Physiotherapeutic procedures are widely used as an additional method to the main treatment, as well as during rehabilitation. This group of methods includes electrophoresis with lidase.
This technique is used in the rehabilitation clinic of the Yusupov Hospital in the treatment of various diseases. The affordable cost of the procedure is combined with the professionalism of specialists and the friendly attitude of the staff, which makes a stay at the Yusupov Hospital not only comfortable, but also beneficial for the body.
Lidase electrophoresis: mechanism of action
Specialists working in the field of aesthetic medicine are faced with solving various problems, the most labor-intensive of which is working with scars. Electrophoresis with lidase is used to treat keloid and hypertrophic scars. This procedure is also used to treat gynecological diseases.
The mechanism of action of electrophoresis is based on the effect on the affected tissues and organs of a low-level direct current, as a result of which metabolic processes in the body are accelerated and rapid cell regeneration occurs. Lidase is an enzyme that increases tissue permeability, improves blood circulation and reduces swelling. Electrophoresis allows the active ingredient lidase to be delivered through the skin. This method does not involve damaging the integrity of the skin, but it allows you to get a positive result.
Many women who are indicated for this procedure ask specialists whether electrophoresis with lidase is safe and effective during menstruation. During menstruation, this procedure can be used, but it is important that the area of influence be clearly localized.
When performing electrophoresis with lidase, specialists at the Yusupov Hospital Rehabilitation Center use high-quality European equipment, which is safe and free of discomfort. An important advantage of visiting the Yusupov Hospital to undergo a course of procedures is the affordable cost of services, which is combined with the professionalism of doctors and the respectful attitude of the staff.
Livazo
Effect on muscle tissue
As with other HMG-CoA reductase inhibitors (statins), there is a possibility of developing myalgia, myopathy and, in rare cases, rhabdomyolysis. Patients should be warned to report any muscle symptoms. CPK activity should be determined in any patient reporting muscle pain, muscle tenderness or weakness, especially if accompanied by malaise or fever.
CPK activity should not be determined after physical exercise or in the presence of any other possible reasons for the increase in CPK that may distort the result. If CPK activity increases (5 times higher than ULN), a control analysis should be performed within 5-7 days.
Very rare cases of immune-mediated necrotizing myopathy (IONM) have been reported during treatment or when discontinuing statins. IONM clinically manifests itself in the form of persistent weakness of the proximal muscles and increased CPK activity in the blood serum, which persist despite the abolition of statins.
Livazo should not be used in conjunction with fusidic acid preparations (orally or by injection) or within 7 days after stopping treatment with fusidic acid-containing preparations. In the case of patients for whom the use of fusidic acid drugs is considered fundamentally necessary, statin therapy should be discontinued for the entire period of treatment with drugs of this group. Cases of rhabdomyolysis (including some deaths) have been reported in patients taking fusidic acid and statins concomitantly. Patients should be warned to seek immediate medical attention if they develop any symptoms characterized by muscle weakness, pain, or muscle tenderness.
Statin therapy can be resumed seven days after the last dose of fusidic acid. In exceptional cases, when long-term systemic use of fusidic acid preparations is necessary, for example, for the treatment of severe infections, the decision on the combined use of Livazo and fusidic acid should be made exclusively on an individual basis under close medical supervision.
Before treatment
Like all statins, Livazo should be prescribed with caution to patients with predisposing factors for the development of rhabdomyolysis. CPK activity should be determined to establish a reference baseline value in the following cases:
- renal failure,
- hypothyroidism,
- personal or family history of hereditary muscle diseases,
- previous history of muscle toxicity during treatment with fibrates or other statins,
- a history of liver disease or alcohol abuse,
- patients over 70 years of age with other predisposing risk factors for the development of rhabdomyolysis.
In such cases, clinical monitoring is recommended and the risk of treatment should be considered in relation to the potential benefit. Treatment with Livazo cannot be started if CPK activity is 5 times higher than the ULN.
During treatment
The patient should be advised to immediately report muscle pain, weakness or cramps to the doctor. CPK activity should be determined, and treatment should be stopped if CPK activity is elevated (5 times the ULN). Discontinuation of treatment should be considered if severe muscle symptoms occur, even if CPK activity does not exceed 5 times the ULN. When symptoms resolve and CPK activity returns to normal, re-prescribing Livazo at a dose of 1 mg may be considered, subject to careful monitoring.
Effects on the liver
Like all statins, Livazo should be prescribed with caution to patients with a history of liver disease or to patients who regularly drink excessive amounts of alcohol. Liver function tests should be performed before starting treatment with Livazo and then periodically during treatment. Patients with a persistent increase in the activity of “liver” transaminases (ALT and AST), exceeding ULN by 3 times, should stop treatment with Livazo.
Effects on the kidneys
Livazo should be used with caution in patients with moderate or severe renal impairment. The dose should be increased only with careful monitoring. The 4 mg dose is not recommended for patients with severe renal impairment.
Diabetes
Some evidence suggests that statins, as a class, increase blood glucose levels, increasing the risk of developing diabetes mellitus in the future, and in some patients at high risk of developing diabetes mellitus, may lead to a level of hyperglycemia at which formal treatment becomes indicated. diabetes mellitus However, this danger is outweighed by the reduction in vascular risk with statin treatment and should therefore not be a reason to discontinue statin treatment. Patients at risk of developing hyperglycemia (fasting glucose concentration from 5.6 to 6.9 mmol/l, body mass index (BMI)>30 kg/m2, increased TG concentration, arterial hypertension) require clinical and biochemical monitoring in accordance with with national recommendations. However, based on the results of both post-marketing observations to assess safety and prospective studies, no confirmed signals were identified regarding the risk of diabetes mellitus with the use of pitavastatin.
Interstitial lung diseases
Rare cases of interstitial lung disease have been reported with the use of some statins, especially with long-term therapy.
Observed clinical signs include shortness of breath, nonproductive cough, and deterioration in general health (fatigue, weight loss, and fever). If interstitial lung disease is suspected, statin therapy should be discontinued.
Pediatric patient population
Limited data are available regarding the long-term effects on growth and puberty in pediatric patients over 6 years of age treated with Livaso. Adult women should receive advice regarding the use of reliable methods of contraception during treatment with Livazo.
Electrophoresis with lidase: contraindications
Before performing electrophoresis with lidase, specialists from the Yusupov Hospital Rehabilitation Center carry out a comprehensive diagnosis aimed at identifying possible contraindications.
The main contraindications for electrophoresis with lidase:
- diseases and damage to the skin;
- malignant formations;
- increased body temperature;
- allergic reaction to lidase;
- diseases of the heart and blood vessels;
- bronchial asthma;
- diseases of the endocrine system;
- pulmonary tuberculosis;
- high sensitivity to electrical discharges.
During pregnancy and lactation, the use of this procedure should also be limited. Lidase for electrophoresis, the price of which is affordable, does not cause unpleasant sensations, nor does exposure to electric current, but during this period the woman is the most sensitive and vulnerable.
The Yusupov Hospital employs experienced physiotherapists who regularly improve their skills, so when contacting the rehabilitation center, patients can be confident that the services provided meet international quality standards.
Lidaza lyophile for intravenous and local use 1280ME amp 5ml No. 10
Compound
Active substance: hyaluronidase 64 IU (which corresponds to lidase 1280 IU).
Indications for use
Burn, traumatic, postoperative scars;
long-term non-healing ulcers (including radiation); Dupuytren's contracture; joint stiffness, joint contractures (after inflammatory processes, injuries), osteoarthritis, ankylosing spondylitis, severe diseases of the lumbar discs; chronic tendovaginitis, scleroderma (skin manifestations), superficial soft tissue hematoma; preparation for skin plastic surgery for scar tissue. Pulmonary tuberculosis with a productive nature of inflammation (as part of complex therapy to increase the concentration of antibacterial agents in the lesions).
Traumatic lesions of the nerve plexuses and peripheral nerves (plexitis, neuritis).
In ophthalmology: for finer scarring of affected areas of the cornea, retinopathy of various etiologies, hemorrhage into the vitreous body.
To improve the absorption of drugs administered subcutaneously and intramuscularly.
Contraindications
Malignant neoplasms, acute infectious and inflammatory diseases, pulmonary hemorrhage, hemoptysis, pulmonary tuberculosis with respiratory failure, fresh vitreous hemorrhage, simultaneous use of estrogens, increased sensitivity to hyaluronidase.
Directions for use and doses
For scar lesions, 64 UE (1 ml) is administered subcutaneously (under the scar tissue) or intramuscularly (near the site of the lesion) daily or every other day (10-20 injections in total).
For traumatic lesions of the nerve plexuses and peripheral nerves, inject subcutaneously into the area of the affected nerve (64 UE in procaine solution) every other day; per course - 12-15 injections. The course of treatment is repeated if necessary.
When used in ophthalmic practice, the drug is administered subconjunctivally - 0.3 ml, parabulbarly - 0.5 ml, and also by electrophoresis.
Patients with pulmonary tuberculosis with a productive nature of inflammation are prescribed in complex therapy to increase the concentration of antibacterial drugs in the lesions in the form of injections and/or inhalations. Inhalations are carried out once daily using 5 ml of solution (320 CU). The course of treatment consists of 20-25 inhalations. If necessary, repeat courses are carried out at intervals of 1.5-2 months.
In the form of bandages soaked in a solution of the drug. To prepare the solution, every 64 units are dissolved in 10 ml of sterile 0.9% sodium chloride solution or boiled water at room temperature. A sterile bandage folded in 4-5 layers is moistened with this solution, applied to the affected area, covered with wax paper and secured with a soft bandage. The dose depends on the area of the lesion (32-64 UE/sq.cm), on average - 320 UE per bandage. The bandage is applied daily for 15-18 hours for 15-60 days. With long-term use, take a break for 3-4 days every 2 weeks.
When used by electrophoresis, 320 UE is dissolved in 64 ml of distilled water, 2-3 drops of a 0.1% hydrochloric acid solution are added and injected from the anode onto the affected area for 20-30 minutes. The course of treatment is 15-20 sessions. The application dosing regimen can be alternated with electrophoresis. The prepared solution must be used within 24 hours.
Storage conditions
In a place protected from light, at a temperature not exceeding 15 ° C. Keep out of the reach of children.
Best before date
2 years. Do not use after the expiration date stated on the package.
special instructions
The solution should not be administered through a catheter into which solutions containing cations have previously been injected.
Before starting treatment, it is advisable to conduct a test with intravenous injection of hyaluronidase.
It should not be injected into areas of infectious inflammation and tumors.
Description
Enzyme agent.
Pharmacodynamics
Enzymatic agent isolated from the testes of cattle. Breaks down the main component of the interstitial substance of connective tissue - hyaluronic acid (mucopolysaccharide, which includes acetylglucosamine and glucuronic acid, is a cementing substance of connective tissue). Hyaluronidase causes the breakdown of hyaluronic acid into glucosamine and glucuric acid and thereby reduces its viscosity. Increases tissue and vascular permeability, facilitates the diffusion of fluids in the interstitial space. Reduces tissue swelling, softens and flattens scars, increases range of motion in joints, reduces contractures and prevents their formation.
The effect of hyaluronidase is reversible: when its concentration decreases, the viscosity of hyaluronic acid is restored.
Duration of action with intravenous administration is up to 48 hours.
Side effects
Possible: allergic reactions; at the injection site - pain and infiltrates.
In some cases: ventricular fibrillation.
Use during pregnancy and breastfeeding
Use with caution during pregnancy and lactation.
Interaction
Hyaluronidase improves the absorption of drugs administered subcutaneously or intramuscularly and accelerates pain relief when local anesthetics are administered.
Use with caution in combination with other drugs, because an unpredictable increase in absorption and increased systemic action are possible.
Overdose
Symptoms: chills, nausea, vomiting, dizziness, tachycardia, decreased blood pressure, local edema, urticaria, erythema.
Treatment: administration of epinephrine, glucocorticosteroids; antihistamines.
Advantages of visiting the Yusupov Hospital
Yusupov Hospital is a medical institution in which doctors maintain the tradition of attentive and respectful treatment of patients, and also provide a wide range of medical services. Electrophoresis with lidase is one of the most popular services in physical therapy, which is why specialists at the rehabilitation center successfully perform it when patients contact us.
The Yusupov Multidisciplinary Hospital has the following advantages:
- high level of services and maintenance. A visit to the Yusupov Hospital is comfortable and effective for every patient. Experienced specialists provide various types of medical services, which allows us to work even with those patients who were rejected in other clinics;
- modern equipment for treatment and diagnostics. When carrying out electrophoresis, European-made devices are used, which are regularly serviced;
- professionalism of employees. The Yusupov Hospital employs more than 150 carefully selected employees, 12 of whom are doctors of science, 36 employees have a candidate’s degree;
- comfortable living conditions. The rooms in the Yusupov Hospital are equipped with comfortable furniture, wireless Internet and the necessary consumables;
- information support for each patient.
Lidase electrophoresis is one of the many procedures performed in the rehabilitation clinic. To use it, you must make an appointment with a physiotherapist by calling the Yusupov Hospital.
