Antibiotics in the elderly

Antibiotics in the elderly: Age-related changes in the liver and kidneys contribute to changes in biotransformation and the elimination of many drugs. This may be the reason for the development of side effects of drugs that are usually safe and non-toxic. Atrophic processes in the gastrointestinal mucosa lead to changes in the absorption of certain drugs, which explains the low effectiveness of therapy.

With age, as a result of weight loss and muscle atrophy, the water content in the body decreases (by 10-15%) and the relative weight of adipose tissue increases (in men from 18 to 36%, in women from 33 to 48%). Consequently, in the elderly, the volume of distribution of water-soluble drugs changes, which is accompanied by a certain increase in their concentration in the blood. The volume of distribution of fat-soluble drugs in the elderly increases.

Antibiotics in the elderly

A decrease in the penetration of drugs into the tissues as a result of a decrease in the volume of distribution and the level of tissue blood flow may be one of the reasons for the insufficient clinical and bacteriological effectiveness of antibiotics in elderly patients.

The level of drug metabolism in the liver decreases with age as a result of a decrease in liver mass (after 40 years by 1% per year), hepatic blood flow (from 25 to 65 years by 40-45%) and the activity of microsomal enzymes. This leads to a decrease in the level of presystemic metabolism and phase I metabolism of medicinal drugs in the liver. As a result, the clearance decreases and the serum concentration of those antibacterial drugs that are mainly metabolized (more than 50%) in the liver increases: cefoperazone, doxycycline, lincomycin, clindamycin, chloramphenicol, pefloxacin, macrolides, rifamgscin, etc.

The elimination of most antibiotics is carried out by the kidneys. With age, as a result of atrophy of the cortical layer of the kidneys, the level of glomerular filtration decreases (from 20 to 50 years by 0.4 ml/min per year, after 50 years — by 1 ml/min per year) and tubular secretion (on average by 7% every 10 years). This is accompanied by a slowdown in the excretion of many drugs in elderly patients, which leads to an increase in their concentration in the blood.

In this regard, it is desirable to adjust the administered doses of antibacterial drugs that have a predominantly renal elimination pathway, in accordance with the value of glomerular filtration. This is especially important for potentially toxic drugs: aminoglycosides, vancomycin, carbenicillin, ticarcillin, tetracyclines, clomiphene, polymyxins, etc.

When deciding on the choice of an antibiotic, it is necessary to consider the features of drug interaction, since many elderly patients simultaneously take several drugs from different groups (hypotensive, antianginal, nootropic, etc.).

IVF pills (IVF preparations)

When using assisted reproductive technologies (ART), as a rule, hormonal drugs (IVF pills) are used. IVF preparations are chemical compounds obtained synthetically, which have the same effect on the body as their own sex hormones.

The drugs are used at the stage of ovulation stimulation, to prepare the endometrium for embryo transfer, as well as to support the luteal phase in early pregnancy.

Below we will look at these medications, but the information on them is in no way a prescription and can not be used by patients on their own without the appointment of the attending physician. Our article is for informational purposes only.

Preparations for ovulation stimulation

Antiestrogens

Clomid (clomiphene, clomiphene citrate, clostylbegite). It is available in tablets of 50 mg. In small doses, it increases the secretion of gonadotropins (prolactin, FSH and LH), stimulates ovulation; in high doses, it inhibits the secretion of gonadotropins. It is used both to stimulate ovulation under the control of ultrasound, and in IVF protocols.

IVF pills

Human Menopausal Gonadotropins

IVF pills: Menopur containing 75ED FSH and 75ED LH (Ferring, Germany). Currently, there is a Menopur-Multidose containing 1200 units of FSH and 1200 UNITS of LC, with the ability to dose the drug using a convenient handle.

Menogon containing 75ED FSH and 75ED LH (Ferring, Germany).

Alterpur-urofollitropin (FSH) , available in doses of 75 and 150 IU; (Ibsa, Switzerland). e

Merional (Ibsa, Switzerland), The ratio of the biological activity of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) is 1:1. It is available in a dose of 75ME and 150ME (the dose is measured by FSH).

Bravel (Ferring, Germany) – urofollitropin (a highly purified follicle-stimulating hormone), is available in a dose of 75 MG FSH.

Previously existing menotropins-Pergonal, Metropin, Humegon – are not currently produced.

The use of estrogens in ART

Estrogens in transdermal (through the skin) or oral (through the mouth) forms are used:

  • in programs using cryopreserved embryos
  • in protocols of superovulation stimulation
  • in patients with endometrial hyperplasia in surrogacy programs.

IVF pills: Proginova 2 mg (Delfarm, France) – dragee for oral administration.

Estrofem 2 mg (NOVO NORDISK, Denmark) – tablets for oral administration.

Divigel 0.5 and 1.0 (Orion Corporation, Finland) – gel for external use in single-dose packages.

Estrogel 2.5 mg (Besins, Belgium) – gel for external use, contains 1.5 mg of estradiol in tubes of 80 g with a measuring spatula.

The Council of Experts of the RARCH (Russian Association of Human Reproduction) recommends continuing estrogen therapy during the first trimester of pregnancy in the absence of their own yellow body, its functional insufficiency or endometrial hypoplasia.

When making a list of drugs that we use in our work, you can not choose the best one or make a universal scheme of stimulation. Depending on the clinical situation, the doctor individually selects the drug and its required dose.

! Attention ! All information on the drugs presented in this article is not intended as a prescription and cannot be used by patients independently without the appointment of the attending physician. The article is for informational purposes only.

How clomid affects the body?

How clomid affects the body: Clomid is a drug in tablet form, which contains clomiphene citrate. This drug is a selective estrogen receptor modulator. This term means that the antiestrogen, by binding to estrogen receptors in a certain area of the body, blocks the effect of female sex hormones, but in other tissues it can act as a natural estrogen. In the sports field, this drug is especially popular in post-course therapy due to its properties to prevent the negative effects of estrogens on the hypothalamus and activate increased testosterone production.

Clomid directly affects the estrogen receptors in the pituitary gland and sex glands. By binding to these receptors in the pituitary gland, the antiestrogen interferes with the process of negative feedback – as a rule, estrogens during the action on the pituitary gland reduce the production of lutenizing and follicle-stimulating hormones, but when using clomid, this process is not carried out in the body. From this, you can perfectly understand how clomid affects testosterone, since these gonadotropins contribute to an increase in the concentration of the main male sex hormone in the body.

How clomid affects the body

It is also worth noting that clomid does not affect the level of estrogens in the blood, it only blocks the work of receptors, but female sex hormones become simply inactive in the body.

What effect does the antiestrogen have on the athlete’s body?

Clomid does not affect the metabolic processes of estrogens in the body, so in the case of using this drug, estrogen is freely destroyed by liver enzymes, and does not accumulate in the athlete’s body. To fully understand the principle of the effect of clomid in the body, it is necessary to consider in detail how the antiestrogen affects a particular process. Next, let’s look at the most popular questions:

  • How does clomid affect the spermogram? Initially, since the 70s of the last century, clomid was used as a drug for the treatment of infertility – both male and female. For men, this drug allowed them to fight idiopathic oligospermia – the missing number of sperm cells that are necessary for fertilization of the egg. Therefore, after taking antiestrogens, an increase in the number of active spermatozoa may be observed in the spermogram.
  • How does clomid affect potency? Antiestrogen in sports practice contributes to the normalization of the functioning of the hypothalamus-pituitary-testicular arch. As a result, the concentration of natural testosterone in the body of a man increases, which has a positive effect on erectile function. Most athletes after a course of the steroid are in the so-called “hormonal pit”, which can negatively affect the sexual life. As a result, with the use of clomid, the athlete can observe an improvement in the quality of sexual life, it should also be noted that the timely start of post-course therapy with clomid will avoid testicular atrophy.

To suppress aromatization in the body, aromatase inhibitors – anastrozole, letrozole, or in extreme cases, proviron-are best suited. These drugs, especially the first two, perfectly cope with the symptoms of gynecomastia, excessive fluid retention, high blood pressure and other signs of aromatization.

Clomid, in turn, is used during post-course therapy, while aromatase inhibitors are taken mainly on the course of anabolic and androgenic substances. It allows you to normalize the production of natural testosterone in the body in a short time, and it also eliminates the symptoms of gynecomastia that appeared after a course of steroids. The optimal dosage of antiestrogen is calculated based on how heavy the course was – how many steroids were present on the course, how large the dosages were.

What negative reactions should you be prepared for on the clomid course?

It is not enough to find out how clomid affects libido and spermogram. Also, before taking any medication, it is necessary to find out what side effects an antiestrogen can cause. Failure to comply with the recommended dosages, the optimal duration of the course may lead to the following negative reactions:

  • vertigo;
  • feeling sleepy or, conversely, sleep problems in the form of insomnia;
  • disorders of the digestive system in the form of nausea or vomiting;
  • frequent headaches;
  • the drug is also able to have a toxic effect on the liver, but if you compare it with another fairly popular antiestrogen tamoxifen, its toxicity is much less;
  • it is worth noting how clomid affects vision, neglect of the rules of taking the drug can lead to serious violations of visual function.

The above-mentioned undesirable effects occur in quite rare cases, and if they are observed, they quickly pass after stopping the use of antiestrogen. It is also worth adding that the use of clomid increases the risk of blood clots. But to minimize this effect during the post-course therapy with the use of antiestrogen, it is necessary to increase the volume of consumption of purified water – by at least one liter per day.

How long it will take to recover is calculated individually, depending on the severity of the course. As the reviews indicate, clomid is a fairly effective antiestrogen. Representatives of sports disciplines speak about it mostly positively, negative reviews describing the side effects of clomiphene citrate can be found quite rarely. Many athletes note that with its help it is possible to recover perfectly in a short period of time after a course of anabolic and androgenic steroids, and to minimize losses after AAS.

Bodybuilding and childbearing functions

Bodybuilding and childbearing functions: Let’s try to understand this poorly lit topic. First of all, if you are engaged in bodybuilding as an amateur and without the use of hormones, then you can only talk about the positive aspects associated with the conception of children. Because all you can get from training in the gym is only health and sexuality.

A man is “responsible” for the sex of the unborn child. Fertilizes the egg with a sperm cell with chromosome XX, it will be a girl, and if with chromosome XY, it will be a boy. Observations have shown that boys ‘spermatozoa are “faster” than girls’ spermatozoa, but they die faster (XY-spermatozoa live for several hours, and XX-for several days). Therefore, if the sexual act occurred at the moment when the egg is fully mature (alkaline environment), then there is a greater chance that a nimble boy will “run” to it faster. And if sexual intercourse occurred before the egg is fully mature (acidic environment), then it is more likely that it will be fertilized by the XX-sperm-long-lived.

It is statistically known that the frequency of male births is higher at the first birth and decreases at subsequent births. The younger the future parents, the more likely they are to conceive a boy, and vice versa. In the offspring of bald men, there are one and a half times more boys.
In addition, it is known that children of the weather are more often of the same sex, and if the interval between births is about three years, then in most cases children of the opposite sex are born. If pregnancy occurs shortly after an abortion, girls are more likely to be born.

Bodybuilding and childbearing functions: Steroids and Children

It is not entirely clear how clomid will act on a woman in the case of bodybuilding, do Bodybuilding and childbearing functions affect her? There are many opinions on this topic.

In principle, testosterone itself is a very natural thing for the male body. And they are afraid of some pathologies, I would not. I have a lot of friends who conceived children on the course and everything was always good. For example, the risk of getting unhealthy offspring is much greater if you sometimes drink beer or any other alcoholic beverage because it is possible to damage your germ cells. And if a man has a complete replacement of the sex cells every three months, then women do not have this in principle, and drinking wine, champagne, and even more vodka is a game of”Russian roulette”. Any gram can be fatal for the cell that will be used during pregnancy and then a freak will be born.

Bodybuilding and childbearing functions

However, it is important to know that anabolic steroids are inherently male contraceptives. In fact, it is to prevent unwanted pregnancy that they are often prescribed in many European countries. Experiments show that after a couple of months of using artificial sex hormones (AS), sperm activity drops to zero. You can have sex as before without the risk of an unwanted pregnancy of your girlfriend. That’s all good. But there is one caveat. I was asked recently: why do chemical athletes have a problem with conceiving a boy (girls are most often born). The answer is quite obvious – during the course ( in the first few months until complete sterilization has occurred) and for some time after the course (until spermatogenesis has not recovered at the proper level), the athlete has a low level and motility of sperm. You remember that the boy’s sperm are more nimble and live less. And girls, on the contrary, are slower and live longer. In conditions when spermatozoa are sedentary and there are few of them, it is the more tenacious and slower female spermatozoa that get the advantage. All this leads to a higher probability of conceiving a girl and not a boy. How to increase the probability of having a boy?

There are several ways to increase the probability of conceiving a boy. All of them are associated with facilitating the fertilization of a female egg. After all, the faster your sperm reach the uterus, the more likely it is that a boy will be born, not a girl.

First, your girl must accurately calculate the time of maturation of her egg, in order to conceive a boy on this day. Here it is important not to make a mistake with the day. How do I do this? It is necessary that the girl for three cycles every day measured the temperature (preferably rectally). The peak temperature falls on ovulation, so if conception occurred on a day – to-day basis, it will be a boy, and if it takes 5-3 days, it will be a girl.

Secondly, it is desirable to do more of what men often do not particularly like to do. I mean the foreplay. For what? For a female orgasm. Have you ever wondered why and why a woman experiences an orgasm? I explain, these most convulsive contractions of female pisi are nothing more than a way to quickly deliver your sperm to the uterus. That is why cheating wives often get pregnant from lovers ( with whom there is an orgasm), and not from husbands (with whom they pretend)

Third, this is dogistyle. Who did not understand gru in Russian: put her cancer! This is also one of the mechanical ways to get your sperm into the uterus easier and faster.

Fourth, do not use lubricants, all sorts of grease and even the saliva at the time of conception of the child. All this interferes with and slows down the work of your sperm.

Fifthly, you can list many other things. Do not smoke – the smoker’s sperm is less mobile, and the cigarettes themselves negatively affect the erection. Don’t use drugs for the same reasons. . In addition, cocaine and opiates cause impotence, and amphetamines reduce sexual desire. Do not use the sauna. If you are more than half an hour in the water, the temperature of which is above 40° C, the number of healthy and mobile spermatozoa decreases. From the sauna, the effect is the same. Do not wear tight underwear made of synthetic fabrics. Because the temperature of the scrotum should be a degree less than the rest of the body.