Instruction for use: Betamethasone (Betamethasonum)

Chemical name

(11beta, 16beta) -9-Fluoro-11,17,21-trihydroxy-16-methylpregna-1,4-diene-3,20-dione (and in the form of dipropionate, disodium phosphate, valerate, etc.)

Pharmacological group

Glucocorticosteroids

Nosological classification (ICD-10)

A16.2 Tuberculosis of lungs without mention of bacteriological or histological confirmation

Disseminated tuberculosis, Caseous pneumonia, Pulmonary tuberculosis, Pulmonary tuberculosis, Tuberculosis of the lung chronic multidrug-resistant, Pulmonary tuberculosis, Fulminant tuberculosis of the lungs, Chronic tuberculosis of the lungs, Disseminated tuberculosis of the lungs

A17 Tuberculosis of the nervous system

Extrapulmonary tuberculosis, Disseminated tuberculosis

A48.3 Toxic shock syndrome

Bacteria-nomic shock, Infectious-toxic shock, intoxication syndrome, Toxic-infectious shock, Toxic shock, Chronic intoxication at diseases of the gastrointestinal tract, Chronic intoxication with gastrointestinal infections, endotoxin shock

C34 Malignant neoplasm of bronchi and lung

Small cell anaplastic lung tumors, Small cell and non-small cell lung cancer, Small cell lung cancer, Locally-distributed small cell lung cancer, Locally advanced non-small cell lung cancer, Undifferentiated lung cancer, Non-small cell lung cancer, Bronchogenic Cancer, Non-small cell lung cancer, Inoperable locally advanced non-small cell lung cancer, Cancer of the bronchi, Lungs' cancer, Small cell lung cancer, Lung cancer, Small cell lung cancer, Non-small cell lung cancer, Lung cancer of squamous cell, Recurrent non-small cell non-small cell lung cancer, Small cell lung carcinoma, Inoperable metastatic non-small cell lung cancer, Lung carcinoma, Ovsyocellular carcinoma of the lung, Disseminated lung cancer, Tumors of the lungs

C81 Hodgkin's disease [lymphogranulomatosis]

Paltauf-Sternberg disease, The generalized form of Hodgkin's disease, Lymphogranulomatosis, Hodgkin's disease, Hodgkin's lymphoma, Hodgkin's malignant lymphoma, Hodgkin's lymphoma, Lymphoproliferative diseases, Reticulosis fibromyaloid, Pelya-Ebstein fever

C84.0 Mushroom mycosis

Mycosis mushroom, Fungoid granuloma

C91.0 Acute lymphoblastic leukemia

Recurrence of acute leukemia, Blast Crisis, Lymphoblastic leukemia, Lymphoid blast crisis, Acute lymphoblastic leukemia, Acute lymphoblastic leukemia in adults and children, Acute lymphoblastic leukemia in children, Acute lymphatic leukemia

C92 Myeloid leukemia [myeloid leukemia]

Ph-positive chronic myelogenous leukemia, Granulocytic leukemia, Myeloid leukemia, Myeloid leukemia, Myeloma disease, Neuroleukemia, Acute myeloblastic leukemia, Acute non-lymphoblastic leukemia, Acute non-lymphoblastic leukemia in adults, Refractory acute non-lymphoblastic leukemia, Induction of remission in PMLL, Transformation of preleukemias, Subleukemic myelosis, Myeloblastic leukemia, Myeloid leukemia

C92.0 Acute myeloid leukemia

Myeloid blast crisis, Acute myeloblastic leukemia in adults, Acute myelogenous leukemia, Acute myelocytic leukemia, Recurrence of acute leukemia, Recurrent acute myeloblastic leukemia, Myeloleukemia acute

D59.1 Other autoimmune hemolytic anemia

Autoimmune hemolytic anemia, Immune hemolytic anemia, Autoimmune hemolytic anemia

D60.9 Acquired pure red cell aplasia, unspecified

Hematopoietic disorders, Partial red cell aplasia of hematopoiesis, Erythroid anemia

D61.0 Constitutional aplastic anemia

Anemia hypoplastic

D61.9 Aplastic anemia, unspecified

Myelophthisis anemia, Anemia hypoplastic, Partial anemia, Aplasia of the bone marrow, Aplastic anemia, Congenital hypoplastic anemia, Bone marrow hypoplasia, Hypoplastic anemia, Hematopoietic disorders, Hereditary hypoplastic anemia, Normochromic-normocytic anemia

D69.3 Idiopathic thrombocytopenic purpura

Werlhof's disease, Idiopathic autoimmune thrombocytopenia, Idiopathic thrombocytopenic purpura of adults, Idiopathic thrombocytopenic purpura in adults, Immune idiopathic thrombocytopenic purpura, Immune thrombocytopenia, Bleeding in patients with thrombocytopenic purpura, Evans Syndrome, Thrombocytopenic purpura, Thrombocytopenia of immune origin, Chronic idiopathic thrombocytopenic purpura, Essential thrombocytopenia, Autoimmune thrombocytopenic purpura in pregnancy, Posttransfusion purpura

D69.5 Secondary thrombocytopenia

Secondary cytopenia

D70 Agranulocytosis

Agranulocytosis is hereditary, Aleicia, Aleykocytosis, Agranulocytic angina, Angina agranulocytic, Primary cytopenia

D86.0 Lung sarcoidosis

E05.5 Thyroid crisis or coma

thyrotoxic crisis, hypothyroid coma, Crease tireotoksicski

E06.9 Thyroiditis, unspecified

Pulmonary thyroiditis, Syndrome of euthyroid pathology

E16.2 Hypoglycemia, unspecified

Hypoglycemic coma, Hypoglycemia, Severe hypoglycemia, Hypoglycaemia

E25.0 Congenital adrenogenital disorders associated with enzyme deficiency

Congenital adrenogenital syndrome, Insufficiency of 17-alpha-hydroxylase

E27.4 Other and unspecified adrenocortical insufficiency

Hypocorticism, Hypoaldosteronism, Adrenal insufficiency, Insufficiency of the adrenal cortex, Insufficiency of the adrenal cortex, Secondary adrenocortical insufficiency, Secondary adrenal insufficiency, Secondary insufficiency of the adrenal cortex, Temporary decrease in the function of the adrenal cortex, Dysfunction of the adrenal cortex

E83.5.0 * Hypercalcemia

Hypercalcemic crisis, Idiopathic hypercalcemia of newborns, Milk-alkaline syndrome

G25.5 Other types of chorea

Hyperkinesis of chorea, Chorea, Chorea small, Chorea, Secondary chorea, Acute chorea, Chronic chorea, St Witt's Dance, Chorea Sidengama (small, rheumatic), Senile chorea, Sydenham chorea

G35 Multiple sclerosis

Disseminated sclerosis, multiple sclerosis, Relapsing Multiple Sclerosis, Secondary progressive multiple sclerosis, Exacerbation of multiple sclerosis, Mixed forms of multiple sclerosis

G93.6 Edema of the brain

Intraoperative cerebral edema, Cerebral edema, Post-traumatic swelling of the brain, Brain edema associated with radiation therapy, Brain edema associated with head trauma, Post-traumatic cerebral edema, Edema of the brain in poisoning

H01.0 Blepharitis

Blepharitis, Inflammation of the eyelids, Inflammatory diseases of the eyelids, Demodectic blepharitis, Superficial bacterial infection of the eyes, Superficial infection of the eye, Scaly blepharitis

H10.1 Acute atopic conjunctivitis

Allergic conjunctivitis, Allergic eye disease, Allergic conjunctivitis, Allergic conjunctivitis is caused by chemical and physical factors, Allergic rhinoconjunctivitis,Allergic inflammation of the eye, Spring catarrh, Spring keratitis, Spring conjunctivitis, allergic Conjunctivitis, Perennial allergic conjunctivitis,Exacerbation of pollen allergy in the form of Syndrome rinokonyunktivalnogo, Acute allergic keratoconjunctivitis, Acute allergic conjunctivitis,Superficial bacterial eye infections,rhinoconjunctivitis, Seasonal allergic conjunctivitis, Seasonal conjunctivitis, Sennoz, Chronic allergic keratoconjunctivitis, Chronic allergic conjunctivitis

H15.0 Sclerite

Acute scleritis, Chronic scleritis, Diffuse scleritis, Sclerite

H16.0 Corneal ulcer

Allergic corneal ulcer, Erosion of the cornea, Regional ulcer, Purulent corneal ulcer,Corneal ulcer, Trophic ulcers of the cornea, Traumatic erosion of the cornea, Ulceration of the cornea, Keratitis with corneal ulceration, Ulcerative keratitis, Purulent corneal ulcers, Epithelial point keratitis, Ulceration of superficial corneal layers, Keratomalacia, Corneal ulcer, Recurrent erosions of the cornea, Recurrent ulcers of the cornea, Bacterial corneal ulcer, Septic ulcer of the cornea, Corneal edge ulcer

H16.2 Keratoconjunctivitis

Chronic allergic keratoconjunctivitis, Bacterial keratoconjunctivitis, Deep forms of adenovirus keratoconjunctivitis, Infectious conjunctivitis and keratoconjunctivitis caused by Chlamydia trachomatis, Acute allergic keratoconjunctivitis, Spring keratoconjunctivitis, Phlyctenular keratoconjunctivitis

H20 Iridocyclitis

recurrent iritis, sympathetic iridocyclitis, Sluggish posterior uveitis, Sluggish posterior uveitis, Posterior uveitis, the posterior segment of the eye Iridocyclitis, Iridocyclitis and other uveitis, Irit, Keratoiridotsiklit, Acute iritis, uveitis, cycle of Acute iridocyclitis, Acute non-infectious uveitis

H30 Chorioretinal inflammation

Retinitis, Chorioretinitis, Central and peripheral chorioretinal dystrophy

H44.1 Other endophthalmitis

Ophthalmic sympathetic, Egyptian ophthalmia,Endophthalmitis

H46 Optic neuritis

Leber Retinitis, Inflammatory optic neuritis of the optic nerve, Strona syndrome, Inflammation of the optic nerve, Papillitis

H60.9 External otitis, unspecified

Inflammation of external auditory canal, Otitis, Chronic external otitis media

I00 Rheumatic fever without mention of cardiac involvement

Acute rheumatism, Rheumatic arthritis acute, Rheumatism is active, Rheumatic fever, Acute attack of rheumatic joint disease

I01 Rheumatic fever with involvement of the heart

Rheumatic carditis acute

J30 Vasomotor and allergic rhinitis

Allergic rinopatiya, Allergic rhinosinusopathy, Allergic respiratory diseases, Allergic rhinitis, nasal allergy, Seasonal Allergic Rhinitis, Vasomotor rhinitis, Long-allergic rhinitis, Perennial allergic rhinitis, Perennial allergic rhinitis, Year-round or seasonal allergic rhinitis, Year-round allergic rhinitis nature, Rhinitis allergic vasomotor, Exacerbation of pollen allergy in the form of Syndrome rinokonyunktivalnogo, Acute allergic rhinitis, Edema of the nasal mucosa, Edema of the nasal mucosa, Swelling of the mucosa of the nasal cavity, Swelling of the nasal mucosa, Swelling of the nasal mucosa, pollen disease, Permanent allergic rhinitis, rhinoconjunctivitis, rhinosinusitis,rhinosinusopathy, Seasonal allergic rhinitis, Seasonal Allergic Rhinitis, Haymarket rhinitis, Chronic allergic rhinitis, Allergic respiratory diseases

J45 Asthma

Asthma physical effort, status asthmaticus, Bronchial asthma, Asthma lung flow, Bronchial asthma with obstruction of sputum discharge, Bronchial asthma heavy currents, Bronchial asthma physical effort, hypersecretory asthma, Hormone-dependent form of bronchial asthma, Relief of asthma attacks in bronchial asthma, Non-allergic asthma, nocturnal asthma, Exacerbation of asthma, Asthma attacks, Endogenous forms of asthma, Night asthma, Cough with bronchial asthma

J46 Status asthmaticus

Asthmatic attack, status asthmaticus, Bronchospasm in bronchial asthma

J63.2 Berylliosis

J67.9 Hypersensitive pneumonitis due to unspecified organic dust

J69.0 Pneumonitis caused by food and vomit

Aspiration pneumonia, Pneumonia aspiration, Postoperative aspiration pneumonia in neurosurgical and thoracic operations

J82 Pulmonary eosinophilia, not elsewhere classified

Pulmonary infiltrate, Eosinophilic pulmonary infiltrate, Leffler's syndrome, Leffler's disease

J84.1 Other interstitial lung diseases with mention of fibrosis

Pneumonia fibrous, Pneumonia chronic, Fibrosis of the lung, Diffuse pulmonary fibrosis, Idiopathic pulmonary fibrosis, Fibrosis of the lungs, Pneumosclerosis, Pleurofibrotic fibrosis, Fibrosis of the lungs idiopathic, Fibrosis of lungs progressive massive, Pneumofibrosis

K50 Crohn's disease [regional enteritis]

Crohn's disease, Crohn's disease with fistula, Granuloma of the intestine, Granulomatous enteritis, Crohn's disease, Regional ileitis, Terminal Ileitis, Enteritis regional

K51 Ulcerative colitis

Colitis acute ulcerative, Colitis ulcerative, Ulcerative-necrotic colitis, Colitis ulcerative-hemorrhagic nonspecific, Colitis ulcerative and trophic, Colitis ulcerative idiopathic, Colitis ulcerative nonspecific, Nonspecific ulcerative colitis, Proctocolitis ulcers, Hemorrhagic purulent rectoxitis, Rectoccolitis ulcerative-hemorrhagic

K52 Other noninfectious gastroenteritis and colitis

senile Bowel Syndrome, sigmoid, Gastroenteritis noninfectious, gastroenterocolitis, Colitis, Colitis non-dysenteric, Colitis noninfectious, Colitis is a chronic, Colitis is a chronic non-infectious, Local enteritis, sigmoid noninfectious, Chronic inflammatory bowel disease, Chronic inflammatory disease of the small intestine, Chronic enterocolitis, Chronic atrophic gastroenteritis, Chronic gastroenteritis, Chronic colitis, Chronic enterocolitis, Enteritis, non-infectious enteritis, Enterocolitis chronic noncommunicable, colon disease

K72.0 Acute and subacute liver failure

Lightning-fast hepatitis, Hepatitis acute, Hepatic failure acute and subacute

K72.9 Hepatic insufficiency, unspecified

Latent hepatic encephalopathy, Acute liver failure, Liver failure, Hepatic precoma, Acute hepatic-renal failure

L10 Pemphigus [pemphigus]

Benign pemphigoid of mucous membranes, Bubble dermatosis, Pemphigus, Dermatitis, vesicular, Benign pemphigus, Ordinary pemphigus, Pemphigus, Bubble dermatitis, Family benign pemphigus Hailey-Hailey

L13.0 Herpetitic dermatitis

Dyurling disease, Bullous herpetiform dermatitis, Duhring's herpetiform dermatitis, Dühring's dermatitis, Herpetiform dermatitis

L20 Atopic dermatitis

Itchy atopic eczema, Common neurodermatitis, Allergic skin diseases, Allergic skin diseases of non-infectious etiology, Allergic skin diseases of non-microbial etiology, Allergic skin diseases, Allergic skin lesions, Allergic manifestations on the skin, Allergic dermatitis, Allergic diathesis, Allergic itching dermatosis, Allergic Skin Disease, Allergic skin irritation, Dermatitis allergic, Atopic dermatitis, Dermatosis allergic, Diathesis exudative, Skin Allergic Disease, Skin allergic reaction to medicinal and chemical preparations, Skin reaction to medication, Skin and allergic disease, Acute eczema, Chronic atopic dermatitis, Exudative diathesis, Itching allergic dermatosis

L21 Seborrheic dermatitis

Dermatitis seborrheic, Increased sebum separation, Seborrheic Eczema, Seborrheic dermatitis of the scalp, Seborrheic pyodermatitis, Seborrhea, Eczema seborrheic

L22 Diaper dermatitis

Children's eczema, Diaper rash, Erythema from diapers

L26 Exfoliative dermatitis

Dermatitis exfoliative, Exfoliative dermatitis generalized

L28.1 Pruritus pruritus

Knotty prurus of Gaida, Knotty scrapie

L29 Itching

Itching with partial obstruction of the biliary tract, Dermatitis itchy, Dermatosis with persistent itching, Other itching dermatoses, Itching dermatoses, Itching allergic dermatosis, Itching dermatitis, Itching itch, Excruciating itching, Severe itching, Endogenous itching, Skin itching with dermatosis, Limited itching dermatitis, Itching of the skin, Itchy scalp, Itching eczema

L30.9 Dermatitis, unspecified

Allergic dermatoses complicated by a secondary bacterial infection, Anal eczema, Bacterial maturation, Varicose Eczema, Venous dermatitis, Inflammation of the skin, Inflammation of the skin upon contact with plants, Inflammatory Skin Diseases, Inflammatory skin reactions, Inflammatory processes of the skin, Hypostatic dermatitis, Fungal Eczema, Fungal dermatosis, Dermatitis, Dermatitis is stagnant, Dermatitis and eczema in the anal area, Dermatitis acute contact, Perianal dermatitis, Dermatosis, Dermatosis of the scalp, Dermatosis of psoriasis, Dermatosis with persistent itching, Dermatoses, Dermatoses itchy, Other itching dermatoses, Significant eczematous manifestations, Itching with, dermatoses, Itching eczema, True eczema, Skin reaction to insect bites,Skin itching with dermatosis, Constitutional eczema, Weeping eczema, Drowsing inflammatory skin disease, Dying Infectious-Inflammatory Skin Disease, Non-allergic dermatitis, Nummular eczema, Acute contact eczema, Acute inflammatory skin disease, Acute dermatosis, Acute severe dermatosis, Perianal dermatitis, Superficial dermatosis, Subacute Contact Eczema, Simple dermatitis, Occupational dermatitis, Psychogenic dermatosis, Bubble dermatitis of newborns, Pustular eruptions, Irritation and redness of the skin, Low-flammable eczema, Dry atrophic eczema, Dry eczema, Toxic dermatitis, Ear eczema like dermatitis, Chronic eczema, Chronic dermatosis, Chronic common dermatosis, Scaly papular dermatosis, Eczema, Eczema anal region, Eczema of the hands, Eczema Contact, Eczema lichenized, Eczema Nummular, Eczema acute, Eczema acute contact, Eczema subacute, Eczematous dermatitis, Eczema-like rashes, Ecome exogenous, Endogenous eczema, Gluteal dermatitis, Restricted itchy dermatitis

L40 Psoriasis

Chronic psoriasis with diffuse plaques, Generalized psoriasis, Psoriasis of the scalp, Psoriasis of the scalp, Generalized form of psoriasis, Psoriasis dermatitis, Psoriasis complicated by erythroderma, Invalidative psoriasis, Isolated psoriatic plaque, Exfoliative psoriasis, Psoriatic Erythroderma, Psoriasis with eczematosis, Hyperkeratosis in psoriasis,Inverse psoriasis,Psoriasis eczematous, Dermatosis of psoriasis, Psoriasis of the genitals, Psoriasis with lesions of hairy areas of skin, Erythrodermal psoriasis, Chronic psoriasis of the scalp, Chronic psoriasis, Ordinary psoriasis, Refractory psoriasis, Kebner phenomenon, Scaly lichen

L43 Red Leaf Flat

Lishay Wilson, Erosive-ulcerative form of red flat lichen, Warty forms of red lichen, Red lichen, Flat lichen, Kebner phenomenon

L50 Urticaria

Idiopathic chronic urticaria, Injury Urticaria, Chronic urticaria, Hives of the newborn

L51 Erythema multiforme

Stevens-Johnson syndrome, Malignant exudative erythema, Multiforme exudative erythema, Erythema multiforme, Multiforme exudative erythema, Stevens-Johnson Syndrome, Exudative multiform erythema, Erythema is polymorphic

L51.1 Bullous erythema multiforme

Polymorphic bullous erythema

L51.2 Toxic epidermal necrolysis [Lyell's]

Lyell's Syndrome, Toxic epidermal necrolysis

L53 Other erythematous conditions

Variable erythrokeratodermia, Malignant exudative erythema, Erythema, Erythematous, Erythroderma, Erythema from diapers

L93.0 Discoid lupus erythematosus

Chronic discoid lupus erythematosus, Red discoid lupus, Discoid lupus, Discoid erythematosis

M06.1 Still's disease, developed in adults

Still's disease, Still's syndrome

M06.9 Other specified rheumatoid arthritis

Rheumatoid arthritis,Pain syndrome in rheumatic diseases, Pain in rheumatoid arthritis, Inflammation in rheumatoid arthritis, Degenerative forms of rheumatoid arthritis, Children's rheumatoid arthritis, Exacerbation of rheumatoid arthritis, Acute articular rheumatism, Rheumatic arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatic polyarthritis, Rheumatoid arthritis, Rheumatoid arthritis of active course, Rheumatoid arthritis, Rheumatoid polyarthritis, Acute rheumatoid arthritis, Acute rheumatism

M07.3 Other psoriatic arthropathies (L40.5 +)

Arthritis psoriatic, The generalized form of psoriatic arthritis, Psoriatic arthritis

M08 Juvenile [juvenile] Arthritis

Juvenile arthritis, Juvenile chronic polyarthritis, Juvenile chronic arthritis, Juvenile rheumatoid arthritis, Arthritis juvenile chronic

M10.0 Idiopathic Gout

Primary gout

M13.0 Unspecified polyarthritis

Polyarthritis, Inflammatory diseases of joints, Nonspecific polyarthritis, Exchange polyarthritis, Polyarthritis, Polyarthropathy, Subchronic polyarthritis, Chronic polyarthritis, Pain with osteoarthritis, Polyarthritis of unclear etiology

M15-M19 Osteoarthritis

M30.0 Nodular polyarteritis

Periarteritis nodosa, Nodular periarteritis, Nodular polyarteritis (periarteritis)

M32 Systemic lupus erythematosus

Lupus erythematosus red disseminated, Disseminated lupus erythematosus, Chronic lupus erythematosus

M33 Dermatopolymiositis

Dermatomyositis, Wagner's disease, Wagner-Unferricht-Hepp Syndrome, Systemic dermatomyositis, Sclerodermatomyositis

M34 Systemic sclerosis

Scleroderma, Scleroderma generalized, Scleroderma diffuse, Scleroderma universal, Sclerosis systemic progressing, Buschke's disease, Sculpting adults, Sclera aponeurotic benign

M45 Ankylosing spondylitis

Ankylosing spondylarthrosis, Marie-Strumpel disease, Ankylosing spondylitis, Pain syndrome in acute inflammatory diseases of the musculoskeletal system, Pain syndrome in chronic inflammatory diseases of the musculoskeletal system, Bechterew's disease, Ankylosing spondylitis, Diseases of the spinal column, Rheumatic spondylitis, Bechterew-Marie-Strumpel disease

M65 Synovitis and tendosynovitis

Acute tenosynovitis, Tendovaginitis (tenovaginitis), Tendosinovit (tenosynovitis), Tendovaginitis, Osteoarthritis in musculo-articular diseases, Inflammatory disease of soft tissues, Nonspecific tenosynovitis, Tendosinovit

M71.9 Bursopathy, unspecified

Bursites, Alberta disease, Acute bursitis

M77.9 Other unspecified

Capsule, Periarthritis, Tendonitis, Tendopathy, Periarthropathy

M79.0 Other unspecified rheumatism

Degenerative rheumatic disease, Degenerative and rheumatic diseases of the tendons, Degenerative rheumatic diseases, Localized forms of rheumatism of soft tissues, Rheumatism, Rheumatism with a pronounced allergic component, Rheumatism of the articular and extraarticular, Rheumatic attack, Rheumatic complaints, Rheumatic diseases, Rheumatic disease of the spine, Relapses of rheumatism, Articular and extra-articular rheumatism, Articular and muscular rheumatism, Articular rheumatism, Articular syndrome with rheumatism, Chronic rheumatic pain, Chronic articular rheumatism, Rheumatoid diseases, Rheumatic diseases of the intervertebral disc

N00 Acute nephritic syndrome

Glomerulonephritis acute, Jade sharp, Disease with minimal changes, Disease of minimal changes, Rapidly progressive glomerulonephritis, Nephrotic syndrome with damage to small legs of podocytes, Acute nephritic syndrome,Acute glomerulonephritis

N04 Nephrotic syndrome

Nephrosis, Edema of the kidneys, Nephrotic syndrome, Lipoid nephrosis, Nephrotic syndrome without uremia, Acute nephrotic syndrome, Edematic syndrome of renal genesis, Renal form of diabetes insipidus, Segmental glomerulonephritis, Focal glomerulonephritis, Family Nephrotic Syndromes, Chronic nephrotic proteinuric syndrome, Lipiduria, Jade hereditary, Nephrotic-proteinuric syndrome

R11 Nausea and vomiting

Postoperative vomiting, Nausea, vomiting, Vomiting in the postoperative period, Vomiting drug, Vomiting on the background radiation therapy, Vomiting indomitable, Vomiting with radiation therapy, persistent vomiting, anacatharsis, Postoperative nausea, Vomiting during chemotherapy, Vomiting of central origin, Vomiting on the background of cytostatic chemotherapy, persistent hiccups, repeated vomiting

R57.0 Cardiogenic shock

cardiogenic shock

R57.8 Other types of shock

Blood transfusion shock, Obstructive shock, Circulatory shock

R57.8.0 * Burn shock

Pain shock with burns, Burn shock

T65.9 Toxic effect of unspecified substance

idiosyncrasy toxic, Intoxication nitro compounds, Intoxication toxins, Professional intoxication, Poisoning nitrites, Poisoning toxins

T78.2 Anaphylactic shock, unspecified

Anaphylactic shock, Anaphylactoid reaction, Anaphylactic shock, Anaphylactic reactions, Anaphylactic shock to drugs

T78.3 Angioedema

Edema Quincke, Laryngeal exacerbation with angioneurotic edema, Recurrent angioedema, Allergic edema, Recurrent swelling of Quincy

T78.4 Allergy, unspecified

Allergic reactions to insulin, Allergic reactions to insect stings, Allergic reactions similar to systemic lupus erythematosus, Allergic diseases, Allergic diseases of mucous membranes, Allergic diseases and conditions resulting from increased release of histamine, Allergic diseases of mucous membranes, Allergic symptoms, Allergic symptoms in the mucous membranes, Allergic reactions, Allergic reactions caused by insect bites, Allergic reactions, Allergic conditions, Allergic laryngeal edema, allergopathy, allergic conditions, Allergy, House dust allergy, Anaphylaxis, Cutaneous reactions to medications, Skin reaction to insect stings, Cosmetic allergy, Drug allergy, Acute allergic reaction, Laryngeal edema allergic genesis and background radiation, Food and drug allergy

T79.4 Traumatic shock

Hemorrhagic shock, Crush syndrome, hemorrhagic shock, postoperative shock, post-traumatic shock, traumatic shock, hemorrhagic shock and encephalopathy syndrome

T80.6 Other serum reactions

Serum sickness, Allergic reaction of the type of serum sickness, Serous disease accelerated

T81.1 Shock during or after the procedure, not elsewhere classified

Operating shock, Postoperative shock, Operational shock

T86.9 Dying and rejection of transplant (s) organ and tissue, unspecified

Rejection reaction, Rejection reaction during organ transplantation, Graft-versus-host response,GVHD, Transplant rejection reactions

Code CAS378-44-9

Characteristics

Hormonal (a glucocorticoid for systemic and topical application).

In medical practice, use betamethasone valerate, betamethasone dipropionate, betamethasone disodium phosphate. Betamethasone valerate and betamethasone dipropionate are the active onset of ointments and creams, betamethasone disodium phosphate in the form of a solution administered intravenously and subconjunctivally.

Betamethasone valerate - white or almost white crystalline powder odorless, practically insoluble in water, freely soluble in acetone and chloroform, soluble in ethanol, slightly soluble in benzene and ether. Molecular weight 476.58.

Betamethasone dipropionate is a white or creamy white crystalline powder, odorless, insoluble in water. Molecular weight 504.6.

Betamethasone disodium phosphate is a white or almost white powder, odorless, hygroscopic, freely soluble in water and methanol, practically insoluble in acetone and chloroform. Molecular weight 516.41.

Betamethasone disodium phosphate / dipropionate (combined drug (drug)) - a fine crystalline suspension; Injected in / m (intramuscularly), intraarticularly, periarticularly (can not be administered intravenously).

Pharmacology

Pharmacological action - anti-inflammatory, antiallergic, antipruritic, glucocorticoid.

It interacts with specific receptors in the cytoplasm of the cell, the resulting complex penetrates into the nucleus of the cell, binds to DNA and stimulates the synthesis of protein-induced mRNA, incl. Lipocortin, mediating cellular effects. In some cells (for example, in lymphocytes) causes suppression of mRNA. Lipocortin depresses phospholipase A2, blocks the liberation of arachidonic acid and the biosynthesis of endoperoxides, PG, leukotrienes (contributing to the development of inflammation, allergy and other pathological processes).

Affects all phases of inflammation. The anti-inflammatory effect is due to many factors. One of the leading ones is inhibition of phospholipase A2 with subsequent inhibition of the formation of proinflammatory mediators - PG and leukotrienes. In addition, it stabilizes the cell membranes, incl. Membranes of lysosomes, prevents the release of lysosomal enzymes and reduces their concentration in the focus of inflammation. It inhibits the migration of neutrophils and macrophages into the focus of inflammation and their phagocytic activity. Improves microcirculation, reduces vascular permeability, causes vasoconstriction of capillaries, reduces exudation of fluid.

The antiallergic effect develops as a result of a decrease in the synthesis and secretion of mediators of allergy, inhibition of release from sensitized mast cells and basophils of histamine and other biologically active substances, a decrease in the number of circulating basophils, suppression of proliferation of lymphoid and connective tissue, a decrease in the number of T- and B-lymphocytes, mast cells , Reducing the sensitivity of effector cells to mediators of allergy, inhibition of antibody formation, changes in the body's immune response.

Immunodepressive effect is associated with suppression of T and B lymphocyte activity, as well as inhibition of the release of cytokines (interleukin-1, interleukin-2, interferon-gamma) from leukocytes and macrophages.

Anti-shock and antitoxic action is associated with increased blood pressure (by increasing the number of circulating catecholamines, restoring the sensitivity of adrenoreceptors to catecholamines and vasoconstriction), activation of liver enzymes involved in the metabolism of endo- and xenobiotics.

Has a pronounced effect on all types of exchange. Stimulates gluconeogenesis in the liver, increases the level of glucose in the blood (glycosuria is possible). Accelerates protein catabolism, especially in muscle tissue. Causes the redistribution of fat: increases lipolysis in the tissues of the limbs, promotes the accumulation of fat mainly in the face (moon face), neck, shoulder girdle. Delays Na + and water, stimulates the excretion of K +, increases the excretion of Ca +.

With prolonged use suppresses the function of the hypothalamus - pituitary - adrenal system.

After parenteral (IM) and enteral administration is rapidly absorbed - the maximum effect (with ingestion) develops in 1-2 hours.

When using a combination of salts in a single preparation of betamethasone, disodium phosphate is well absorbed from the site of administration and has a rapid effect, betamethasone dipropionate has a slower absorption, but it provides a duration of the effect.

When instilled into the conjunctival sac, it penetrates into the intraocular fluid, the cornea, the iris, the choroid of the eye, the ciliary body, and the retina. Systemic absorption can be significant only when used in high doses or with prolonged use in children.

With local application on the skin, the intensity of absorption depends on a number of factors: solvent (polypropylene components improve diffusion), the state of the epidermal barrier (inflammation and skin diseases increase absorption).

It binds to plasma proteins. Easily passes gistogematicheskie barriers, including placental. Partially excreted in breast milk. Biotransformed mainly in the liver, the metabolites formed are inactive. Excreted by the kidneys.

Carcinogenicity, mutagenicity, effects on fertility

Long-term studies in animals to assess the potential carcinogenicity or effects on the fertility of betamethasone for topical application has not been carried out. Betamethasone was genotoxic in vitro in a test of chromosomal aberrations in human lymphocytes (with metabolic activation) and in vivo in a micronucleus test on the bone marrow of mice.

Additional information

No mutagenic activity of betamethasone was detected in the bacterial test using S. typhimurium and E. coli, in a test aimed at detecting mutations using Chinese hamster ovary cells and hypoxanthine-guanine phosphoribosyl transferase (CHO / HPRT test). However, the mutagenic activity of betamethasone in vitro in a test aimed at detecting chromosomal aberrations in human lymphocytes was noted. The results obtained in the micronuclear test (the method of accounting for chromosomal aberrations in vivo in red bone marrow cells of mice) have been mixed. In this respect, betamethasone is close in properties to dexamethasone and hydrocortisone.

Additional information

There have been no long-term studies aimed at studying the carcinogenic activity of betamethasone in animals.

In studies performed on rabbits, mice and rats, betamethasone was administered in / m at doses up to 1, 33 and 2 mg / kg, respectively. A dose-dependent increase in the frequency of fetal intrauterine resorption in rabbits and mice was observed.

Indications

Solution for injection, suspension for injection. Shock (burn, traumatic, operational, toxic, cardiogenic, blood transfusion, anaphylactic); Allergic (acute, severe forms) and anaphylactoid reactions; Cerebral edema (including on the background of a brain tumor or associated with surgical intervention, radiation therapy or head trauma); Bronchial asthma (severe form), asthmatic status; Systemic connective tissue diseases: systemic lupus erythematosus, rheumatoid arthritis; Acute adrenal insufficiency; Thyrotoxic crisis; Acute hepatitis, hepatic coma; Poisoning with cauterizing fluids (reducing inflammation and preventing cicatricial narrowing).

Intra-articular introduction: rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Reiter's disease, osteoarthrosis (in the presence of pronounced signs of joint inflammation, synovitis).

Pills. Systemic diseases of connective tissue: systemic lupus erythematosus, scleroderma, nodular periarteritis, dermatomyositis, rheumatoid arthritis; Acute and chronic inflammatory diseases of the joints: gouty and psoriatic arthritis, juvenile arthritis, osteoarthritis (including post-traumatic), polyarthritis, humeropathy periarteritis, ankylosing spondylitis (Bechterew's disease), Still's syndrome in adults, bursitis, nonspecific tendosynovitis, synovitis and epicondylitis ; Acute rheumatism, rheumatic heart disease, small chorea; bronchial asthma; Acute and chronic allergic diseases: allergic reactions to drugs and food, drug exanthema, serum sickness, urticaria, allergic rhinitis, pollinosis, Quincke's edema; Skin diseases: pemphigus, psoriasis, eczema, atopic dermatitis, contact dermatitis (with large skin lesions), toxemia, seborrheic dermatitis, exfoliative dermatitis, toxic epidermal necrolysis (Lyell's syndrome), bullous herpetiform dermatitis, malignant exudative erythema (Stevens-Johnson syndrome ); Cerebral edema (traumatic, postoperative, metastatic) after previous parenteral administration; Allergic eye diseases: allergic corneal ulcers, allergic forms of conjunctivitis; Inflammatory eye diseases: sympathetic ophthalmia, severe sluggish anterior and posterior uveitis, optic neuritis; Congenital adrenal hyperplasia; Primary or secondary adrenal insufficiency (including the condition after removal of the adrenal glands); Kidney disease of autoimmune genesis (including acute glomerulonephritis), nephrotic syndrome; Subacute thyroiditis; Diseases of the hematopoiesis: agranulocytosis, panmyelopathy, autoimmune hemolytic anemia, congenital (erythroid) hypoplastic anemia, acute lympho- and myeloid leukemia, lymphogranulomatosis, thrombocytopenic purpura, secondary thrombocytopenia in adults, erythroblastopenia (erythrocyte anemia); Interstitial lung diseases: acute alveolitis, pulmonary fibrosis, sarcoidosis II-III; tuberculous meningitis, tuberculosis, aspiration pneumonia (in combination with a specific chemotherapy), berylliosis, Loeffler's syndrome (not amenable to other therapy), lung cancer (in combination with cytotoxic drugs); multiple sclerosis; Diseases of the digestive tract (gastrointestinal tract): ulcerative colitis, Crohn's disease, local enteritis; Hepatitis, hypoglycemic conditions; Prevention of graft rejection reaction; Hypercalcemia due to malignant neoplasms, nausea and vomiting during cytostatic therapy; Myeloma disease.

When applied to the skin: dermatitis (simple, exfoliative, sunny, seborrheic, radiation, herpetiform, contact, atopic, etc.), eczema (child, coin-like, etc.), psoriasis, gibbous gibberish, skinny itch, discoid lupus erythematosus, urticaria, erythema multiforme, generalized erythroderma (composed of combination therapy), pemphigus, mycosis fungoides and other skin diseases.

Eye and ear drops: allergic and inflammatory eye diseases, incl. allergic blepharitis, conjunctivitis, keratoconjunctivitis, scleritis, uveitis, chorioretinitis, sympathetic iridocyclitis, central retinitis; Optic neuritis, retrobulbar neuritis, external otitis media.

Contraindications

Hypersensitivity (for short-term systemic use according to vital indications is the only contraindication).

For systemic use (parenterally and internally): systemic mycoses, herpetic diseases, incl. Chicken pox, as well as measles (currently or recently transferred, including recent contact with the patient), strongyloidiasis (established or suspected), tuberculosis (active form in the absence of specific treatment, latent), immunodeficient conditions (including AIDS or HIV-infection), gastrointestinal diseases (including peptic ulcer, gastric ulcer and duodenal ulcer in the phase of exacerbation, diverticulitis, esophagitis, gastritis, newly created intestinal anastomosis), diseases of the cardiovascular system (including recently Rescheduled first myocardial infarction, congestive heart failure, arterial hypertension), diabetes (including impaired glucose tolerance), myastenia gravis, acute psychosis, renal / hepatic failure, vaccination period.

For intraarticular administration, to the lesion: unstable joints, previous arthroplasty, pathological hemorrhage (endogenous or caused by the use of anticoagulants), transgressive bone fracture, infected foci of the joints, near-articular soft tissues and intervertebral spaces, expressed near-joint osteoporosis.

When applied to the skin: cutaneous manifestations of syphilis, skin tuberculosis; Bacterial, viral, fungal skin diseases (including chicken pox, herpes); Trophic ulcers of the lower leg, associated with varicose veins; Skin cancer, nevus, atheroma, melanoma, hemangioma, xanthoma, sarcoma; rosacea and acne vulgaris (possible worsening of the disease), post-vaccination skin reactions in children up to 1 year - rash (on the background of diaper rash).

Drops of the eye and ear: fungal lesions of the eyes or ear, acute virus diseases of the eyes (including acute superficial keratitis caused by Herpes simplex) or ear, tuberculosis of the eyes (including in the history) or ear, bacterial infections of the eyes Or ear, thinning or the presence of a defect in the epithelium of the cornea, sclera; Glaucoma, the presence of chronic or previous otitis media, perforation of the tympanic membrane (possibly development of ototoxicity).

Restrictions

For systemic use (parenteral and oral): open-angle glaucoma, hyperlipidemia, hypoalbuminemia, viral and bacterial infections, syphilis, Icyco-Cushing's disease, systemic osteoporosis, thrombophlebitis, and obesity of grade III-IV.

For intraarticular administration: the general severe condition of the patient, ineffectiveness or short duration of action of the two previous administrations (taking into account the individual properties of the applied GC).

When applied to the skin: with prolonged use or application on large surfaces - cataract, diabetes, glaucoma, tuberculosis.

Children's age: in children in the period of growth is used only in absolute indications.

pregnancy and lactation

When pregnancy is possible, if the expected effect of therapy exceeds the potential risk to the fetus (adequate and strictly controlled safety studies have not been conducted); Contraindicated - with pre-eclampsia, eclampsia, the presence of symptoms of placenta damage. Do not use often, in high doses, for a long period of time.

Potential teratogenicity of betamethasone dipropionate was not evaluated in case of skin application. The teratogenicity of betamethasone dipropionate in rabbits is shown for intravenous administration in doses of 0.05 mg / kg. Fixed disorders included umbilical hernia, cephalocele, wolf mouth.

The action category for fetus by FDA is C.

It is recommended that breastfeeding women stop breastfeeding or use betamethasone (especially in high doses).

Additional information

With systemic administration, betamethasone is found in breast milk. The use of betamethasone during lactation can affect the synthesis of endogenous glucocorticosteroids, cause growth suppression and other adverse reactions in the child. There is no data on the possibility of detecting betamethasone in breast milk when it is applied topically due to percutaneous absorption. Considering the fact that many drugs are excreted in human breast milk, care must be taken when prescribing betamethasone ointment when lactating.

Side effects of the substance Betamethasone

The frequency of development and severity of side effects depend on the duration of application and the amount of dose used. High doses or long-term use of HA can cause a pronounced manifestation of mineral- and glucocorticoid effects, considered as side effects.

System Effects

From the side of the nervous system and sense organs: delirium (confusion, excitement, anxiety), disorientation, euphoria, hallucinations, manic / depressive episode, depression or paranoia, increased intracranial pressure with edema of the optic nerve disk (pseudotumor of the cerebellum) - usually after treatment, sleep disturbances, dizziness, vertigo, headache, sudden loss of vision (for parenteral administration in the head, neck, nasal turbinate, the scalp may be due to the deposition of crystal vessels in the eye ), Posterior subcapsular cataract formation, elevation of intraocular pressure with possible damage to the optic nerve, glaucoma, exophthalmos steroid, the development of secondary fungal or viral infections of the eyes.

From the cardiovascular system and blood (hematopoiesis, hemostasis): arterial hypertension, the development of chronic heart failure (in predisposed patients), myocardial dystrophy, hypercoagulation, thrombosis, ECG changes characteristic of hypokalemia.

From the digestive tract: nausea, vomiting, erosive and ulcerative lesions of the gastrointestinal tract, pancreatitis, erosive esophagitis, hiccups, increased / decreased appetite.

From the metabolism: the delay of Na + and water, gipokaliemia, negative nitrogen balance due to protein catabolism, weight gain.

On the part of the endocrine system: suppression of adrenal cortex function, decreased glucose tolerance, steroid diabetes mellitus or manifestation of latent diabetes mellitus, Itenko-Cushing syndrome, hirsutism, growth retardation in children.

From the musculoskeletal system: muscle weakness, steroid myopathy, muscle mass reduction, osteoporosis (including spontaneous bone fractures, aseptic necrosis of the femoral head), tendon rupture.

For the skin: steroid acne, stretch marks, skin thinning, hyper- or hypopigmentation, petechiae and ecchymosis, delayed wound healing, increased sweating.

Allergic reactions: skin rash, hives, swelling of the face, stridor or shortness of breath, anaphylactic shock.

Other: decreased immunity and activation of infectious diseases, irregularity of menstruation, withdrawal syndrome (anorexia, nausea, block, pain in muscles or joints, back, abdominal pain, general weakness, etc.).

With iv introduction: arrhythmia, flushes of blood to the face, convulsions.

With intraarticular administration: increased pain in the joint.

Local reactions with parenteral administration: burning, numbness, pain, paresthesia and infection at the injection site, scar formation at the injection site; Atrophy of the skin and subcutaneous tissue (with the / m introduction).

When applied to the skin: itching, redness, burning and dryness of the skin, erythema, steroid acne, striae, folliculitis, hypertrichosis, sudamen, secondary infections of the skin and mucous membranes; With prolonged use - skin atrophy, local hirsutism, telangiectasia, purpura, hypopigmentation; When applied to large surfaces, systemic manifestations (gastritis, ulceration of the gastrointestinal mucosa) are possible.

Eye drops and ear: increased intraocular pressure, glaucoma, posterior subcapsular cataract formation, thinning or perforation of the cornea, the sclera; A burning sensation and tingling in the ear; Irritation, pain, itching and burning of the skin; Dermatitis, the development of secondary infection, with prolonged use in high doses - the development of systemic action of the GC.

Interaction

Therapeutic, toxic effects reduce the inducers of liver enzymes, enhance - estrogens and oral contraceptives, the likelihood of arrhythmias and hypokalemia increases glycogenides of digitalis, diuretics (causing potassium deficiency), amphotericin B, carbonic anhydrase inhibitors; Risk of ulcerative-erosive lesions or bleeding in the digestive tract (gastrointestinal tract) - alcohol and NSAIDs (non-steroidal anti-inflammatory drugs); The likelihood of infection and development of lymphomas and other lymphoproliferative diseases - immunosuppressants, the possibility of lung edema in pregnant women - ritodrin. Weaken the hypoglycemic activity of antidiabetic drugs and insulin, natriuretic and diuretic - diuretic, vaccine activity (due to decreased production of antibodies); Anticoagulant - derivatives of coumarin and indanedione, heparin, streptokinase and urokinase. Increases hepatotoxicity of paracetamol. Reduces the concentration in the blood of salicylates, mexiletine.

Overdose

Symptoms: nausea, vomiting, sleep disorders, euphoria, arousal. With prolonged use in high doses - osteoporosis, fluid retention in the body, increased blood pressure (arterial pressure) and other signs of hypercorticism, including Itenko-Cushing syndrome, secondary adrenal insufficiency.

Treatment: against the background of a gradual withdrawal of the drug maintenance of vital functions, correction of electrolyte balance, antacids, phenothiazines, lithium preparations; With Isenko-Cushing syndrome - aminoglutethimide.

Routes of administration

Inside, parenterally, topically.

Precautions

Mental disorders are more likely in patients with chronic diseases predisposing to the development of these disorders, and when taking high doses; Symptoms may occur between a few days and 2 weeks after initiation of therapy.

Use with caution in diabetes mellitus, corneal herpes simplex, systemic lupus erythematosus (increased risk of aseptic necrosis), osteoporosis, in patients with risk of thrombosis (prescribe against anticoagulants), in the elderly (increased risk of arterial hypertension, osteoporosis, especially in postmenopausal women Period), only against the background of appropriate antibiotic therapy - with abscesses, purulent infections, tuberculosis. It is necessary to take into account the increased effect in hypothyroidism, liver cirrhosis, the likelihood of developing (especially with prolonged use) relative adrenal insufficiency (within a few months after drug withdrawal).

With prolonged treatment, you should carefully monitor the dynamics of growth and development in children, periodically conduct an ophthalmological examination (for the detection of glaucoma, cataracts, etc.), regularly monitor the function of the hypothalamic-pituitary-adrenal system, glucose in the blood and urine (especially in patients with sugar Diabetes), electrolytes in the serum, hidden blood in the feces. For systemic use, EEG monitoring is recommended (electroencephalography, electroencephalogram).

Avoid contact with eyes and mucous membranes of medicinal forms for application to the skin.

During the therapy, vaccination and immunization are avoided. Do not drink alcohol.

Additional information

It is necessary to monitor the function of the hypothalamic-pituitary-adrenal system in patients receiving betamethasone preparations. For this purpose it is expedient to use such methods of laboratory diagnostics as stimulation of the adrenal cortex by adrenocorticotropic hormone (ACTH), determination of the level of free cortisol in the urine.