Микст-аллерген из пыльцы деревьев Раствор, 2 шт, 5 мл, 10 тыс.PNU/мл, для подкожного введения

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лебеда татарская) пыльцой луговых трав (тимофеевка луговая ежа сборная райграс пастбищный костер прямой овсяница луговая пырей ползучий лисохвост луговой мятлик луговой).","Показаниями для диагностики являются клинические проявления заболевания и данные анамнеза а для иммунотерапии данные кожного тестирования со специфическим микст-аллергеном.","При проведении специфической диагностики и иммунотерапии детям следует руководство­ваться приказом МЗ РФ от 04.11.2002 г. \"О совершенствовании аллергологической помощи детям в РФ\"."]}}]},{"id":9,"name":"Противопоказания","slug":"contraindications","body":[{"type":"paragraph","data":{"text":"Противопоказания для проведения специфической иммунотерапии:"}},{"type":"paragraph","data":{"text":"1. Обострение аллергического заболевания."}},{"type":"paragraph","data":{"text":"2. Тяжелая форма атопической экземы."}},{"type":"paragraph","data":{"text":"3. Аутоиммунные заболевания."}},{"type":"paragraph","data":{"text":"4. Иммунодефицитные состояния."}},{"type":"paragraph","data":{"text":"5. Острые инфекции."}},{"type":"paragraph","data":{"text":"6. Туберкулез любой локализации в период обострения."}},{"type":"paragraph","data":{"text":"7. Злокачественные новообразования и болезни крови."}},{"type":"paragraph","data":{"text":"8. Хронические заболевания в стадии декомпенсации."}},{"type":"paragraph","data":{"text":"9. Сердечно-сосудистые заболевания."}},{"type":"paragraph","data":{"text":"10. Беременность и период лактации."}},{"type":"paragraph","data":{"text":"11. Психические заболевания в периоде обострения."}},{"type":"paragraph","data":{"text":"12. 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Любые формы гормональной терапии терапия антигистаминными препаратами и бронхоспазмолитиками."}}]},{"id":12,"name":"Способ применения и дозы","slug":"dosage","body":[{"type":"paragraph","data":{"text":"Кожные пробы и лечение микст-аллергенами следует про­водить через:"}},{"type":"paragraph","data":{"text":"- 1 неделю после туберкулиновой пробы;"}},{"type":"paragraph","data":{"text":"- 2 недели после применения инактивированных вакцин и терапии антигистаминными препаратами;"}},{"type":"paragraph","data":{"text":"- 4 недели после применения живых вакцин;"}},{"type":"paragraph","data":{"text":"- 8-12 недель после применения вакцины БЦЖ."}},{"type":"paragraph","data":{"text":"С целью выявления противопоказаний врач в день постановки аллергических проб и в день проведения специфической иммунотерапии проводит осмотр больного."}},{"type":"paragraph","data":{"text":"I. Специфическая диагностика."}},{"type":"paragraph","data":{"text":"Препарат используют для постановки кожных проб (скари­фикация внутрикожно и прик тест)."}},{"type":"paragraph","data":{"text":"У больного имеющего повышенную чувствительность к данному комплексу микст-аллергенов возникает реакция немедленного волдырного типа (положительный результат). Вопрос о необходимости постановки кожных проб с отдельными моноаллергенами входящими в состав микст-аллергена решает врач-аллерголог."}},{"type":"paragraph","data":{"text":"Постановку кожных проб осуществлять с микст-аллергеном содержащим 10000±2500 PNU/мл. У пациентов с высокой степенью сенсибилизации возможно применять пре­парат в концентрации 5000±1500 PNU/мл. При отсутствии реакции на кожную пробу в концентра­ции 10000±2500 PNU/мл переходят к его внутрикожному введению в дозе 002 мл в концентрации 1000±250 PNU/мл. Препарат предварительно разводят разводящей жидкостью. Разведенный препа­рат не хранят."}},{"type":"paragraph","data":{"text":"Постановка скарификационных аллергических кожных проб"}},{"type":"paragraph","data":{"text":"Скарификационные аллергические пробы ставят на внутренней поверхности предплечья или на коже спины. Одномоментно с микст-аллергеном разрешается проводить до 15 проб с различ­ными пыльцевыми аллергенами кроме видов растений входящих в состав микст-аллергена. За 2-3 дня до постановки кожных проб должны быть отменены антигистаминные препараты. При сомни­тельных результатах кожные пробы можно повторить через 2 сут после стихания местной реакции на предыдущие пробы. В случае положительного результата кожные пробы с пыльцевыми аллерге­нами можно повторять не чаще одного раза в месяц."}},{"type":"paragraph","data":{"text":"Металлический колпачок флаконов (с микст-аллергеном или тест-контрольной жидкостью) протирают спиртом."}},{"type":"paragraph","data":{"text":"Удаляют стерильным пинцетом центральную крышку колпачка а резиновую пробку пред­варительно обработанную спиртом прокалывают стерильной иглой."}},{"type":"paragraph","data":{"text":"Кожу внутренней поверхности предплечья протирают 70° спиртом и дают ей высохнуть."}},{"type":"paragraph","data":{"text":"На дезинфицированную кожу с помощью шприцов наносят каплю испытуемого микст-аллергена и каплю тест-контрольной жидкости на расстоянии (30±10) мм друг от друга. Одновре­менно ставят скарификационную пробу с каплей 001% раствора гистамина положительная реакция на который не менее \"+\" свидетельствует о наличии достаточной реактивности кожи."}},{"type":"paragraph","data":{"text":"Стерильными скарификаторами или стерильными одноразовыми инъекционными иглами отдельными для микст-аллергена и для каждого больного через капли микст-аллергена тест-контрольной жидкости и раствора гистамина наносят две параллельные царапины длиной по 5 мм так чтобы не повредить кровеносных сосудов кожи."}},{"type":"paragraph","data":{"text":"Через 5-10 мин стерильными ватными тампончиками \"промокают\" капли тест-контрольной жидкости и микст-аллергена в месте царапины (ватный тампончик должен быть отдельным для каж­дой капли аллергенов гистамина и тест-контрольной жидкости)."}},{"type":"paragraph","data":{"text":"Если скарификационная проба дает отрицательную реакцию а по анамнезу имеется подоз­рение на повышенную чувствительность к растительной пыльце входящей в состав микст-аллергена или если необходимо провести аллергометрическое титрование перед началом специфической иммунотерапии ставят внутрикожные пробы."}},{"type":"paragraph","data":{"text":"Постановка внутрикожных проб"}},{"type":"paragraph","data":{"text":"Внутрикожные пробы проводят на внутренней поверхности предплечья. Кожу натягивают движением пальца книзу иглу вводят под углом 15° к поверхности кожи при этом необходимо следить за тем чтобы отверстие иглы полностью скрывалось в эпидермисе игла должна быть тонкой с коротким острием."}},{"type":"paragraph","data":{"text":"Стерильными одноразовыми отдельными для микст-аллергена и для каждого больного шприцами туберкулинового типа со шкалой деления 002 мл строго внутрикожно вводят 002 мл микст-аллергена и тест-контрольной жидкости пробу с 001% гистамином ставят методом скари­фикации. Микст-аллерген набранный в шприц нельзя выливать обратно во флакон."}},{"type":"paragraph","data":{"text":"Диагностику тестом укола (прик-тест) осуществляют в соответствии с методическими ре­комендациями М3 СССР 10-11/20 от 10 марта 1985 года."}},{"type":"paragraph","data":{"text":"Оценка диагностических кожных проб"}},{"type":"paragraph","data":{"text":"Результат диагностических проб учитывают через 15-20 мин (реакция немедленного типа). О специфической реакции на микст-аллерген судят только при отсутствии реакции на тест-контрольную жидкость и при наличии положительной пробы на гистамин (не менее \"+\")."}},{"type":"paragraph","data":{"text":"II. Специфическая иммунотерапия."}},{"type":"paragraph","data":{"text":"Специфическая иммунотерапия показана в тех слу­чаях когда невозможно исключить контакт сенсибилизированного больного с аллергеном. Показа­ния для проведения специфической иммунотерапии определяет врач-аллерголог на основании дан­ных анамнеза клинических проявлений заболевания результатов кожного тестирования с учетом противопоказаний."}},{"type":"paragraph","data":{"text":"Иммунотерапию микст-аллергеном проводят больным у которых установлена сенсибили­зация ко всем видам пыльцы входящей в состав комплексного препарата."}},{"type":"paragraph","data":{"text":"Иммунотерапию начинают с дозы в 10 раз меньшей чем та которая вызвала минимальную положительную реакцию при внутрикожном введении."}},{"type":"paragraph","data":{"text":"Микст-аллерген при специфической иммунотерапии вводят подкожно."}},{"type":"paragraph","data":{"text":"За приготовление и использование разведений микст-аллергена в условиях асептики ответственность несет врач-аллерголог."}}]},{"id":13,"name":"Побочное действие","slug":"side_effects","body":[{"type":"paragraph","data":{"text":"Местная реакция на микст-аллерген возникает через 15-20 мин (реак­ция немедленного типа). У особо чувствительных больных может возникнуть системная аллергиче­ская реакция и анафилактический шок. В связи с этим в кабинете где проводится специфическая диагностика и специфическая иммунотерапия больных должны находиться фармакологические препараты средства противошоковой терапии и инструментарий для оказания неотложной помощи."}},{"type":"paragraph","data":{"text":"Оказание помощи при реакциях общего типа и анафилактическом шоке"}},{"type":"paragraph","data":{"text":"В случаях если во время введения микст-аллергена с диагностической или лечебной целью у пациента возни­кает общая слабость или возбуждение беспокойство чувство жара во всем теле покраснение лица сыпь кашель затрудненное дыхание боли в животе необходимо проводить следующие мероприя­тия."}},{"type":"paragraph","data":{"text":"Первая доврачебная помощь"}},{"type":"paragraph","data":{"text":"Немедленно прекратить введение микст-аллергена; уложить больного (голова ниже ног) повернуть голову в сторону выдвинуть нижнюю челюсть удалить сни­мающиеся зубные протезы."}},{"type":"paragraph","data":{"text":"1. Если препарат был введен в конечность наложить жгут выше места введения на 25 мин."}},{"type":"paragraph","data":{"text":"2. Обколоть место инъекции 03-05 мл 01% раствора адреналина с 45 мл 09% раство­ра хлористого натрия."}},{"type":"paragraph","data":{"text":"3. В конечность свободную от жгута ввести подкожно или внутримышечно 03-05 мл 01% раствора адреналина (детям 005-03 мл)."}},{"type":"paragraph","data":{"text":"4. К месту инъекции приложить лед или грелку с холодной водой на 10-15 мин."}},{"type":"paragraph","data":{"text":"5. Срочно вызвать врача."}},{"type":"paragraph","data":{"text":"Первая врачебная помощь"}},{"type":"paragraph","data":{"text":"Если выполнены пункты 1-5 и нет эффекта следует:"}},{"type":"paragraph","data":{"text":"1. Ввести 03-05 мл (детям 005-03 мл) 01% раствора адреналина подкожно с интервалами 5-10 мин. Кратность и доза вводимого адреналина зависит от тяжести реакции и показателей артери­ального давления. При тяжелом анафилактическом шоке раствор адреналина необходимо ввести внутривенно в 20 мл 09% раствора хлористого натрия. Общая доза адреналина не должна превы­шать 2 мл (детям 1 мл) 01% раствора. Следует помнить что повторное введение малых доз адрена­лина более эффективно чем однократные введения большой дозы."}},{"type":"paragraph","data":{"text":"2. Если артериальное давление не стабилизируется необходимо срочно начать внутривен­ное капельное введение норадреналина (или мезатона) 02-10-20 мл на 5000 мл 09% раствора хлористого натрия."}},{"type":"paragraph","data":{"text":"3. Внутримышечно или внутривенно струйно ввести глюкокортикостероидные препараты: преднизолон 60-120 мг (детям 40-100 мг) дексаметазон 8-16 мг (детям 4-8 мг) или гидрокортизон сукцинат или гемисукцинат 125-250 мг (детям 25-125 мг)."}},{"type":"paragraph","data":{"text":"4. Внутримышечно ввести 20 мл (детям 05-15 мл) раствора 01% раствора тавегила или 25% раствора супрастина."}},{"type":"paragraph","data":{"text":"5. При бронхоспазме внутривенно вводится 100 мл (детям 2-3 мл) 24% раствора эуфиллина на 09% растворе хлористого натрия."}},{"type":"paragraph","data":{"text":"6. Сердечные гликозиды дыхательные аналептики (строфантин коргликон кордиамин) вводятся по показаниям."}},{"type":"paragraph","data":{"text":"7. При необходимости следует отсосать слизь из дыхательных путей рвотные массы и про­водить оксигенотерапию."}},{"type":"paragraph","data":{"text":"Все больные с анафилактическим шоком подлежат госпитализации. Транспортировка боль­ных производится после выведения из угрожающего состояния реанимационной бригадой т. к. в ходе эвакуации возможно повторное падение артериального давления и развитие коллапса."}},{"type":"paragraph","data":{"text":"Дозы вводимых препаратов и тактика врача определяются клинической картиной но во всех случаях необходимо в первую очередь введение адреналина глюкокортикоидов антигистаминных препаратов."}},{"type":"paragraph","data":{"text":"Введение антигистаминных препаратов фенотиазинового ряда (пипольфен дипразин и др.) и препаратов кальция не рекомендуется."}}]},{"id":15,"name":"Взаимодействие с другими лекарственными средствами","slug":"drugs_interaction","body":[{"type":"paragraph","data":{"text":"Взаимодействие с другими ле­карственными средствами не установлено."}}]},{"id":18,"name":"Форма выпуска","slug":"","body":[{"type":"paragraph","data":{"text":"Раствор для накожного скарификационного нанесения внутрикожного и подкожного введения 10000 PNU/мл."}}]},{"id":19,"name":"Условия хранения","slug":"storage","body":[{"type":"paragraph","data":{"text":"Микст-аллергены хранят в соответствии с СП 3.3.2.1248-03 в недоступном для детей месте при температуре от 2 до 8 °С."}},{"type":"paragraph","data":{"text":"Транспортирование осуществляют в со­ответствии с СП 3.3.2.1248-03 при температуре от 2 до 8 °С."}}]},{"id":20,"name":"Срок годности","slug":"expiry_date","body":[{"type":"paragraph","data":{"text":"Микст-аллергена - 2 года тест-контрольной и разводящей жидкостей - 5 лет."}},{"type":"paragraph","data":{"text":"Препарат с истекшим сроком годности применению не подлежит."}}]},{"id":21,"name":"Условия отпуска","slug":"release_condition","body":[{"type":"paragraph","data":{"text":"По рецепту."}}]}],"source":null},"description_toggle":false,"short_description":"Иммунологические свойства Основным действующим началом пыльцевых микст-аллергенов является белково-полисахаридный комплекс позволяющий диагностировать у больного при 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