{"id":57310,"date":"2024-02-27T17:36:16","date_gmt":"2024-02-27T17:36:16","guid":{"rendered":"https:\/\/medsname.com\/hisone\/"},"modified":"2026-04-30T10:24:29","modified_gmt":"2026-04-30T10:24:29","slug":"hisone","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/hisone\/","title":{"rendered":"Hisone"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 24px 0;border-radius:4px;\">\n<h3 class=\"wp-block-heading\" style=\"margin:0 0 8px 0;font-size:16px;font-weight:700;\">\u26a1 Rychl\u00e1 odpov\u011b\u010f \u2014 Co je Hisone?<\/h3>\n<p style=\"margin:0;\"><strong>Hisone<\/strong> je peror\u00e1ln\u00ed tableta od spole\u010dnosti Samarth Pharma obsahuj\u00edc\u00ed <strong>hydrokortizon<\/strong> (syntetickou formu t\u011blu vlastn\u00edho kortizolu). Dostupn\u00e9 v <strong>5 mg, 10 mg a 20 mg tablet\u00e1ch<\/strong>. Hydrokortizon je <strong>preferovan\u00fd glukokortikoid pro fyziologickou substitu\u010dn\u00ed terapii<\/strong> p\u0159i prim\u00e1rn\u00ed adren\u00e1ln\u00ed insuficienci (Addisonova choroba), sekund\u00e1rn\u00ed adren\u00e1ln\u00ed insuficienci (po operaci hypof\u00fdzy, deficitu ACTH, vysazen\u00ed dlouhodob\u011b vysok\u00fdch d\u00e1vek steroid\u016f) a vrozen\u00e9 hyperplazii nadledvin. Standardn\u00ed n\u00e1hradn\u00ed d\u00e1vka pro dosp\u011bl\u00e9 je <strong>15\u201325 mg\/den ve 2\u20133 d\u00edl\u010d\u00edch d\u00e1vk\u00e1ch<\/strong> \u2014 obvykle 10 mg po probuzen\u00ed, 5 mg v poledne a 5 mg pozd\u011b odpoledne (vy\u0161\u0161\u00ed rann\u00ed a ni\u017e\u0161\u00ed ve\u010dern\u00ed d\u00e1vka napodobuj\u00edc\u00ed p\u0159irozen\u00fd kortizolov\u00fd rytmus t\u011bla). N\u00e1hradn\u00ed terapie je <strong>do\u017eivotn\u00ed, bez postupn\u00e9ho sni\u017eov\u00e1n\u00ed<\/strong> \u2014 pacient nahrazuje to, co jeho nadledviny ji\u017e neprodukuj\u00ed. <strong>Pravidla pro nemoc jsou z\u00e1sadn\u00ed: zdvojn\u00e1sobit denn\u00ed d\u00e1vku b\u011bhem nemoci, hore\u010dky nebo v\u00fdrazn\u00e9ho stresu; p\u0159ej\u00edt na IM hydrokortizon p\u0159i zvracen\u00ed nebo neschopnosti udr\u017eet tablety; m\u00edt u sebe pohotovostn\u00ed injek\u010dn\u00ed sadu s kortikoidy a identifikaci Medic-Alert.<\/strong> Vynech\u00e1n\u00ed d\u00e1vek nebo n\u00e1hl\u00e9 vysazen\u00ed m\u016f\u017ee vyvolat adren\u00e1ln\u00ed krizi \u2014 stav vy\u017eaduj\u00edc\u00ed neodkladnou l\u00e9ka\u0159skou pomoc.<\/p>\n<\/div>\n<p><!-- medsbase-specialist-strip --><\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:16px 20px;margin:0 0 24px 0;border-radius:4px;font-size:14px;\"><strong>\u2695 L\u00e9k vy\u017eaduj\u00edc\u00ed odborn\u00fd dohled \u2014 nutn\u00fd klinick\u00fd dohled.<\/strong> Toto je z\u00e1va\u017en\u00fd imunomodula\u010dn\u00ed l\u00e9k se specifick\u00fdmi po\u017eadavky na p\u0159edl\u00e9\u010debn\u00e9 vy\u0161et\u0159en\u00ed, \u010dern\u00fdmi v\u00fdstrahami a povinn\u00fdm laboratorn\u00edm monitorov\u00e1n\u00edm. M\u011bl by b\u00fdt p\u0159edepisov\u00e1n a sledov\u00e1n revmatologem, gastroenterologem, dermatologem nebo jin\u00fdm odborn\u00edkem zku\u0161en\u00fdm s jeho u\u017e\u00edv\u00e1n\u00edm. Ne <strong>ne<\/strong> p\u0159edepisujte si ho sami, neupravujte d\u00e1vku ani neza\u010d\u00ednejte\/nep\u0159est\u00e1vejte bez pokyn\u016f p\u0159edepisuj\u00edc\u00edho l\u00e9ka\u0159e. V\u017edy poskytn\u011bte sv\u00e9mu o\u0161et\u0159uj\u00edc\u00edmu l\u00e9ka\u0159i aktu\u00e1ln\u00ed p\u0159edpis p\u0159ed objedn\u00e1n\u00edm z MedsBase.<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f6f8;border:1px solid #e1e4e8;border-radius:4px;padding:14px 18px;margin:18px 0;display:flex;flex-wrap:wrap;gap:14px;font-size:0.95em;\"><span>\u2705 <strong>WHO-GMP certifikov\u00e1no<\/strong> v\u00fdrobce<\/span><span>\ud83d\udce6 <strong>Diskr\u00e9tn\u00ed balen\u00ed<\/strong><\/span><span>\ud83c\udf0d <strong>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/strong><\/span><span>\ud83d\udcac <a href=\"\/cs\/reviews\/\">1,400+ recenz\u00ed z\u00e1kazn\u00edk\u016f<\/a><\/span><\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\"><strong>Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/strong><\/a> \u2014 pokud va\u0161e z\u00e1silka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f, p\u0159epos\u00edl\u00e1me ji.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Na\u0161e generick\u00e9 l\u00e9ky poch\u00e1zej\u00ed od v\u00fdrobc\u016f certifikovan\u00fdch WHO-GMP a jsou expedov\u00e1ny po cel\u00e9m sv\u011bt\u011b v diskr\u00e9tn\u00edm, nen\u00e1padn\u00e9m balen\u00ed \u2013 na vn\u011bj\u0161\u00ed stran\u011b bal\u00edku nen\u00ed uveden n\u00e1zev l\u00e9ku. Platby kartou jsou sm\u011brov\u00e1ny prost\u0159ednictv\u00edm regulovan\u00e9ho procesoru (popisky na v\u00fdpisu zahrnuj\u00ed regulovan\u00e9ho procesora plateb kartou \u2013 nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku). P\u0159ij\u00edm\u00e1me tak\u00e9 kryptom\u011bny a bankovn\u00ed p\u0159evody SEPA. Ka\u017ed\u00e1 objedn\u00e1vka je zaji\u0161t\u011bna na\u0161\u00ed politikou p\u0159eposl\u00e1n\u00ed.<\/p>\n<h2 class=\"wp-block-heading\">Co je Hisone?<\/h2>\n<p>Hisone jsou peror\u00e1ln\u00ed tablety vyr\u00e1b\u011bn\u00e9 spole\u010dnost\u00ed Samarth Pharma obsahuj\u00edc\u00ed <strong>hydrokortizon<\/strong> \u2014 syntetickou formu kortizolu, vlastn\u00edho prim\u00e1rn\u00edho stresov\u00e9ho hormonu t\u011bla. Kortizol je produkov\u00e1n k\u016frou nadledvin pod kontrolou hypofyz\u00e1rn\u00edho ACTH. Reguluje hladinu cukru v krvi, krevn\u00ed tlak, rovnov\u00e1hu sol\u00ed a vody, reakci t\u011bla na z\u00e1n\u011bt a infekci a kortizolov\u00fd rytmus bd\u011bn\u00ed-sp\u00e1nku.<\/p>\n<p>Hisone je zna\u010dkov\u00fd hydrokortizonov\u00fd tablet od spole\u010dnosti Samarth Pharma \u2014 standardn\u00ed hydrokortizon pro indick\u00fd trh dod\u00e1van\u00fd v sil\u00e1ch 5 mg, 10 mg a 20 mg, aby umo\u017e\u0148oval pru\u017en\u00e9 sestaven\u00ed typick\u00e9 n\u00e1hradn\u00ed d\u00e1vky 15\u201325 mg\/den. T\u0159i s\u00edly jsou navr\u017eeny tak, aby se kombinovaly: typick\u00fd dosp\u011bl\u00fd na d\u00e1vce 20 mg\/den m\u016f\u017ee u\u017e\u00edvat 10 mg tablet r\u00e1no + 5 mg v poledne + 5 mg pozd\u011b odpoledne, \u010d\u00edm\u017e napodobuje p\u0159irozen\u00fd rytmus kortizolu v t\u011ble. Na rozd\u00edl od prednisolonu nebo methylprednisolonu \u2014 kter\u00e9 se pou\u017e\u00edvaj\u00ed ve suprafyziologick\u00fdch d\u00e1vk\u00e1ch k potla\u010den\u00ed z\u00e1n\u011btu a imunitn\u00edho syst\u00e9mu \u2014 hydrokortizon v n\u00e1hradn\u00ed d\u00e1vce prost\u011b <strong>obnovuje norm\u00e1ln\u00ed hladiny kortizolu u pacient\u016f, jejich\u017e nadledviny ji\u017e neprodukuj\u00ed dostatek vlastn\u00edho<\/strong>. Klinick\u00e9 c\u00edle, d\u00e1vkovac\u00ed pravidla a strategie monitorov\u00e1n\u00ed jsou zcela odli\u0161n\u00e9 od protiz\u00e1n\u011btliv\u00e9ho pou\u017eit\u00ed glukokortikoid\u016f.<\/p>\n<h2 class=\"wp-block-heading\">Jak Hisone funguje?<\/h2>\n<p>Hydrokortizon je toto\u017en\u00fd s endogenn\u00edm kortizolem. Po vst\u0159eb\u00e1n\u00ed se v\u00e1\u017ee na intracelul\u00e1rn\u00ed glukokortikoidn\u00ed receptor (a p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch na mineralokortikoidn\u00ed receptor) a reguluje transkripci stovek gen\u016f. Klinicky relevantn\u00ed \u00fa\u010dinky p\u0159i <strong>n\u00e1hradn\u00ed d\u00e1vce<\/strong> jsou:<\/p>\n<ul>\n<li><strong>Udr\u017euje hladinu gluk\u00f3zy v krvi<\/strong> prost\u0159ednictv\u00edm glukoneogeneze \u2014 pacienti s nedostatkem kortizolu jsou n\u00e1chyln\u00ed k hypoglyk\u00e9mii nala\u010dno.<\/li>\n<li><strong>Podporuje c\u00e9vn\u00ed tonus a krevn\u00ed tlak<\/strong> \u2014 kortizol zvy\u0161uje c\u00e9vn\u00ed citlivost na katecholaminy; nedostatek zp\u016fsobuje ortostatickou hypotenzi a \u0161ok b\u011bhem stresu.<\/li>\n<li><strong>Rovnov\u00e1ha sod\u00edku a vody<\/strong> \u2014 hydrokortizon m\u00e1 slabou mineralokortikoidn\u00ed aktivitu (asi 1\/300 aldosteronu), dostate\u010dnou k podpo\u0159e retence sod\u00edku p\u0159i vy\u0161\u0161\u00edch d\u00e1vk\u00e1ch, ale nedostate\u010dnou k \u00fapln\u00e9 n\u00e1hrad\u011b aldosteronu p\u0159i prim\u00e1rn\u00ed adren\u00e1ln\u00ed insuficienci (kde se p\u0159id\u00e1v\u00e1 fludrokortizon).<\/li>\n<li><strong>Protiz\u00e1n\u011btliv\u00e9 a imunomodula\u010dn\u00ed \u00fa\u010dinky<\/strong> p\u0159i v\u0161ech d\u00e1vk\u00e1ch, ale p\u0159i n\u00e1hradn\u00ed d\u00e1vce jsou tyto \u00fa\u010dinky fyziologick\u00e9, nikoli terapeutick\u00e9.<\/li>\n<li><strong>Stresov\u00e1 reakce<\/strong> \u2014 produkce kortizolu prudce stoup\u00e1 b\u011bhem nemoci, \u00farazu, operace a siln\u00e9ho emo\u010dn\u00edho stresu. N\u00e1hradn\u00ed terapie mus\u00ed b\u00fdt odpov\u00eddaj\u00edc\u00edm zp\u016fsobem zv\u00fd\u0161ena (\u201cstresov\u00e9 d\u00e1vkov\u00e1n\u00ed\u201d).<\/li>\n<\/ul>\n<p>N\u00e1stup \u00fa\u010dinku: 30\u201360 minut po peror\u00e1ln\u00edm pod\u00e1n\u00ed. Polo\u010das v plazm\u011b ~90 minut; biologick\u00fd polo\u010das 8\u201312 hodin. Kr\u00e1tk\u00fd biologick\u00fd polo\u010das je d\u016fvod, pro\u010d je n\u00e1hrada rozd\u011blena do 2\u20133 denn\u00edch d\u00e1vek nam\u00edsto jedn\u00e9 denn\u00ed d\u00e1vky.<\/p>\n<h2 class=\"wp-block-heading\">Pou\u017eit\u00ed a indikace<\/h2>\n<p>Hisone se pou\u017e\u00edv\u00e1 pro <strong>fyziologickou n\u00e1hradu glukokortikoid\u016f<\/strong>, nikoli pro kr\u00e1tkodobou protiz\u00e1n\u011btlivou terapii (kde je prednisolon nebo methylprednisolon preferov\u00e1n pro jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed).<\/p>\n<ul>\n<li><strong>Prim\u00e1rn\u00ed adren\u00e1ln\u00ed insuficience (Addisonova choroba)<\/strong> \u2014 autoimunitn\u00ed, infek\u010dn\u00ed (TBC, HIV), bilater\u00e1ln\u00ed adrenalektomie, vrozen\u00e1. Kombinuje se s fludrokortizonem pro n\u00e1hradu mineralokortikoid\u016f.<\/li>\n<li><strong>Sekund\u00e1rn\u00ed adren\u00e1ln\u00ed insuficience<\/strong> \u2014 n\u00e1dor hypof\u00fdzy, poopera\u010dn\u00ed stav po operaci hypof\u00fdzy, hypopituitarismus, izolovan\u00fd deficit ACTH. Mineralokortikoidy jsou zachov\u00e1ny (\u0159\u00edzeny renin-angiotenzinov\u00fdm syst\u00e9mem), tak\u017ee fludrokortizon obvykle nen\u00ed pot\u0159eba.<\/li>\n<li><strong>Terci\u00e1rn\u00ed adren\u00e1ln\u00ed insuficience<\/strong> \u2014 potla\u010den\u00ed v d\u016fsledku dlouhodob\u00e9 exogenn\u00ed steroidn\u00ed terapie. N\u00e1hrada je nutn\u00e1 b\u011bhem m\u011bs\u00edc\u016f, kter\u00e9 jsou pot\u0159eba pro obnovu osy HPA.<\/li>\n<li><strong>Vrozen\u00e1 adren\u00e1ln\u00ed hyperplazie (CAH)<\/strong> \u2014 zejm\u00e9na klasick\u00fd deficit 21-hydroxyl\u00e1zy. Hydrokortizon je preferov\u00e1n v d\u011btstv\u00ed, proto\u017ee kortikoidy s krat\u0161\u00edm \u00fa\u010dinkem zp\u016fsobuj\u00ed men\u0161\u00ed potla\u010den\u00ed r\u016fstu.<\/li>\n<li><strong>Adren\u00e1ln\u00ed krize<\/strong> \u2014 nouzov\u00e9 parenter\u00e1ln\u00ed pod\u00e1n\u00ed hydrokortizonu (100 mg IV\/IM okam\u017eit\u011b, pot\u00e9 50\u2013100 mg ka\u017ed\u00fdch 6 hodin) je l\u00e9\u010dbou prvn\u00ed volby. Peror\u00e1ln\u00ed hydrokortizon se obnov\u00ed po stabilizaci stavu.<\/li>\n<li><strong>Kryt\u00ed stresu p\u0159i operaci, v\u00e1\u017en\u00e9m onemocn\u011bn\u00ed nebo porodu<\/strong> u jak\u00e9hokoli pacienta se zn\u00e1mou supres\u00ed HPA \u2014 dvojn\u00e1sobn\u00e1 a\u017e trojn\u00e1sobn\u00e1 n\u00e1hradn\u00ed d\u00e1vka peror\u00e1ln\u011b, nebo p\u0159echod na IV\/IM, pokud je peror\u00e1ln\u00ed pod\u00e1n\u00ed nebezpe\u010dn\u00e9.<\/li>\n<li><strong>Protiz\u00e1n\u011btliv\u00e9 nebo imunosupresivn\u00ed pou\u017eit\u00ed<\/strong> \u2014 z\u0159\u00eddka prvn\u00ed volba; prednisolon nebo methylprednisolon jsou obvykle preferov\u00e1ny, proto\u017ee jejich del\u0161\u00ed polo\u010das umo\u017e\u0148uje jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed a maj\u00ed men\u0161\u00ed mineralokortikoidn\u00ed \u00fa\u010dinek p\u0159i vysok\u00fdch protiz\u00e1n\u011btliv\u00fdch d\u00e1vk\u00e1ch.<\/li>\n<\/ul>\n<p>Hisone je <strong>ne<\/strong> n\u00e1hradou za prednisolon p\u0159i b\u011b\u017en\u00e9m astmatu, RA, IBD, vzplanut\u00ed lupusu nebo vaskulitidy. Pou\u017eijte spr\u00e1vn\u00fd steroid pro spr\u00e1vn\u00fd \u00fa\u010del: hydrokortizon pro n\u00e1hradu; prednisolon (nebo methylprednisolon, dexamethason) pro terapeutick\u00fd protiz\u00e1n\u011btliv\u00fd \u00fa\u010dinek.<\/p>\n<h2 class=\"wp-block-heading\">D\u00e1vkov\u00e1n\u00ed Hisone a zp\u016fsob u\u017e\u00edv\u00e1n\u00ed<\/h2>\n<p>Hisone je dod\u00e1v\u00e1n v <strong>5 mg, 10 mg a 20 mg tablet\u00e1ch<\/strong>.  . S\u00edly 5 mg, 10 mg a 20 mg umo\u017e\u0148uj\u00ed flexibiln\u00ed sestaven\u00ed fyziologick\u00fdch n\u00e1hradn\u00edch d\u00e1vek.<\/p>\n<h3 class=\"wp-block-heading\">Standardn\u00ed n\u00e1hradn\u00ed d\u00e1vka pro dosp\u011bl\u00e9<\/h3>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u010cas<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Typick\u00e1 d\u00e1vka<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">D\u016fvod<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Po probuzen\u00ed (07:00\u201308:00)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>10 mg<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Napodobuje p\u0159irozen\u00fd vrchol kortizolu; pom\u00e1h\u00e1 pacientovi zvl\u00e1dnout dopoledne<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Poledne (12:00\u201313:00)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">5 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kompensuje p\u0159irozen\u00fd pokles kortizolu dopoledne<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Odpoledne (16:00\u201317:00)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">5 mg<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zaji\u0161\u0165uje pacientovi ve\u010der; vyvarujte se pozd\u011bj\u0161\u00edch d\u00e1vek (zp\u016fsobuj\u00ed nespavost)<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>Celkov\u00e1 denn\u00ed d\u00e1vka<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\"><strong>15\u201325 mg\/den<\/strong><\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vy\u0161\u0161\u00ed d\u00e1vky pro v\u011bt\u0161\u00ed pacienty nebo aktivn\u00ed \u017eivotn\u00ed styl; ni\u017e\u0161\u00ed d\u00e1vky pro men\u0161\u00ed pacienty nebo p\u0159\u00edznaky p\u0159ed\u00e1vkov\u00e1n\u00ed<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h3 class=\"wp-block-heading\">Pravidla pro nemoc \u2013 nejd\u016fle\u017eit\u011bj\u0161\u00ed v\u011bc k nau\u010den\u00ed<\/h3>\n<p>Pacienti s nedostatkem kortizolu nemohou mobilizovat vlastn\u00ed stresovou reakci, proto mus\u00ed <strong>manu\u00e1ln\u011b zv\u00fd\u0161it d\u00e1vku<\/strong> b\u011bhem jak\u00e9hokoli akutn\u00edho onemocn\u011bn\u00ed, hore\u010dky, zran\u011bn\u00ed nebo v\u00fdrazn\u00e9ho stresu. Selh\u00e1n\u00ed v tomto m\u016f\u017ee v\u00e9st k adren\u00e1ln\u00ed krizi \u2013 \u017eivot ohro\u017euj\u00edc\u00edmu stavu.<\/p>\n<ul>\n<li><strong>M\u00edrn\u00e9 onemocn\u011bn\u00ed s hore\u010dkou 37,5\u201339\u00b0C, ch\u0159ipkov\u00e9 p\u0159\u00edznaky, drobn\u00e9 poran\u011bn\u00ed<\/strong> \u2014 <strong>double<\/strong> denn\u00ed d\u00e1vku po dobu trv\u00e1n\u00ed onemocn\u011bn\u00ed, pot\u00e9 se vra\u0165te k b\u011b\u017en\u00e9 d\u00e1vce po uzdraven\u00ed.<\/li>\n<li><strong>T\u011b\u017ek\u00e9 onemocn\u011bn\u00ed s hore\u010dkou &gt; 39\u00b0C, zvracen\u00ed a pr\u016fjem, v\u00e1\u017en\u00e9 trauma, zlomenina<\/strong> \u2014 <strong>triple<\/strong> denn\u00ed d\u00e1vku a kontaktujte sv\u016fj endokrinologick\u00fd t\u00fdm.<\/li>\n<li><strong>Zvracen\u00ed, pr\u016fjem nebo neschopnost udr\u017eet tablety<\/strong> \u2014 okam\u017eit\u011b p\u0159ejd\u011bte na <strong>IM hydrokortizon 100 mg<\/strong> z pohotovostn\u00ed injek\u010dn\u00ed sady a vyhledejte l\u00e9ka\u0159skou pomoc.<\/li>\n<li><strong>Chirurgie<\/strong> \u2014 drobn\u00fd v\u00fdkon (zubn\u00ed, katarakta): u\u017eijte jednu extra d\u00e1vku 1 hodinu p\u0159ed v\u00fdkonem; v\u011bt\u0161\u00ed operace: intraven\u00f3zn\u00ed hydrokortizon pod\u00e1van\u00fd v nemocnici p\u0159ed, b\u011bhem a po operaci, postupn\u011b sni\u017eujte na peror\u00e1ln\u00ed pod\u00e1n\u00ed b\u011bhem 1\u20133 dn\u016f.<\/li>\n<li><strong>Porod a porod<\/strong> \u2014 dvojn\u00e1sobn\u00e1 d\u00e1vka p\u0159i n\u00e1stupu porodu; IM\/IV pod\u00e1n\u00ed b\u011bhem porodu; dvojn\u00e1sobn\u00e1 d\u00e1vka po dobu 24\u201348 hodin po porodu.<\/li>\n<li><strong>Siln\u00fd emocion\u00e1ln\u00ed stres (\u00famrt\u00ed bl\u00edzk\u00e9 osoby, rozpad man\u017eelstv\u00ed, zkou\u0161ka, ve\u0159ejn\u00e9 vystoupen\u00ed)<\/strong> \u2014 zva\u017ete extra d\u00e1vku 5\u201310 mg; obvykle nen\u00ed nutn\u00e9 form\u00e1ln\u00ed zv\u00fd\u0161en\u00ed d\u00e1vky, pokud se neobjev\u00ed somatick\u00e9 p\u0159\u00edznaky.<\/li>\n<\/ul>\n<h3 class=\"wp-block-heading\">Jak spr\u00e1vn\u011b u\u017e\u00edvat Hisone<\/h3>\n<ol>\n<li><strong>Rann\u00ed d\u00e1vku u\u017eijte ihned po probuzen\u00ed<\/strong> \u2014 neodkl\u00e1dejte ji a\u017e na sn\u00eddani. Pacient \u010dasto poci\u0165uje slabost a nevolnost po probuzen\u00ed, ne\u017e se prvn\u00ed d\u00e1vka vst\u0159eb\u00e1.<\/li>\n<li><strong>U\u017e\u00edvejte s mal\u00fdm mno\u017estv\u00edm j\u00eddla<\/strong> \u2014 sni\u017euje \u017ealude\u010dn\u00ed podr\u00e1\u017ed\u011bn\u00ed, ale neodkl\u00e1dejte rann\u00ed d\u00e1vku kv\u016fli sn\u00eddani.<\/li>\n<li><strong>Tablety polykejte vcelku se sklenic\u00ed vody.<\/strong> Tablety lze rozd\u011blit, pokud jsou d\u011blen\u00e9.<\/li>\n<li><strong>Vyhn\u011bte se ve\u010dern\u00edm d\u00e1vk\u00e1m<\/strong> \u2014 d\u00e1vky po 18:00 naru\u0161uj\u00ed p\u0159irozen\u00fd kortizolov\u00fd rytmus a zp\u016fsobuj\u00ed nespavost.<\/li>\n<li><strong>Nikdy nevynechejte d\u00e1vku.<\/strong> Pokud jste d\u00e1vku vynechali o m\u00e9n\u011b ne\u017e 4 hodiny, u\u017eijte ji, jakmile si vzpomenete. Pokud jste ji vynechali o v\u00edce ne\u017e 4 hodiny, u\u017eijte ji, ale bu\u010fte p\u0159ipraveni na mo\u017enou vlnu \u00fanavy uprost\u0159ed cyklu. N\u00e1sleduj\u00edc\u00ed d\u00e1vku nezdvojujte, pokud to nen\u00ed sou\u010d\u00e1st\u00ed va\u0161eho pl\u00e1nu pro nemocn\u00e9 dny.<\/li>\n<li><strong>M\u011bjte u sebe n\u00e1ramek Medic-Alert nebo steroidn\u00ed kartu<\/strong> v\u017edy s n\u00e1pisem \u201cadren\u00e1ln\u00ed insuficience \u2014 v p\u0159\u00edpad\u011b nouze nutn\u00fd hydrokortizon\u201d. Toto je nezbytn\u00e1 podm\u00ednka pro pacienty na substitu\u010dn\u00ed terapii.<\/li>\n<li><strong>M\u011bjte u sebe pohotovostn\u00ed soupravu s hydrokortizonem pro intramuskul\u00e1rn\u00ed injekci<\/strong> \u2014 l\u00e9ka\u0159 by m\u011bl zajistit, aby vy i \u010dlen rodiny v\u011bd\u011bli, jak ji pou\u017e\u00edt. Souprava by m\u011bla b\u00fdt dostupn\u00e1 doma, v pr\u00e1ci i na cest\u00e1ch.<\/li>\n<li><strong>Informujte ka\u017ed\u00e9ho zdravotn\u00edka<\/strong> \u017ee u\u017e\u00edv\u00e1te Hisone pro adren\u00e1ln\u00ed insuficienci \u2014 v\u010detn\u011b zuba\u0159\u016f, optometrist\u016f, praktik\u016f alternativn\u00ed medic\u00edny, anesteziolog\u016f a l\u00e9ka\u0159\u016f na pohotovosti.<\/li>\n<li><strong>P\u0159i prim\u00e1rn\u00ed Addisonov\u011b chorob\u011b<\/strong>, budete tak\u00e9 u\u017e\u00edvat <strong>fludrokortizon 0,05\u20130,2 mg\/den<\/strong> pro mineralokortikoidn\u00ed substituci \u2014 to je odd\u011blen\u00e9 od Hisone a b\u011bhem nemoci se nem\u011bn\u00ed.<\/li>\n<\/ol>\n<h2 class=\"wp-block-heading\">Pro\u010d se Hisone NESNI\u017dUJE postupn\u011b jako jin\u00e9 steroidy<\/h2>\n<p>Toto je jeden z nej\u010dast\u011bji nepochopen\u00fdch bod\u016f substitu\u010dn\u00ed terapie. Kdy\u017e pacient u\u017e\u00edv\u00e1 prednisolon kv\u016fli astmatu, vzplanut\u00ed RA nebo jak\u00e9mukoli protiz\u00e1n\u011btliv\u00e9mu \u00fa\u010dinku, d\u00e1vka se mus\u00ed postupn\u011b sni\u017eovat, proto\u017ee pacient dost\u00e1v\u00e1 nadfyziologick\u00e9 d\u00e1vky potla\u010duj\u00edc\u00ed jeho vlastn\u00ed osu HPA.<\/p>\n<p>Substitu\u010dn\u00ed d\u00e1vka hydrokortizonu je odli\u0161n\u00e1: <strong>15\u201325 mg\/den hydrokortizonu zhruba odpov\u00edd\u00e1 denn\u00ed produkci t\u011bla<\/strong>. Pacient NAHRAZUJE to, co jeho nadledviny ji\u017e nevytv\u00e1\u0159ej\u00ed. Nen\u00ed zde \u017e\u00e1dn\u00e9 potla\u010den\u00ed osy HPA, kter\u00e9 by se muselo obnovit \u2014 osa HPA je ji\u017e po\u0161kozena (Addisonova choroba) nebo chyb\u00ed (po operaci hypof\u00fdzy). <strong>N\u00e1hrada je celo\u017eivotn\u00ed<\/strong> a nen\u00ed postupn\u011b sni\u017eov\u00e1na. P\u0159eru\u0161en\u00ed u\u017e\u00edv\u00e1n\u00ed p\u0159\u00edpravku Hisone kdykoli u pacienta s prim\u00e1rn\u00ed nebo sekund\u00e1rn\u00ed adren\u00e1ln\u00ed insuficienc\u00ed zp\u016fsob\u00ed adren\u00e1ln\u00ed krizi b\u011bhem n\u011bkolika hodin a\u017e jednoho dne. Jedin\u00e1 zm\u011bna d\u00e1vky je sm\u011brem nahoru (dny nemoci, stresov\u00e9 d\u00e1vkov\u00e1n\u00ed) \u2014 nikoli sm\u011brem dol\u016f.<\/p>\n<p>V\u00fdjimka: pacienti postupn\u011b vysazuj\u00edc\u00ed dlouhodobou vysokod\u00e1vkovou exogenn\u00ed steroidn\u00ed terapii. Jakmile se denn\u00ed d\u00e1vka prednisolonu sn\u00ed\u017e\u00ed pod ekvivalent 5\u20137,5 mg\/den, n\u011bkte\u0159\u00ed klinici p\u0159ech\u00e1zej\u00ed na fyziologickou n\u00e1hradu hydrokortizonem, aby umo\u017enili obnovu potla\u010den\u00e9 osy HPA. V tomto p\u0159\u00edpad\u011b je d\u00e1vka hydrokortizonu nakonec postupn\u011b sni\u017eov\u00e1na, ale a\u017e pot\u00e9, co Synacthen test potvrd\u00ed obnovu osy HPA \u2014 obvykle m\u011bs\u00edce po ukon\u010den\u00ed p\u016fvodn\u00edho steroidn\u00edho cyklu.<\/p>\n<h2 class=\"wp-block-heading\">Vedlej\u0161\u00ed \u00fa\u010dinky p\u0159\u00edpravku Hisone<\/h2>\n<p>P\u0159i fyziologick\u00e9 <strong>n\u00e1hradn\u00ed d\u00e1vce (15\u201325 mg\/den)<\/strong>, hydrokortizon zp\u016fsobuje m\u00e1lo vedlej\u0161\u00edch \u00fa\u010dink\u016f \u2014 pacient prost\u011b dost\u00e1v\u00e1 to, co by jeho t\u011blo m\u011blo p\u0159irozen\u011b produkovat. Klasick\u00fd Cushingoidn\u00ed profil vedlej\u0161\u00edch \u00fa\u010dink\u016f glukokortikoid\u016f se rozv\u00edj\u00ed pouze p\u0159i suprafyziologick\u00fdch d\u00e1vk\u00e1ch. Riziko je p\u0159ev\u00e1\u017en\u011b <strong>p\u0159i nedostate\u010dn\u00e9 n\u00e1hrad\u011b<\/strong> (\u00fanava, hypotenze, hypoglyk\u00e9mie, \u00fabytek hmotnosti, hyperpigmentace u prim\u00e1rn\u00ed AI, eventu\u00e1ln\u00ed adren\u00e1ln\u00ed krize) nebo <strong>p\u0159ed\u00e1vkov\u00e1n\u00ed<\/strong> (Cushingoidn\u00ed rysy, osteopor\u00f3za, diabetes, hypertenze, poruchy n\u00e1lady).<\/p>\n<p><strong>P\u0159\u00edznaky nedostate\u010dn\u00e9 n\u00e1hrady \u2014 je t\u0159eba zv\u00fd\u0161it d\u00e1vku nebo zm\u011bnit d\u00e1vkovac\u00ed sch\u00e9ma:<\/strong><\/p>\n<ul>\n<li>P\u0159etrv\u00e1vaj\u00edc\u00ed \u00fanava, zejm\u00e9na v pozdn\u00edm odpoledni\/ve\u010deru<\/li>\n<li>Z\u00e1vrat\u011b p\u0159i zm\u011bn\u011b polohy, slabost<\/li>\n<li>Chu\u0165 na s\u016fl (nazna\u010duje nedostate\u010dnou d\u00e1vku fludrokortizonu u prim\u00e1rn\u00ed AI)<\/li>\n<li>\u00dabytek hmotnosti, nechutenstv\u00ed, nevolnost<\/li>\n<li>Zv\u00fd\u0161en\u00e1 pigmentace p\u0159i prim\u00e1rn\u00ed AI (vysok\u00fd ACTH)<\/li>\n<li>Opakuj\u00edc\u00ed se p\u0159\u00edznaky p\u0159i la\u010dn\u011bn\u00ed nebo p\u0159ed d\u00e1vkou<\/li>\n<\/ul>\n<p><strong>P\u0159\u00edznaky p\u0159ed\u00e1vkov\u00e1n\u00ed \u2014 nutn\u00e9 sn\u00ed\u017een\u00ed d\u00e1vky:<\/strong><\/p>\n<ul>\n<li>P\u0159\u00edr\u016fstek hmotnosti, centr\u00e1ln\u00ed obezita<\/li>\n<li>M\u011bs\u00edcovit\u00fd obli\u010dej, hrb<\/li>\n<li>Snadn\u00e1 tvorba mod\u0159in, zten\u010den\u00ed k\u016f\u017ee, b\u0159i\u0161n\u00ed strie<\/li>\n<li>Zv\u00fd\u0161en\u00e1 hladina cukru v krvi, zv\u00fd\u0161en\u00fd krevn\u00ed tlak<\/li>\n<li>Nespavost, zv\u00fd\u0161en\u00e1 n\u00e1lada, neklid<\/li>\n<li>Sn\u00ed\u017een\u00e1 hustota kost\u00ed (zejm\u00e9na p\u0159i dlouhodob\u00e9m pod\u00e1v\u00e1n\u00ed d\u00e1vek &gt; 25 mg\/den)<\/li>\n<\/ul>\n<p><strong>Akutn\u00ed p\u0159ed\u00e1vkov\u00e1n\u00ed (nap\u0159. n\u00e1hodn\u00e9 pod\u00e1n\u00ed d\u00e1vky p\u0159i nemoci bez z\u00e1kladn\u00edho onemocn\u011bn\u00ed)<\/strong> Kr\u00e1tkodob\u00e9 u\u017e\u00edv\u00e1n\u00ed po n\u011bkolik dn\u00ed nem\u00e1 v\u00fdznamn\u00e9 ne\u017e\u00e1douc\u00ed \u00fa\u010dinky \u2013 to je podstata tzv. stresov\u00e9ho d\u00e1vkov\u00e1n\u00ed. Dlouhodob\u00e9 nadm\u011brn\u00e9 pod\u00e1v\u00e1n\u00ed v pr\u016fb\u011bhu m\u011bs\u00edc\u016f a\u017e let v\u0161ak vede k rozvoji Cushingova syndromu.<\/p>\n<h2 class=\"wp-block-heading\">Varov\u00e1n\u00ed a opat\u0159en\u00ed<\/h2>\n<ul>\n<li><strong>Nikdy nevynech\u00e1vejte d\u00e1vky a nevysazujte l\u00e9\u010dbu bez konzultace s odborn\u00edkem.<\/strong> Adren\u00e1ln\u00ed krize se m\u016f\u017ee rozvinout b\u011bhem n\u011bkolika hodin.<\/li>\n<li><strong>V\u017edy m\u011bjte u sebe steroidn\u00ed kartu a identifika\u010dn\u00ed n\u00e1ramek Medic-Alert.<\/strong> Bez tohoto ozna\u010den\u00ed nemus\u00ed b\u00fdt pacient v bezv\u011bdom\u00ed s adren\u00e1ln\u00ed insuficienc\u00ed spr\u00e1vn\u011b rozpozn\u00e1n a l\u00e9\u010den.<\/li>\n<li><strong>V\u017edy m\u011bjte u sebe pohotovostn\u00ed injek\u010dn\u00ed sadu s hydrokortizonem k intramuskul\u00e1rn\u00ed aplikaci<\/strong> p\u0159i cestov\u00e1n\u00ed mimo domov.<\/li>\n<li><strong>Diabetes<\/strong> N\u00e1hradn\u00ed d\u00e1vka hydrokortizonu m\u00e1 minim\u00e1ln\u00ed vliv na glyk\u00e9mii; stresov\u00e9 d\u00e1vkov\u00e1n\u00ed zp\u016fsobuje p\u0159echodn\u00e9 zv\u00fd\u0161en\u00ed hladiny gluk\u00f3zy.<\/li>\n<li><strong>Hypertenze<\/strong> P\u0159i n\u00e1hradn\u00ed d\u00e1vce obvykle \u017e\u00e1dn\u00fd \u00fa\u010dinek; nadm\u011brn\u00e9 d\u00e1vkov\u00e1n\u00ed m\u016f\u017ee zv\u00fd\u0161it krevn\u00ed tlak.<\/li>\n<li><strong>Osteopor\u00f3za<\/strong> Dlouhodob\u00e9 nadm\u011brn\u00e9 d\u00e1vkov\u00e1n\u00ed zvy\u0161uje riziko zlomenin; c\u00edlem je nejni\u017e\u0161\u00ed \u00fa\u010dinn\u00e1 d\u00e1vka, screening DEXA ka\u017ed\u00e9 2\u20133 roky.<\/li>\n<li><strong>T\u011bhotenstv\u00ed<\/strong> Hydrokortizon je preferovan\u00fdm glukokortikoidem pro substitu\u010dn\u00ed l\u00e9\u010dbu v t\u011bhotenstv\u00ed; placent\u00e1rn\u00ed 11\u03b2-hydroxysteroid dehydrogen\u00e1za inaktivuje p\u0159ibli\u017en\u011b 85 % l\u00e9ku p\u0159ed pr\u016fchodem k plodu. Ve t\u0159et\u00edm trimestru m\u016f\u017ee b\u00fdt nutn\u00e9 zv\u00fd\u0161en\u00ed d\u00e1vky. Stresov\u00e9 pokryt\u00ed b\u011bhem porodu je nezbytn\u00e9.<\/li>\n<li><strong>Kojen\u00ed<\/strong> Bezpe\u010dn\u00e9 v substitu\u010dn\u00edch d\u00e1vk\u00e1ch; do mate\u0159sk\u00e9ho ml\u00e9ka p\u0159ech\u00e1z\u00ed minim\u00e1ln\u00ed mno\u017estv\u00ed bez klinick\u00e9ho v\u00fdznamu.<\/li>\n<li><strong>D\u011bti<\/strong> U d\u011bt\u00ed je hydrokortizon preferov\u00e1n p\u0159ed dlouhodob\u011b p\u016fsob\u00edc\u00edmi steroidy kv\u016fli men\u0161\u00edmu vlivu na r\u016fst. D\u00e1vkov\u00e1n\u00ed se po\u010d\u00edt\u00e1 podle t\u011blesn\u00e9ho povrchu (10\u201312 mg\/m\u00b2\/den).<\/li>\n<li><strong>Star\u0161\u00ed pacienti<\/strong> Sn\u00ed\u017een\u00e1 pot\u0159eba substituce; c\u00edlem je spodn\u00ed hranice d\u00e1vkov\u00e9ho rozmez\u00ed.<\/li>\n<li><strong>\u017div\u00e9 vakc\u00edny<\/strong> BEZPE\u010cN\u00c9 v substitu\u010dn\u00ed d\u00e1vce. Kontraindikace plat\u00ed pouze pro imunosupresivn\u00ed d\u00e1vky (\u2265 20 mg ekvivalentu prednisolonu po dobu 2+ t\u00fddn\u016f). Substitu\u010dn\u00ed d\u00e1vka hydrokortizonu \u2264 25 mg\/den = 6,25 mg ekvivalentu prednisolonu \u2013 nen\u00ed imunosupresivn\u00ed.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Kontraindikace \u2014 Kdo by NEM\u011aL u\u017e\u00edvat Hisone<\/h2>\n<ul>\n<li>Zn\u00e1m\u00e1 p\u0159ecitliv\u011blost na hydrokortizon nebo jakoukoli pomocnou l\u00e1tku v tablet\u011b<\/li>\n<li>Syst\u00e9mov\u00e1 pl\u00eds\u0148ov\u00e1 infekce (pokud nen\u00ed sou\u010dasn\u011b l\u00e9\u010dena a n\u00e1hrada je nezbytn\u00e1)<\/li>\n<li>Ned\u00e1vn\u00e9 pod\u00e1n\u00ed \u017eiv\u00e9 vakc\u00edny u pacient\u016f na imunosupresivn\u00edch d\u00e1vk\u00e1ch (nevztahuje se na n\u00e1hradn\u00ed d\u00e1vku)<\/li>\n<\/ul>\n<p>U pacienta s potvrzenou adren\u00e1ln\u00ed insuficienc\u00ed je jedinou \u00fa\u010dinnou kontraindikac\u00ed skute\u010dn\u00e1 p\u0159ecitliv\u011blost na hydrokortizon samotn\u00fd \u2014 v takov\u00e9m p\u0159\u00edpad\u011b se m\u00edsto n\u011bj pou\u017eije prednisolon nebo dexamethason. <strong>Onemocn\u011bn\u00ed je neslu\u010diteln\u00e9 s neu\u017e\u00edv\u00e1n\u00edm glukokortikoidn\u00ed n\u00e1hrady<\/strong> \u2014 proto se ostatn\u00ed kontraindikace \u0159e\u0161\u00ed l\u00e9\u010dbou sou\u010dasn\u00e9ho probl\u00e9mu sp\u00ed\u0161e ne\u017e vynech\u00e1n\u00edm hydrokortizonu.<\/p>\n<h2 class=\"wp-block-heading\">Interakce s l\u00e9\u010divy<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Kombinujte s<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">\u00da\u010dinek<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Co d\u011blat<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00ed induktory CYP3A4 (rifampicin, fenytoin, karbamazepin, t\u0159ezalka te\u010dkovan\u00e1)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Ni\u017e\u0161\u00ed hladiny hydrokortizonu \u2014 riziko relativn\u00edho nedostate\u010dn\u00e9ho nahrazen\u00ed a krize<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zvy\u0161te n\u00e1hradn\u00ed d\u00e1vku o 50\u2013100 % b\u011bhem sou\u010dasn\u00e9ho pod\u00e1v\u00e1n\u00ed; pe\u010dliv\u00e9 sledov\u00e1n\u00ed; odborn\u00fd dohled.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Siln\u00e9 inhibitory CYP3A4 (ketokonazol, ritonavir, klarithromycin)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00e9 hladiny hydrokortizonu \u2014 p\u0159\u00edznaky nadm\u011brn\u00e9ho nahrazen\u00ed<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sni\u017ete n\u00e1hradn\u00ed d\u00e1vku o 25\u201350 %; sledujte p\u0159\u00edznaky Cushingova syndromu.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Levothyroxin<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159i adren\u00e1ln\u00ed insuficienci m\u016f\u017ee zah\u00e1jen\u00ed l\u00e9\u010dby levothyroxinem P\u0158ED adekv\u00e1tn\u00ed n\u00e1hradou hydrokortizonu vyvolat adren\u00e1ln\u00ed krizi (tyroidn\u00ed hormony zvy\u0161uj\u00ed clearance kortizolu).<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159i nov\u011b diagnostikovan\u00e9 kombinovan\u00e9 adren\u00e1ln\u00ed a tyreoid\u00e1ln\u00ed insuficienci v\u017edy za\u010dn\u011bte nejprve s hydrokortizonem. Pokud je nutn\u00e9 nahradit oboj\u00ed, pod\u00e1vejte hydrokortizon alespo\u0148 3 dny p\u0159ed levothyroxinem.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">L\u00e9ky na diabetes<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Zv\u00fd\u0161en\u00ed d\u00e1vek b\u011bhem nemoci m\u016f\u017ee p\u0159echodn\u011b zv\u00fd\u0161it hladinu gluk\u00f3zy<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Sledujte kapil\u00e1rn\u00ed gluk\u00f3zu b\u011bhem zv\u00fd\u0161en\u00e9ho d\u00e1vkov\u00e1n\u00ed p\u0159i nemoci; obvykle nen\u00ed nutn\u00e1 trval\u00e1 zm\u011bna.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">NSAID<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Kombinovan\u00e9 riziko vzniku gastrointestin\u00e1ln\u00edch v\u0159ed\u016f (ni\u017e\u0161\u00ed ne\u017e p\u0159i vysok\u00fdch d\u00e1vk\u00e1ch steroid\u016f + NSAID)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">P\u0159i chronick\u00e9m u\u017e\u00edv\u00e1n\u00ed NSAID p\u0159edepisujte sou\u010dasn\u011b PPI.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Mifepriston, ketokonazol (vysok\u00e9 d\u00e1vky)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Antagonismus glukokortikoid\u016f \u2013 m\u016f\u017ee vyvolat adren\u00e1ln\u00ed krizi<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Vyvarujte se pod\u00e1v\u00e1n\u00ed pacient\u016fm na substitu\u010dn\u00ed l\u00e9\u010db\u011b hydrokortizonem, pokud nejsou pod dohledem endokrinologick\u00e9ho specialisty.<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u017div\u00e9 vakc\u00edny<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">\u017d\u00e1dn\u00e1 interakce p\u0159i substitu\u010dn\u00edch d\u00e1vk\u00e1ch<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Bezpe\u010dn\u00e9; doporu\u010den\u00e9 (ka\u017edoro\u010dn\u00ed o\u010dkov\u00e1n\u00ed proti ch\u0159ipce, MMR, plan\u00e9 ne\u0161tovice, \u017elut\u00e1 zimnice p\u0159i cestov\u00e1n\u00ed).<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Pokyny k uchov\u00e1v\u00e1n\u00ed<\/h2>\n<ul>\n<li>Skladujte p\u0159i pokojov\u00e9 teplot\u011b, <strong>pod 25\u00b0C<\/strong>, chr\u00e1n\u011bno p\u0159ed sv\u011btlem a vlhkost\u00ed.<\/li>\n<li>Tablety uchov\u00e1vejte v p\u016fvodn\u00edm blistru a\u017e do pou\u017eit\u00ed.<\/li>\n<li>Neskladujte v koupeln\u011b \u2013 vlhkost zkracuje trvanlivost.<\/li>\n<li>P\u0159i cestov\u00e1n\u00ed v\u017edy m\u011bjte u sebe alespo\u0148 7denn\u00ed z\u00e1sobu plus pohotovostn\u00ed injek\u010dn\u00ed soupravu pro intramuskul\u00e1rn\u00ed pod\u00e1n\u00ed.<\/li>\n<li>Uchov\u00e1vejte mimo dosah d\u011bt\u00ed \u2013 i u pacient\u016f s adren\u00e1ln\u00ed insuficienc\u00ed m\u016f\u017ee p\u0159ed\u00e1vkov\u00e1n\u00ed d\u011btsk\u00e9ho organismu d\u00e1vkami pro dosp\u011bl\u00e9 zp\u016fsobit v\u00e1\u017en\u00e9 onemocn\u011bn\u00ed.<\/li>\n<li>Nepou\u017e\u00edvejte po uplynut\u00ed data expirace uveden\u00e9ho na obalu.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Souvisej\u00edc\u00ed alternativy na MedsBase<\/h2>\n<p>Dal\u0161\u00ed l\u00e9ky pou\u017e\u00edvan\u00e9 v protiz\u00e1n\u011btliv\u00e9 a autoimunitn\u00ed p\u00e9\u010di skladem vedle tohoto produktu:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/barinat\/\"><strong>Barinat (baricitinib 2 \/ 4 mg) \u2014 inhibitor JAK1\/2 pro RA<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/tofe\/\"><strong>Tofe (tofacitinib 5 mg) \u2014 inhibitor JAK1\/3 pro RA, UC, PsA<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/azoran\/\"><strong>Azoran (azathioprin 50 mg) \u2014 klasick\u00e9 imunosupresivum DMARD<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lefuheal\/\"><strong>Lefuheal (leflunomid) \u2014 peror\u00e1ln\u00ed DMARD pro revmatoidn\u00ed artritidu<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/conimune-me\/\"><strong>Conimune ME (cyklosporin) \u2014 inhibitor kalcineurinu<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/wysolone\/\"><strong>Wysolone (prednisolon 5 \/ 10 \/ 20 mg) \u2014 peror\u00e1ln\u00ed kortikosteroid<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/medrol\/\"><strong>Medrol (methylprednisolon 4 \/ 8 \/ 16 mg) \u2014 peror\u00e1ln\u00ed kortikosteroid<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/predniheal\/\"><strong>Predniheal (prednisolon) \u2014 peror\u00e1ln\u00ed kortikosteroid<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/budez-cr\/\"><strong>Budez CR (budesonid) \u2014 st\u0159evn\u011b p\u016fsob\u00edc\u00ed kortikosteroid pro Crohnovu chorobu<\/strong><\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/kenacort\/\"><strong>Kenacort (triamcinolon) \u2014 syst\u00e9mov\u00fd kortikosteroid<\/strong><\/a><\/li>\n<\/ul>\n<p>Prozkoumejte celou <a href=\"https:\/\/medsbase.com\/cs\/anti-inflammatory-autoimmune-care\/\">Protiz\u00e1n\u011btliv\u00e1 a autoimunitn\u00ed p\u00e9\u010de<\/a> kategorie.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3 class=\"wp-block-heading\">Pro\u010d hydrokortizon m\u00edsto prednisolonu pro substitu\u010dn\u00ed l\u00e9\u010dbu?<\/h3>\n<p>Hydrokortizon je identick\u00fd s p\u0159irozen\u00fdm kortizolem \u2014 stejn\u00e1 molekula, stejn\u00e9 receptory, stejn\u00fd metabolismus. Jeho kr\u00e1tk\u00fd biologick\u00fd polo\u010das (8\u201312 hodin) umo\u017e\u0148uje p\u0159ibli\u017en\u011b napodobit p\u0159irozen\u00fd rytmus kortizolu pomoc\u00ed 2\u20133 denn\u00edch d\u00e1vek. Prednisolon m\u00e1 del\u0161\u00ed polo\u010das a je obt\u00ed\u017en\u011bj\u0161\u00ed d\u00e1vkovat pro fyziologickou n\u00e1hradu; tak\u00e9 zp\u016fsobuje v\u011bt\u0161\u00ed potla\u010den\u00ed r\u016fstu v d\u011btstv\u00ed. Dexamethason m\u00e1 je\u0161t\u011b del\u0161\u00ed polo\u010das a obecn\u011b se vyh\u00fdb\u00e1 jeho rutinn\u00edmu u\u017e\u00edv\u00e1n\u00ed pro n\u00e1hradu, a\u010dkoli se n\u011bkdy pou\u017e\u00edv\u00e1 u CAH pro svou \u00fa\u010dinnost a jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed.<\/p>\n<h3 class=\"wp-block-heading\">Co je adren\u00e1ln\u00ed krize a jak se j\u00ed vyhnout?<\/h3>\n<p>Adren\u00e1ln\u00ed krize je akutn\u00ed, t\u011b\u017ek\u00fd nedostatek kortizolu \u2014 t\u011blo nedok\u00e1\u017ee udr\u017eet krevn\u00ed tlak, hladinu cukru v krvi, rovnov\u00e1hu sod\u00edku nebo c\u00e9vn\u00ed tonus. P\u0159\u00edznaky: siln\u00e1 slabost, bolesti b\u0159icha, zvracen\u00ed, n\u00edzk\u00fd krevn\u00ed tlak, zmatenost, hore\u010dka, hypoglyk\u00e9mie. <strong>Nel\u00e9\u010den\u00e1 je smrteln\u00e1.<\/strong> L\u00e9\u010dba: okam\u017eit\u00fd IM\/IV hydrokortizon 100 mg, IV tekutiny (fyziologick\u00fd roztok nebo gluk\u00f3zo-fyziologick\u00fd roztok), \u00faprava elektrolyt\u016f, l\u00e9\u010dba vyvol\u00e1vaj\u00edc\u00edho onemocn\u011bn\u00ed. Jak se j\u00ed VYHNOUT: nikdy nevynechejte n\u00e1hradn\u00ed d\u00e1vku, dodr\u017eujte pravidla pro nemocn\u00e9, m\u011bjte u sebe nouzovou injek\u010dn\u00ed sadu IM, noste Medic-Alert identifik\u00e1tor a informujte ka\u017ed\u00e9ho zdravotn\u00edka, \u017ee m\u00e1te adren\u00e1ln\u00ed insuficienci.<\/p>\n<h3 class=\"wp-block-heading\">Kdy pou\u017e\u00edt nouzovou injek\u010dn\u00ed sadu s hydrokortizonem?<\/h3>\n<p>Pou\u017eijte ji (nebo nechte partnera\/\u010dlena rodiny ji pou\u017e\u00edt) okam\u017eit\u011b, kdy\u017e: zvrac\u00edte a nem\u016f\u017eete udr\u017eet tablety; m\u00e1te siln\u00fd pr\u016fjem; m\u00e1te hore\u010dku nad 39\u00b0C a c\u00edt\u00edte se velmi \u0161patn\u011b; utrp\u011bli jste v\u00e1\u017en\u00e9 trauma; ztr\u00e1c\u00edte v\u011bdom\u00ed nebo se c\u00edt\u00edte na pokraji kolapsu. Sada obsahuje 100 mg hydrokortizonu (Solu-Cortef nebo ekvivalent) pro IM injekci do vn\u011bj\u0161\u00ed strany stehna. Po pou\u017eit\u00ed sady volejte z\u00e1chrannou slu\u017ebu a vyhledejte nemocni\u010dn\u00ed vy\u0161et\u0159en\u00ed. NE\u010cEKEJTE \u201ca uvid\u00edte\u201d \u2014 pou\u017eit\u00ed sady, kdy\u017e jste ji nepot\u0159ebovali, nem\u00e1 v\u00fdznamn\u00e9 negativn\u00ed d\u016fsledky; nepod\u00e1n\u00ed, kdy\u017e jste ji pot\u0159ebovali, je potenci\u00e1ln\u011b smrteln\u00e9.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017eu u\u017e\u00edvat Hisone jednou denn\u011b m\u00edsto t\u0159ikr\u00e1t?<\/h3>\n<p>Ne \u2014 kr\u00e1tk\u00fd biologick\u00fd polo\u010das hydrokortizonu 8\u201312 hodin znemo\u017e\u0148uje jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed bez dlouh\u00fdch mezer v nedostatku kortizolu v pozdn\u00edm odpoledni a p\u0159es noc. Mnoho pacient\u016f se sna\u017e\u00ed d\u00e1vkov\u00e1n\u00ed t\u00edmto zp\u016fsobem zjednodu\u0161it; v\u017edy to vede k \u00fanav\u011b, slabosti nebo p\u0159\u00edznak\u016fm nedostate\u010dn\u00e9 n\u00e1hrady v druh\u00e9 polovin\u011b dne. Rozvrh 2\u20133 d\u00e1vek (10\/5\/5 nebo 10\/5\/5 nebo 15\/5 rozd\u011blen\u00ed) p\u0159ibli\u017en\u011b napodobuje p\u0159irozen\u00fd rytmus kortizolu. Nov\u011bj\u0161\u00ed hydrokortizon s prodlou\u017een\u00fdm uvol\u0148ov\u00e1n\u00edm (Plenadren, Chronocort) je navr\u017een pro jednodenn\u00ed d\u00e1vkov\u00e1n\u00ed, ale nen\u00ed to stejn\u00fd produkt jako standardn\u00ed tablety hydrokortizonu.<\/p>\n<h3 class=\"wp-block-heading\">Mus\u00edm si vz\u00edt v\u00edce Hisone p\u0159ed cvi\u010den\u00edm?<\/h3>\n<p>Rutinn\u00ed m\u00edrn\u00e9 cvi\u010den\u00ed (jogging, posilovna, cyklistika, plav\u00e1n\u00ed) nevy\u017eaduje extra d\u00e1vku \u2014 n\u00e1hradn\u00ed d\u00e1vka pokr\u00fdv\u00e1 norm\u00e1ln\u00ed aktivitu. <strong>N\u00e1ro\u010dn\u00e9 cvi\u010den\u00ed<\/strong> (dlouh\u00e9 b\u011bhy, dlouh\u00e9 t\u00fary, sout\u011b\u017en\u00ed sport, t\u011b\u017ek\u00e1 manu\u00e1ln\u00ed pr\u00e1ce po n\u011bkolik hodin) m\u016f\u017ee m\u00edt prosp\u011bch z mal\u00e9 extra d\u00e1vky 5\u201310 mg 30\u201360 minut p\u0159edem. Vytrvalostn\u00ed ud\u00e1losti trvaj\u00edc\u00ed hodiny mohou pot\u0159ebovat d\u00e1vku uprost\u0159ed ud\u00e1losti. Proberte se sv\u00fdm endokrinologick\u00fdm t\u00fdmem. Neexistuje n\u00e1hrada za sebe-monitorov\u00e1n\u00ed \u2014 pokud se pravideln\u011b c\u00edt\u00edte slab\u00ed, z\u00e1vrat\u011b nebo t\u0159esav\u00ed b\u011bhem sv\u00e9ho obvykl\u00e9ho cvi\u010den\u00ed, v\u00e1\u0161 n\u00e1hradn\u00ed pl\u00e1n pot\u0159ebuje revizi.<\/p>\n<h3 class=\"wp-block-heading\">M\u016f\u017eu p\u00edt alkohol na Hisone?<\/h3>\n<p>M\u00edrn\u00e9 pit\u00ed alkoholu je obecn\u011b bezpe\u010dn\u00e9 p\u0159i n\u00e1hradn\u00ed d\u00e1vce. Siln\u00e9 pit\u00ed je nebezpe\u010dn\u00e9 u adren\u00e1ln\u00ed insuficience ze dvou d\u016fvod\u016f: (1) zvracen\u00ed spojen\u00e9 s kocovinou vystavuje pacienta riziku vynechan\u00fdch d\u00e1vek a adren\u00e1ln\u00ed krize; (2) hypoglyk\u00e9mie z alkoholu je z\u00e1va\u017en\u011bj\u0161\u00ed u pacient\u016f s nedostatkem kortizolu. Pokud pijete, jezte s alkoholem, udr\u017eujte p\u0159\u00edjem m\u00edrn\u00fd, nikdy nevynechejte rann\u00ed d\u00e1vku pot\u00e9 a m\u011bjte u sebe IM sadu.<\/p>\n<h3 class=\"wp-block-heading\">Mohu podstoupit operaci p\u0159i u\u017e\u00edv\u00e1n\u00ed Hisone?<\/h3>\n<p>Ano, ale pot\u0159ebujete <strong>zv\u00fd\u0161enou d\u00e1vku kryt\u00ed<\/strong>. U drobn\u00fdch v\u00fdkon\u016f (zubn\u00ed z\u00e1kroky, operace \u0161ed\u00e9ho zataru, jednoduch\u00e9 ko\u017en\u00ed z\u00e1kroky): u\u017eijte jednu extra d\u00e1vku 1 hodinu p\u0159ed v\u00fdkonem a pot\u00e9 pokra\u010dujte v b\u011b\u017en\u00e9m d\u00e1vkov\u00e1n\u00ed. U st\u0159edn\u011b n\u00e1ro\u010dn\u00fdch operac\u00ed (laparoskopie, n\u00e1hrada kloubu): nitro\u017eiln\u011b hydrokortizon 50\u2013100 mg p\u0159ed indukc\u00ed anestezie, pot\u00e9 50\u2013100 mg ka\u017ed\u00fdch 6\u20138 hodin po dobu 24 hodin, n\u00e1sledn\u011b dvojn\u00e1sobn\u00e1 peror\u00e1ln\u00ed d\u00e1vka po dobu 1\u20132 dn\u016f. U rozs\u00e1hl\u00fdch operac\u00ed (srde\u010dn\u00ed, transplantace, dlouhotrvaj\u00edc\u00ed b\u0159i\u0161n\u00ed v\u00fdkony): nitro\u017eiln\u011b hydrokortizon 100 mg p\u0159ed indukc\u00ed, infuze 200 mg b\u011bhem 24 hodin, pot\u00e9 postupn\u00e1 redukce d\u00e1vky b\u011bhem 3\u20135 dn\u016f. <strong>P\u0159i ka\u017ed\u00e9 p\u0159edopera\u010dn\u00ed kontrole v\u017edy informujte anesteziologa a opera\u010dn\u00ed t\u00fdm o sv\u00e9 adren\u00e1ln\u00ed insuficienci.<\/strong><\/p>\n<h3 class=\"wp-block-heading\">Mohu dostat \u017eiv\u00e9 vakc\u00edny p\u0159i u\u017e\u00edv\u00e1n\u00ed Hisone?<\/h3>\n<p><strong>Ano<\/strong> \u2014 n\u00e1hradn\u00ed d\u00e1vka hydrokortizonu (15\u201325 mg\/den) je pod prahem imunosuprese (kter\u00fd je \u2265 20 mg\/den ekvivalentu prednisolonu = ~80 mg\/den hydrokortizonu). V\u0161echny \u017eiv\u00e9 vakc\u00edny \u2014 MMR, plan\u00e9 ne\u0161tovice, \u017elut\u00e1 zimnice, BCG, \u017eiv\u00e1 nosn\u00ed ch\u0159ipka, \u017eiv\u00fd Zostavax \u2014 jsou bezpe\u010dn\u00e9 a doporu\u010den\u00e9 p\u0159i n\u00e1hradn\u00ed d\u00e1vce. Cestovn\u00ed o\u010dkov\u00e1n\u00ed je t\u0159eba pl\u00e1novat s p\u0159edstihem, abyste mohli zajistit zv\u00fd\u0161en\u00e9 kryt\u00ed d\u00e1vkou. Inaktivovan\u00e9 vakc\u00edny (ka\u017edoro\u010dn\u00ed ch\u0159ipka, pneumokokov\u00e1, COVID-19, rekombinantn\u00ed Shingrix) jsou tak\u00e9 bezpe\u010dn\u00e9 a doporu\u010den\u00e9.<\/p>\n<h3 class=\"wp-block-heading\">Jak se p\u0159ipravit na cestov\u00e1n\u00ed?<\/h3>\n<p>M\u011bjte p\u0159i sob\u011b v p\u0159\u00edru\u010dn\u00edm zavazadle (nikoli v odbaven\u00e9m) z\u00e1sobu Hisone na 2\u20133 t\u00fddny plus nouzovou intramuskul\u00e1rn\u00ed sadu. M\u011bjte u sebe l\u00e9ka\u0159sk\u00e9 potvrzen\u00ed vysv\u011btluj\u00edc\u00ed va\u0161i adren\u00e1ln\u00ed insuficienci a seznam v\u0161ech l\u00e9k\u016f \u2014 u\u017eite\u010dn\u00e9 pro celn\u00edky a nouzovou p\u00e9\u010di v zahrani\u010d\u00ed. M\u011bjte na pam\u011bti, \u017ee dlouh\u00e9 lety a zm\u011bny \u010dasov\u00fdch p\u00e1sem mohou naru\u0161it rytmus d\u00e1vkov\u00e1n\u00ed; po p\u0159\u00edjezdu p\u0159ejd\u011bte na m\u00edstn\u00ed \u010das. Cestovn\u00ed poji\u0161t\u011bn\u00ed mus\u00ed b\u00fdt informov\u00e1no o va\u0161\u00ed adren\u00e1ln\u00ed insuficienci, jinak je neplatn\u00e9. P\u0159ed odjezdem si nechte aplikovat v\u0161echna b\u011b\u017en\u00e1 a cestovn\u00ed o\u010dkov\u00e1n\u00ed s kryt\u00edm zv\u00fd\u0161enou d\u00e1vkou.<\/p>\n<h3 class=\"wp-block-heading\">Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Hisone je dod\u00e1v\u00e1n v\u00fdrobcem certifikovan\u00fdm WHO-GMP s kompletn\u00ed dokumentac\u00ed COA. Z\u00e1silky odes\u00edl\u00e1me po cel\u00e9m sv\u011bt\u011b v nen\u00e1padn\u00e9m obalu a ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed <a href=\"\/cs\/medsbase-re-shipment-assurance-policy\/\">Z\u00e1rukou op\u011btovn\u00e9ho odesl\u00e1n\u00ed<\/a>. V\u00e1\u0161 popis transakce p\u0159i platb\u011b kartou zobrazuje regulovan\u00e9ho zpracovatele plateb (regulovan\u00e9ho zpracovatele plateb kartou), nikdy \u201cMedsBase\u201d nebo n\u00e1zev l\u00e9ku.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h3 class=\"wp-block-heading\">Dal\u0161\u00ed protiz\u00e1n\u011btliv\u00e9 a autoimunitn\u00ed l\u00e9ky<\/h3>\n<p>Pokud Hisone nevyhovuje va\u0161\u00ed situaci, v t\u00e9to kategorii jsou k dispozici n\u00e1sleduj\u00edc\u00ed mo\u017enosti:<\/p>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/wysolone\/\">Wysolone (Prednisolon 5\/10\/20 mg) \u2014 kr\u00e1tk\u00e9 protiz\u00e1n\u011btliv\u00e9 k\u00fary<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/predniheal\/\">Predniheal (Prednisolon 5\/10\/20\/40 mg) \u2014 pln\u00e9 spektrum d\u00e1vek<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/medrol\/\">Medrol (Methylprednisolon 4\/8\/16 mg) \u2014 alternativa pro z\u00e1n\u011bty<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/kenacort\/\">Kenacort (Triamcinolon 4 mg)<\/a><\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/betnesol-tab\/\">Betnesol Tab (Betamethason 0,5 mg) \u2014 dlouhodob\u011b p\u016fsob\u00edc\u00ed fluorovan\u00fd steroid<\/a><\/li>\n<\/ul>","protected":false},"excerpt":{"rendered":"<p>\u2705 Zm\u00edr\u0148uje z\u00e1n\u011bt k\u016f\u017ee<br \/>\n\u2705 L\u00e9\u010d\u00ed alergick\u00e9 reakce<br \/>\n\u2705 Sni\u017euje sv\u011bd\u011bn\u00ed a zarudnut\u00ed<br \/>\n\u2705 Zvl\u00e1d\u00e1 ko\u017en\u00ed vyr\u00e1\u017eky<br \/>\n\u2705 Zm\u00edr\u0148uje p\u0159\u00edznaky ekz\u00e9mu<\/p>\n<p>Hisone obsahuje Hydrokortizon.<\/p>","protected":false},"featured_media":57311,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3897,3141,3223],"product_tag":[4285,4286],"class_list":{"0":"post-57310","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-anti-inflammatory-autoimmune-care","7":"product_cat-category-overview","8":"product_cat-chronic-conditions","9":"product_tag-hisone","10":"product_tag-hydrocortisone","12":"first","13":"instock","14":"shipping-taxable","15":"purchasable","16":"product-type-variable","17":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/57310","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=57310"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/57311"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=57310"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=57310"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=57310"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=57310"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}