Amowycombe etc. However, any substitute should only be prescribed by a doctor. You can choose a cheaper analogue in tablets, for example, Augmentin. You can also choose a Russian analogue, for example, Amoxicillin.

Flemoklav Solutab and Amoxiclav: the difference between the drugs

The active components of the drugs are similar. The difference between the drugs is in the dosage of the active components in the release forms of these drugs. Both drugs fall into approximately the same price category.

Which is better: Amoxiclav or Augmentin?

What is the composition of Amoxiclav and Augmentin, what is the difference between these drugs? Both of these products contain similar active ingredients, that is, in fact they are the same thing. Accordingly, the pharmacological action of the drugs is almost identical, as are the side effects. Only the manufacturers of these drugs differ.

Which is better: Sumamed or Amoxiclav?

Sumamed contains azithromycin, which is a broad-spectrum antibiotic. Before prescribing any of the drugs, it is important to check the sensitivity of the microflora to their action.

Which is better: Flemoxin Solutab or Amoxiclav?

In the composition of the product Flemoxin contains only amoxicillin. Accordingly, its spectrum of influence is less than that of the drug Amoxiclav, which also contains clavulonic acid.

Amoxiclav for children

Children should take antibiotics only after a doctor's prescription. It is important to adhere to the specified dosage. Children under 12 years of age are usually prescribed a suspension. The dosage of Amoxiclav suspension for children depends on the severity of the disease and diagnosis. As a rule, children under 2 years of age are prescribed a dose of 62.5 mg, from 2 to 7 years of age - 125 mg, from 7 to 12 years of age - 250 mg.

Amoxiclav and alcohol

This drug should not be combined with alcohol. When taken simultaneously, the load on the liver increases significantly, and the likelihood of a number of negative effects also increases.

Amoxiclav during pregnancy and lactation

Amoxiclav at pregnancy can be used if the expected effect exceeds the possible harm to the fetus. It is undesirable to use the drug Amoxiclav in the early stages of pregnancy. The 2nd trimester and 3rd trimester are more preferable, but even during this period, the dosage of Amoxiclav during pregnancy must be observed very precisely. Amoxiclav at breastfeeding not prescribed, since the active components of the drug pass into breast milk.

Reviews about Amoxiclav

In the process of discussing the drug Amoxiclav, reviews from doctors and patients are predominantly positive. It is noted that the antibiotic is effective in the treatment of respiratory diseases, and it is suitable for both adults and children. Reviews mention the effectiveness of the product for sinusitis, otitis media, and genital tract infections. As a rule, adult patients take 875 mg + 125 mg tablets; if the dosage is correct, relief occurs quickly. Reviews note that after a course of antibiotic treatment, it is advisable to take drugs that restore normal microflora.

Reviews of the Amoxiclav suspension are also positive. Parents write that it is convenient to give the product to children, as it has a pleasant taste and is normally perceived by children.

Amoxiclav price, where to buy

The price of Amoxiclav tablets 250 mg + 125 mg is on average 230 rubles for 15 pieces. You can buy an antibiotic 500 mg + 125 mg at a price of 360 – 400 rubles for 15 pcs. How much 875 mg + 125 mg tablets cost depends on the place of sale. On average, their cost is 420 – 470 rubles for 14 pieces.

Price Amoxiclav Quiktab 625 mg – from 420 rubles for 14 pcs.

The price of Amoxiclav suspension for children is 290 rubles (100 ml).

Price Amoxiclav 1000 mg in Ukraine (Kyiv, Kharkov, etc.) – from 200 hryvnia for 14 pieces.

• Online pharmacies in RussiaRussia
• Online pharmacies in UkraineUkraine
• Online pharmacies in KazakhstanKazakhstan

WER.RU

Amoxiclav powder 400 mg+57 mg 17.5 g 70 ml Lek d. d.

Amoxiclav tablets 375 mg 15 pcs. Lek d. d.

Amoxiclav powder 25 g 100 ml 20 doses

Amoxiclav powder 35 g

ZdravZone

Amoxiclav powder for injection 600 mg No. 5 bottle Lek D.D.

Amoxiclav powder for injection 1200 mg No. 5 bottle Lek D.D.

Amoxiclav Quiktab 1000 mg No. 14 tablets Lek D.D.

Amoxiclav Quiktab 625 mg No. 14 tablets Lek D.D.

Amoxiclav 375 mg No. 15 tablets Lek D.D.

Pharmacy IFC

AmoksiklavLek, Slovenia

AmoksiklavLek, Slovenia

AmoksiklavLek, Slovenia

Amoxiclav QuiktabLek, Slovenia

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Pharmacy24

AmoxiclavLek (Slovenia)

Amoxiclav1

Amoxiclav 2x14

Amoxiclav 2x14

Amoxiclav quiktab dispersible tablets 875 mg/125 mg No. 10 Sandoz

PaniPharmacy

Amoxiclav 2 tablets p/o 875/125 mg No. 14 Sandoz

Amoxiclav 2 tablets p/o 875/125 mg No. 14 Sandoz

Amoxiclav 2 tablets p/o 875/125 mg No. 14 Sandoz

Amoxiclav 2 tablets p/o 875/125 mg No. 14 Sandoz

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BIOSPHERE

Amoxiclav 375 mg No. 15 tablet p.p.o.

Amoxiclav 156.25 mg/5 ml 100 ml portions/susp. for oral administration Lek Pharmaceuticals d.d. (Slovenia)

Amoxiclav 312.5 mg/5 ml 100 ml portions/susp. for oral administration

Amoxiclav 625 mg No. 15 tablet p.p.o.

Amoxiclav 2X 625 mg No. 14 tablet p.p.o.

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PLEASE NOTE! Information about medications on the site is for reference and general information, collected from publicly available sources and cannot serve as a basis for making a decision on the use of medications in the course of treatment. Before using the drug Amoxiclav, be sure to consult with your doctor.

INSTRUCTIONS
on the use of the drug
for medical use

Read these instructions carefully before you start taking/using this medicine.
Save the instructions, you may need them again.
If you have any questions, consult your doctor.
This medicine is prescribed for you personally and should not be given to others because it may harm them even if they have the same symptoms as you.

Registration number

Trade name

Amoxiclav®

Group name

amoxicillin + clavulanic acid

Dosage form

Film-coated tablets

Compound

Active substances (core): each 250 mg + 125 mg tablet contains 250 mg of amoxicillin in the form of trihydrate and 125 mg of clavulanic acid in the form of potassium salt;
each 500 mg + 125 mg tablet contains 500 mg of amoxicillin in the form of trihydrate and 125 mg of clavulanic acid in the form of potassium salt;
Each 875mg+125mg tablet contains 875 mg of amoxicillin in the form of trihydrate and 125 mg of clavulanic acid in the form of potassium salt.
Excipients (respectively for each dosage): colloidal silicon dioxide 5.40 mg/9.00 mg/12.00 mg, crospovidone 27.40 mg/45.00 mg/61.00 mg, croscarmellose sodium 27.40 mg/ 35.00 mg/47.00, magnesium stearate 12.00 mg/20.00 mg/17.22 mg, talc 13.40 mg (for dosage 250 mg + 125 mg), microcrystalline cellulose up to 650 mg/up to 1060 mg/up 1435 mg;
film coating tablets 250 mg + 125 mg - hypromellose 14.378 mg, ethylcellulose 0.702 mg, polysorbate 80 - 0.780 mg, triethyl citrate 0.793 mg, titanium dioxide 7.605 mg, talc 1.742 mg;
film coating tablets 500 mg + 125 mg - hypromellose 17.696 mg, ethylcellulose 0.864 mg, polysorbate 80 - 0.960 mg, triethyl citrate 0.976 mg, titanium dioxide 9.360 mg, talc 2.144 mg;
film coating tablets 875 mg + 125 mg - hypromellose 23.226 mg, ethylcellulose 1.134 mg, polysorbate 80 - 1.260 mg, triethyl citrate 1.280 mg, titanium dioxide 12.286 mg, talc 2.814 mg.

Description

250 mg + 125 mg tablets: white or off-white, oblong, octagonal, biconvex, film-coated tablets, imprinted “250/125” on one side and “AMC” on the other side.
Tablets 500 mg + 125 mg: white or almost white, oval, biconvex film-coated tablets.
Tablets 875 mg + 125 mg: white or off-white, oblong, biconvex, film-coated tablets, scored and imprinted “875/125” on one side and “AMC” on the other side.
Fracture appearance: yellowish mass.

Pharmacotherapeutic group

Antibiotic – semi-synthetic penicillin + beta-lactamase inhibitor

ATX code: J01CR02.

Pharmacological properties

Pharmacodynamics
Mechanism of action
Amoxicillin is a semisynthetic penicillin that is active against many gram-positive and gram-negative microorganisms. Amoxicillin disrupts the biosynthesis of peptidoglycan, which is a structural component of the bacterial cell wall. Violation of peptidoglycan synthesis leads to loss of cell wall strength, which causes lysis and death of microorganism cells. At the same time, amoxicillin is susceptible to destruction by beta-lactamases, and therefore the spectrum of activity of amoxicillin does not extend to microorganisms that produce this enzyme.
Clavulanic acid is a beta-lactamase inhibitor, structurally related to penicillins, and has the ability to inactivate a wide range of beta-lactamases found in microorganisms resistant to penicillins and cephalosporins. Clavulanic acid is sufficiently effective against plasmid beta-lactamases, which most often cause bacterial resistance, and is not effective against type I chromosomal beta-lactamases, which are not inhibited by clavulanic acid.
The presence of clavulanic acid in the drug protects amoxicillin from destruction by enzymes - beta-lactamases, which allows expanding the antibacterial spectrum of amoxicillin.
Below is the activity of the combination of amoxicillin and clavulanic acid in vitro.

Bacteria, usually sensitive

Gram-positive aerobes: Bacillus anthracis, Enterococcus faecalis, Listeria monocytogenes, Nocardia asteroides, Streptococcus pyogenes and other beta-hemolytic streptococci1,2, Streptococcus agalactiae1,2, Staphylococcus aureus (sensitive to methicillin)1, Staphylococcus saprophyticus (sensitive to methicillin), gulase-negative staphylococci (methicillin sensitive). Gram-negative aerobes: Bordetella pertussis, Haemophilus influenzae1, Helicobacter pylori, Moraxella catarrhalis1, Neisseria gonorrhoeae, Pasteurella multocida, Vibrio cholerae. Other: Borrelia burgdorferi, Leptospira icterohaemorrhagiae, Treponema pallidum. Gram-positive anaerobes: species of the genus Clostridium, Peptococcus niger, Peptostreptococcus magnus, Peptostreptococcus micros, species of the genus Peptostreptococcus. Gram-negative anaerobes: Bacteroides fragilis, species of the genus Bacteroides, species of the genus Capnocytophaga, Eikenella corrodens, Fusobacterium nucleatum, species of the genus Fusobacterium, species of the genus Porphyromonas, species of the genus Prevotella.

Bacteria for which acquired resistance is likely to a combination of amoxicillin and clavulanic acid

Gram-negative aerobes: Escherichia сoli1, Klebsiella oxytoca, Klebsiella pneumoniae, species of the genus Klebsiella, Proteus mirabilis, Proteus vulgaris, species of the genus Proteus, species of the genus Salmonella, species of the genus Shigella. Gram-positive aerobes: species of the genus Corynebacterium, Enterococcus faecium, Streptococcus pneumoniae1,2, streptococci of the Viridans group.

Naturally resistant bacteria to a combination of amoxicillin and clavulanic acid

Gram-negative aerobes: species of the genus Acinetobacter, Citrobacter freundii, species of the genus Enterobacter, Hafnia alvei, Legionella pneumophila, Morganella morganii, species of the genus Providencia, species of the genus Pseudomonas, species of the genus Serratia, Stenotrophomonas maltophilia, Yersinia enterocolitica. Other: Chlamydophila pneumoniae, Chlamydophila psittaci, species of the genus Chlamydia, Coxiella burnetii, species of the genus Mycoplasma. 1 For these bacteria, the clinical effectiveness of the combination of amoxicillin with clavulanic acid has been demonstrated in clinical studies. 2 strains of these bacterial species do not produce beta-lactamases. Sensitivity during amoxicillin monotherapy suggests similar sensitivity to the combination of amoxicillin and clavulanic acid.

Pharmacokinetics
The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid are highly soluble in aqueous solutions with a physiological pH value and, after taking Amoxiclav® orally, they are quickly and completely absorbed from the gastrointestinal tract (GIT). Absorption of the active substances amoxicillin and clavulanic acid is optimal when taken at the beginning of a meal.
The bioavailability of amoxicillin and clavulanic acid after oral administration is about 70%.
The following are the pharmacokinetic parameters of amoxicillin and clavulanic acid after administration at a dose of 875 mg/125 mg and 500 mg/125 mg twice daily, 250 mg/125 mg three times daily in healthy volunteers.

Mean (±SD) pharmacokinetic parameters
Active substances Amoxicillin/ clavulanic acid	One-time dose (mg)	Cmax (µg/ml)	Tmax (hour)	AUC (0-24h) (mcg.hour/ml)	T1/2 (hour)
Amoxicillin
875 mg/125 mg	875	11.64±2.78	1.50 (1.0-2.5)	53.52±12.31	1.19±0.21
500 mg/125 mg	500	7.19±2.26	1.50 (1.0-2.5)	53.5±8.87	1.15±0.20
250 mg/125 mg	250	3.3±1.12	1,5 (1,0-2,0)	26.7±4.56	1.36±0.56
Clavulanic acid
875 mg/125 mg	125	2.18±0.99	1.25 (1.0-2.0)	10.16±3.04	0.96±0.12
500 mg/125 mg	125	2.40±0.83	1.5 (1.0-2.0)	15.72±3.86	0.98±0.12
250 mg/125 mg	125	1.5±0.70	1,2 (1,0-2,0)	12.6±3.25	1.01±0.11

Cmax – maximum concentration in blood plasma;

Tmax – time to reach maximum concentration in blood plasma;

AUC – area under the concentration-time curve;

T1/2 – half-life

Distribution
Both components are characterized by a good volume of distribution in various organs, tissues and fluids of the body (including the lungs, abdominal organs; adipose, bone and muscle tissues; pleural, synovial and peritoneal fluids; skin, bile, urine, purulent discharge, sputum, interstitial fluid).
Plasma protein binding is moderate: 25% for clavulanic acid and 18% for amoxicillin.
The volume of distribution is approximately 0.3-0.4 l/kg for amoxicillin and approximately 0.2 l/kg for clavulanic acid.
Amoxicillin and clavulanic acid do not penetrate the blood-brain barrier when the meninges are not inflamed.
Amoxicillin (like most penicillins) is excreted in breast milk. Trace amounts of clavulanic acid are also found in breast milk. Amoxicillin and clavulanic acid penetrate the placental barrier.
Metabolism
About 10-25% of the initial dose of amoxicillin is excreted by the kidneys in the form of inactive penicillic acid. Clavulanic acid in the human body undergoes intensive metabolism with the formation of 2,5-dihydro-4-(2-hydroxyethyl)-5-oxo-1H-pyrrole-3-carboxylic acid and 1-amino-4-hydroxy-butan-2-one and is excreted by the kidneys, through the gastrointestinal tract, and also with exhaled air in the form of carbon dioxide.
Removal
Amoxicillin is eliminated primarily by the kidneys, while clavulanic acid is eliminated through both renal and extrarenal mechanisms. After a single oral dose of one tablet of 250 mg/125 mg or 500 mg/125 mg, approximately 60-70% of amoxicillin and 40-65% of clavulanic acid are excreted unchanged by the kidneys during the first 6 hours.
The average half-life (T1/2) of amoxicillin/clavulanic acid is approximately one hour, and the average total clearance is approximately 25 L/h in healthy patients.
The largest amount of clavulanic acid is excreted during the first 2 hours after administration.
Patients with impaired renal function
The total clearance of amoxicillin/clavulanic acid decreases in proportion to the decrease in renal function. The decrease in clearance is more pronounced for amoxicillin than for clavulanic acid, because Most amoxicillin is excreted by the kidneys. Doses of the drug for renal failure should be selected taking into account the undesirability of amoxicillin accumulation while maintaining normal levels of clavulanic acid.
Patients with liver dysfunction
In patients with impaired liver function, the drug is used with caution; continuous monitoring of liver function is necessary.
Both components are removed by hemodialysis and minor amounts by peritoneal dialysis.

Indications for use

Infections caused by sensitive strains of microorganisms:
infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis);
lower respiratory tract infections (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia);
urinary tract infections;
infections in gynecology;
skin and soft tissue infections, as well as wounds from human and animal bites;
infections of bone and connective tissue;
biliary tract infections (cholecystitis, cholangitis);
odontogenic infections.

Contraindications

Hypersensitivity to the components of the drug;
history of hypersensitivity to penicillins, cephalosporins and other beta-lactam antibiotics;
cholestatic jaundice and/or other liver dysfunction caused by a history of taking amoxicillin/clavulanic acid;
infectious mononucleosis and lymphocytic leukemia;
children under 12 years of age or with a body weight of less than 40 kg.

With caution

History of pseudomembranous colitis, diseases of the gastrointestinal tract, liver failure, severe renal dysfunction, pregnancy, lactation, when used simultaneously with anticoagulants.

Use during pregnancy and breastfeeding

Animal studies have not revealed any evidence of harm from taking the drug during pregnancy or its effect on the embryonic development of the fetus.
One study in women with premature rupture of membranes found that prophylactic use of amoxicillin/clavulanic acid may be associated with an increased risk of neonatal necrotizing enterocolitis.
During pregnancy and lactation, the drug is used only if the expected benefit to the mother outweighs the potential risk to the fetus and child.
Amoxicillin and clavulanic acid pass into breast milk in small quantities.
Breastfed infants may develop sensitization, diarrhea, and candidiasis of the oral mucosa. When taking the drug Amoxiclav®, it is necessary to decide whether to stop breastfeeding.

Directions for use and doses

Inside.
The dosage regimen is set individually depending on the age, body weight, kidney function of the patient, as well as the severity of the infection.
Amoxiclav® is recommended to be taken at the beginning of a meal for optimal absorption and to reduce possible side effects from the digestive system.
Course of treatment is 5-14 days. The duration of treatment is determined by the attending physician. Treatment should not continue for more than 14 days without repeated medical examination.
Adults and children 12 years and older or weighing 40 kg or more:
For the treatment of mild to moderate infections - 1 tablet 250 mg + 125 mg every 8 hours (3 times a day).
For the treatment of severe infections and respiratory infections - 1 tablet 500 mg + 125 mg every 8 hours (3 times a day) or 1 tablet 875 mg + 125 mg every 12 hours (2 times a day).
Since amoxicillin and clavulanic acid combination tablets of 250 mg + 125 mg and 500 mg + 125 mg contain the same amount of clavulanic acid - 125 mg, then 2 tablets of 250 mg + 125 mg are not equivalent to 1 tablet of 500 mg + 125 mg.
Patients with impaired renal function
Dose adjustments are based on the maximum recommended dose of amoxicillin and are based on creatinine clearance (CC) values.

QC	Amoxiclav® dosage regimen
>30 ml/min	No dosage adjustment required
10-30 ml/min	1 tablet 500 mg + 125 mg 2 times a day or 1 tablet 250 mg + 125 mg 2 times a day (depending on the severity of the disease).
30 ml/min. Patients with liver dysfunction Amoxiclav® should be taken with caution. It is necessary to regularly monitor liver function. Does not require adjustment of the dosage regimen for elderly patients. In elderly patients with impaired renal function, the dose should be adjusted as for adult patients with impaired renal function. Side effect According to the World Health Organization (WHO), adverse effects are classified according to their frequency as follows: very often (≥1/10), often (≥1/100, Amoxiclav - new instructions for use of the drug, you can see contraindications, side effects, prices in pharmacies for Amoxiclav. Reviews about Amoxiclav - A broad-spectrum penicillin antibiotic with a beta-lactamase inhibitor. Drug: AMOXICLAV® Active substance of the drug: amoxicillin, clavulanic acid ATX coding: J01CR02 KFG: Broad-spectrum penicillin antibiotic with beta-lactamase inhibitor Registration number: P No. 012124/02 Registration date: 09/01/06 Owner reg. cert.: LEK d.d. (Slovenia) Amoxiclav release form, drug packaging and composition. Powder for the preparation of a solution for intravenous administration is white to yellowish-white in color. Powder for preparing a solution for intravenous administration 1 fl. amoxicillin (sodium salt) 500 mg clavulanic acid (potassium salt) 100 mg Powder for the preparation of a solution for intravenous administration is white to yellowish-white in color. Powder for preparing a solution for intravenous administration 1 fl. amoxicillin (sodium salt) 1 g clavulanic acid (potassium salt) 200 mg Bottles (5) - cardboard packs. The description of the drug is based on the officially approved instructions for use. Pharmacological action Amoxiclav Broad-spectrum antibiotic; contains semisynthetic penicillin amoxicillin and β-lactamase inhibitor clavulanic acid. Clavulanic acid forms a stable inactivated complex with β-lactamases and ensures the resistance of amoxicillin to their effects. Clavulanic acid, similar in structure to β-lactam antibiotics, has weak intrinsic antibacterial activity. Thus, Amoxiclav has a bactericidal effect on a wide range of gram-positive and gram-negative bacteria (including strains that have become resistant to beta-lactam antibiotics due to the production of β-lactamases). Amoxiclav is active against aerobic gram-positive bacteria: Streptococcus spp. (including Streptococcus pneumoniae, Streptococcus viridans, Streptococcus pyogenes, Streptococcus bovis), Enterococcus spp., Staphylococcus aureus (except methicillin-resistant strains), Staphylococcus epidermidis (except methicillin-resistant strains), Staphylococcus saprophyticus, Listeria spp.; aerobic gram-negative bacteria: Bordetella pertussis, Brucella spp., Campylobacter jejuni, Escherichia coli, Gardnerella vaginalis, Haemophilus ducreyi, Haemophilus influenzae, Helicobacter pylori, Klebsiella spp., Moraxella catarrhalis, Neisseria gonorrhoeae, Neisseria meningitidis, Pasteurella multocida, Proteus spp. , Providencia spp., Salmonella spp., Shigella spp., Vibrio cholerae, Yersinia enterocolitica, Eikenella corrodens; anaerobic gram-positive bacteria: Peptococcus spp., Actinomyces israelii, Prevotella spp., Clostridium spp., Peptostreptococcus spp., Fusobacterium spp.; anaerobic gram-negative bacteria: Bacteroides spp. Pharmacokinetics of the drug. The main pharmacokinetic parameters of amoxicillin and clavulanic acid are similar. Amoxicillin and clavulanic acid in combination do not affect each other. Distribution Cmax after a bolus injection of Amoxiclav 1.2 g is 105.4 mg/l for amoxicillin and 28.5 mg/l for clavulanic acid. Both components are characterized by a good volume of distribution in body fluids and tissues (lungs, middle ear, pleural and peritoneal fluids, uterus, ovaries). Amoxicillin also penetrates into the synovial fluid, liver, prostate gland, tonsils, muscle tissue, gall bladder, secretions of the paranasal sinuses, saliva, and bronchial secretions. Amoxicillin and clavulanic acid do not penetrate the BBB when the meninges are not inflamed. Cmax in body fluids is observed 1 hour after reaching Cmax in blood plasma. The active substances penetrate the placental barrier and are excreted in breast milk in trace concentrations. Amoxicillin and clavulanic acid are characterized by low binding to plasma proteins. Metabolism Amoxicillin is partially metabolized, clavulanic acid appears to be extensively metabolized. Removal Amoxicillin is excreted by the kidneys almost unchanged by tubular secretion and glomerular filtration. Clavulanic acid is excreted by glomerular filtration, partly in the form of metabolites. Small amounts may be excreted through the intestines and lungs. T1/2 of amoxicillin and clavulanic acid is 1-1.5 hours. Both components are removed by hemodialysis and, in small quantities, by peritoneal dialysis. Pharmacokinetics of the drug. in special clinical cases In severe renal failure, T1/2 increases to 7.5 hours for amoxicillin and to 4.5 hours for clavulanic acid. Indications for use: Treatment of infectious and inflammatory diseases caused by microorganisms sensitive to the drug: - infections of the upper respiratory tract and ENT organs (including acute and chronic sinusitis, acute and chronic otitis media, retropharyngeal abscess, tonsillitis, pharyngitis); - infections of the lower respiratory tract (including acute bronchitis with bacterial superinfection, chronic bronchitis, pneumonia); - urinary tract infections; - gynecological infections; - skin and soft tissue infections, including human and animal bites; - infections of bones and joints; - abdominal infections, incl. biliary tract (cholecystitis, cholangitis); - odontogenic infections; - sexually transmitted infections (gonorrhea, chancroid); - prevention of infections after surgical interventions. The drug is administered intravenously. For adults and children over 12 years of age (with body weight >40 kg), the drug is prescribed at a dose of 1.2 g (1000 mg + 200 mg) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours. For children aged 3 months to 12 years, the drug is prescribed at a dose of 30 mg/kg body weight (calculated for the entire Amoxiclav) with an interval of 8 hours, in case of severe infection - with an interval of 6 hours. Children under 3 months of age: premature and during the perinatal period - at a dose of 30 mg/kg body weight (in terms of the entire Amoxiclav) every 12 hours; in the postperinatal period - at a dose of 30 mg/kg body weight (in terms of the entire Amoxiclav) every 8 hours. Every 30 mg of Amoxiclav contains 25 mg of amoxicillin and 5 mg of clavulanic acid. The prophylactic dose for surgical interventions is 1.2 g during induction anesthesia (for an operation lasting less than 2 hours); for longer operations - 1.2 g up to 4 times a day. For patients with renal failure, the dose and/or interval between doses of the drug should be adjusted depending on creatinine clearance (see table). Creatinine clearance Dosage and method of administration of the drug. >0.5 ml/s (>30 ml/min) no dose adjustment required 0.166-0.5 ml/s (10-30 ml/min) first dose - 1.2 g (1000 mg + 200 mg), and then 600 mg (500 mg+100 mg) IV every 12 hours Excipients Film shell composition: 15 pcs. - dark glass bottles (1) - cardboard packs. 20 pcs. - dark glass bottles (1) - cardboard packs. 21 pcs. - dark glass bottles (1) - cardboard packs. Film-coated tablets white or almost white, oval, biconvex. Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose. Film shell composition: hypromellose, ethylcellulose, diethyl phthalate, macrogol 6000, titanium dioxide. 5 pcs. - blisters (3) - cardboard packs. 15 pcs. — bottles (1) — cardboard packs. Film-coated tablets white or almost white, oblong, biconvex, with the imprint “AMC” on one side, with a notch and imprint “875” and “125” on the other. Excipients: colloidal silicon dioxide, crospovidone, croscarmellose sodium, magnesium stearate, talc, microcrystalline cellulose. Film shell composition: hypromellose, ethylcellulose, povidone, triethyl citrate, titanium dioxide, talc. 5 pcs. - blisters (2) - cardboard packs. 7 pcs. - blisters (2) - cardboard packs.

The radar emits electromagnetic energy and detects echoes coming from reflected objects and also determines their characteristics. The purpose of the course project is to consider an all-round radar and calculate the tactical indicators of this radar: maximum range taking into account absorption; real resolution in range and azimuth; real accuracy of range and azimuth measurements. The theoretical part provides a functional diagram of a pulsed active radar for air targets for air traffic control.

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Radar systems (radars) are designed to detect and determine the current coordinates (range, speed, elevation and azimuth) of reflected objects.

The radar emits electromagnetic energy and detects echoes coming from reflected objects, and also determines their characteristics.

The purpose of the course project is to consider an all-round radar and calculate the tactical indicators of this radar: maximum range taking into account absorption; real resolution in range and azimuth; real accuracy of range and azimuth measurements.

The theoretical part provides a functional diagram of a pulsed active radar for air targets for air traffic control. The system parameters and formulas for its calculation are also given.

In the calculation part, the following parameters were determined: maximum range taking into account absorption, real range and azimuth resolution, range and azimuth measurement accuracy.

1. Theoretical part

1.1 Functional diagram of the radarall-round view

Radar the field of radio engineering, which provides radar observation of various objects, that is, their detection, measurement of coordinates and movement parameters, as well as the identification of certain structural or physical properties by using radio waves reflected or re-emitted by objects or their own radio emission. The information obtained during radar surveillance is called radar. Radio technical radar surveillance devices are called radar stations (radars) or radars. The radar surveillance objects themselves are called radar targets or simply targets. When using reflected radio waves, radar targets are any inhomogeneities in the electrical parameters of the medium (dielectric and magnetic permeability, conductivity) in which the primary wave propagates. This includes aircraft (airplanes, helicopters, weather balloons, etc.), hydrometeors (rain, snow, hail, clouds, etc.), river and sea vessels, ground objects (buildings, cars, airplanes at airports, etc.). ), all kinds of military objects, etc. A special type of radar targets are astronomical objects.

The source of radar information is the radar signal. Depending on the methods of obtaining it, the following types of radar surveillance are distinguished.

1. Passive response radar,based on the fact that the oscillations emitted by the radar probing signal are reflected from the target and enter the radar receiver in the form of a reflected signal. This type of surveillance is sometimes also called active passive response radar.

Active response radar,called active radar with an active response, it is characterized by the fact that the response signal is not reflected, but re-emitted using a special transponder - a repeater. At the same time, the range and contrast of radar observation significantly increases.

Passive radar is based on receiving the targets' own radio emissions, mainly in the millimeter and centimeter ranges. If the sounding signal in the two previous cases can be used as a reference signal, which provides the fundamental possibility of measuring range and speed, then in this case there is no such possibility.

A radar system can be thought of as a radar link, similar to radio communications or telemetry links. The main components of a radar are a transmitter, a receiver, an antenna device, and a terminal device.

The main stages of radar surveillance are:detection, measurement, resolution and recognition.

Detection is the process of deciding on the presence of goals with an acceptable probability of an erroneous decision.

Measurement allows you to estimate the coordinates of targets and the parameters of their movement with acceptable errors.

Permission consists of performing the tasks of detecting and measuring the coordinates of one target in the presence of others that are close in range, speed, etc.

Recognition makes it possible to establish some characteristic features of the target: is it point or group, moving or group, etc.

Radar information coming from the radar is transmitted via radio channel or cable to the control point. The process of radar tracking of individual targets is automated and carried out using a computer.

Aircraft navigation along the route is provided by the same radars that are used in air traffic control. They are used both to monitor adherence to a given route and to determine location during the flight.

To perform landing and its automation, along with radio beacon systems, landing radars are widely used, providing monitoring of the aircraft’s deviation from the course and glide path.

A number of airborne radar devices are also used in civil aviation. This primarily includes on-board radar for detecting dangerous weather formations and obstacles. Usually it also serves to survey the earth in order to provide the possibility of autonomous navigation along characteristic ground-based radar landmarks.

Radar systems (radars) are designed to detect and determine the current coordinates (range, speed, elevation and azimuth) of reflected objects. The radar emits electromagnetic energy and detects echoes coming from reflected objects, and also determines their characteristics.

Let's consider the operation of a pulsed active radar for detecting air targets for air traffic control (ATC), the structure of which is shown in Figure 1. The view control device (antenna control) is used to view space (usually circular) with an antenna beam, narrow in the horizontal plane and wide in the vertical.

The radar in question uses a pulsed radiation mode, therefore, at the moment the next probing radio pulse ends, the only antenna switches from transmitter to receiver and is used for reception until the next probing radio pulse begins to be generated, after which the antenna is again connected to the transmitter, and so on.

This operation is performed by a transmit-receive switch (RTS). The trigger pulses, which set the repetition period of the probing signals and synchronize the operation of all radar subsystems, are generated by a synchronizer. The signal from the receiver after the analog-to-digital converter (ADC) goes to the information processing equipment signal processor, where primary information processing is performed, consisting of detecting the signal and changing the coordinates of the target. Target marks and trajectory tracks are formed during the initial processing of information in the data processor.

The generated signals, together with information about the angular position of the antenna, are transmitted for further processing to the command post, as well as for monitoring to the all-round visibility indicator (PVI). When the radar operates autonomously, the PPI serves as the main element for monitoring the air situation. Such a radar usually processes information in digital form. For this purpose, a device for converting the signal into a digital code (ADC) is provided.

Figure 1 Functional diagram of all-round radar

1.2 Definitions and main parameters of the system. Formulas for calculation

Basic tactical characteristics of the radar

Maximum range

The maximum operating range is set by tactical requirements and depends on many technical characteristics of the radar, radio wave propagation conditions and target characteristics, which are subject to random changes in real conditions of use of stations. Therefore, the maximum range is a probabilistic characteristic.

The free-space range equation (i.e., without taking into account the influence of the ground and absorption in the atmosphere) for a point target establishes the relationship between all the main parameters of the radar.

where E isl - energy emitted in one pulse;

S a - effective antenna area;

S efo - effective reflective target area;

 - wavelength;

k p - discriminability coefficient (signal-to-noise energy ratio at the receiver input, which ensures the reception of signals with a given probability of correct detection W by and the probability of a false alarm Wlt);

E sh - energy of noise acting during reception.

Where R and - and pulse power;

 and , - pulse duration.

Where d ag - horizontal size of the antenna mirror;

d av - vertical size of the antenna mirror.

k r = k r.t. ,

where k r.t. - theoretical coefficient of distinguishability.

k r.t. =,

where q 0 - detection parameter;

N - the number of pulses received from the target.

where Wlt - probability of false alarm;

W by - probability of correct detection.

where t region,

F and - pulse sending frequency;

Q a0.5 - antenna radiation pattern width at 0.5 power level

where is the angular speed of rotation of the antenna.

where T review is the review period.

where k =1.38  10 -23 J/deg - Boltzmann's constant;

k sh - receiver noise figure;

T - receiver temperature in degrees Kelvin ( T =300K).

The maximum range of the radar, taking into account the absorption of radio wave energy.

where  donkey - attenuation coefficient;

 D - width of the weakening layer.

Minimum radar range

If the antenna system does not impose restrictions, then the minimum range of the radar is determined by the pulse duration and the recovery time of the antenna switch.

where c is the speed of propagation of an electromagnetic wave in vacuum, c = 3∙10 8 ;

 and , - pulse duration;

τ in - recovery time of the antenna switch.

Radar range resolution

The real range resolution when using an all-round visibility indicator as an output device will be determined by the formula

 (D)=  (D) sweat +  (D) ind,

g de  (D) sweat - potential range resolution;

 (D) ind - range resolution of the indicator.

For a signal in the form of an incoherent train of rectangular pulses:

where c is the speed of propagation of an electromagnetic wave in a vacuum; c = 3∙10 8 ;

 and , - pulse duration;

 (D) ind - the range resolution of the indicator is calculated by the formula

g de D shk - limit value of the range scale;

k e = 0.4 - screen utilization factor,

Q f - focusing quality of the tube.

Radar azimuth resolution

The actual azimuth resolution is determined by the formula:

 ( az) =  ( az) sweat +  ( az) ind,

where  ( az) sweat - potential azimuth resolution when approximating the radiation pattern of a Gaussian curve;

 ( az ) ind - azimuth resolution of the indicator

 ( az ) sweat =1.3  Q a 0.5 ,

 ( az ) ind = d n M f ,

where dn - spot diameter of the cathode ray tube;

M f scale scale.

where r - removing the mark from the center of the screen.

Accuracy of determining coordinates by range And

The accuracy of range determination depends on the accuracy of measuring the delay of the reflected signal, errors due to suboptimal signal processing, the presence of unaccounted signal delays in the transmission, reception and indication paths, and random errors in range measurement in indicator devices.

Accuracy is characterized by measurement error. The resulting root mean square error of range measurement is determined by the formula:

where  (D) sweat - potential range measurement error.

 (D) distribution error due to non-linearity of propagation;

 (D) app - hardware error.

where q 0 - double signal-to-noise ratio.

Azimuth coordinate determination accuracy

Systematic errors in azimuth measurements can occur due to inaccurate orientation of the radar antenna system and due to a mismatch between the antenna position and the electrical azimuth scale.

Random errors in measuring the target azimuth are caused by the instability of the antenna rotation system, the instability of the azimuth marking generation schemes, as well as reading errors.

The resulting root mean square error in azimuth measurement is determined by:

Initial data (option 5)

1. Wavelength  , [cm] …............................................. ........................... .... 6
2. Pulse power R and , [kW] ............................................. .............. 600
3. Pulse duration and , [μs] .................................................... ........... 2,2
4. Pulse sending frequency F and , [Hz]................................................... ...... 700
5. Horizontal size of antenna mirror d ag [m] ........................ 7
6. Vertical size of antenna mirror d av , [m] ..................... 2.5
7. Review period T review , [With] .............................................. .............................. 25
8. Receiver noise figure k sh ................................................. ....... 5
9. Probability of correct detection W by ............................. .......... 0,8
10. Probability of false alarm W lt.. ................................................ ....... 10 -5
11. Around View Indicator Screen Diameter d e , [mm] .................... 400
12. Effective reflective target area S efo, [m 2 ] …...................... 30
13. Focus quality Q f ............................................................... ...... 400
14. Range scale limit D shk1 , [km] ........................... 50 D shk2 , [km] ......................... 400
15. Range measuring marks D , [km] ......................................... 15
16. Azimuth measuring marks , [deg] .......................................... 4

2. Calculation of tactical indicators of all-round radar

2.1 Calculation of maximum range taking into account absorption

First, the maximum range of the radar is calculated without taking into account the attenuation of radio wave energy during propagation. The calculation is carried out according to the formula:

(1)

Let's calculate and establish the quantities included in this expression:

E isl = P and  and =600  10 3  2.2  10 -6 =1.32 [J]

S a = d ag d av =  7  2.5 = 8.75 [m 2 ]

k r = k r.t.

k r.t. =

101,2

0.51 [deg]

14.4 [deg/s]

Substituting the resulting values, we will have:

t region = 0.036 [s], N = 25 pulses and k r.t. = 2.02.

Let = 10, then k P =20.

E sh - energy of noise acting during reception:

E w =kk w T =1.38  10 -23  5  300=2.07  10 -20 [J]

Substituting all the obtained values ​​into (1), we find 634.38 [km]

Now we determine the maximum range of the radar, taking into account the absorption of radio wave energy:

(2)

Value  donkey we find it from the graphs. For =6 cm  donkey taken equal to 0.01 dB/km. Let us assume that attenuation occurs over the entire range. Under this condition, formula (2) takes the form of a transcendental equation

(3)

We solve equation (3) graphically. For osl = 0.01 dB/km and D max = 634.38 km calculated D max.osl = 305.9 km.

Conclusion: From the calculations obtained it is clear that the maximum range of the radar, taking into account the attenuation of radio wave energy during propagation, is equal to D max.os l = 305.9 [km].

2.2 Calculation of real resolution in range and azimuth

The real range resolution when using an all-round visibility indicator as an output device will be determined by the formula:

 (D) =  (D) sweat +  (D) ind

For a signal in the form of an incoherent train of rectangular pulses

0.33 [km]

for D shk1 =50 [km],  (D) ind1 =0.31 [km]

for D shk2 =400 [km],  (D) ind2 =2.50 [km]

Real range resolution:

for D wk1 =50 km  (D) 1 =  (D) sweat +  (D) ind1 =0.33+0.31=0.64 [km]

for D wk2 =400 km  (D) 2 =  (D) sweat +  (D) ind2 =0.33+2.50=2.83 [km]

We calculate the real azimuth resolution using the formula:

 ( az) =  ( az) sweat +  ( az) ind

 ( az ) sweat =1.3  Q a 0.5 =0.663 [deg]

 ( az ) ind = d n M f

Taking r = k e d e / 2 (mark on the edge of the screen), we get

0.717 [deg]

 ( az )=0.663+0.717=1.38 [deg]

Conclusion: The actual range resolution is:

for D shk1 = 0.64 [km], for D shk2 = 2.83 [km].

Real azimuth resolution:

 ( az )=1.38 [deg].

2.3 Calculation of real accuracy of range and azimuth measurements

Accuracy is characterized by measurement error. The resulting root mean square error in range measurement will be calculated using the formula:

40,86

 (D) sweat = [km]

Error due to non-linearity of propagation (D) distribution neglected. Hardware errors (D) app are reduced to errors in reading on the indicator scale (D) ind . We adopt the method of counting by electronic marks (scale rings) on the all-round display indicator screen.

 (D) ind = 0.1  D =1.5 [km], where  D - scale division price.

 (D) = = 5 [km]

We determine the resulting root-mean-square error in azimuth measurement in a similar way:

0,065

 ( az ) ind =0.1   = 0.4

Conclusion: Having calculated the resulting root mean square error of range measurement, we obtain (D)  ( az) =0.4 [deg].

Conclusion

In this course work, the parameters of a pulsed active radar were calculated (maximum range taking into account absorption, real resolution in range and azimuth, accuracy of range and azimuth measurements) for detecting air targets for air traffic control.

During the calculations, the following data were obtained:

1. The maximum range of the radar, taking into account the attenuation of radio wave energy during propagation, is equal to D max.osl = 305.9 [km];

2. Real range resolution is equal to:

for D wk1 = 0.64 [km];

for D shk2 = 2.83 [km].

Real azimuth resolution: ( az )=1.38 [deg].

3. The resulting root mean square error of range measurement is obtained(D) =1.5 [km]. Root mean square error of azimuth measurement ( az ) =0.4 [deg].

The advantages of pulse radars include the ease of measuring distances to targets and their range resolution, especially when there are many targets in the viewing area, as well as almost complete time decoupling between received and emitted oscillations. The latter circumstance allows the use of the same antenna for both transmission and reception.

The disadvantage of pulsed radars is the need to use high peak power of emitted oscillations, as well as the inability to measure short ranges large dead zone.

Radars are used to solve a wide range of problems: from ensuring soft landing of spacecraft on the surface of planets to measuring the speed of human movement, from controlling weapons in anti-missile and anti-aircraft defense systems to personal protection.

References

1. Vasin V.V. Range of radio engineering measuring systems. Methodological development. - M.:MIEM 1977
2. Vasin V.V. Resolution and accuracy of measurements in radio engineering measuring systems. Methodological development. - M.: MIEM 1977
3. Vasin V.V. Methods for measuring coordinates and radial speed of objects in radio engineering measuring systems. Lecture notes. - M.: MIEM 1975.

4. Bakulev P.A. Radar systems. Textbook for universities. M.: “Radio-

Technique" 2004

5. Radio systems: Textbook for universities / Yu. M. Kazarinov [etc.]; Ed. Yu. M. Kazarinova. M.: Academy, 2008. 590 p.:

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