Thus, it is rather probable, that thanks to braking influence on function of monocytes gold preparations oppress immune reactions and chronic rhematoid inflammatory process, i.e. Give the immunodepressive and mediated antiinflammatory effect. As monocytes - the long-living cells, the stated concept are explained by slow development of therapeutic effect of gold. Treatment begin with one or several trial injections of small doses - 0,5-1 ml of a solution of Crysanolum of 5 % with an interval of 7 days, order ultram cheap and then pass to one weekly introduction of a solution of Crysanolum of 2 ml of 5 % within 7-8 months After that at good shipping and achievement of convincing improvement intervals between injections enlarge to 2 . If during the following 3-4 improvement or remission signs remain, intervals between injections can be enlarged to 3 . More rare injections, despite available references (1 time in 4 and is more rare), apparently, are inexpedient, as thus through 3-5 relapses are rather often observed. The maintenance therapy with its introduction of 1 times in 3 at good shipping is spent by Crysanolum practically constantly. Former reasons about rationality of course treatment (before reception by the patient 1-2 pure gold) have appeared wrong as after course end naturally there were relapses (usually in some months, sometimes in 1 year and later). This circumstance is necessary for meaning and consequently, that at renewal in connection with relapses the worst results are usually observed, than at the first appointment. If in a maintenance therapy there are exacerbation first signs, it is necessary to translate again the patient on more frequent injections. prescribe similarly; the trial dose usually makes 20 mg, medical - 50 mg.
Consider, that in the absence of effect during 4 it is expedient to enlarge a weekly dose to 100 mg. If such dose in some weeks does not lead to improvement, it is necessary to cancel. It is so long apply and in a daily dose of 6 mg. It is necessary to remember, that improvement first signs appear late - sometimes through 3-4 continuous . Therefore the patient should be adjusted on very slow development of effect and not stop treatment prematurely. Improvement at a number of patients reaches degrees of true remission with disappearance of pains and other signs of an arthritis, ESR normalisation, sharp depression the Russian Federation, possibility of cancellation applied earlier and Prednisolonum. Therapeutic effect more low, than the preparations of gold applied . Therefore with other things being equal and availability of various medicines can be begun with , and at its inefficiency it is continued by means of Crysanolum or . It is very important, that long application of preparations of gold is capable to brake pseudorheumatism advance, and on occasion at erosive process in bones leads even to restoration of osteal structure. The most frequent complications - the allergic pruritic eruptions often combined with an eosinophilia and increase of level IgE. The "Gold" dermatitis disappears in some days (especially against antihistamine preparations) is more often, but 1 year and more can last 1 2 , and sometimes. The insolation is capable to strengthen its implications. Stomatites and conjunctivitises concern complications also. Rather seldom there is an alopecia, metal smack in a mouth and small adjournment of gold not having clinical value in a cornea and a lens. Treatment by gold is frequent leads to a vpxl cheap proteinuria which at its ignoring and therapy continuation can be replaced by an obvious nephrotic syndrome. it is possible to continue, if the quantity of fiber in urine does not exceed 0,1 g/l, and erythrocytes - 5-10 in sight. At excess of these indicators a preparation temporarily cancel, and after normalisation of analyses of urine reception renew in a smaller dose or with the enlarged intervals. If these changes arise again, cancel. At development of a nephrotic syndrome or a proof appreciable proteinuria Prednisolonum reception (since 30-40 mg/sut) as at the heart of such renal lesions shown by a glomerulonephritis, adjournment in glomuluses of a complement and immune complexes in which as an antigen bond of gold with fiber serves is supposed is expedient. The forecast at this renal pathology the good.