Обработка кожи пациента до и после проведения оперативных вмешательств (в т. ч. инъекции, пункции, биопсия, взятие крови), обработка ран, ожогов, трофических язв, пролежней, суперинфекционных дерматитов, гигиеническая обработка больных
Противопоказания
Гипертиреоз, аденома щитовидной железы, герпетиформный дерматит Дюринга, одновременное применение радиоактивного йода, детский возраст до 8 лет, повышенная чувствительность к йоду и другим компонентам препарата. С осторожностью следует применять препарат при беременности и в период лактации (грудного вскармливания)
100 мл раствора содержит: активное вещество – повидон-йод 10 г (чтосоответствует количеству 0. 9 - 1. 2 г активного йода), вспомогательные вещества: глицерин, ноноксинол 9, кислота лимонная безводная, динатрия гидрофосфат ангидрат, едкийнатр (10 % раствор (м/о) для установления pH), вода очищенная.
Фармакологические свойства
Длительное нанесение препарата Бетадин на обширные раны и ожоги, а также слизистые оболочки, может привести к всасыванию значительного количества йода. Как правило, вызванное этим повышение содержания йода в крови быстро проходит (концентрация возвращается к исходному уровню через 7-14 дней после последнего применения препарата). У пациентов с нормальной функцией щитовидной железы повышенное всасывание йода не вызывает никаких существенных изменений в ее гормональной функции. Всасывание повидона и его выделение почками зависит от среднего молекулярного веса (смеси). Для веществ с молекулярным весом выше 35000- 50000 возможна задержка в организме, особенно в ретикулогистиоцитарной системе. Объем распределения йода после всасывания соответствует примерно 38% веса тела (в кг), время биологического полувыведения после вагинального применения составляет примерно 2 дня. Нормальный общий уровень йода в плазме крови составляет примерно 3,8-6,0 мкг/дл, а уровень неорганического йода - 0,01-0,5 мкг/дл. Йод выделяется исключительно почками с показателем клиренса от 15 до 60 мл плазмы в минуту (нормальные пределы: 100-300 мкг йода на 1 г креатинина).
Показания к применению
Обработка кожи пациента до и после проведения оперативных вмешательств (в т. ч. инъекции, пункции, биопсия, взятие крови), обработка ран, ожогов, трофических язв, пролежней, суперинфекционных дерматитов, гигиеническая обработка больных
Противопоказания
Гипертиреоз, аденома щитовидной железы, герпетиформный дерматит Дюринга, одновременное применение радиоактивного йода, детский возраст до 8 лет, повышенная чувствительность к йоду и другим компонентам препарата. С осторожностью следует применять препарат при беременности и в период лактации (грудного вскармливания)
Применение при беременности и в период грудного вскармливания
Бетадин противопоказан с третьего месяца беременности и при грудном вскармливании. Первые два месяца применение возможно с осторожностью только по назначению и под контролем врача.
Способ применения и дозы
Раствор Бетадина можно использовать без разведения или в виде водного раствора в разведении 1: 10 или 1: 100. Для дезинфекции кожи на ее здоровых участках применяют раствор в неразведенном виде с экспозицией 1-2 мин. При обработке ран, ожогов, бактериальных и грибковых поражений кожи применяют водный раствор Бетадина в разведении 1: 10. Для гигиенической обработки больного используют водный раствор Бетадина в разведении 1: 100.
Побочное действие
Возможно: местное проявление аллергической реакции на йод (зуд, гиперемия), что требует отмены препарата.
Передозировка
Симптомы: анурия, недостаточностькровообращения, отек гортани, отек легких, нарушения обмена веществ. Лечение: немедленное введение пищевыхпродуктов, содержащих крахмал или белок (например, раствор крахмала в воде илимолоке). Промывание желудка 5%-ымраствором тиосульфата натрия (или внутривенное введение 10 мл 10%-го раствора тиосульфата натрия) стрехчасовыми интервалами по мере необходимости. Кроме того, тщательное клиническоенаблюдение за функцией щитовидной железы должно быть установлено для исключенияили раннего выявления вызванного йодом гипертиреоза.
Особые указания
Поскольку невозможно исключить развитиегипертиреоза, длительное (более 14 дней) применение Бетадина или его применениев значительных количествах на обширных поверхностях (более 10% поверхноститела) у пациентов (особенно у пожилых) с латентными нарушениями функциищитовидной железы, допустимо только после тщательного сопоставления ожидаемойпользы и возможного риска. За такими пациентами следует установить наблюдениедля выявления ранних признаков гипертиреоза и надлежащего исследования функциищитовидной железы, даже после прекращения применения препарата (на срок до 3месяцев). Применение Бетадина может снизитьпоглощение йода щитовидной железой, что может повлиять на результаты некоторыхисследований и процедур (сцинтиграфия щитовидной железы, определениебелково-связанного йода, диагностические процедуры с применением радиоактивногойода), в связи, с чем планирование лечения заболеваний щитовидной железыпрепаратами йода может стать невозможным. После прекращения применения Бетадинаследует выдержать интервал не менее 1 - 4 недель. Окислительное действие Бетадина можетпривести к ложноположительным результатам различных диагностических проб (например, выявление скрытой крови в кале или моче и глюкозы в моче с применениемтолуидина и гваяковых смол). Окислительные свойства Бетадина могутвызвать коррозию металлов, тогда как пластмассовые и синтетические материалыобычно не чувствительны к повидон-йоду. В отдельных случаях может наблюдатьсяизменение цвета, который обычно восстанавливается. Раствор Бетадин легко удаляется стекстильных и иных материалов теплой водой с мылом. Трудноудалимые пятнаследует обработать раствором аммиака или тиосульфатом натрия. Применение в педиатрии: У новорожденных и у детей в возрасте до 6месяцев применение Бетадина допустимо лишь по строгим показаниям. Принеобходимости следует контролировать функцию щитовидной железы.
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