FrancophonIA/ELRC3.0 huggingface dataset:
English: The hypotensive effects of dexmedetomidine may be of greater significance in those patients with preexisting hypotension (especially if not responsive to vasopressors), hypovolaemia, chronic hypotension or reduced functional reserve such as patients with severe ventricular dysfunction and the elderly and special care is warranted in these cases (see section 4.3).
Croatian: Učinak deksmedetomidina na smanjivanje krvnoga tlaka može biti od veće važnosti kod bolesnika s već razvijenom hipotenzijom (osobito ako ona ne reagira na vazopresore), hipovolemijom, kroničnom hipotenzijom ili smanjenom funkcionalnom rezervom poput bolesnika s teškim oblikom ventrikularne disfunkcije te starijih osoba pa je u takvim slučajevima potreban poseban oprez (vidjeti dio 4.3).
English: During the current reporting period 16 March 2017 - 15 Mar 2018, the market authorisation holder, Orion pharma undertook a cumulative review of all reports of the adverse reaction of hyperthermia Their review identified 172 reports, 91 of which were serious and 81 of which were non-serious.
Croatian: Tijekom trenutnog razdoblja prijave od 16. ožujka 2017. do 15. ožujka 2018. nositelj odobrenja za stavljanje u promet, Orion pharma, proveo je kumulativni pregled svih prijavljenih slučajeva hipertermije kao nuspojave.
English: The adverse reactions listed in Table 1 have been accumulated from pooled data of clinical trials in intensive care.
Croatian: Podaci o nuspojavama popisani u Tablici 1 sakupljeni su iz podataka kliničkih ispitivanja u jedinicama intenzivnog liječenja.
English: Hypertension has been associated with the use of a loading dose and this reaction can be reduced by avoiding such a loading dose or reducing the infusion rate or size of the loading dose.
Croatian: Hipertenzija je bila povezana s upotrebom udarne doze, a ta se reakcija može ublažiti izbjegavanjem takve udarne doze ili smanjivanjem brzine infundiranja ili veličine udarne doze.
English: Inhibition of CYP enzymes including CYP2B6 by dexmedetomidine has been studied in human liver microsome incubations.
Croatian: Inhibicija enzima CYP, uključujući CYP2B6, deksmedetomidinom istraživana je u inkubaciji mikrosoma ljudske jetre.
English: 2, 5 or 10 ml Type I glass vials (with filling volumes of 2, 4 and 10 ml), grey bromobutyl rubber closure with fluoropolymer coating
Croatian: I od 2, 5 ili 10 ml (s volumenom punjenja 2, 4 i 10 ml), sivi čep od brombutilne gume s fluoropolimernom oblogom
English: Children > 1 month post-natal, predominantly post-operative, have been evaluated for treatment up to 24 hours in the ICU and demonstrated a similar safety profile as in adults.
Croatian: Kod djece >1 mjececa postnatalno, pretežno nakon kirurškog zahvata, procijenjivane za liječenje do 24 sata u jedinici intenzivnog liječenja pokazao se sličan sigurnosni profil kao kod odraslih.
English: CONTENTS BY WEIGHT, BY VOLUME OR BY UNIT 200 mcg/ 2 ml
Croatian: SADRŽAJ PO TEŽINI, VOLUMENU ILI DOZNOJ JEDINICI LIJEKA 200 µg/ 2 ml
English: There are three types of initial metabolic reactions; direct N-glucuronidation, direct N-methylation and cytochrome P450 catalysed oxidation.
Croatian: Tri su tipa početnih metaboličkih reakcija; izravna N-glukuronidacija, izravna N-metilacija i citokromom P450 katalizirana oksidacija.
English: Elderly patients over 65 years of age may be more prone to hypotension with the administration of dexmedetomidine, including a loading dose, for procedures.
Croatian: Bolesnici stariji od 65 godina mogu biti skloniji hipotenziji kod primjene deksmedetomidina, uključujući udarnu dozu, za postupke.
English: When Dexdor is used in an outpatient setting patients should normally be discharged into the care of a suitable third party.
Croatian: Ako se Dexdor upotrebljava u ambulantnim uvjetima, bolesnici se obično otpuštaju na njegu odgovarajućoj trećoj strani.
English: The use of Dexdor for longer than this period should be regularly reassessed.
Croatian: Primjenu lijeka Dexdor u razdoblju dužem od toga treba redovito procjenjivati.
English: In the rabbit study intravenous administration of the maximum dose, 96 µg/kg/day, produced exposures that are similar to those observed clinically.
Croatian: U ispitivanju na kunićima intravenska je primjena maksimalne doze, 96 µg/kg/dnevno, dovelo do izloženosti sličnih onima zapaženima u kliničkim uvjetima.
English: Lactated Ringers, 5% glucose solution, sodium chloride 9 mg/ml (0.9%) solution for injection, mannitol 200 mg/ml (20%), thiopental sodium, etomidate, vecuronium bromide, pancuronium bromide, succinylcholine, atracurium besylate, mivacurium chloride, rocuronium bromide, glycopyrrolate bromide, phenylephrine HCl, atropine sulfate, dopamine, noradrenaline, dobutamine, midazolam, morphine sulfate, fentanyl citrate, and a plasma-substitute.
Croatian: Ringerov laktat, 5%-tna otopina glukoze, otopina natrijevog klorida za injekciju koncentracije 9 mg/ml (0,9%), otopina manitola koncentracije 200 mg/ml (20%), natrijev tiopental, etomidat, vekuronijev bromid, pankuronijev bromid, sukcinilkolin, atrakurijev besilat, mivakurijev klorid, rokuronijev bromid, glikopirolatbromid, fenilefrinklorid, atropinsulfat, dopamin, noradrenalin, dobutamin, midazolam, morfinsulfat, fentanilcitrat i nadomjestak plazme.
English: The sedative effects are mediated through decreased firing of locus coeruleus, the predominant noradrenergic nucleus, situated in the brainstem.
Croatian: Sedativni učinci ostvaruju se putem smanjenog okidanja lokusa ceruleusa, dominantne noradrenergičke jezgre koja se nalazi u moždanom deblu.
English: The mean percentage of unbound dexmedetomidine in plasma ranged from 8.5% in healthy subjects to 17.9% in subjects with severe hepatic impairment.
Croatian: Srednja vrijednost postotka nevezana deksmedetomidina u plazmi bila je u rasponu od 8,5% kod zdravih osoba do 17,9% kod osoba s teškim poremećajem rada jetre.
English: 1000 mcg/ 10 ml
Croatian: 1000 µg/ 10 ml
English: There are no or limited amount of data from the use of dexmedetomidine in pregnant women.
Croatian: Nema podataka ili su podaci o primjeni deksmedetomidina u trudnica ograničeni.
English: Orion pharma noted that case reports of overdose are frequently associated with ADRs of bradycardia, hypotension, over sedation, cardiac arrest, respiratory depression and hypertension so proposed to reinforce the existing warnings in section 4.9 of the SmPC and to include the adverse reaction of hypertension, and to redefine somnolence as respiratory depression.
Croatian: Orion pharma zabilježio je i da su prijavljeni slučajevi predoziranja često povezani s nuspojavama u vidu bradikardije, hipotenzije, prekomjerne sedacije, srčanog zastoja, respiratorne depresije i hipertenzije te je predložio pojačavanje postojećih upozorenja u odjeljku 4.9 Sažetka opisa svojstava i dodavanje hipertenzije kao nuspojave, kao i ponovno određivanje somnolencije kao respiratorne depresije.
English: Reduced fetal body weight was noted also in the rat fertility study at dose 18 µg/kg/day and was accompanied with delayed ossification at dose 54 µg/kg/day.
Croatian: Smanjena je fetalna tjelesna masa zabilježena i u istraživanju plodnosti štakora pri dozi od 18 µg/kg/dnevno, a nju je pratila i odgođena osifikacija pri dozi od 54 µg/kg/dnevno.
English: Dexmedetomidine exhibits a two-compartment disposition model.
Croatian: Deksmedetomidin pokazuje dispozicijski model s dva odjeljka.
English: If you are given too much Dexdor, your blood pressure may go up or down, your heartbeat may slow down, you may breathe more slowly and you may feel more drowsy.
Croatian: Ako primite više lijeka Dexdor nego što ste trebali Primite li previše lijeka Dexdor, krvni tlak mogao bi vam se sniziti ili povisiti, srčano bilo moglo bi vam se usporiti, mogli biste disati sporije i osjećati se pospanije.
English: Experience of dexmedetomidine in severe neurological disorders such as head injury and after neurosurgery is limited and it should be used with caution here, especially if deep sedation is required.
Croatian: Iskustva upotrebe deksmedetomidina kod teških neuroloških poremećaja poput ozljede glave i nakon neurokirurških zahvata ograničena su pa se u takvim slučajevima treba upotrebljavati s oprezom,
English: General precautions
Croatian: Općenite mjere opreza
English: - The maintenance infusion is generally initiated at 0.6-0.7 microgram/kg/hour and titrated to achieve desired clinical effect with doses ranging from 0.2 to 1 microgram/kg/hour.
Croatian: Infuzija održavanja obično se započinje uz 0,6 - 0,7 mikrograma/kg/h i titrira do postizanja željenog kliničkog učinka s dozama u rasponu od 0,2 do 1 mikrogram/kg/h.
English: - The other ingredients are sodium chloride and water for injections.
Croatian: Drugi sastojci su natrijev klorid i voda za injekcije.
English: Patients with impaired peripheral autonomic activity (e.g. due to spinal cord injury) may have more pronounced haemodynamic changes after starting dexmedetomidine and so should be treated with care.
Croatian: Bolesnici s poremećajem aktivnosti perifernog autonomnog živčanog sustava (primjerice zbog ozljede leđne moždine) mogu imati izraženije hemodinamske promjene nakon početka davanja deksmedetomidina pa im treba posvetiti posebnu pozornost.
English: Keep the ampoules or vials in the outer carton in order to protect from light.
Croatian: Čuvati ampule ili bočice u vanjskom pakiranju radi zaštite od svjetlosti.
English: Most dexmedetomidine patients required no additional sedative treatment.
Croatian: Većina bolesnika koji su primali deksmedetomidin nije trebala primati nikakve dodatne sedativne lijekove.
English: Dexmedetomidine treatment should be discontinued in the event of a sustained unexplained fever and is not recommended for use in malignant hyperthermia-sensitive patients.
Croatian: Terapija deksmedetomidinom mora se prekinuti u slučaju dugotrajne neobjašnjive vrućice i ne preporučuje se za primjenu u bolesnika osjetljivih na malignu hipertermiju.
English: In vitro study suggests that interaction potential in vivo exists between dexmedetomidine and substrates with dominant CYP2B6 metabolism.
Croatian: Ispitivanje in vitro nalaže kako mogućnost takve interakcije in vivo postoji između deksmedetomidina i supstrata s dominantnim metabolizmom putem CYP2B6.
English: Caution is advised when administering dexmedetomidine together with spinal or epidural anaesthesia due to possible increased risk of hypotension or bradycardia.
Croatian: Potreban je oprez prilikom primjene deksmedetomidina zajedno sa spinalnom ili epiduralnom anestezijom zbog mogućeg povećanja rizika od hipotenzije ili bradikardije.
English: Co-administration of dexmedetomidine with anaesthetics, sedatives, hypnotics, and opioids is likely to lead to an enhancement of effects, including sedative, anaesthetic and cardiorespiratory effects.
Croatian: Davanje deksmedetomidina zajedno s anesteticima, sedativima, hipnoticima i opioidima vjerojatno će pojačati djelovanje, uključujući sedativne, anestetičke i kardiorespiratorne učinke.
English: Metabolite H-1, N-methyl 3-hydroxymethyl dexmedetomidine O-glucuronide, is also a major circulating product of dexmedetomidine biotransformation.
Croatian: Metabolit H-1, N-metil 3-hidroksimetil deksmedetomidin O-glukuronid, također je glavni produkt biotransformacije deksmedetomidina u optoku.
English: Sedation of adult ICU (Intensive Care Unit) patients The most frequently reported adverse reactions with dexmedetomidine in ICU setting are hypotension, hypertension and bradycardia, occurring in approximately 25%, 15% and 13% of patients respectively.
Croatian: Sedacija odraslih bolesnika u jedinici za intenzivno liječenje (JIL) Najčešće zabilježene nuspojave deksmedetomidina su hipotenzija, hipertenzija i bradikardija, koje se pojavljuju u približno 25%, 15% odnosno 13% bolesnika.
English: To maintain a Ramsay Sedation Scale ≥2 53% of the patients receiving dexmedetomidine did not require midazoloam rescue vs. 14% of patients receiving placebo.
Croatian: Da bi se održala razina sedacije prema Ramsayevoj ljestvici ≥2, za 53% bolesnika koji su primali deksmedetomidin nije bio potreban rescue midazolam naspram 14 % bolesnika koji su primali placebo.
English: Dexdor contains less than 1 mmol sodium (23 mg) per ml.
Croatian: Dexdor sadrži manje od 1 mmol natrija (23 mg) po ml.
English: In the reproductive toxicity studies, dexmedetomidine had no effect on male or female fertility in the rat, and no teratogenic effects were observed in the rat or rabbit.
Croatian: U ispitivanjima reproduktivne toksičnosti, deksmedetomidin nije pokazao nikakav učinak na plodnost mužjaka ili ženki štakora, a kod štakora i kunića nisu zapaženi nikakvi teratogeni učinci.
English: In clinical studies, cases of sinus arrest reversed spontaneously or responded to treatment with atropine and glycopyrrolate.
Croatian: U kliničkim se ispitivanjima pojava zastoja sinusnog ritma spontano povlačila ili je reagirala na liječenje atropinom i glikopirolatom.
English: Although dexmedetomidine is dosed to effect, it is advisable to use components with synthetic or coated natural rubber gaskets.
Croatian: Iako se deksmedetomidin dozira prema učinku, preporučljivo je upotrebljavati dijelove opreme sa sintetičkim ili obloženim brtvilima od prirodne gume.
English: Please refer to section 4.2.
Croatian: Vidjeti dio 4.2.
English: The pharmacokinetics of dexmedetomidine in subjects with severe renal impairment (creatinine clearance <30 ml/min) is not altered relative to healthy subjects.
Croatian: Farmakokinetička svojstva deksmedetomidina kod osoba s teškim poremećajem rada bubrega (klirens kreatinina <30 ml/min) jednaka su onima kod zdravih osoba.
English: It must be administered only as a diluted intravenous infusion using a controlled infusion device
Croatian: Mora se primjenjivati samo kao razrijeđena intravenska infuzija putem uređaja za kontroliranu infuziju.
English: Dexmedetomidine binds to both human serum albumin and Alpha-1-acid glycoprotein with serum albumin as the major binding protein of dexmedetomidine in plasma.
Croatian: Deksmedetomidin se veže i na humani serumski albumin i na alfa-1-kiseli glikoprotein pri čemu je serumski albumin glavni vezni protein deksmedetomidina u plazmi.
English: Subjects with varying degrees of hepatic impairment (Child-Pugh Class A, B, or C) had decreased hepatic clearance of dexmedetomidine and prolonged plasma elimination t1/2.
Croatian: Kod osoba s različitim stupnjevima poremećaja rada jetre (stadij A, B ili C prema Child-Pughu) jetreni klirens deksmedetomidina je smanjen, a t1/2 plazmatske eliminacije se produžen.
English: Patients failing to achieve an adequate level of sedation with the maximum dose of dexmedetomidine should be switched to an alternative sedative agent.
Croatian: Za bolesnike kod kojih se ne postigne odgovarajuća razina sedacije maksimalnom dozom deksmedetomidina treba primijeniti drugo sredstvo za sedaciju.
English: Patients should be advised to refrain from driving or other hazardous tasks and where possible to avoid the use of other agents that may sedate (e.g, benzodiazepines, opioids, alcohol) for a suitable period of time based on observed effects of dexmedetomidine, the procedure, concomitant medications, the age and the condition of the patient.
Croatian: Bolesnike je potrebno upozoriti da se suzdrže od upravljanja vozilom i drugih opasnih radnji te da po mogućnosti tijekom odgovarajućeg razdoblja izbjegavaju uzimanje drugih sredstava koja mogu izazvati sedaciju (primjerice benzodiazepina, opioida, alkohola), a na temelju opaženih učinaka deksmedetomidina, postupka, istodobne primjene drugih lijekova, dobi i stanja bolesnika.
English: The observed exposure levels in the rat are below the clinical exposure range.
Croatian: Zapažene razine izloženosti kod štakora bile su ispod raspona izloženosti u kliničkim uvjetima.
English: Hypotension and bradycardia were also the most frequent dexmedetomidine-related serious adverse reactions occurring in 1.7% and 0.9% of randomised Intensive Care Unit (ICU) patients respectively.
Croatian: Hipotenzija i bradikardija također su najčešće kao ozbiljne nuspojave povezane s deksmedetomidinom a pojavile su se kod 1,7% odnosno and 0,9% nasumično odabranih bolesnika u jedinicama intenzivnog liječenja.
English: Dose reduction or discontinuation should be considered in a patient developing signs of myocardial or cerebral ischaemia.
Croatian: Smanjivanje doze ili prekid davanja infuzije treba razmotriti kod bolesnika kod kojih se razviju znaci moždane ishemije ili ishemije miokarda.
English: Patients already intubated and sedated may switch to dexmedetomidine with an initial infusion rate of 0.7 micrograms/kg/h which may then be adjusted stepwise within the dose range 0.2 to 1.4 micrograms/kg/h in order to achieve the desired level of sedation, depending on the patient's response.
Croatian: Kod bolesnika koji su već intubirani i sedirani može se prijeći na deksmedetomidin uz početnu brzinu infundiranja od 0,7 mikrograma/kg/h što se može zatim postupno prilagoditi unutar raspona od 0,2 do 1,4 mikrograma/kg/h kako bi se postigla željena razina sedacije, ovisno o reakciji bolesnika.
English: Dexmedetomidine is very potent and the infusion rate is given per hour.
Croatian: Deksmedetomidin je vrlo jak lijek pa je brzina infundiranja dana po satu.
English: Dexdor is intended for use in an intensive care setting, operating room and during diagnostic procedures.
Croatian: Dexdor je namijenjen za upotrebu na odjelu intenzivnog liječenja, u operacijskoj dvorani i tijekom dijagnostičkih postupaka.
English: Although dexmedetomidine is administered to effect, it may be necessary to consider initial/maintenance dose reduction in patients with hepatic impairment depending on the degree of impairment and the response.
Croatian: Iako se deksmedetomidin dozira s obzirom na učinak, možda će biti nužno razmotriti smanjivanje početne doze ili doze održavanja kod bolesnika s poremećajem rada jetre, ovisno o težini poremećaja i reakciji.
English: Patients with high physical fitness and slow resting heart rate may be particularly sensitive to bradycardic effects of alpha-2 receptor agonists and cases of transient sinus arrest have been reported.
Croatian: Bolesnici dobre tjelesne kondicije i spore srčane frekvencije mogu biti posebno osjetljivi na bradikardične učinke agonista alfa-2 receptora, a zabilježeni su i slučajevi prolaznih zastoja sinusnog ritma.
English: Dexmedetomidine is metabolised in the liver and should be used with caution in patients with hepatic impairment.
Croatian: Deksmedetomidin se metabolizira u jetri i treba ga koristiti oprezno kod bolesnika s oštećenjem funkcije jetre.
English: The time to recovery ranged from a short time after discontinuation of dexmedetomidine, to some days later.
Croatian: Vrijeme oporavka kretalo se od momentalnog do nekoliko dana nakon prestanka uzimanja deksmedetomidina.
English: Caution should be exercised when administering dexmedetomidine to elderly patients.
Croatian: Potreban je oprez prilikom primjene deksmedetomidina u starijih bolesniika.
English: - Hypotension (55 % in dexmedetomidine-group vs. 30 % in placebo-group receiving rescue midazolam and fentanyl) - Respiratory depression ( 38 % in dexmedetomidine-group vs. 35 % in placebo-group receiving rescue midazolam and fentanyl) - Bradycardia (14 % in dexmedetomidine-group vs. 4 % in placebo-group receiving rescue midazolam and fentanyl)
Croatian: - Hipotenzija (55 % u skupini koja je primala deksmedetomidin nasuprot 30 % u placebo skupini koja je primala midazolam i fentanil kao medikaciju spasa (engl. rescue)) - Respiratorna depresija (38 % u skupini koja je primala deksmedetomidin nasuprot 35 % u placebo skupini koja je primala midazolam i fentanil kao medikaciju spasa (rescue)) - Bradikardija (14 % u skupini koja je primala deksmedetomidin nasuprot 4 % u placebo skupini koja je primala midazolam i fentanil kao medikaciju spasa (rescue))
English: In double blind comparator controlled ICU studies the incidence of cortisol suppression in patients treated with dexmedetomidine (n=778) was 0.5% compared with 0% in patients treated with either midazolam (n=338) or propofol (n=275).
Croatian: U dvostruko slijepim, poredbenim lijekom kontroliranim ispitivanjima u jedinicama intenzivnog liječenja, incidencija supresije kortizola kod bolesnika koji primaju deksmedetomidin (n=778) bila je 0,5% u usporedbi s 0% kod bolesnika koji su primali bilo midazolam (n=338) ili propofol (n=275).
English: Dexmedetomidine plasma protein binding is decreased in subjects with hepatic impairment compared with healthy subjects.
Croatian: Vezanje deksmedetomidina za proteine plazme smanjeno je kod osoba s poremećajem rada jetre, u usporedbi sa zdravim osobama.
English: For the full list of excipients, see section 6.1.
Croatian: Za cjeloviti popis pomoćnih tvari pogledajte odjeljak 6.1.
English: Cytochrome P-450 catalyses the formation of two minor circulating metabolites, 3-hydroxymethyl dexmedetomidine produced by hydroxylation at the 3-methyl group of dexmedetomidine and H-3 produced by oxidation in the imidazole ring.
Croatian: Citokrom P-450 katalizira stvaranje dva manje zastupljena metabolita u optoku, 3-hidroksimetil deksmedetomidina koji nastaje hidroksilacijom na 3-metilnoj skupini deksmedetomidina, te spoja H-3 koji nastaje oksidacijom u imidazolskom prstenu.
English: Dexmedetomidine lacks the anticonvulsant action of some other sedatives and so will not suppress underlying seizure activity.
Croatian: Deksmedetomidin nema antikonvulzivno djelovanje kao neki drugi sedativi i neće spriječiti podležeću epileptičnu aktivnost.
English: Delirium measured by the CAM-ICU scale was reduced in a study compared to midazolam and delirium-related adverse events were lower on dexmedetomidine compared to propofol.
Croatian: U ispitivanju je delirij izmjeren prema ljestvici CAM-ICU bio smanjen u usporedbi s midazolamom, a s delirijem povezane nuspojave bile su rjeđe za deksmedetomidin u usporedbi s propofolom.
English: For sedation of adult ICU (Intensive Care Unit) patients requiring a sedation level not deeper than arousal in response to verbal stimulation (corresponding to Richmond Agitation-Sedation Scale (RASS) 0 to -3).
Croatian: Za sedaciju odraslih bolesnika u jedinici za intenzivno liječenje (JIL) do razine ne dublje od one koja omogućuje odgovor na verbalnu stimulaciju (na Richmond Agitation-Sedation Scale (RASS) odgovara vrijednosti od 0 do -3).
English: 400 mcg/ 4 ml
Croatian: 400 µg/ 4 ml
English: The concentration of the final solution after dilution should be either 4 micrograms/ml or 8 micrograms/ml.
Croatian: Koncentracija konačne otopine nakon razrjeđivanja treba biti 4 mikrograma/ml ili 8 mikrograma/ml.
English: New-born infants may be particularly sensitive to the bradycardic effects of Dexdor in the presence of hypothermia and in conditions of heart rate-dependent cardiac output.
Croatian: Novorođenčad može biti posebno osjetljiva na bradikardijske učinke lijeka Dexdor uz postojanje hipotermije i u stanjima kada minutni volumen srca ovisi o srčanoj frekvenciji.
English: The most common adverse reactions reported in conjunction with overdose include bradycardia, hypotension, hypertension, oversedation, respiratory depression and cardiac arrest.
Croatian: Najčešće zabilježene nuspojave povezane s predoziranjem uključuju bradikardiju, hipotenziju, hipertenziju, prejaku sedaciju, respiratornu depresiju i srčani zastoj.
English: The mean plasma clearance values of unbound dexmedetomidine for subjects with mild, moderate, and severe hepatic impairment were 59%, 51% and 32% of those observed in the normal healthy subjects, respectively.
Croatian: Srednje vrijednosti plazmatskog klirensa nevezanog deksmedetomidina kod osoba s blagim, srednjim i teškim poremećajima rada jetre bile su 59%, 51% odnosno 32% vrijednosti zabilježenih kod normalnih zdravih osoba.