Amoxicillin Clavulanic acid (Amoxicillin Clavulanic acid)

Kufotokozera kogwirizana ndi 15.05.2015

• Dzina lachi Latin: Amoxicillin + Clavulanic ac>

Kuphatikizika kwa kukonzekera kumakhala ndi zosakaniza zomwe zimagwira amoxicillin + clavulanic acid, komanso zowonjezera.

Pharmacodynamics ndi pharmacokinetics

Mankhwala osakanikirana a Amoxicillin + Clavulanic acid ndi beta-lactamase inhibitor omwe ali ndi bactericidal zotsatira zomwe zimalepheretsa kuphatikizika kwa khoma la bakiteriya. Kuphatikiza apo, ntchito ya mankhwalawa imawonetsedwa poyerekeza ndi mabakiteriya ena abwino aerobic, kuphatikiza tizilombo ta kutulutsa ma beta-lactamase, mwachitsanzo: Staphylococcus aureus, mabakiteriya ena aerobic gramu osagwirizana: Haemophilus influenzae, Enterobacter spp, Escherichia coli, Klebsiella spp. ndi ma tizilombo tina tovuta, mabakiteriya a anaerobic gram-positive, anaerobic ndi aerobic gram-negative bacteria, ndi zina zotero.

Clavulanic acid imatha kupondereza mitundu ya II-V ya beta-lactamases osakhala yogwira motsutsana ndi mtundu 1 wa beta-lactamases womwe Pseudomonas aeruginosa, Acinetobacter spp ndi Serratia spp amapanga. Komanso, chinthuchi chimadziwika ndi kutentha kwakukulu kwa penicillinases, omwe amapanga khola lolimba ndi enzyme ndi kupewa kuwonongeka kwa enzymatic kwa amoxicillin ndi beta-lactamases.

Mkati mwa thupi, chilichonse cha zinthu zomwe zimapangidwira zimayamwa mofulumira m'mimba. The achire ndende zimawonedwa mkati 45 Mphindi. Kuphatikiza apo, pokonzekera zosiyanasiyana, clavulanic acid, kuchuluka kwake ndi amoxicillin ndi gawo limodzi la mapiritsi a 125 mpaka 250, 500 ndi 850 mg.

Mankhwala amamangidwa pang'ono ndi mapuloteni a plasma: clavulanic acid wokhudza 22-30%, amoxicillin ndi 17-20%. Kupenda Zinthu izi zimachitika m'chiwindi: clavulanic acid pafupifupi 50%, ndi amoxicillin ndi 10% ya mlingo womwe umalandiridwa.

Mankhwalawa amachotsedwa osasinthika makamaka ndi impso mkati mwa maola 6 kuchokera nthawi yomwe amagwiritsidwa ntchito.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amadziwitsidwa zochizira matenda angapo bakiteriya:

• kupuma kwapadera -bronchitis, chibayo, mankhwala a pleura, mapapo
• Mwachitsanzo ziwalo za ENT sinusitis, otitis media, tonsillitis,
• The genitourinary dongosolo ndi ziwalo zina za m'chiuno ndi pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, salpingo-oophoritis, endometritis, bacterial vaginitis ndi zina zotero
• khungu ndi zofewa minofu, mwachitsanzo, ndi erysipelas, impetigo, dermatoses yachiwiri yopatsirana, ma abscesses, phlegmon,
• komansoosteomyelitis, matenda opatsirana,kupewa matenda opaleshoni.

Contraindication

Mankhwala sakhazikitsidwa:

• Hypersensitivity
• matenda mononucleosis,
• phenylketonuria, magawo jaundicekapena kukanika kwa chiwindi komwe kumachitika chifukwa cha kumwa awa kapena mankhwala enanso.

Muyenera kusamala pochiza akazi ndi amayi apakati, odwala kwambiri chiwindi kulephera, matenda ammimba thirakiti.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa Amoxicillin + Clavulanic acid:

• mapiritsi okhala ndi kanema: oval, biconvex, pafupifupi oyera kapena oyera, akulemba "A" mbali imodzi, "63" mbali inayi (mapiritsi a 250 mg + 125 mg), kapena mapiritsi a "64" (500 mg + 125 mg) ,, kapena olembedwa ndi zolemba zoika pachiwopsezo - "6 | 5" (mapiritsi a 875 mg + 125 mg), pamtandapo mutha kuwona chimacho chachikasu chazunguliridwa ndi chipolopolo choyera kapena choyera (ma 7 ma PC. ),
• ufa wa kuyimitsidwa kwamlomo (sitiroberi): granular, pafupifupi yoyera kapena yoyera (pamlingo wa 125 mg + 31.25 mg / 5 ml - 7.35 g aliyense m'mabotolo a translucent a 150 ml, pa mulingo wa 250 mg + 62) 5 mg / 5 ml - 14.7 g aliyense mu translucent 150 ml mabotolo, botolo lililonse mu katoni),
• ufa pakakonzedwe ka yankho la intravenous (iv) makonzedwe: kuyambira oyera mpaka oyera ndi tint wachikasu (m'mabotolo 10 ml, mabotolo 1 kapena 10 osungidwa mu katoni, kuwayika zipatala - 1 mpaka 50 m'mabokosi a makatoni) .

Piritsi limodzi:

• yogwira zinthu: amoxicillin (mu mawonekedwe a trihydrate) - 250 mg, kapena 500 mg, kapena 875 mg, clavulanic acid (monga potaziyamu clavulanate) - 125 mg,
• othandizira (osagwira) zigawo zikuluzikulu: sodium carboxymethyl starch, microcrystalline cellulose, magnesium stearate, colloidal silicon dioxide, oyera opadra 06V58855 (titanium dioxide, macrogol, hypromellose-15cP, hypromellose-5cP.

Kuphatikizidwa kwa 5 ml ya kuyimitsidwa (komwe kumapangidwa ndi ufa kuyimitsidwa):

• yogwira pophika: amoxicillin (mu mawonekedwe a trihydrate) - 125 mg ndi clavulanic acid (mu mawonekedwe a potaziyamu clavulanate) - 31.25 mg, kapena amoxicillin - 250 mg ndi clavulanic acid - 62,5 mg,
• othandizira zigawo zikuluzikulu: xanthan chingamu, silicon dioxide, hypromellose, aspartame, succinic acid, colloidal silicon dioxide, kununkhira kwa sitiroberi.

Zosakaniza zofunikira mu 1 botolo la ufa pokonzekera njira yothetsera utsogoleri wa iv: amoxicillin - 500 mg ndi clavulanic acid - 100 mg, kapena amoxicillin - 1000 mg ndi clavulanic acid - 200 mg.

Pharmacokinetics

Mutatenga Amoxicillin + Clavulanic acid mkati, zinthu zomwe zimagwira mwachangu zimatenga msanga komanso kutuluka kwathunthu kuchokera kumimba. Kuzindikira kwakukulu kumachitika pambuyo pa maola 1-2. Kuthira koyenera kumawonedwa pakumwa mankhwala kumayambiriro kwa chakudya.

Mukamamwa komanso kudzera m'mitsempha, zinthu zomwe zimakhala ndi mphamvu zimakhala ndi mapuloteni amodzi a plasma: amoxicillin - 17-20%, clavulanic acid - 22-30%.

Zonsezi zimadziwika ndi kuchuluka kwabwino kogawa madzi amthupi ndi zimakhala. Amapezeka m'mapapu, khutu lapakati, ma pleural ndi peritoneal fluid, chiberekero, mazira. Tizilomboti, tinthu tating'onoting'ono, timadzi tating'onoting'ono, kutulutsa kwa bronchi, minofu minofu, chikhodzodzo, chikhodzodzo ndi chiwindi zimalowa mwachinsinsi. Amoxicillin amatha kudutsa mkaka wa m'mawere, komanso ma penicillin ambiri. Zotsatira za clavulanic acid zapezekanso mkaka wa m'mawere.

Amoxicillin ndi clavulanic acid amawoloka placental zotchinga. Musadutse chotchinga chaubongo wamagazi, bola kuti mankhwalawo asadzapunduke.

Zonsezi zimapukusidwa mu chiwindi: amoxicillin - pafupifupi 10% ya mlingo, clavulanic acid - pafupifupi 50% ya mlingo.

Amoxicillin (50-78% ya mlingo) amachotsa pafupifupi osasinthika ndi impso ndi kusefera kwamadzi ndi kubisalira kwa tubular. Clavulanic acid (25- 40% ya mlingo) amachotseredwa ndi kusefera kwa impso pang'ono ndi mawonekedwe a metabolites komanso osasinthika. Zonsezi zimachotsedwa pakatha maola 6. Zing'onozing'ono zimatha kupukusidwa kudzera m'mapapu ndi matumbo.

A kwambiri aimpso kulephera, kuphatikiza theka moyo kumawonjezera: kwa amoxicillin - mpaka maola 7.5, kwa clavulanic acid - mpaka 4.5 maola.

Zinthu zonse zogwira ma antibayotiki zimachotsedwa pa hemodialysis, ochepa pogwiritsa ntchito peritoneal dialysis.

Mapiritsi okhala ndi mafilimu

Mu mawonekedwe a piritsi, mankhwalawo amawonetsedwa pakamwa. Kwa mayamwidwe oyenera komanso muchepetse chiopsezo cha zotsatira zoyipa za m'mimba, kumwa mapiritsi kumalimbikitsidwa kumayambiriro kwa chakudya.

Dokotalayo amawona mtundu wa mankhwalawa payekha malinga ndi kuopsa kwa matenda opatsirana, msinkhu wa wodwalayo, kulemera kwake kwa thupi ndi impso.

Ngati ndi kotheka, gwiritsani ntchito mankhwala othandizira: choyamba, mankhwalawa Amoxicillin + Clavulanic acid amaperekedwa kudzera pakamwa, pambuyo pake amatengedwa pakamwa.

Mlingo wolimbikitsidwa wa akulu ndi ana opitilira zaka 12 kapena wolemera kuposa 40 makilogalamu:

• wofatsa pamatenda oyenera: 250 mg + 125 mg maola 8 aliwonse kapena 500 mg + 125 mg maola 12 aliwonse,
• matenda oopsa, matenda opuma: 500 mg + 125 mg katatu pa tsiku kapena 875 mg + 125 mg 2 kawiri pa tsiku.

Pazipita tsiku lililonse la amoxicillin sayenera kupitirira 6000 mg, clavulanic acid - 600 mg.

Kutalika kochepa kwambiri kwa chithandizo ndi masiku 5, pazofika masiku 14.Pakatha masabata awiri chiyambireni maphunziro, dokotalayo amawunika momwe aliri, ndipo ngati kuli kotheka, apanga lingaliro la kupitiriza kwa mankhwalawa. Kutalika kwa mankhwala kwa zovuta pachimake otitis media ndi masiku 5-7.

Ndikofunikira kudziwa kuti mapiritsi awiri a 250 mg + 125 mg molingana ndi clavulanic acid sofanana ndi piritsi limodzi la 500 mg + 125 mg.

Ngati matenda aimpso ayambitsidwa, mlingo wa amoxicillin umasinthidwa malinga ndi chilolezo cha creatinine (CC):

• QC> 30 ml / min: palibe kukonza komwe kukufunika
• KK 10-30 ml / mphindi: 2 kawiri pa tsiku, piritsi limodzi 250 mg (kwa matenda ofatsa komanso olimbitsa) kapena piritsi limodzi 500 mg,
• QA 30 ml / mphindi.

Akuluakulu pa hemodialysis amatchulidwa piritsi limodzi la 500 mg + 125 mg kapena mapiritsi awiri a 250 mg + 125 mg kamodzi patsiku. Kuphatikiza apo, mlingo umodzi umayikidwa pa gawo la dialysis ndi mlingo wina kumapeto kwa gawoli.

Mphamvu yakuyimitsidwa pakamwa

Suspension Amoxicillin + Clavulanic acid nthawi zambiri amalembera ana osakwana zaka 12.

Mu mawonekedwe awa, mankhwalawa amapangidwira pakamwa. Kuyimitsidwa kumakonzedwa kuchokera ku ufa: kuwiritsa ndikuphika kulowa firiji madzi akumwa amathiridwa mu vial 2/3, wogwedezeka bwino, ndiye kuti voliyumuyo imasinthidwa kukhala chizindikiro (100 ml) ndikugwedezanso mwamphamvu. Phwando lililonse lisanalandiridwe, bokosi liyenera kugwedezeka.

Kuti mupeze dosing yolondola, kit imakhala ndi chipewa choyezera chomwe chili ndi zoopsa za 2,5 ml, 5 ml ndi 10 ml. Iyenera kutsukidwa ndi madzi oyera mukatha kugwiritsa ntchito.

Dokotalayo amawona mtundu wa mankhwalawa payekha malinga ndi kuopsa kwa matenda opatsirana, msinkhu wa wodwalayo, kulemera kwake kwa thupi ndi impso.

Pofuna kuyamwa bwino kwa zinthu zogwira ntchito ndikuchepetsa chiopsezo cha zovuta m'mimba, tikulimbikitsidwa kutenga kuyimitsidwa kwa Amoxicillin + Clavulanic acid kumayambiriro kwa chakudya.

Kutalika kwa mankhwala osachepera masiku 5, koma osapitilira masiku 14. Pakatha masabata awiri chiyambireni maphunziro, dokotalayo amawunika momwe aliri, ndipo ngati kuli kotheka, apanga lingaliro la kupitiriza kwa mankhwalawa.

Kwa ana kuyambira miyezi itatu kufika zaka 12 kapena wolemera mpaka 40 makilogalamu, kuyimitsidwa kumayikidwa pa mlingo wa 125 mg + 31.25 mg wa 5 ml kapena 250 mg + 62,5 mg pa 5 ml katatu patsiku pakadutsa maola 8.

Mlingo wocheperako tsiku lililonse wa amoxicillin ndi 20 mg / kg, momwe muliri ndi 40 mg / kg. Mlingo wochepa, mankhwalawa amagwiritsidwa ntchito popezekanso ndi zilonda zapakhosi, matenda a pakhungu ndi minofu yofewa. Muli waukulu - ndi sinusitis, otitis media, matenda am'munsi kupuma thirakiti, kwamikodzo thirakiti, mafupa ndi mafupa.

Kwa ana kuyambira nthawi yobadwa mpaka miyezi itatu, muyezo wa 30 mg / kg wa amooticillin umalimbikitsidwa. Iyenera kugawidwa pawiri.

Palibe malingaliro pa mtundu wa ana omwe amabadwa masiku asanakwane.

Mu vuto la impso, mtundu wa amoxicillin umasinthidwa malinga ndi QC:

• QC> 30 ml / min: palibe kukonza komwe kukufunika
• KK 10-30 ml / min: 15 mg + 3.75 mg pa kilogalamu yakulemera thupi kawiri pa tsiku, koma osapitirira 500 mg + 125 mg kawiri patsiku,
• QC

Zotsatira zoyipa

Pochiza ndi Amoxicillin + Clavualanic acid, mavuto osiyanasiyana amatha kuchitika omwe amakhudza chimbudzi, ziwalo zopangira magazi, dongosolo lamanjenje, ndi zina zotero.

Chifukwa chake, zoyipa zimachitika: nseru, kusanza, kutsegula m'mimba, matenda am'mimba, matenda am'mimba, matenda am'mimba, matenda am'mimba, chiwindi, leukopenia, agranulocytosis, chizungulire, kupweteka kwa mutu, kufooka, nkhawa ndi zizindikiro zina.

Kukula kwanyumba ndi thupi lawo siligwirizana ndi zovuta zina.

Model Clinical-Pharmacological Article 1

Zochita pafamu. Kuphatikiza kophatikizira kwa amoxicillin ndi clavulanic acid, choletsa-lactamase inhibitor. Imagwira bactericidal, imalepheretsa kapangidwe ka khoma la bakiteriya. Yogwiritsa ntchito mabakiteriya olimbitsa thupi aerobic gram (kuphatikizapo beta-lactamase yopanga tizilombo ta): Staphylococcus aureus, mabakiteriya olakwika a grobic: Enterobacter spp., Escherichia coli, Haemophilus influenzae, Klebsiella spp., Moraxella catarrhalis. Mavuto otsatirawa ndiwokhudza mtima. mu vitro : Staphylococcus epidermidis,Streptococcus pyogene, Streptococcus anthracis, Streptococcus pneumoniae, Streptococcus viridans, Enterococcus faecalis, Corynebacterium spp., Listeria monocytogene, mabakiteriya a anaerobic gramu: Clostridium spp., Peptococcus spp., Peptostreptococcus spp., anaerobic Clostridium spp., Peptococcus spp., Peptostreptococcus spp., mabakiteriya olakwika a grobic (kuphatikizapo beta-lactamase yopanga tizilombo ta): Proteus mirabilis, Proteus vulgaris, Salmonella spp., Shigella spp., Bordetella pertussis, Yersinia enterocolitica, Gardnerella vaginalis, Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus ducreyi, Yersinia multocida (kale Pasteurella), Campylobacter jejuni, mabakiteriya osokoneza bongo a anaerobic gramu (kuphatikizapo tizilombo ta kutulutsa ma beta-lactamase): Bacteroides spp., kuphatikiza Bacteroides fragilis. Clavulanic acid imaphatikizira mtundu II, III, IV ndi V mitundu ya beta-lactamase, yosagwira ntchito motsutsana ndi mtundu I beta-lactamases wopangidwa Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid imakhala yogwirizana kwambiri ndi ma penicillinases, omwe amapanga zovuta kwambiri ndi enzyme, omwe amalepheretsa kuchepa kwa enzymatic pansi pa mphamvu ya beta-lactamases.

Pharmacokinetics Pambuyo pakukonzekera pakamwa, zonse ziwiri zimatengedwa mwachangu m'mimba. Kudya nthawi imodzi sikukhudza kuyamwa. T c_max - Mphindi 45 Pambuyo m`kamwa makonzedwe a 250/125 mg aliyense 8 maola C_max amoxicillin - 2.18-4.5 μg / ml, clavulanic acid - 0.8-2.2 μg / ml, pa mlingo wa 500/125 mg maola 12 aliwonse_max amoxicillin - 5.09-7.91 μg / ml, clavulanic acid - 1.19-2.41 μg / ml, pa mlingo wa 500/125 mg maola 8 aliwonse_max amoxicillin - 4,94-9,646 μg / ml, clavulanic acid - 1.57-3.23 μg / ml, pa mlingo wa 875/125 mg C_max amoxicillin - 8.82-14.38 μg / ml, clavulanic acid - 1.21-3.19 μg / ml. Pambuyo iv makonzedwe Mlingo wa 1000/200 ndi 500/100 mg C_max amoxicillin - 105.4 ndi 32.2 μg / ml, motero, ndi clavulanic acid - 28,5 ndi 10,5 μg / ml. Nthawi yakukwanira kuzungulira kwa 1 μg / ml kwa amoxicillin ndi yofanana mukamagwiritsa ntchito maola 12 ndi maola 8 mwa akulu ndi ana. Kuyankhulana ndi mapuloteni a plasma: amoxicillin - 17-20%, clavulanic acid - 22-30%. Zonsezi mu chiwindi zimapukusidwa: amoxicillin - ndi 10% ya mankhwala omwe amaperekedwa, clavulanic acid - ndi 50%. T_1/2 pambuyo makonzedwe pa mlingo wa 375 ndi 625 mg, 1 ndi 1,3 maola amoxicillin, 1,2 ndi 0,8 maola clavulanic acid, motero. T_1/2 pambuyo iv makonzedwe pa mlingo 1200 ndi 600 mg, 0,9 ndi 1,07 h kwa amoxicillin, 0,9 ndi 1,12 h kwa clavulanic acid, motero. Amapukusidwa makamaka ndi impso (kusefera kwa glomerular ndi katulutsidwe): 50-78 ndi 25-40% ya mankhwala omwe amamwa amoillillin ndi clavulanic acid amawachotsa osasinthika, pakadutsa maola 6 atangoyenda.

Zizindikiro. Matenda oyambitsidwa ndi bakiteriya omwe amapezeka ndi tizilombo tating'onoting'ono tomwe timayambitsa matenda ochepa: kupuma kwam'mimba thirakiti (bronchitis, chibayo, matenda a m'mimba, zotupa zam'mapapo), matenda amtundu wa ENT (sinusitis, tonsillitis, otitis media), matenda amtundu wa genitourinary ndi ziwalo za pelvic (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, salpingoophoritis, tubo-ovarian abscess, endometritis, bakiteriya vaginitis, kuchotsa septic, pambuyo pake koma dermatoses kachilombo, abscesses, cellulitis, bala matenda), osteomyelitis, matenda postoperative, kupewa matenda opaleshoni.

Contraindication Hypersensitivity (kuphatikizapo cephalosporins ndi mankhwala ena a beta-lactam), mononucleosis wopatsirana (kuphatikizapo mawonekedwe a chotupa), phenylketonuria, episode jaundice kapena chiwindi ntchito chifukwa cha kugwiritsa ntchito amoxicillin / clavulanic acid m'mbiri CC zosakwana 30 ml / min (mapiritsi 875 mg / 125 mg).

Mosamala. Mimba, mkaka wa m`mawere, chiwindi chachikulu kulephera, matenda am'mimba thirakiti (kuphatikizapo mbiri ya colitis yokhudzana ndi kugwiritsidwa ntchito kwa penicillins), kulephera kwaimpso.

Gawo la zochita pa mwana wosabadwa. B

Mlingo Mkati, mu / mkati.

Mlingo amawerengedwa mogwirizana ndi amoxicillin. Mlingo wothandizirana umayikidwa payekha kutengera mtundu wa maphunzirowo ndi malo omwe matendawa alowa, chidwi cha tizilomboti.

Ana osakwana zaka 12 zakubadwa - mu mawonekedwe a kuyimitsidwa, madzi kapena kutsikira pakamwa.

Mlingo umodzi umakhazikitsidwa malinga ndi zaka zake: ana mpaka miyezi itatu - 30 mg / kg / tsiku m'magawo awiri ogawanika, miyezi itatu ndi okulirapo - matenda opweteka kwambiri - 25 mg / kg / tsiku mu 2 mg waukulu kapena 20 mg / kg / tsiku Mlingo 3, odwala kwambiri - 45 mg / kg / tsiku mu 2 Mlingo kapena 40 mg / kg / tsiku mu 3 waukulu.

Akuluakulu ndi ana opitirira zaka 12 kapena zolemera makilogalamu 40 kapena kupitilira: 500 mg 2 nthawi / tsiku kapena 250 mg katatu kapena tsiku. Odwala kwambiri ndi matenda opatsirana thirakiti - 875 mg 2 nthawi / tsiku kapena 500 mg katatu / tsiku.

Mulingo wambiri tsiku lililonse wa amoxicillin wa akulu ndi ana opitirira zaka 12 ndi 6 ga, kwa ana ochepera zaka 12 - 45 mg / kg thupi.

Mlingo wambiri watsiku ndi tsiku wa clavulanic acid kwa akulu ndi ana opitirira zaka 12 ndi 600 mg, kwa ana ochepera zaka 12 - 10 mg / kg thupi.

Ndi zovuta kumeza mwa akulu, kugwiritsa ntchito kuyimitsidwa kumalimbikitsidwa.

Pokonzekera kuyimitsidwa, madzi ndi madontho, madzi ayenera kugwiritsidwa ntchito ngati chosungunulira.

Akapatsidwa mtsempha wa magazi, akuluakulu ndi achinyamata opitirira zaka 12 amapatsidwa 1 ga (amoxicillin) katatu pa tsiku, ngati pakufunika 4 pa tsiku. Mulingo wambiri watsiku ndi tsiku ndi 6 ga kwa ana a zaka 3 mpaka 12 - 25 mg / kg katatu patsiku, ovulala kwambiri - 4 pa tsiku, kwa ana mpaka miyezi 3: asanabadwe komanso nthawi yayikulu - 25 mg / kg 2 kamodzi pa tsiku, pambuyo pa nthawi - 25 mg / kg katatu patsiku.

Kutalika kwa mankhwala mpaka masiku 14, pachimake otitis media - mpaka masiku 10.

Pofuna kupewa matenda opatsirana pambuyo pogwira ntchito osakwana 1 ora, mlingo wa 1 g iv umaperekedwa pakulimbikitsa mankhwala opaleshoni. Kwa ntchito yayitali - 1 g maola 6 aliwonse patsiku. Pa chiopsezo chachikulu chotenga kachilomboka, makonzedwe angathe kupitilizidwa kwa masiku angapo.

Ngati matenda a impso alephera, mlingo komanso pafupipafupi makonzedwe amasinthidwa malinga ndi CC: chifukwa CC yopitilira 30 ml / min, kusintha kwa mankhwalawa sikofunikira, chifukwa CC 10-30 ml / min: mkati - 250-500 mg / tsiku lililonse maola 12, iv 1 g, ndiye 500 mg iv, ndi CC osakwana 10 ml / mphindi - 1 g, ndiye 500 mg / tsiku iv kapena 250-500 mg / tsiku pakamwa kamodzi. Kwa ana, mlingo uyenera kuchepetsedwa chimodzimodzi.

Odwala pa hemodialysis - 250 mg kapena 500 mg pakamwa limodzi kapena 500 mg iv, gawo lina la 1 pa dialysis ndi wina mlingo 1 kumapeto kwa dialysis.

Zotsatira zoyipa. Kuchokera pamiyambo ya m'mimba: kusanza, kusanza, kutsegula m'mimba, gastritis, stomatitis, glossitis, kuchuluka kwa mankhwala a "chiwindi", m'malo ochepa - cholestatic jaundice, hepatitis, kulephera kwa chiwindi (nthawi zambiri okalamba, abambo, omwe amakhala ndi chithandizo chambiri), pseudomembranous ndi hemorrhagic colitis (itha kupanga pambuyo pa mankhwala), enterocolitis, lilime la "tsitsi" lakuda, kudetsa khungu la mano.

Hematopoietic ziwalo: kuwonjezereka kosinthika kwa nthawi ya prothrombin ndi nthawi ya magazi, thrombocytopenia, thrombocytosis, eosinophilia, leukopenia, agranulocytosis, hemolytic anemia.

Kuchokera ku dongosolo lamanjenje: chizungulire, kupweteka mutu, chithokomiro, nkhawa, kusintha kwa machitidwe, kupweteka.

Zomwe zimachitika mdera: nthawi zina, phlebitis pamalo a jekeseni wa iv.

Thupi lawo siligwirizana: urticaria, erythematous totupa, kawirikawiri - multiforme exudative erythema, anaphylactic mantha, angioedema, osowa kwambiri - exfoliative dermatitis, zilonda zapamwamba zotupa erythema (Stevens-Johnson syndrome), matupi awo a vasculitis, matenda, chitsanzo .

Zina: candidiasis, kukula kwa mphamvu, interstitial nephritis, crystalluria, hematuria.

Bongo. Zizindikiro: kuphwanya kwam'mimba komanso kuchuluka kwamkati wamadzi.

Chithandizo: Zizindikiro. Hemodialysis ndiyothandiza.

Kuchita. Maantacid, glucosamine, mankhwala othandizira, aminoglycosides amachepetsa komanso kuchepetsa kuyamwa, ascorbic acid imawonjezera kuyamwa.

Mankhwala a Bacteriostatic (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) ali ndi zotsatira zotsutsana.

Zimawonjezera kugwira ntchito kwa anticoagulants osalunjika (kupondereza microflora yamatumbo, kumachepetsa kapangidwe ka vitamini K ndi index ya prothrombin). Ndi munthawi yomweyo makonzedwe a anticoagulants, ndikofunikira kuyang'anira zomwe zikuwonetsa magazi.

Amachepetsa mphamvu ya njira zakulera zam'mlomo, mankhwala, panthawi ya kagayidwe kamene PABA imapangidwa, ethinyl estradiol - chiopsezo chakutuluka kwa magazi.

Ma diuretics, allopurinol, phenylbutazone, NSAIDs ndi mankhwala ena omwe amatsekera katulutsidwe ka tubular kumawonjezera kuchuluka kwa amoxicillin (clavulanic acid imachotsedwa makamaka ndi kusefera kwa glomerular).

Allopurinol imawonjezera mwayi wokhala ndi zotupa pakhungu.

Malangizo apadera. Ndi njira ya chithandizo, ndikofunikira kuwunika momwe ntchito ya magazi, chiwindi ndi impso.

Pofuna kuchepetsa chiwopsezo cha mavuto obwera kuchokera m'matumbo am'mimba, mankhwalawa amayenera kumwa ndi zakudya.

Ndikotheka kukhala ndi superinitness chifukwa cha kukula kwa microflora sazindikira izi, zomwe zimafunikira kusintha kofananirana ndi mankhwala opha maantibayotiki.

Zitha kupereka zotsatira zabodza pakupanga shuga mu mkodzo. Poterepa, tikulimbikitsidwa kugwiritsa ntchito njira ya glucose oxidant pofufuza kuchuluka kwa shuga mumkodzo.

Pambuyo pa kuchepetsedwa, kuyimitsidwa kuyenera kusungidwa osaposa masiku 7 mufiriji, koma osapanga chisanu.

Odwala omwe ali ndi hypersensitivity ku penicillin, zovuta zomwe zimachitika ndi mankhwala a cephalosporin zimatheka.

Milandu yokhudzana ndi kukula kwa necrotizing colitis mu akhanda komanso amayi apakati omwe ali ndi nthawi yopasuka yam'mimba adawululidwa.

Popeza mapiritsiwo ali ndi kuchuluka komweko kwa clavulanic acid (125 mg), ayenera kukumbukira kuti mapiritsi 2 a 250 mg (a amoxicillin) siofanana ndi piritsi limodzi la 500 mg (la amoxicillin).

Kulembetsa boma boma. Kusindikiza kovomerezeka: m'ma 2. M: Medical Council, 2009. - Vol 2, gawo 1 - 568 s., Gawo 2 - 560 s.

Mlingo Wamitundu

Amoxicillin + Clavulanic acid amapangidwa monga:

• mapiritsi okhala ndi mavalo osiyanasiyana
• asidi clavulanic nthawi zonse amakhala 0,125 g,
• amoxicillin
  • 250,
  • 500,
  • 875,
• ufa woyimitsidwa - 156 mg / 5 ml, 312 mg / 5 ml,
• ufa wa jakisoni ndi mlingo wa 600 mg / 1200 mg.

Pakukonzekera kovuta, clavulanic acid imapezeka ngati mchere wa potaziyamu - potaziyamu clavulanate.

Mapiritsi a Amoxicillin + Clavulanate ali ndi mawonekedwe obiconvex, oyera pamtundu wokhala ndi chiopsezo chosinthika. Kuphatikiza pazomwe zimagwira, mawonekedwe a mapiritsiwo ndi:

• mafilimu - silicon dioxide, magnesium stearate, cellcrystalline cellulose,
• mu chipolopolo - polyethylene glycol, hypromellose, titanium dioxide.

Amoxicillin + Clavualanic acid, malangizo ntchito (Njira ndi Mlingo)

Zokonzekera zomwe zimapangidwa pamaziko a zinthu izi zitha kugwiritsidwa ntchito pakamwa, intravenous kapena intramuscular. Pankhaniyi, muyezo, nthawi komanso nthawi yayitali yamankhwala zimakhazikitsidwa chifukwa cha zovuta za matendawa, chidwi cha pathogen, malo omwe matenda ndi mawonekedwe a wodwalayo.

Mwachitsanzo, odwala omwe ali ndi zaka zosakwana 12 amalangizidwa kuti amwe mankhwalawa ngati madzi, kuyimitsidwa kapena madontho, omwe cholinga chake ndi kugwiritsidwa ntchito mkati. Mlingo umodzi umakhazikitsidwa kutengera kulemera ndi msinkhu wa odwala.

Mlingo wambiri tsiku lililonse wa amoxicillin wa ana kuyambira zaka 12 ndi odwala wamkulu ndi 6 g, ndipo kwa odwala ochepera zaka 12, tikulimbikitsidwa kuwerengetsa mlingo wa 45 mg pa kg yolemera.

Mlingo woyenera wambiri wa clavulanic acid wa ana azaka 12 ndi akulu ndi 600 mg, ndipo kwa ana osakwana zaka 12 pa 10 mg pa kilogalamu yolemera.

Nthawi yayitali ya chithandizo ikhoza kukhala masiku 10-14.

Ntchito Yogwiritsa Ntchito Yoyambitsa Matendawa

Amoxicillin / Clavulanic acid ali ndi zochita za bactericidal, imagwira ntchito motsutsana ndi mabakiteriya ndi protozoa omwe amadziwikanso ndi amoxicillin, kuphatikizapo beta-lactamase yopanga tizilombo ta.

Ntchito ya bactericidal imatheka ndikusokoneza kapangidwe ka bakiteriya peptidoglycan kofunikira pa khoma la bakiteriya.

Makulidwe owonjezera a inhibitor oteteza maantioticillin okhala ndi clavulanic acid akuphatikizapo:

• mawonekedwe a gramu:
  • Staphylococcus sp. Kuphatikiza ma micophylline ozindikira a Staphylococcus aureus,
  • streptococci, pneumococci, hemolytic streptococcus,
  • enterococci,
  • mndandanda
• Gram-negative aerobes - Escherichia coli, Haemophilus fuluwenza, Enterobacter, Klebsiella, Moxarell, Neisseria, Helicobacter pylori,
• gram zabwino anaerobes - clastridia, peptococci,
• anaerobes a gramu-bactericids, fusobacteria.

Semisynthetic penicillin, omwe mphamvu zake zimapezeka patsamba la Penicillin Row, ayamba kulimbana ndi mabakiteriya ambiri.

Kupezeka kukana kwa semisynthetic penicillin amoxicillin amawonedwa pamagawo ena a Escherichia coli, Klebsiella, Proteus, Salmonella, Shigella, Enterococci, Corynebacter. Sizingatengeke ndi amoxicillin / clavulanate chlamydia ndi mycoplasma.

Clavulanic acid sachita beta-lactamases, omwe amapangidwa:

• Pseudomonas aeruginosa, wokhala ndi "quorum" yomwe imakuthandizani kuti muzitha kusintha maantibayotiki, kupanga zovuta zosagwirizana nawo,
• serration - mabakiteriya omwe amayambitsa matumbo, kwamikodzo, khungu,
• Acinetobacter (Acinetobacter) - oyambitsa septicemia, meningitis, wophatikizidwa mchaka cha 2017 ndi bungwe la WHO mndandanda wa matenda oopsa kwambiri.

Zotsatira za pharmacological

Zigawo zogwira ntchito za mankhwalawa zimatengedwa mwachangu ngati zimamwa pakamwa, komanso ngati mankhwalawa alowetsedwa kudzera m'mitsempha. Mafuta ophatikizika Amoxicillin / Clavulanate m'magazi, ofunikira pakuchiritsa, adapangidwa pambuyo pa mphindi 45.

Zomwe zimagwiritsa ntchito mankhwalawa zimangokhala ndi mapuloteni am'magazi, ndipo 70-80% ya mankhwala omwe amalandiridwa m'magazi ndi omasuka.

Fotokozerani zinthu zofunikira m'chiwindi:

• amooticillin - 10% ya maantibayotiki omwe adalandiridwa amasinthidwa,
• clavulanic ku - yomwe imagawika 50% ya zomwe zikubwera.

Amoxicillin amamuchotsa ndi kwamikodzo dongosolo. Hafu ya moyo wa mankhwala ophatikiza, kutengera mlingo, ndi maola 1.3.

Mankhwalawa amachotsedwa pakumwa mankhwalawa mogwirizana ndi malangizo, pafupifupi mkati mwa maola 6.

Amoxicillin + Clavulanic acid amalembera ana ndi akulu momwe amapangira mapiritsi, kuyimitsidwa, jakisoni wothandizila mu mulingo wofotokozedwa mu malangizo ogwiritsira ntchito.

Zisonyezero zakupereka kwa amoxicillin / clavulanate ndi matenda:

• kupuma:
  • chibayo chopezeka pagulu, chifuwa cham'mapapo,
  • yabwino
  • bronchitis
• Matenda a ENT:
  • sinusitis
  • tonillitis, tonsillitis,
  • otitis media
• ziwalo:
  • pyelonephritis, cystitis,
  • kutupa kwa fallopian machubu, endometritis, cervicitis, prostatitis,
  • chancre, gonorrhea,
• khungu:
  • erysipelas
  • phlegmon
  • impetigo
  • cellulite
  • kuluma nyama
• osteomyelitis
• popewa komanso kuchiza matenda a postoperative.

Malangizo ogwiritsira ntchito

Kutalika kwa kumwa mankhwala ndi amoxicillin ndi clavulanic acid sikuyenera kupitirira masabata awiri. Chithandizo cha otitis media chizikhala masiku 10.

Mankhwala okhala m'mapiritsi amatsukidwa ndi madzi mukamamwa ndi chakudya. Ufa woyimitsidwa umasungunuka ndi madzi owiritsa, kuchuluka kwa theka lagalasi.

Kuyimitsidwa ndikulimbikitsidwa zochizira ana komanso akulu omwe akumeza movutikira.

Mlingo wa mankhwala amawerengedwa ndi amoxicillin.

Dokotala amatenga dongosolo la mankhwala payekha malinga ndi zaka zake, kulemera kwake, magwiridwe ake a kwamikodzo, komanso kutengera kwa zotupa.

Tiyenera kukumbukira kuti 0,5 g ya amoxicillin / 125 mg wa clavulanic acid sangathe m'malo mwa 2 waukulu wa 250 mg / 125 mg.

Kuchuluka kwa clavulanate kumapeto kumakhala kwakukulu, komwe kumachepetsa kuchuluka kwa maantibayotiki mumankhwala.

Mlingo wa tsiku ndi tsiku sayenera kukhala wopitilira:

• amoxicillin:
  • pambuyo 12 l - 6 g
  • pansi pa malita 12 - zosaposa 45 mg / kg,
• clavulanic to:
  • zopitilira 12 l. - 600 mg
  • osakwana 12 malita - 10 mg / kg.

Mapiritsi a akulu, malangizo

Akuluakulu, ana opitilira 40 kg ndi Amoxicillin / Clavulanate malinga ndi malangizo ogwiritsidwa ntchito:

• Ndi matenda ofatsa:
  • katatu / d. 0,25 g
  • kawiri pa tsiku. 500 mg
• ndi matenda am'mapapo, matenda oopsa:
  • katatu / tsiku. 0,5 g
  • kawiri pa tsiku. 0,875 g.

Upangiri wa kuyimitsidwa kwa ana

Choyimira chachikulu pakuwerengera mlingo wa mankhwalawa malinga ndi malangizo ndi kulemera ndi zaka. Amoxicillin / Clavulanic acid ndi mankhwala tsiku lililonse:

• kuyambira kubadwa kwa miyezi itatu. - imwani 30 mg / kg m'mawa / madzulo,
• 3 miyezi mpaka 12 l.
  • Ndi matenda ofatsa:
    • chithandizo ndi 25 mg / kg kawiri / d.,
    • kudya 20 mg / kg 3 r mu maola 24,
  • kutupa kovuta:
    • kumwa 45 mg / kg 2 p / maola 24.,
    • kutenga 40 mg / kg 3 p / maola 24

Mwana wochepera zaka 12 ayenera kupatsidwa kuyimitsidwa katatu / tsiku. Mlingo umodzi wa kuyimitsidwa koyenera ndi:

• Miyezi 9 - zaka 2 - 62,5 mg wa amoxicillin,
• kuchokera 2 l. mpaka malita 7 - 125,
• 7 l mpaka malita 12 - 250 mg.

Dokotala wa ana amatha kuchulukitsa kapena kuchepetsa kuchuluka kwa mankhwalawa kutengera kulemera, msinkhu wa mwana komanso kuopsa kwa matendawa.

Kuchita

Mankhwala ndi mankhwala molumikizana ndimaantacid, Glucosamine, mankhwala othandizira komanso aminoglycosides pali kutsika ndi kuchepa kwa mayamwidwe, ndipo ascorbic acid m'malo mwake, kumawonjezera mayamwidwe.

Mankhwala ena a bacteriostatic, monga: macrolides, lincosamides, chloramphenicol, tetracyclines ndi sulfonamidesonetsani zotsatira zopikisana.

Mankhwala akhoza kuonjezera mphamvu ya yosayenera anticoagulants, amene limodzi ndi kuponderezana matumbo microflora, kuchepa kwa kapangidwe ka vitamini K ndi index ya prothrombin. Kuphatikiza ndi anticoagulants kumafuna kuwunika mosamala pakupanga magazi.

Zochita zimachepetsedwa kulera kwapakamwa, ethinyl estradiol, komanso mankhwala omwe amaphatikiza PABA, yomwe imawonjezera ngozi yotulutsa magazi. Diuretics, Phenylbutazone, Allopurinol, othandizira omwe amateteza katulutsidwe ka tubular - amatha kuwonjezera kuchuluka kwa amoxicillin.

Malangizo apadera

Njira ya maphunzirowa iyenera kuchitidwa mothandizidwa ndi magazi, impso ndi chiwindi. Kuchepetsa chiopsezo cha zosafunikira m'mimba, mankhwala ayenera kumwedwa ndi chakudya.

Ndi kukula kwa mankhwala osaganizira microflora, kupezeka kwa mphamvu kungayambike, kumafunikira antibacterial mankhwala. Zotsatira zabodza nthawi zina zimawonedwa pokhudzana ndi shuga mu mkodzo. Njira ya glucose oxidant yokhazikitsira ndende ndikulimbikitsidwa.shugakapangidwe ka mkodzo.

Kuyimitsidwa kothiriridwa kumatha kusungidwa mufiriji, koma osapitirira masiku 7, popanda kuzizira. Odwala ndi tsankho penicillinmtanda thupi lawo siligwirizana mankhwala a cephalosporin.

Kuphatikizidwa kwa mapiritsiwa kumaphatikizanso kuchuluka kwa clavulanic acid, ndiko kuti 125 mg, kotero muyenera kukumbukira kuti m'mapiritsi awiri a 250 mg aliyense ali ndi zinthu zosiyanasiyana, poyerekeza ndi 500 mg.

Tsiku lotha ntchito

Zofanizira zazikulu zimayimiriridwa ndi mankhwala: Amovicomb, Amoxivan, Amoxiclav, Quicktab, Amoxicillin trihydrate + Potaziyamu clavulanate, Arlet, Augmentin, Baktoklav, Verklav, Klamosar, Liklav, Medoklav, Panclav, Ranklav, Rapiklav, Taromentin, Fibell, Flemoklav Solutab ndi Mochulukitsa.

Mankhwalawa mukamalandira mankhwala aliwonse othana ndi mankhwala, kumwa mowa kumapangidwa, chifukwa izi zimachepetsa mphamvu ya mankhwalawa ndikuwonjezera zovuta za mavuto.

Ndemanga pa Amoxicillin + Clavualanic Acid

Monga mukudziwa, maantibayotiki ndi mankhwala omwe amakambidwa kwambiri pamafomu osiyanasiyana. Odwala ali ndi nkhawa chimodzimodzi ndikuchita bwino komanso chitetezo cha mankhwalawa. Nthawi yomweyo, ndemanga za Amoxicillin + Clavualanic acid kukonzekera nthawi zambiri zimakhala zabwino.

Palibe amene amakayikira kuyamwa kwa maantibayotiki, chifukwa chake amalembedwa pochiza matenda. Komabe, nthawi zambiri odwala amakhala ndi chidwi ndi clavulanic acid, momwe imakhalira komanso momwe imaphatikizira ndi amoxicillin, ndiye kuti, imakulitsa kapena kufetsa mphamvu yake. Dziwani kuti chinthu ichi chili ndi ntchito yake yoletsa antibacterial.

Komanso, mankhwalawa amapezeka kawirikawiri pazokambirana zokhudzana ndi chithandizo cha amayi apakati. Koma akatswiri ambiri amalangiza kumwa mankhwalawa nthawi imeneyi. Amoxiclav. Izi zimatsimikizidwanso ndi azimayi omwe adalandira mankhwalawa nthawi zosiyanasiyana. wa mimba. Monga lamulo, chithandizo nthawi zonse chimathandiza kuthana ndi vutoli popanda kuvulaza wodwala kapena mwana wosabadwayo.

Maantibayotiki ndi gawo limodzi la mankhwalawa ambiri achire omwe amagwirizana ndi mankhwalawa. Tiyenera kukumbukira kuti kumwa mankhwalawa ndizotheka pokhapokha ngati dokotala watchulidwa. Koma choyamba muyenera kudziwa zamphamvu za pathogen pa mankhwalawa. Ndipokhapo pamene zotsatira zabwino za chithandizo zitha kuyembekezeredwa popanda kuwononga thupi.

Jakisoni wa IV, malangizo a akulu

Amoxicillin / clavulanic acid amathandizira kudzera mkati mwa zaka 12 katatu patsiku kapena 4 r / tsiku muyezo:

• Ndi matenda ofatsa - 1 g,
• pa matenda oopsa - 1200 mg.

Jekeseni wa IV kwa ana, malangizo

Mwana amene ali ndi zaka zosakwana 12 amakhala ndi mankhwala ophaanti:

• Miyezi itatu., Makanda oyambira asanakwane masabata 22 - kawiri / tsiku. 25 mg / kg
• 3 miyezi mpaka 12 l.
  • kuyenda kosavuta - katatu patsiku 25 mg / kg,
  • mukudwala kwambiri - kanayi / tsiku. 25 mg / kg.

Kuwongolera kumachitika pamalo otsika a creatinine chilolezo, chomwe chimayezedwa mu ml / min.

• zosakwana 30 koma zopitilira 10:
  • Mlingo wa mapiritsi ndi 0,25 g -0,5 g pakatha maola 12.
  • mu / mu - kawiri pa tsiku, woyamba 1 g, pambuyo - 0, 5 g,
• zosakwana 10:
  • pakamwa - 0, 25 g kapena 0, 5 g,
  • mu / mu - 1 g, pambuyo 0,5 g.

Ndi dokotala yekhayo amene amatha kusintha mlingo wake malinga ndi zotsatira za kafukufuku wambiri.

Amoxicillin / Clavulanic acid amaloledwa kuchiza odwala a hemodialysis. Mlingo pambuyo pa 12 l .:

• mapiritsi - 250 mg / 0,5 g
• jakisoni iv - 0,5 g - 1 nthawi.

Panthawi ya hemodialysis kumayambiriro ndi kumapeto kwa gawolo, mankhwalawa amagwiritsidwa ntchito mopitilira muyeso umodzi.

Zochita zamankhwala osokoneza bongo

Mafuta a Amoxicillin / Clavulanate amayamba kumwa mankhwala:

• Maantacid - mankhwala omwe amachepetsa mphamvu ya m'mimba,
• mankhwala aminoglycoside,
• mankhwala othandizira
• glucosamine.

Kuthira kwa kuphatikiza kwa Vitamini C kophatikizidwa kumakulimbikitsidwa, pomwe munthawi yomweyo makonzedwe a allopurinol, NSAIDs, calcium blockers amawonjezera kuchuluka kwake m'magazi, kumachepetsa kuchuluka kwa kusefera kwa impso.

Amoxicillin / Clavulanate ndi mankhwala omwe ali ndi bacteriostatic zotsatira - macrolides, lincosamines, tetracyclines, chloramphenicol - sichinapangidwe nthawi imodzi.

Mankhwalawa Amoxicillin + Clavulanic acid, momwe machitidwewo asinthira:

• anticoagulants - ukuwonjezeka, chifukwa chomwe kuyendetsa magazi pamafunika kuthandizira,
• njira zakulera pakamwa - yafupika.

Sitikulimbikitsidwa mu malangizo ogwiritsira ntchito Amoxicillin / Clavulanate pochiza mankhwalawa pogwiritsa ntchito mowa, chifukwa izi zimawonjezera katundu pa chiwindi ndikuwonjezera chiopsezo cha mavuto.

Mimba

Amoxicillin / Clavulanate ndi teratogenic mkalasi ya B. Izi zikutanthauza kuti ngakhale maphunziro a mankhwalawo sanawonetse mavuto aliwonse obwera chifukwa cha mwana wosabadwayo, palibe chidziwitso chokwanira chachipatala chokhudza chitetezo chonse cha mankhwalawa.

Amoxillin + Clavulanate ayenera kugwiritsidwa ntchito mosamalitsa malinga ndi malangizo ogwiritsira ntchito komanso dongosolo lomwe dokotala wakhazikitsa. Kupereka mankhwala a Amoxicillin + Clavulanic acid kwa amayi apakati ndikotheka malinga ndi zikuwonetsa, kukumbukira phindu la mankhwalawo komanso momwe zimakhudzira mwana wosabadwayo.

Arlet, Amoxiclav, Panclave, Ranklav, Augmentin, Flemoklav Solutab, Quicktab, Klavocin, Moksiklav.

Analogs Amoxicillin clavulanic acid

Ma analogues amo amoillillin clavulanic acid amaphatikizidwa kukonzekera komwe kumakhala ndi zinthu zingapo zazikuluzikulu - amoxicillin ndi clavulanic acid, komanso magawo angapo othandiza, omwe amatha kusiyanasiyana pamankhwala osiyanasiyana.

Amoxiclav

Amoxiclav ndi mankhwala antibacterial omwe ali ndi zotsatira zosiyanasiyana. Muli zigawo ziwiri zazikulu:

• Amoxicillin - mankhwala, mankhwala,
• Clavulanic acid - ili ndi katundu wocheperako wa antibacterial. Ntchito yake yayikulu ndikuteteza amoxicillin ku zovuta zomwe zimachitika mkati mwa munthu.

Kutengera mtundu wa kumasulidwa, zinthu zina zothandizira zimawonjezeredwa ku mankhwalawo, mlingo wa zigawo zazikulu umasiyananso:

• Mapiritsi okhala ndi 250 mg, 875 mg kapena 500 mg ya antibacterial agent ndi 125 mg ya acid. Omwe amathandizira amaphatikizapo: silicon dioxide, triethyl citrate, titanium dioxide, cellulose ndi talc,
• Kuyimitsidwa 5 ml ya madzi okonzedwa amakhala ndi 125 mg ya amoxicillin ndi 31 mg ya chinthu choteteza. Kuti mankhwalawa asunge mawonekedwe ake ndikumvetsetsa bwino, citric acid, cellulose, sodium benzoate ndi mitundu ina yamafuta amathandizidwanso.

Amoxiclav ndi analog ya amoxicillin clavulanate, yomwe siyimasiyana pakapangidwe kake. Amagwiritsidwa ntchito ngati ma pathologies ofanana ndi ma antibacterial othandizira okhala ndi amoxicillin ndi clavulanic acid. Mtengo wa mankhwalawa ndi wotsika pang'ono kuposa mtengo wamalingaliro ake. Koma pa avareji, kusiyana kwake ndikosakwanira (ma ruble 50-100).

• Mapiritsi a 500 mg atenga 340-360 ruble pazinthu 15,
• Ufa wopangira 100 ml ya kuyimitsidwa umawononga pafupifupi ma ruble 300,
• Njira yothetsera makulidwe a makolo - ma 850- 900 ma ruble 5 a mbale 5 omwe ali ndi 1 g ya amoxicillin iliyonse.

Flemoklav Solutab

Mndandanda wotsika mtengo wa mankhwala Amoxicillin ndi Flemoklav Solutab. Kapangidwe kake sikosiyana ndi zomwe zili mu Amoxiclav, koma zimapezeka pokhapokha piritsi. Pankhaniyi, ndizoyenera chithandizo cha ana okalamba ndi akulu.

Mapiritsi 20, omwe ali ndi 125 mg ya amoxicillin ndi 31 ml ya clavulanic acid, angagulidwe kuzipatala zama 300 rub20 rubles. Zambiri zapamwamba pazinthu zazikulu zidzadya ndalama zambiri - ma 500-520 ma ruble a mapiritsi 14 a 875 mg aliyense.

Augmentin ndi mankhwala omwe ali analogue of amoxicillin clavulanic acid. Nyimbo zawo ndizofanana - zigawo ziwiri zazikulu, komanso cellulose, potaziyamu, silicon ndi zina zotero. Ndondomeko yamitengo ilinso yofanana ndi zida zina zofananira.

Kutulutsa Mafomu:

• Mphamvu yakuyimitsidwa
• Mapiritsi
• Yankho la jakisoni.

Zilonda zazikulu zamankhwala zimakupatsani mwayi kuti musankhe mankhwala abwino kwambiri. Mutha kusankha wojambula wakunja kapena waku Russia, mlingo woyenera ndi mawonekedwe abwino kwambiri omasulidwa.

Ngati mukukhulupirira mawunikidwe, aliyense wogwirizira Amoxicillin clavulanic acid amatha bwino ndi matenda aliwonse kuchokera mndandanda wamatenda omwe akuwonetsedwa mu malangizo ogwiritsira ntchito mankhwalawa.

Mwapeza cholakwika? Sankhani ndikusindikiza Ctrl + Lowani

Kufanizira tebulo

Mndandanda wa mankhwala Amoxicillin + Clavulanic acid

Amoxicillin + Clavulanic acid
Sindikizani mndandanda wazofanana
Amoxicillin + Clavulanic acid (Amoxicillin + Clavulanic acid) Antibiotic-penicillin theka-synthetic + beta-lactamase inhibitor Mapiritsi ophatikizidwa, lyophilisate pakukonzekera kuyimitsidwa kwamankhwala, mapiritsi, ufa pakukonzekera njira yovomerezeka, mapiritsi piritsi yotsatsira

Kuphatikiza kophatikizira kwa amoxicillin ndi clavulanic acid, choletsa-lactamase inhibitor. Imagwira bactericidal, imalepheretsa kapangidwe ka khoma la bakiteriya.

Yogwira pakulimbana ndi bakiteriya wa gram - kuphatikizapo beta-lactamase yopanga tizilombo ta: Staphylococcus aureus,

mabakiteriya aerobic gram-negative: Enterobacter spp., Escherichia coli, Haemophilus influenzae, Klebsiella spp., Moraxella catarrhalis.

Tizilombo toyambitsa matenda totsatirayi timangokhala tokha mu vitro: Staphylococcus epidermidis, Streptococcus pyogenes, Streptococcus anthracis, Streptococcus pneumoniae, Streptococcus viridans, Enterococcus faecalis, Corynebacterium spp.

mabakiteriya osokoneza bongo a aerobic gramu-kuphatikizapo michere ya beta-lactamase): Proteus mirabilis, Proteus vulgaris, Salmonella spp., Shigella spp. ), Campylobacter jejuni,

mabakiteriya a anaerobic gram-osavomerezeka (kuphatikizapo beta-lactamase yopanga tizilombo ta): Bacteroides spp. kuphatikizapo Bacteroides fragilis.

Clavulanic acid imaphatikizira mtundu II, III, IV ndi V beta-lactamases, osagwira motsutsana ndi mtundu I beta-lactamases, opangidwa ndi Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp. Clavulanic acid imakhala yogwirizana kwambiri ndi ma penicillinases, omwe amapanga zovuta kwambiri ndi enzyme, omwe amalepheretsa kuchepa kwa enzymatic pansi pa mphamvu ya beta-lactamases.

Matenda oyambitsidwa ndi bakiteriya omwe amapezeka ndi tizilombo tating'onoting'ono tomwe timayambitsa matenda ochepa: kupuma kwam'mimba thirakiti (bronchitis, chibayo, matenda a m'mimba, zotupa zam'mapapo), matenda amtundu wa ENT (sinusitis, tonsillitis, otitis media), matenda amtundu wa genitourinary ndi ziwalo za pelvic (pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, cervicitis, salpingitis, salpingoophoritis, tubo-ovarian abscess, endometritis, bakiteriya vaginitis, kuchotsa septic, pambuyo pake koma dermatoses kachilombo, abscesses, cellulitis, bala matenda), osteomyelitis, matenda postoperative, kupewa matenda opaleshoni.

Zotsatira zoyipa

Kuchokera pamiyambo ya m'mimba: kusanza, kusanza, kutsegula m'mimba, matenda am'mimba, matenda a chiwindi, nthawi zina - cholestatic jaundice, hepatitis, kulephera kwa chiwindi (nthawi zambiri okalamba, abambo, omwe amakhala ndi chithandizo chambiri), pseudomembranous ndi hemorrhagic colitis (itha kupanga pambuyo pa mankhwala), enterocolitis, lilime lakuda "lakuda", kuyimitsa kwa enamel.

Hematopoietic ziwalo: kuwonjezereka kosinthika kwa nthawi ya prothrombin ndi nthawi ya magazi, thrombocytopenia, thrombocytosis, eosinophilia, leukopenia, agranulocytosis, hemolytic anemia.

Kuchokera ku dongosolo lamanjenje: chizungulire, kupweteka mutu, chithokomiro, nkhawa, kusintha kwa machitidwe, kupweteka.

Zomwe zimachitika mdera: nthawi zina, phlebitis pamalo a intravenous makonzedwe.

Thupi lawo siligwirizana: urticaria, erythematous totupa, kawirikawiri - multiforme exudative erythema, anaphylactic mantha, angioedema, osowa kwambiri - exfoliative dermatitis, zilonda zapamwamba zotupa erythema (Stevens-Johnson syndrome), matupi awo a vasculitis, matenda, chitsanzo .

Zina: candidiasis, kukula kwa mphamvu, interstitial nephritis, crystalluria, hematuria.

Ntchito ndi mlingo

Mlingo amawerengedwa mogwirizana ndi amoxicillin. Mlingo wothandizirana umayikidwa payekha kutengera mtundu wa maphunzirowo ndi malo omwe matendawa alowa, chidwi cha tizilomboti.

Ana osakwana zaka 12 zakubadwa - mu mawonekedwe a kuyimitsidwa, madzi kapena kutsikira pakamwa.Mlingo umodzi umakhazikitsidwa malinga ndi zaka zake: ana mpaka miyezi itatu - 30 mg / kg / tsiku m'magawo awiri ogawanika, miyezi itatu ndi okulirapo - matenda opweteka kwambiri - 25 mg / kg / tsiku mu 2 mg waukulu kapena 20 mg / kg / tsiku Mlingo 3, odwala kwambiri - 45 mg / kg / tsiku mu 2 Mlingo kapena 40 mg / kg / tsiku mu 3 waukulu.

Akuluakulu ndi ana opitirira zaka 12 kapena zolemera makilogalamu 40 kapena kupitilira: 500 mg 2 nthawi / tsiku kapena 250 mg katatu kapena tsiku. Odwala kwambiri ndi matenda opatsirana thirakiti - 875 mg 2 nthawi / tsiku kapena 500 mg katatu / tsiku.

Mulingo wambiri tsiku lililonse wa amoxicillin wa akulu ndi ana opitirira zaka 12 ndi 6 ga, kwa ana ochepera zaka 12 - 45 mg / kg thupi.

Mlingo wambiri watsiku ndi tsiku wa clavulanic acid kwa akulu ndi ana opitirira zaka 12 ndi 600 mg, kwa ana ochepera zaka 12 - 10 mg / kg thupi.

Ndi zovuta kumeza mwa akulu, kugwiritsa ntchito kuyimitsidwa kumalimbikitsidwa.

Pokonzekera kuyimitsidwa, madzi ndi madontho, madzi ayenera kugwiritsidwa ntchito ngati chosungunulira.

Akapatsidwa mtsempha wa magazi, akuluakulu ndi achinyamata opitirira zaka 12 amapatsidwa 1 ga (amoxicillin) katatu pa tsiku, ngati pakufunika 4 pa tsiku. Mlingo wapamwamba tsiku lililonse ndi 6 g.

Kwa ana a miyezi itatu - 12 wazaka - 25 mg / kg katatu patsiku, m'malo ovuta kwambiri - 4 pa tsiku, kwa ana mpaka miyezi itatu: nthawi isanakwane komanso mu nthawi ya perinatal - 25 mg / kg kawiri pa tsiku, nthawi yayitali - 25 mg / kg katatu patsiku.

Kutalika kwa mankhwala mpaka masiku 14, pachimake otitis media - mpaka masiku 10.

Pofuna kupewa matenda opatsirana pambuyo pogwira ntchito osakwana 1 ora, mlingo wa 1 g iv umaperekedwa pakulimbikitsa mankhwala opaleshoni. Kwa ntchito yayitali - 1 g maola 6 aliwonse patsiku. Pa chiopsezo chachikulu chotenga kachilomboka, makonzedwe angathe kupitilizidwa kwa masiku angapo.

Pankhani ya kufooka kwa impso, mlingo ndi mlingo wa mankhwalawa zimapangidwa malinga ndi CC: kwa CC yoposa 30 ml / min, kusintha kwa mlingo sikofunikira, chifukwa CC 10-30 ml / min: mkati - 250-500 mg / tsiku lililonse maola 12, iv - 1 g, ndiye 500 mg iv, ndi CC osakwana 10 ml / mphindi - 1 g, ndiye 500 mg / tsiku iv kapena 250-500 mg / tsiku pakamwa kamodzi. Kwa ana, mlingo uyenera kuchepetsedwa chimodzimodzi.

Odwala pa hemodialysis - 250 mg kapena 500 mg pakamwa limodzi kapena 500 mg iv, gawo lina la 1 pa dialysis ndi wina mlingo 1 kumapeto kwa gawo la dialysis.

Amoxicillin + Clavulanic acid: malangizo ogwiritsira ntchito

Kudzipatsa nokha mankhwala kungavulaze thanzi lanu.
Ndikofunikira kufunsa dokotala, komanso kuwerenga malangizo musanayambe kugwiritsa ntchito.

Ufa yankho la mtsempha wa mtsempha wa magazi

0,5 g + 0,1 g, 1.0 g +0.2 g.

Botolo limodzi lili

yogwira zinthu: amoxicillin sodium malinga ndi amoxicillin - 0,5 g, 1.0 g

potaziyamu clavulanate malinga ndi clavulanic acid - 0,1 g, 0,2 g

Ufa kuyambira oyera mpaka oyera ndi tint chikasu.

Mankhwala

Pambuyo mtsempha wa mtsempha wa magazi Mlingo wa 1,2 ndi 0,6 ga, muyezo wa mulingo wambiri wa plasma (Cmax) wa amoxicillin ndi 105.4 ndi 32.2 μg / ml, clavulanic acid - 28,5 ndi 10,5 μg / ml, motsatana.

Zonsezi zimadziwika ndi kuchuluka kogawika m'madzi amthupi ndi minyewa (mapapu, khutu lapakati, zotuluka ndi zotumphukira za m'mimba, chiberekero, mazira).

Amoxicillin imalowanso madzi ophatikizika a chiwindi, chiwindi, matumbo a prostate, minofu ya palatine, minofu ya minyewa, chikhodzodzo, kutsekeka kwa mphulupulu, kubisala kwa bronchial. Amoxicillin ndi clavulanic acid samadutsa chotchinga magazi mu maukonde osavulala.

Zinthu zodutsa zimadutsa chotchinga ndipo poyang'ana mozama zimafukusidwa mkaka wa m'mawere.

Kumangiriza kumapuloteni a plasma a amoxicillin ndi 17-20%, a clavulanic acid - 22-30%.

Zinthu zonse ziwiri za chiwindi zimapukusidwa. Amoxicillin pang'ono zimapukusidwa - 10% ya kutumikiridwa mlingo, clavulanic acid amakhala ndi kagayidwe kakakulu - 50% ya mlingo kutumikiridwa.

Pambuyo mtsempha wa magazi mankhwala amoxicillin + clavulanic acid mu Mlingo wa 1.2 ndi 0,6 ga, theka-moyo (T1 / 2) kwa amooticillin ndi 0,9 ndi 1,07 maola, chifukwa cha clavulanic acid 0,9 ndi 1,12.

Amoxicillin amachotseredwa ndi impso (50-78% ya mankhwala omwe atumizidwa) pafupifupi osasinthika ndi katulutsidwe katulutsidwe ndi kusefera kwa glomerular. Clavulanic acid imachotsedwanso ndi impso ndi kusungunuka kosasinthika, pang'ono pang'ono mwa mawonekedwe a metabolites (25-40% ya mlingo woperekedwa) mkati mwa maola 6 mutatha kumwa mankhwalawa.

Zing'onozing'ono zimatha kupukusidwa kudzera m'matumbo ndi m'mapapu.

Mankhwala ndi osakaniza a semisynthetic penicillin amoxicillin ndi beta-lactamase inhibitor - clavulanic acid. Imagwira bactericidal, imalepheretsa kapangidwe ka khoma la bakiteriya.

Yogwira:

mabakiteriya olimbitsa aerobic gram - kuphatikiza tizilombo ta beta-lactamase)

mabakiteriya a anaerobic gamu: Clostridium spp., Peptococcus spp., Peptostreptococcus spp.,

mabakiteriya aerobic gram-osavomerezeka (kuphatikiza zingwe zopanga beta-lactamases): Escherichia coli, Proteus mirabilis, Proteus vulgaris, Klebsiella spp., Salmonella spp., Shigella spp.

, Bordetella pertussis, Yersinia kulowa,

mabakiteriya a anaerobic gram-osavomerezeka (kuphatikizapo beta-lactamase yopanga tizilombo ta): Bacteroides spp. kuphatikizapo Bacteroides fragilis.

Clavulanic acid imaphatikizira mtundu II, III, IV ndi V mitundu ya beta-lactamases, yosagwira motsutsana ndi mtundu I beta-lactamases wopangidwa ndi Enterobacter spp, Pseudomonas aeruginosa, Serratia spp., Acinetobacter spp.

Clavulanic acid imakhala yogwirizana kwambiri ndi ma penicillinases, omwe amapanga zovuta kwambiri ndi enzyme, omwe amalepheretsa kuchepa kwa enzymatic pansi pa mphamvu ya beta-lactamases.

Matenda opatsirana komanso otupa omwe amayambitsidwa ndi tizilombo tating'ono ta mankhwala:

- matenda am'mimba kupuma thirakiti (kuphatikizapo ziwalo za ENT):

sinusitis yovuta komanso yopweteka kwambiri,

pharyngeal abscess, tonsillitis, pharyngitis

- kuchepetsa kupuma thirakiti matenda: pachimake bronchitis ndi bakiteriya wamphamvu, matenda a chifuwa, chibayo

- matenda a genitourinary system: pyelonephritis, pyelitis, cystitis, urethritis, prostatitis, chancre, kufatsa

- Matenda a gynecology: cervicitis, salpingitis, salpingoophoritis, tubo-ovarian abscess, endometritis, bacterial vaginitis, kuchotsa mimba

- Matenda a pakhungu ndi minofu yofewa: erysipelas, impetigo, dermatoses wachiwiri wokhala ndi kachilombo, katemera, phlegmon, matenda opweteka

- Matenda am'mafupa

- matenda a biliary thirakiti: cholecystitis, cholangitis

- odontogenic matenda, pambuyo opaleshoni matenda, kupewa matenda oyambitsidwa ndi tizilombo tating'onoting'ono pa opaleshoni mankhwala a matenda a m'mimba thirakiti

Mlingo ndi makonzedwe

Mlingo wa mankhwalawa umayikidwa payekha kutengera zaka, kulemera kwa thupi, ntchito ya impso, komanso ku kuwopsa kwa matenda. Kuchiza sikuyenera kupitilizidwa kwa masiku opitilira 14 popanda kuonanso momwe wodwalayo alili.

Akuluakulu ndi ana opitilira zaka 12; mankhwalawa amadziwitsidwa muyezo wa 1.2 ga maola 8 aliwonse katatu pa tsiku, ngati mukudwala kwambiri - maola 6 aliwonse, kanayi pa tsiku. Mlingo wapamwamba tsiku lililonse ndi 6 g.

Mu ana masekeli osakwana 40 makilogalamu, dosing imagwiritsidwa ntchito kutengera thupi la mwana. Ndikulimbikitsidwa kuti pakhale nthawi yotalikirana maola 4 pakati pa jakisoni wa Amoxicillin + Clavulanic acid kuti muchepetse kuchuluka kwa clavulanic acid.

Ana osakwana miyezi 3

Ana olemera zosakwana 4 makilogalamu: 50/5 mg / kg maola 12 aliwonse

Ana masekeli oposa 4 makilogalamu: 50/5 mg / kg maola 8 aliwonse, kutengera kuopsa kwa matendawa

Ana kuyambira miyezi itatu mpaka zaka 12

50 / 5mg / kg maola 6-8 aliwonse, kutengera kuopsa kwa matendawa

Kwa odwala omwe ali ndi vuto la impso, muyezo komanso / kapena pakati pakati pa jakisoni amayenera kusinthidwa molingana ndi kuchuluka kwa kusakwanira: pomwe clearinine chilolezo chimaposa 30 ml / min, kuchepetsa kwa mankhwalawa sikofunikira, pamene creatinine chilolezo ndi 10-30 ml / min, chithandizo chimayamba ndi 1.2 g , ndiye 0,6 g maola 12 aliwonse, pomwe pali creatinine chilolezo chochepera 10 ml / mphindi - 1,2 g, ndiye 0,6 g / tsiku.

Kwa ana omwe ali ndi mtundu wa creatinine wochepera 30 ml / min, kugwiritsa ntchito mawonekedwe a Amoxicillin + Clavulanic acid sikuloledwa.Popeza 85% ya mankhwalawa imachotsedwa ndi hemodialysis, kumapeto kwa njira iliyonse ya hemodialysis, muyenera kulowa muyezo.

Ndi peritoneal dialysis, kusintha kwa mankhwala sikofunikira.

Kukonzekera ndi kutsata njira yothetsera jakisoni wamkati: sungani zomwe zili mu vial 0,6 g (0,5 g + 0,1) mu 10 ml ya madzi a jakisoni kapena 1.2 g (1,0 g + 0,2 g) ya 20 ml ya madzi a jakisoni.

Mu / kulowa kulowa pang'onopang'ono (mkati mwa mphindi 3-4.)

Kukonzekera ndi kuyambitsa mayankho a kulowetsedwa kwa mtsempha: makonzedwe okonzekera kulowetsedwa kwa mtsempha wa magazi omwe ali ndi 0,6 g (0,5 g + 0,1) kapena 1.2 g (1,0 g + 0,2) wa mankhwalawa amayenera kuchepetsedwa mu 50 ml kapena 100 ml ya njira yothetsera kulowetsedwa, motero. Kutalika kwa kulowetsedwa ndi mphindi 30 mpaka 40.

Mukamagwiritsa ntchito njira zotsatirazi zobwezeretsera m'mavuto omwe adatsimikizika, maantibiotic ofunika amawasungira.

Monga solvent ya kulowetsedwa kwa mtsempha, kulowetsedwa kungagwiritsidwe ntchito: yankho la sodium kolorayidi 0,9%, yankho la Ringer, yankho la potaziyamu mankhwala ena.

Amoxicillin ndi clavulanic acid - mankhwalawa pharmacology ya sungunuka mitundu ya maantibayotiki

Ndi kubwera ku Russia wa sungunuka maantibayotiki mankhwala monga amoxicillin clavulanic acid, timalandira zomwe takhala tikuyembekezera kwanthawi yayitali - mankhwala okhala ndi mwayi wocheperapo wosintha, wokhala ndi chiyembekezo chowonjezereka.

Pakadali pano, ngati mukuyang'ana chithunzi chenicheni cha mankhwala othandizira antimicrobial (pano - PL) m'dziko lathu, titha kudziwa kuti, ngakhale kuyesayesa kupatula othandizira ena pazovuta zaukadaulo wothandiza, nkhaniyi idakalipobe .

Komabe, tikuwona zomwe zikuchitika pakugwiritsa ntchito mankhwala mwakugwiririka. Ngati tirikunena za chithandizo cha matenda opumira, titha kudziwa njira zazikuluzikulu zothandizira odwala athu - iyi ndi nkhondo yolimbana ndi Str.pneumoniae, H.influenzae ndi Moraxella catarrbalis.

Mankhwala osokoneza bongo monga amoxicillin ali mtsogoleri m'dziko lathu. Ntchito zake zapamwamba motsutsana ndi gulu la beta-hemolytic A streptococci, pneumococci, hemophilic bacillus (osatulutsa beta-lactamase) adatsimikiziridwa.

Kuphatikizika kophatikizira amoxicillin + clavulanic acid kumadziwika ndi kuchuluka kwakukulu ndi mayamwidwe ambiri kuposa ampicillin, amakhala ndi gawo lalikulu la kulowetsedwa kwamatoni, ma sinillor sinus, chapakati khutu lamkati, bronchopulmonary system.

Poyerekeza ampicillin trihydrate, amoxicillin wokhala ndi clavulanic acid ali ndi mwayi wambiri - kukula kwamamolekyu ochepa, komwe kumathandizira kuti kulowere kulowa mu cell yaying'ono, kwambiri bioavailability, komwe kumakhala kosadalira chakudya, komwe kumakhala makamaka ndi mawonekedwe osungunuka a mankhwalawa opangidwa pogwiritsa ntchito ukadaulo wa Solutab ”(Flemoxin Solutab). High bioavailability pa mankhwala a antimicrobial ndikofunikira osati chifukwa cha mphamvu ya mankhwalawo, komanso pokhudzana ndi ngozi ya matumbo a dysbiosis. Kupatula apo, kuchuluka kwa maantibayotiki omwe sanatengere mu kayendedwe kazinthu komweko kumakhalabe m'matumbo lumen, komwe kumawonjezera mwayi wamatumbo a dysbiotic ndi kutsekula m'mimba.

Mutu womwe takambirana ndi kuphatikiza kwa amoxicillin ndi clavulanic acid mu mawonekedwe osungunuka (pano - LF).

Ndikofunika kunena kuti kupangidwa kwa mankhwala osungunuka ndikofunikanso kuyambira pakuwonetsetsa: Ngakhale kuti mankhwala amadzimadzi amapangidwira ana, ndipo mankhwala olimba (makapisozi ndi mapiritsi) adapangidwira achikulire, akulu ambiri amatengera zomwe amakonda kapena zifukwa zina (okalamba, ogona) wodwala) akufuna kugwiritsa ntchito madzi LF. Mankhwala amadzimadzi achikhalidwe, mwachitsanzo, madzi osakanikirana ndi omwe ali ndi malire mu mankhwala omwe amayamba chifukwa cha kusungunuka kwa mankhwalawo, kuyimitsidwa - chiwopsezo choyenera cha mankhwala othandizira / okhazikika.Njira yothetsera vutoli inali kutuluka kwa ukadaulo wa "Solutab", momwe zinthu zomwe zimayikidwa zimayikidwa mu ma Microganeles, omwe aliwonse omwe amaphatikizidwa ndi membrane yemwe amasungunuka m'malo amchere wa matumbo aang'ono.

Amoxicillin mu ma microspheres amasunga kukhazikika m'malo acidic. Mukamamwa mankhwala a habicillin wambiri, ena amasungunuka m'mimba, ndiye kuti timataya mankhwalawo.

Mukamamwa, kusungunuka kwa mankhwalawa kumachitika kumtunda kwa matumbo aang'ono, komwe kumayambitsa kuthamanga, kuthira kwathunthu kwathunthu komanso kusasokoneza kwenikweni m'mimba.

Tekinoloje yamankhwala ya "Solutab" imalola kuwonjezera bioavailability, osati amoxicillin, komanso clavulanic acid.

Malinga ndi zomwe zili pachithunzi chotsatirachi, ndizotheka kutsimikizira kuti omwe amwazika omwe ali ndi ma LF ali ndi zabwino zambiri pazomwe zimachitika, osati pokhapokha pa pharmacokinetics, komanso kutsatira: mwayi wotenga "odwala ogona" popanda chiopsezo cha mapiritsi kapena mapiritsi omwe ali "kumapeto" kwa munthu wamkulu komanso mwana, kusankha ndikusungunula piritsi kapena kumwa lonse. Tisaiwale kuti mphamvu yochepa ya Flemoklav Solutab pamatumbo am'mimba imatsimikiziridwa ndi chotsalira chotsalira cha mankhwalawa m'matumbo.

Pakadali pano pali kuwonjezeka kwa kupezeka kwa tizilombo ta tizilombo tating'onoting'ono tomwe timapanga beta-lactamases. Ma enzyme amenewa amapanga tizilombo toyambitsa matenda topuma a matenda opumira: H.influenzae, Moraxella catarrbalis, E. coli. Kugwiritsira ntchito ma penicillin otetezedwa ndi inhibitor ndi njira imodzi yolimbikitsa kwambiri yothana ndi kukhudzidwa komwe kumapangidwa ndi beta-lactamases.

Ma inhibitors sangasinthe ku beta-lactamases (omwe amatchedwa kuti akufuna kudzipha) onse kunja kwa khungu (mu gram-bacteria) komanso mkati mwake (mu gram-negative), ndikuthandizira maantibayotiki kuti azitha kuthana ndi vuto.

Zotsatira zakugwiritsira ntchito ma inhibitors ndikuchepa kwambiri kwa osachepera odziletsa (MIC) a mankhwalawa ndipo, motero, kuwonjezeka kwakukulu kwa mphamvu ya mankhwalawa, omwe amawoneka bwino poyerekeza ntchito ya amoxicillin komanso kuphatikiza kwake ndi clavulanic acid.

Clavulanic acid imakulitsa zochita za antibacteria osati chifukwa chakuletsa kwa ma enzymes, komanso chifukwa cha mphamvu yotsutsa-kuchepa (kuchepa kwa kuchuluka kwa ma virus pa unit voliyumu) ​​komanso post-beta-lactamase-inhibitory zotsatira motsutsana ndi tizilombo tina toyambitsa matenda.

Tanthauzo la izi ndikuti mothandizidwa ndi clavulanate, khungu lama microbial limaleka kupanga beta-lactamase kwakanthawi, zomwe zimapatsa amoxicillin "ufulu wina". Pambuyo-beta-lactamase-inhibitory zotsatira zimapitirira kwa maola osachepera asanu.

asidi atayamba kugwira ntchito, ndipo ngati maselo okhala ndi ma cell ochepa satulutsa beta-lactamase mkati mwa maola 5, mwachilengedwe, ntchito ya amoxicillin imawonjezeka.

Amoxicillin osakanikirana ndi clavulanic acid amawonetsa kuthekera kwakukulu kwa izi. Kuphatikiza kwa beta-lactamase inhibitor kumapangitsanso zochitika zotsutsana ndi anaerobic, zomwe ndizofunikira kuchiza matenda osakanikirana, omwe amakhala wamba, mwachitsanzo, machitidwe a obstetric ndi gynecological.

Tiyeni tibwererenso ku ma pharmacokinetics a mankhwalawo omwe akufunsidwa. Pali kusiyana kwa mayamwidwe amo amoillillin ndi clavulanic acid chifukwa cha kusiyana kwazomwe zimapanga asidi pazinthu izi.

Amoxicillin ndi malo ofooka, ndipo clavulanate ndi asidi wofooka. Zotsatira zake, mankhwalawa ali ndi mitundu ina ya mayamwidwe, ndipo mikhalidwe imapangidwa kuti isaberekedwe kacululanate kosakwanira.

Poyeneranso, pali zosiyana mu nthawi ya mayamwidwe - mayamwidwe amachitika osati ndi mitundu yaying'ono, komanso kuthamanga kosiyana.

Awa ndi mkhalidwe wachiwiri womwe clavulanic acid "imayamwa" ndikulowetsa ndende ndikutsalira komwe kumayambitsa matumbo, zomwe zimapangitsa kuti pakhale zotsatira zoyipa za asidi pamatumbo a mucosa - 20-25% ya odwala omwe amalandira chithandizo chamankhwala cham'mimba, kuwapangitsa kuti akane kumwa mankhwalawo.

Momwe mungasinthire kusiyanasiyana kwa mayamwidwe? Kupatula apo, asidi wambiri akamalowa m'matumbo, amachepetsa mphamvu yotsalira yamatumbo.

Zotsatira zoyipa zomwe zimakhudzana ndi mayankho osakwanira a beta-lactamase inhibitor ndi kutsekula m'mimba, pseudomembranous colitis, nseru, ndi kusintha kwa zomverera.

Ukadaulo wa Solyutab pogwiritsira ntchito mawonekedwe a microencapsulated umakupatsani mwayi wowonjezera kuyamwa mosalekeza wa inhibitor, pomwe kuyamwa nthawi zonse kwa antibayotiki kumakulirakulira pang'ono (5%) yokha. Mukamagwiritsa ntchito Flemoklav Solutab, zotsatira zoyipa zochepa zimayembekezeredwa.

Tsopano, mwachitsanzo, kafukufuku akuchitika ku Russian Federation, zoyambirira zotsatira zomwe zinawonetsa kusapezeka kwa izi zosafunika, zomwe zimawonedwa kwa nthawi yoyamba pokhudzana ndi amoxicillin / clavulanate, panthawi imodzimodziyo pali umboni wotsimikizira zazinthu zachilengedwe zamankhwala.

Palinso kusiyana pakumveka kosiyanasiyananso kwa mitundu ya LF amoxycillini + acidi clavulanici yokhala ndi maselo osiyana maselo. Chithunzichi chikuwonetsa bwino momwe kupezekera kwa njira wamba zamankhwala zomwe zimakhala ndi kulemera kwa 600-800 g / mol zimasiyana ndi Flemoklav Solutab (200-400 g / mol).

Zinapezeka kuti kusinthasintha kwa m'mimba pakulandila mwachindunji kumadalira kutembenuka kwa mayamwidwe a clavulanate. Mukamagwiritsa ntchito mapiritsi a LF amoxicillin okhala ndi clavulanate, kuphatikiza mankhwala oyamba, sizotheka kukwaniritsa yunifolomu komanso kuyamwa mwachangu asidi.

Pankhani ya Flemoklav Solutab, timapeza zotsatira zolimbikitsa kwambiri: kusiyanasiyana kwa kuphatikizika kwa clavulanate piritsi yomwe idatengedwa kwathunthu kapena yomwe kale idasungunuka sikofunika.

Nthawi yomweyo, titha kuwona kuwonjezeka kwa kuchuluka kwa clavulanate m'magazi a magazi - pogwiritsa ntchito LF, mutha kukwaniritsa kuchuluka kwa 2 μg / ml, pogwiritsa ntchito Flemoklav - pafupifupi 3 μg / ml.

Zomwe zimachitika masiku ano m'magawo a mankhwala, zomwe zimakhudza ma pharmacokinetic katundu wa antimicrobials, zitha kukonza chithandizo cha mankhwala othandizira motsutsana ndikuchepa kwa chiwerengero komanso kuzunza kwamwano.

New soluble LF amoxycillinum / acidum clavulanicum - Flemoklav Solutab - ndi gawo labwino mwatsatanetsatane muukadaulo wa mankhwala.

Kuchulukana kwa acidi clavulanici kumawonjezera chitetezo ndi mphamvu ya amoxycillini ndipo nthawi yomweyo imachepetsa mwayi wokhala ndi zovuta zoyanjana ndi clavulanic acid, makamaka matenda opatsirana m'mimba.

LF yapadera imawonjezera kuchuluka kwa "pharmacodynamic katundu" pamafakiteriya opatsirana, omwe amathandizira kuthetseratu kwathunthu, ndipo chifukwa chake, kupewa kwatsopano kwa mabakiteriya omwe ali ndi chiopsezo cha kupangika kwa mabakiteriya osagwira. Nthawi yomweyo, LF "Solyutab" ndiyabwino kwambiri kwa onse akuluakulu omwe amakonda mapiritsi oyimitsidwa komanso a ana.

Kutulutsa mawonekedwe, ma CD ndi kuphatikizika Amoxicillin + Clavulanic acid - Vial

mabotolo (1) - mapaketi a makatoni.
mabotolo (10) - mapaketi a makatoni (12) - makatoni.
mabotolo (10) - mapaketi a makatoni (50) - mabokosi a makatoni.
mabotolo (10) - mapaketi a makatoni (60) - makatoni.

Zisonyezo Amoxicillin + Clavulanic acid - Vial

Bacteria matenda oyambitsidwa ndi tizilombo tating'ono ta mankhwala:

• matenda am'munsi kupuma thirakiti (kuchulukitsa kwa matenda a bronchitis, ziphuphu zakumaso ndi bronchopneumonia),
• matenda a ziwalo za ENT (atitis media, sinusitis, recillion tonsillitis),
• matenda a kwamkodzo thirakiti (kuphatikizapo cystitis, urethritis, pyelonephritis),
• matenda am'matumbo (kuphatikizapo salpingitis, salpingoophoritis, endometritis, septic mimba, pelvioperitonitis, postpartum sepsis),
• matenda a pakhungu ndi zofewa (phlegmon, matenda a bala, erysipelas, impetigo, abscesses),
• matenda a mafupa ndi mafupa (kuphatikizapo osteomyelitis),
• matenda opatsirana pogonana (chinzonono, chancre),
• matenda ena opatsirana: septicemia, peritonitis, intraabdominal sepsis, matenda a postoperative.

Kupewa matenda opatsirana pambuyo pakuchita opaleshoni yam'mimba, ziwalo zamkati, mutu ndi khosi, mtima, impso, mathirakiti a biliary komanso kuphatikizidwa kwa mafupa.

Mlingo

Mankhwalawa amagwiritsidwa ntchito iv.

Mlingo wa mankhwalawa umatengera zaka, kulemera kwa thupi ndi impso za wodwalayo, komanso kuopsa kwa matendawa.

Njira yochepetsetsa ya mankhwala opha maantibayotiki ndi masiku 5. Kutalika kwakukulu kwa mankhwalawa kumatha kukhala masiku 14, pambuyo pake kuwunika kwake ndi kulolerana kwake.

Mlingo umawerengeredwa potengera zomwe amoxicillin / clavulanic acid.

Akuluakulu ndi ana opitirira zaka 12 okhala ndi thupi lolemera kuposa 40 kg

Mulingo wamba: 1000 mg / 200 mg maola 8 aliwonse.

Matenda owopsa: 1000 mg / 200 mg maola 4 kapena 4 aliwonse.

Kupewa Opaleshoni

Zithandizo zopitilira osakwana ola limodzi: 1000 mg / 200 mg pakulimbitsa thupi

Zowonjezera zomwe zimatenga nthawi yopitilira 1 ola limodzi: mpaka 4 mg wa 1000 mg / 200 mg kwa maola 24.

Odwala ndi mkhutu aimpso ntchito

Kusintha kwa Mlingo wokhazikika pazotsatira zoyenera za amoxicillin.