03 May, 2024
    Chithandizo ndi kupewa

    Augmentin ufa: malangizo ogwiritsira ntchito

    Nambala yolembetsa: P N015030 / 04-131213
    Dzina la Brand: Augmentin®
    Mayiko ena osagwirizana kapena dzina la gulu: amoxicillin + clavulanic acid.
    Fomu ya Mlingo: ufa wa kuyimitsidwa pakamwa.

    The zikuchokera mankhwala
    Zinthu zogwira ntchito:
    Amoxicillin trihydrate malinga ndi amoxicillin 125.0 mg, 200.0 mg kapena 400.0 mg mu 5 ml ya kuyimitsidwa.
    Potaziyamu clavulanate molingana ndi clavulanic acid 31.25 mg, 28,5 mg kapena 57.0 mg mu 5 ml ya kuyimitsidwa.
    Othandizira:
    Xanthan chingamu, aspartame, succinic acid, colloidal silicon dioksidi, hypromellose, kununkhira kwa lalanje 1, kukoma kwa lalanje 2, kununkhira kwa rasipiberi, Kuwala kwa molasses, silicon dioxide.
    Chiyerekezo cha magawo omwe amagwira ntchito poyimitsidwa

    Mlingo wa kuchuluka kwa zigawo zikuluzikulu Amoxicillin, mg (mu mawonekedwe a amoxicillin trihydrate) Clavulanic acid, mg (mu mawonekedwe a potaziyamu clavulanate)
    Ufa woyimitsidwa wa 125 mg / 31.25 mg mu 5 ml 4: 1 125 31.25
    Ufa wa kuyimitsidwa 200 mg / 28,5 mg mu 5 ml 7: 1,200 28,5
    Ufa pakukonzekera kuyimitsidwa kwa 400 mg / 57 mg mu 5 ml 7: 1 400 57

    Kufotokozera
    Mlingo wa 125 mg / 31.25 mg mu 5 ml: ufa wamtundu woyera kapena pafupifupi woyera, wokhala ndi fungo labwino. Ikaphatikizidwa, kuyimitsidwa koyera kapena pafupifupi koyera kumapangidwa. Poimirira, yoyera kapena yoyera imayamba pang'onopang'ono.
    Mlingo wa 200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml: ufa wosayera kapena pafupifupi woyera, wokhala ndi fungo labwino. Ikaphatikizidwa, kuyimitsidwa koyera kapena pafupifupi koyera kumapangidwa. Poimirira, yoyera kapena yoyera imayamba pang'onopang'ono.

    Gulu la Pharmacological: Antibiotic, penicillin-beta-lactamase inhibitor.

    Code ya ATX: J01CR02

    ZOCHULUKA ZA PHARMACOLOGICAL

    Mankhwala
    Njira yamachitidwe
    Amoxicillin ndi mankhwala osokoneza bongo owoneka bwino omwe ali ndi ntchito yolimbana ndi ma gram ambiri komanso gram alibe tizilombo. Nthawi yomweyo, amoxicillin amatha kuwonongedwa ndi beta-lactamases, chifukwa chake ntchito yokhala ndi amoxicillin sinafikira tizilombo tomwe timatulutsa timadzi tambiri.
    Clavulanic acid, beta-lactamase inhibitor yokhudzana ndi penicillin, amatha kuyambitsa mitundu yambiri ya beta-lactamases yomwe imapezeka mu penicillin ndi cephalosporin zosagwira tizilombo. Clavulanic acid ili ndi mphamvu yokwanira yolimbana ndi plasmid beta-lactamases, yomwe nthawi zambiri imatsimikiza kukana kwa mabakiteriya, ndipo sagwira ntchito motsutsana ndi mtundu wa 1 wa chromosomal beta-lactamases, womwe suletsedwa ndi clavulanic acid.
    Kupezeka kwa clavulanic acid mu kukonzekera kwa Augmentin® kumateteza amoxicillin ku chiwonongeko cha ma enzyme - beta-lactamases, omwe amalola kukulitsa kuchuluka kwa antibacterial a amoxicillin.
    Otsatirawa ndi ntchito ya vitro yosakanikirana ya amoxicillin yokhala ndi clavulanic acid.
    Bacteria imakonda kuphatikizidwa ndi amoxicillin ndi clavulanic acid
    Zoyipa zamagalamu
    Bacillus anthracis
    Enterococcus faecalis
    Listeria monocytogene
    Nocardia asteroides
    Streptococcus pyogene1,2
    Streptococcus agalactiae 1.2
    Streptococcus spp. (ena beta hemolytic streptococci) 1,2
    Staphylococcus aureus (methicillin chidwi) 1
    Staphylococcus saprophyticus (methicillin chidwi)
    Coagulase-hasi staphylococci (wokhudzidwa ndi methicillin)
    Zoyipa za grram zabwino
    Clostridium spp.
    Peptococcus niger
    Peptostreptococcus magnus
    Peptostreptococcus micros
    Peptostreptococcus spp.
    Zoyipa zamagalamu
    Bordetella pertussis
    Haemophilus influenzae1
    Helicobacter pylori
    Moraxella catarrhalis1
    Neissevia gonorrhoeae
    Pasteurella multocida
    Vibrio cholerae
    Ma gram alibe anaerobes
    Bacteroides fragilis
    Bacteroides spp.
    Capnocytophaga spp.
    Eikenella corrodens
    Fusobacterium nucleatum
    Fusobacterium spp.
    Porphyromonas spp.
    Prevotella spp.
    Zina
    Borrelia burgdorferi
    Leptospira icterohaemorrhagiae
    Treponema pallidum
    Bacteria yomwe idayamba kukana kuphatikiza amoxicillin ndi clavulanic acid ndiyotheka
    Zoyipa zamagalamu
    Escherichia coli1
    Klebsiella oxytoca
    Klebsiella pneumoniae1
    Klebsiella spp.
    Proteus mirabilis
    Proteus vulgaris
    Proteus spp.
    Salmonella spp.
    Shigella spp.
    Zoyipa zamagalamu
    Corynebacterium spp.
    Enterococcus faecium
    Streptococcus pneumoniae 1.2
    Gulu la Streptococcus Viridans
    Bacteria yomwe imagwirizana mwachilengedwe pakuphatikizidwa kwa amoxicillin ndi clavulanic acid
    Zoyipa zamagalamu
    Spinetobacter spp.
    Citrobacter freundii
    Enterobacter spp.
    Hafnia alvei
    Legionella pneumophila
    Morganella morganii
    Providencia spp.
    Pseudomonas spp.
    Serratia spp.
    Stenotrophomonas maltophilia
    Yersinia enterocolitica
    Zina
    Chlamydia chibayo
    Chlamydia psittaci
    Chlamydia spp.
    Coxiella burnetii
    Mycoplasma spp.
    1 - kwa mabakiteriya awa, kufunikira kwakanthawi kothandizirana kwa amoxicillin ndi clavulanic acid kwawonetsedwa mu maphunziro azachipatala.
    2 - mitundu ya mabakiteriya amtunduwu samatulutsa beta-lactamases.
    Kuzindikira ndi amoxicillin monotherapy kumasonyezanso chidwi chofanana ndi kuphatikiza kwa amoxicillin ndi clavulanic acid.
    Pharmacokinetics
    Zogulitsa
    Zosakaniza zonse zogwiritsidwa ntchito ndi mankhwalawa Augmentin ®, amoxicillin ndi clavulanic acid, zimatengedwa mwachangu komanso mokwanira kuchokera m'matumbo am'mimba (GIT) pambuyo pakamwa. Kuyamwa kwa zinthu zomwe zimagwiritsidwa ntchito pokonzekera Augmentin ® ndizabwino kwambiri ngati mankhwalawa amwedwa kumayambiriro kwa chakudya.
    Ma paracokinetic magawo a amoxicillin ndi clavulanic acid omwe amapezeka pachiwonetsero chazachipatala akuwonetsedwa pansipa, pamene odzipereka athanzi azaka za 2 mpaka 12 pamimba yopanda kanthu amatenga Augmentin® ufa kuti ayimitse pakamwa, 200 mg / 28,5 mg mu 5 ml (228 , 5 mg) pa mlingo wa 45 mg / 6.4 mg / kg patsiku, wogawidwa pawiri.
    Magawo a pharmacokinetic oyambira

    Cmax yogwira pophika (mg / l) Tmax (maola) AUC (mg × h / l) T1 / 2 (maola)
    Amoxicillin 11.99 ± 3.28 1.0 (1.0-2.0) 35.2 ± 5.01.22 ± 0.28
    Clavulanic acid 5.49 ± 2.71 1.0 (1.0-2.0) 13.26 ± 5.88 0.99 ± 0.14

    Ma paracokinetic magawo a amoxicillin ndi clavulanic acid omwe amapezeka pachiyeso chachipatala amawonetsedwa pansipa pamene odzipereka athanzi atatenga mlingo umodzi wa Augmentin®, ufa kuti ayimitse pakamwa, 400 mg / 57 mg mu 5 ml (457 mg).
    Magawo a pharmacokinetic oyambira

    Cmax yogwira pophika (mg / l) Tmax (maola) AUC (mg × h / l)
    Amoxicillin 6.94 ± 1.24 1.13 (0.75-1.75) 17.29 ± 2.28
    Clavulanic acid 1.10 ± 0.42 1.0 (0.5-1.25) 2.34 ± 0.94

    Cmax - pazipita plasma ndende.
    Tmax - nthawi yakukwanira ndende ya plasma.
    AUC ndi dera lomwe limaponderezedwa nthawi yayitali.
    T1 / 2 - theka moyo.
    Kugawa
    Monga kuphatikizira kwa mtsempha wa amoxicillin ndi clavulanic acid, njira zochizira za amoxicillin ndi clavulanic acid zimapezeka m'misempha yambiri komanso mkati mwazigawo (mu ndulu, matumbo am'mimba, khungu, adipose ndi minofu minofu, zotumphukira ndi zotumphukira). .
    Amoxicillin ndi clavulanic acid ali ndi malire ofooka a mapuloteni a plasma. Kafukufuku wasonyeza kuti pafupifupi 25% ya kuchuluka kwathunthu kwa clavulanic acid ndi 18% ya amoxicillin m'magazi am'magazi amaphatikizika ndi mapuloteni am'magazi.
    Mu maphunziro a nyama, palibe chowerengera cha zigawo za kukonzekera kwa Augmentin® mu chiwalo chilichonse chomwe chidapezeka.
    Amoxicillin, monga ma penicillin ambiri, amadutsa mkaka wa m'mawere. Zotsatira za clavulanic acid zimapezekanso mkaka wa m'mawere. Kupatula kuthekera kwa kutulutsa chidwi, kutsegula m'mimba ndi candidiasis ya mucous membrane wamkamwa, palibe zovuta zina za amoxicillin ndi clavulanic acid paumoyo wa ana oyamwitsa amadziwika.
    Kafukufuku wothandizira kubereka kwanyama akuwonetsa kuti amoxicillin ndi clavulanic acid amawoloka chotchinga. Komabe, palibe zoyipa zilizonse pa mwana wakhanda zomwe zapezeka.
    Kupenda
    10-25% ya mlingo woyambirira wa amoxicillin amuchotseredwa ndi impso mu mawonekedwe a metabolite wa penicilloic acid. Clavulanic acid imapangidwa modabwitsa kwambiri mpaka 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid ndi 1-amino-4-hydroxybutan-2-imodzi ndipo imayesedwa ndi impso. komanso ndi mpweya wake womwe watha mwanjira ya mpweya woipa.
    Kuswana
    Monga ma penicillin ena, amoxicillin amathandizidwa ndi impso, pomwe clavulanic acid imachotsedwanso ndi machitidwe a impso komanso owonjezera. Pafupifupi 60-70% ya amoxicillin ndi 40-65% ya clavulanic acid amachotsedwa ndi impso zosasinthika maola 6 atangotenga piritsi limodzi la 250 mg / 125 mg kapena piritsi limodzi la 500 mg / 125 mg. Kukhazikitsidwa pamodzi kwa probenecid kumachepetsa kuchotsa kwa amoxicillin, koma osati clavulanic acid (onani gawo "Kuyanjana ndi mankhwala ena").

    MALO OGWIRITSITSA NTCHITO Ntchito

    Matenda oyambitsidwa ndi bakiteriya omwe amayang'aniridwa ndi amoxicillin / clavulanic acid:
    • Matenda a ENT, monga pafupipafupi tonillitis, sinusitis, otitis media, omwe amayamba chifukwa cha Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis ndi Streptococcus pyogenes.
    • Matenda ochepetsa kupuma am'mimba, monga kufalikira kwa chifuwa cham'mimba, chibayo, ndi bronchopneumonia, omwe amayamba chifukwa cha Streptococcus pneumoniae, Haemophilus fuluwenza, ndi Moraxella catarrhalis.
    • Matenda amtundu wa urogenital, monga cystitis, urethritis, pyelonephritis, matenda amtundu wachikazi, omwe nthawi zambiri amayamba chifukwa cha mitundu ya banja la Enterobacteriaceae (makamaka Escherichia coli), Staphylococcus saprophyticus ndi mitundu ya genus Enterococcus, komanso gonorrhea yoyambitsidwa ndi Neisseria gonorrhoeae.
    • Matenda a pakhungu ndi minofu yofewa, yomwe nthawi zambiri imayamba chifukwa cha Staphylococcus aureus, Streptococcus pyogene, ndi mitundu ya mtundu wa Bacteroides.
    • Matenda am'mafupa ndi mafupa, monga osteomyelitis, omwe nthawi zambiri amayamba chifukwa cha Staphylococcus aureus, ngati chithandizo cha nthawi yayitali chikufunika.

    Matenda oyambitsidwa ndi tizilombo tomwe timayamwa amoxicillin amatha kuthandizidwa ndi Augmentin®, chifukwa amoxicillin ndi chimodzi mwazomwe zimagwira.

    MALANGIZO OGULITSIRA

    • Hypersensitivity kwa amoxicillin, clavulanic acid, magawo ena a mankhwala, mankhwala a beta-lactam (mwachitsanzo, penicillins, cephalosporins) mu anamnesis,
    • magawo am'mbuyomu a jaundice kapena chiwindi chovuta kugwiritsa ntchito kuphatikiza kwa amoxicillin ndi clavulanic acid m'mbiri,
    • Ana okulirapo mpaka miyezi itatu,
    • kuwonongeka kwa impso (kulengedwa kwa creatinine zosakwana 30 ml / min),
    • phenylketonuria.

    KUGWIRITSA NTCHITO CHIYEMBEKEZO NDIPONSO KULIMBITSA KWAMBIRI

    Mimba
    Mu maphunziro a kubereka mu nyama, pakamwa komanso mwa uchembere wa Augmentin ® sizinayambitse zotsatira za teratogenic.
    Pa kafukufuku m'modzi mwa azimayi omwe ali ndi matuza kusanachitike, anapezeka kuti mankhwala a prophylactic amatha kuphatikizidwa ndi chiopsezo chowonjezeka cha necrotizing enterocolitis akhanda. Monga mankhwala onse, Augmentin® siyikulimbikitsidwa kuti mugwiritse ntchito panthawi yomwe muli ndi pakati, pokhapokha ngati phindu lomwe mayi akuyembekezera limaposa chiwopsezo cha mwana wosabadwayo.
    Nthawi yoyamwitsa
    Mankhwala Augmentin® angagwiritsidwe ntchito poyamwitsa. Kupatula kuti kuthekera kwa kutulutsa chidwi, kutsegula m'mimba, kapena kufinya kwamkamwa, komwe kumalumikizidwa ndi kulowetsedwa kwa kuchuluka kwa zinthu zomwe zimagwiritsidwa ntchito ndi mankhwalawa mkaka wa m'mawere, palibe zovuta zina zomwe zimawonedwa mu makanda oyamwa. Pakakhala zovuta m'makanda oyamwitsa, kuyamwitsa kuyenera kusiyidwa.

    ULEMEKEZO NDI KULAMULIRA

    Zokhudza pakamwa.
    Mlingo wa mankhwalawa umayikidwa payekha kutengera zaka, kulemera kwa thupi, impso ya wodwalayo, komanso kuopsa kwa matendawa.
    Kuti muchepetse kusokonezeka kwa m'mimba ndikuwonjezera kuyamwa, mankhwalawa ayenera kumwedwa kumayambiriro kwa chakudya.
    Njira yocheperako yotsutsa-bakiteriya ndi masiku 5.
    Kuchiza sikuyenera kupitilira masiku opitilira 14 osanenapo za matenda.
    Ngati ndi kotheka, ndizotheka kuchita pang'ono pang'onopang'ono mankhwala oyambira (oyang'anira oyang'anira a Augmentin ® pokonzekera mlingo wa ufa ndi ufa wopangira yankho la kukonzekera kwamkati mwakusintha kwina kwa kukonzekera kwa Augmentin® mu mitundu ya pakamwa).
    Akuluakulu ndi ana azaka 12 kapena kupitirira kapena masekeli 40 kapena kupitilira
    Ndikulimbikitsidwa kugwiritsa ntchito mitundu ina ya Augmentin® kapena 11 ml ya kuyimitsidwa pamiyeso ya 400 mg / 57 mg mu 5 ml, womwe ndi wofanana ndi piritsi limodzi la Augmentin®, 875 mg / 125 mg.
    Ana a zaka zitatu mpaka zaka 12 okhala ndi thupi lochepera 40 makilogalamu
    Kuwerengera Mlingo kumachitika malinga ndi zaka komanso kulemera kwa thupi, zomwe zimawonetsedwa mu mg / kg thupi patsiku kapena ma milliliters a kuyimitsidwa. Mlingo wa tsiku lililonse umagawidwa mu 2 Mlingo uliwonse maola 12 aliwonse. Mlingo woyeserera komanso kuchuluka kwa makonzedwe akufotokozedwa pansipa.
    Gawo la regmentin la Augmentin ® (kuwerengetsa kwa mtundu wa amoxicillin)

    Kuyimitsidwa 7: 1 (200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml) mu 2 Mlingo uliwonse maora 12
    Mlingo wotsika 25 mg / kg / tsiku
    Mlingo waukulu 45 mg / kg / tsiku

    Mlingo wocheperako wa Augmentin ® umalimbikitsidwa pochizira matenda a pakhungu ndi minofu yofewa, komanso matendawa.
    Mlingo wapamwamba wa Augmentin ® umalimbikitsidwa pochizira matenda monga otitis media, sinusitis, matenda am'munsi kupuma ndi kwamkodzo, matenda a mafupa ndi mafupa.
    Kwa mankhwalawa Augmentin ® ndi muyezo wa amoxicillin wa clavulanic acid 7: 1, palibe zosakwanira muchipatala zomwe zingalimbikitse kugwiritsidwa ntchito kwa mankhwala opitilira 45 mg / kg / tsiku mu 2 Mlingo wa ana osakwana zaka 2.
    Ana kuyambira pakubadwa mpaka miyezi itatu
    Kugwiritsa ntchito kuyimitsidwa ndi chiŵerengero cha amoxicillin kuti clavulanic acid 7: 1 (200 mg / 28,5 mg mu 5 ml ndi 400 mg / 57 mg mu 5 ml) ndi contraindified mwa anthuwa.
    Ana asanakwane
    Palibe malingaliro pa mtundu uliwonse wa mankhwalawo.
    Magulu apadera a odwala
    Odwala okalamba
    Malangizo a mtundu sagwiritsidwanso ntchito mulingo womwewo sagwiritsidwanso ntchito; Okalamba odwala mkhutu aimpso ntchito, Mlingo woyenera amamulembera odwala omwe ali ndi vuto laimpso.
    Odwala ndi mkhutu aimpso ntchito
    Kuyimitsidwa kwa 7: 1 (200 mg / 28,5 mg mu 5 ml kapena 400 mg / 57 mg mu 5 ml) iyenera kugwiritsidwa ntchito mwa odwala omwe ali ndi clearinine chilolezo chachikulu kuposa 30 ml / min, popanda kusintha kwa mlingo wofunikira.
    Nthawi zambiri, ngati kuli kotheka, chithandizo cha makolo chithandizike.
    Odwala omwe ali ndi vuto la chiwindi
    Kuchiza kumachitika mosamala; ntchito ya chiwindi imayang'aniridwa nthawi zonse.
    Palibe deta yokwanira kuti musinthe malangizowo mwa odwala.
    Njira yokonzekera kuyimitsidwa
    Kuyimitsidwa kumakonzedwa nthawi yomweyo asanagwiritse ntchito koyamba.
    Pafupifupi 40 ml ya madzi owiritsa owiritsa kuti afundire kutentha ayenera kuwonjezeredwa ku botolo la ufa, ndiye kutseka botolo ndi chivindikiro ndikugwedeza mpaka ufa utasungunuka kwathunthu, lolani botolo kuti liyime kwa mphindi 5 kuti mutsimikizire kuchepetsedwa kwathunthu. Kenako yikani madzi pachizindikiro pa botolo ndikugwedezaninso botolo. Pazonse, pafupifupi 64 ml ya madzi amafunikira kuti ayimitse kuyimitsidwa.
    Botolo liyenera kugwedezedwa bwino musanagwiritse ntchito. Kuti mupeze dosing yolondola ya mankhwalawa, gwiritsani ntchito kapu kapena syringe yoyenera, yomwe imayenera kutsukidwa bwino ndi madzi mukatha kugwiritsa ntchito.Pambuyo pa kuchepetsedwa, kuyimitsidwa kuyenera kusungidwa osaposa masiku 7 mufiriji, koma osapanga chisanu.
    Kwa ana osakwana zaka 2, muyezo umodzi wokha wa kuyimitsidwa kwa mankhwalawa Augmentin® akhoza kuchepetsedwa ndi madzi muyezo wa 1: 1.

    Kutulutsa mawonekedwe ndi kapangidwe kake

    Maantibayotiki amapezeka mwanjira izi:

    • mapiritsi okhala ndi filimu: ozungulira, oyera kapena pafupifupi oyera, pakuwonekera - kuyambira yoyera-yachikasu mpaka pafupi yoyera mu 250 mg Mlingo (250 + 125): lolemba lolemba mbali imodzi ya piritsi ya AUGMENTIN (m'matumba a ma PC 10. ma carton pack 2 matuza), 500 mg iliyonse (500 + 125): cholembedwa chokhala ndi mawu akuti "АС" ndi chiopsezo mbali imodzi (m'matumba a ma 7 kapena 10 ma PC., pamatumba mabokosi 2 matuza), 875 mg (875 + 125 ): yokhala ndi zilembo "A" ndi "C" mbali zonse ziwiri za piritsi ndi chiwopsezo cha kuwonongeka mbali imodzi (m'matumba a 7 ma PC., pamakatoni olemba matuza 2),
    • ufa woyimitsidwa pakumwa pakamwa: yoyera kapena pafupifupi yoyera, yokhala ndi fungo labwino, ikapukutidwa, kuyimitsidwa (koyera kapena pafupifupi) kumapezeka, momwe amafananira mitundu yopuma (m'mabotolo agalasi, botolo limodzi lokhala ndi kapu woyezera m'bokosi lamatoni) ,
    • ufa wa yankho la kulowetsedwa kwa mtsempha: kuyambira kuyera mpaka kuyera (mu paketi ya makatoni 10 mabotolo).

    Augmentin amagwiritsa ntchito mankhwala osakanikirana a clavulanic acid (munthawi ya mchere wam potaziyamu) ndi amoxicillin (mu mawonekedwe a mchere wa sodium) monga zinthu zomwe zimagwira.

    Piritsi limodzi lili:

    • yogwira zinthu: clavulanic acid - 125 mg, amoxicillin (monga trihydrate) - 250, 500 kapena 875 mg,
    • zotuluka: sodium carboxymethyl wowuma, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

    Kuphatikizika kwa kuphatikizika kwa mafilimu kumakhala ndi: hypromellose, hypromellose (5cP), macrogol 6000, macrogol 4000, dimethicone, titanium dioxide.

    5 ml ya kuyimitsidwa okonzekera kukonzekera pakamwa imakhala ndi:

    • yogwira zinthu mulingo wa amoxicillin (mu mawonekedwe a trihydrate) mpaka clavulanic acid (munthawi ya mchere wam potaziyamu): 125 mg / 31.25 mg, 200 mg / 28,5 mg, 400 mg / 57 mg,
    • zotupa: hypromellose, xanthan chingamu, presinic acid, aspartame, colloidal silicon dioxide, kununkhira (lalanje 1, lalanje 2, rasipiberi, "Bright molasses"), silicon dioxide.

    1 vial (1200 mg) yothetsera mtsempha wamagazi uli ndi zinthu zomwe zimagwira ntchito:

    • amoxicillin (munthawi ya mchere wa sodium) - 1000 mg,
    • clavulanic acid (munthawi ya mchere wam potaziyamu) - 200 mg.

    Mankhwala

    Amoxicillin ndi semisynthetic yotakata-sipikitantiotic yomwe imagwira ntchito motsutsana ndi michere yambiri yama gramu-gram komanso gram-positive. Komabe, amoxicillin ikutha kuwonongeka ndi β-lactamases, chifukwa chake, mawonekedwe ake ochita ntchito samapitilira mpaka mabakiteriya omwe amapanga enzyme iyi.

    Clavulanic acid imakhala ndi mawonekedwe ofanana ndi penicillin ndipo imalepheretsa ma β-lactamases, omwe amafotokozera mphamvu yake yopanga ma β-lactamase osiyanasiyana, omwe amapezeka mu tizilombo tating'ono tomwe timayimira kukana kwa cephalosporins ndi penicillin. Gawo lothandizali limagwira bwino ntchito pa plasmid β-lactamases, yomwe nthawi zambiri imapereka kukana kwa mabakiteriya, ndipo imagwira ntchito motsutsana ndi mtundu wa 1 chromosome β-lactamases yomwe singalepheretsedwe ndi clavulanic acid.

    Kuphatikizidwa kwa clavulanic acid mu kapangidwe ka Augmentin kumakuthandizani kuti muteteze amoxicillin kuti asawonongedwe ndi ma enzyme - β-lactamases, omwe amatsimikizira kukulira kwa mawonekedwe a antibacterial a chinthu ichi.

    Mu vitro, ma tizilombo totsatirawa amakhudzidwa ndikuphatikizidwa kwa amoxicillin ndi clavulanic acid:

    • gram-negative aerobes: Vibrio cholerae, Bordetella pertussis, Pasteurella multocida, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Helicobacter pylori,
    • Gram-aerobes ogwirizana: coagulase-negative staphylococci (amagwiritsa ntchito methicillin), Staphylococcus saprophyticus (wowonetsa chidwi cha methicillin), Staphylococcus aureus (wowonetsa chidwi cha methicillin), Bacillus anthracis, Streptocococal agal. (zina β-hemolytic streptococci), Streptococcus pyogene, Enterococcus faecalis, Nocardia asteroides, Listeria monocytogene,
    • gram-negative anaerobes: Prevotella spp., Bacteroides fragilis, Bacteroides spp., Porphyromonas spp., Fusobacterium spp., Fusobacterium nucleatum, Eikenella corrodens, Capnocytophaga spp.,
    • grid-ana anaerobes: Peptostreptococcus spp., Peptostreptococcus magnus, Peptostreptococcus micros, Peptostreptococcus niger, Clostridium spp.,
    • Ena: Treponema pallidum, Leptospira icterohaemorrhagiae, Borrelia burgdorferi.

    Ma tizilombo totsatirawa amadziwika ndi kupezeka kwa kuphatikiza kwa amoxicillin ndi clavulanic acid:

    • gram-positive aerobes: streptococci of the Viridans group, Corynebacterium spp., Streptococcus pneumoniae (mitundu ya mabakiteriya yamtunduwu simatulutsa β-lactamases, ndipo kuthandizira kwamankhwala kumatsimikiziridwa ndi zotsatira za maphunziro azachipatala), Enterococcus faecium,
    • gram-negative aerobes: Shigella spp., Escherichia coli, Salmonella spp., Klebsiella spp., Klebsiella pneumoniae, Klebsiella oxytoca, Proteus spp., Proteus vulgaris, Proteus mirabilis.

    Mabakiteriya otsatirawa amakhala osagwirizana ndi mankhwalawa, omwe amaphatikiza amoxicillin ndi clavulanic acid:

    • gram-negative aerobes: Yersinia enterocolitica, Acinetobacter spp., Stenotrophomonas maltophilia, Citrobacter freundii, Serratia spp., Enterobacter spp, Pseudomonas spp., Hafnia alvei, Providencia spp., Morganella morganii, Legionella pneum
    • ena: Coxiella burnetii, Chlamydia psittaci, Chlamydia pneumoniae, Chlamydia spp., Mycoplasma spp.

    Kuzindikira kwa pathogen kwa amoetyillin monotherapy kumasonyezanso chidwi chofananacho ndikuphatikizidwa kwa amoxicillin ndi clavulanic acid.

    Pharmacokinetics

    Clavulanic acid ndi amoxicillin amayamba msanga ndipo pafupifupi 100% amatengedwa kuchokera m'matumbo am'mimba (GIT) mukamamwa. Kuyamwa kwa yogwira zigawo za Augmentin amatengedwa mulingo woyenera pamene mankhwalawa alowa m'thupi kumayambiriro kwa chakudya.

    Kugwiritsa ntchito poyimitsidwa pakamwa pakamwa kunaphunziridwa m'mayesero azachipatala omwe odzipereka athanzi azaka ziwiri mpaka 12 anachita nawo. Adatenga Augmentin mu Mlingo wa 125 mg / 31.25 mg 5 ml pamimba yopanda 3 mgulu wogawika, tsiku lililonse ndi amoxicillin ndi clavulanic acid 40 ndi 10 mg / kg, motero. Chifukwa cha kuyesaku, magawo a pharmacokinetic otsatirawa adapezeka:

    • clavulanic acid: kuchuluka kwathunthu kwa 2.7 ± 1.6 mg / ml, nthawi yoti mufikire pazinthu zambiri za ma plasma a maola 1.6 (osiyanasiyana maola 1-2), AUC 5.5 ± 3.1 mg × h / ml, kuthetsa theka-moyo wa 0,94 ± 0.05 maola,
    • amoxicillin: ndende yayikulu 7.3 ± 1.7 mg / ml, nthawi yofika pazinthu zambiri za plasma 2.1 maola (osiyanasiyana 1,2-3 maola), AUC 18.6 ± 2.6 mg × h / ml Kutha kwa theka-moyo wa maora a 1.0 ± 0,33.

    Kafukufuku wowerengeka wamakhalidwe a pharmacokinetics a Augmentin adachitidwanso ndikuwatenga monga mapiritsi, mapiritsi okhala ndi filimu (pamimba yopanda kanthu). Zotsatira za kudziwa magawo a pharmacokinetic kutengera mphamvu za Augmentin, clavulanic acid ndi amoxicillin mu Mlingo wosiyanasiyana anali motere:

    • piritsi limodzi la Augmentin ndi muyezo wa 250 mg / 125 mg: kwa amoxicillin - kuchuluka kwambiri kwa 3,7 mg / l, nthawi yoti mufikire pazambiri za plasma ndende ya maola a 1.1, AUC (dera lomwe limapendekera "nthawi yayitali" h / ml theka-moyo (T1/2) 1 ora. Kwa clavulanic acid, kuchuluka kwathunthu ndi 2.2 mg / l, nthawi yofika ndende yambiri m'madzi am'magazi ndi maora a 1,2, AUC 6.2 mg × h / ml, T1/2 - Maola 1.2
    • mapiritsi awiri a Augmentin omwe ali ndi Mlingo wa 250 mg / 125 mg: kwa amoxicillin - kuchuluka kwambiri kwa 5.8 mg / l, nthawi yofikira kuchuluka kwa plasma yambiri kwa maola 1.5, AUC 20,9 mg × h / ml, T1/2 - Maola 1.3. Kwa clavulanic acid, kuphatikiza kwakukulu ndi 4.1 mg / L, nthawi yofika ndende yozama kwambiri ya plasma ndi maola 1.3, AUC 11.8 mg × h / ml, T1/2 - 1 ora
    • piritsi limodzi la Augmentin ndi muyezo wa 500 mg / 125 mg: kwa amoxicillin - kuchuluka kwa 6.5 mg / l, nthawi yofikira kuchuluka kwakukulu kwa plasma kwa maola 1.5, AUC 23.2 mg × h / ml, T1/2 - Maola 1.3. Kwa clavulanic acid, kuchuluka kwathunthu ndi 2.8 mg / l, nthawi yofika ndende yambiri m'madzi am'magazi ndi maola 1.3, AUC 7.3 mg × h / ml, T1/2 - maola 0,8
    • amoxicillin payokha pa mlingo wa 500 mg: pazipita ndende 6.5 mg / l, nthawi yofika pazipita plasma ndende maola 1,3, AUC 19.5 mg × h / ml, T1/2 - Maola 1.1
    • asidi clavulanic yekha muyezo wa 125 mg: pazipita 3,4 mg / l, nthawi yofika kwambiri plasma ndende 0,9, AUC 7.8 mg × h / ml, T1/2 - maola 0,7.

    Ma pharmacokinetics a mankhwalawo adafufuzidwanso ndi makulidwe othandizira a Augmentin kwa odzipereka athanzi. Zotsatira zake, magawo a pharmacokinetic otsatirawa adalandiridwa kutengera mlingo:

    • Mlingo wa 1000 mg / 200 mg: kwa amoxicillin - kuchuluka kwa kuchuluka kwa 105.4 μg / ml, T1/2 - 0,9 maola AUC 76.3 mg × h / ml, wowonjezera mkodzo mkati mwa maola 6 atangoyambitsidwa ndi 77.4% yogwira ntchito. Kwa clavulanic acid, ndende yayikulu ndi 28,5 μg / ml, T1/2 – Maola 0,9, AUC 27.9 mg × h / ml, wokhathamira mkodzo m'maola 6 oyambilira atatha 63.8% yogwira ntchito,
    • Mlingo wa 500 mg / 100 mg: kwa amoxicillin - ambiri pazomwe 32.2 μg / ml, T1/2 - Maola 1.07, AUC 25,5 mg × h / ml, wokhathamira mkodzo m'maola 6 oyambilira atatha 66,5% yogwira ntchito. Kwa clavulanic acid, kuphatikiza kwakukulu ndi 10,5 μg / ml, T1/2 - maola 1.12, AUC 9.2 mg × h / ml, wokhathamira mkodzo m'maola 6 oyambilira atatha 46% yogwira ntchito.

    Onse akamamwa pakamwa ndi kudzera m'mitsempha, clavulanic acid ndi amoxicillin mu mankhwala othandizira amatsimikiza mu mkati mwa madzi ndi ziwalo zosiyanasiyana (mu minofu yam'mimba, adipose ndi minofu minofu, khungu, chikhodzodzo, zotupa zotulutsa, bile, peritoneal and synovial zakumwa).

    Zonsezi zomwe zimagwira mu Augmentin zimangokhala zolimba kumapuloteni a plasma. Zotsatira zakuwonetserazi zikuwonetsa kuti kuchuluka kwa kumanga kwa mapiritsi a amoxicillin ndi mapuloteni a plasma pafupifupi 18%, ndi clavulanic acid - 25%. Kuyesa kwanyama sikutsimikizira kuchuluka kwa zinthu zogwira ntchito m'ziwalo zilizonse.

    Amoxicillin amadutsa mkaka wa m'mawere, amenenso amatsimikiza clavulanic acid mofufuza. Zotsatira zoyipa za zinthu izi pa thanzi la ana oyamwa, kuwonjezera pa chitukuko cha ma membrane a mucous a mucous mkamwa, kutsekula m'mimba komanso chiwopsezo cha chidwi, sizinadziwike.

    Kafukufuku wokhudzana ndi kubereka mu nyama mukamagwiritsa ntchito amoxicillin osakanikirana ndi clavulanic acid adawonetsa kuti magawo omwe amagwira ntchito a Augmentin amalowera pazolepheretsa, koma musakhale ndi vuto pa mwana wosabadwayo.

    Kuchokera pa 10 mpaka 25% ya muyezo wovomerezeka wa amoxicillin umachotsedwa mu mkodzo mwa penicilloic acid, metabolite yomwe siziwonetsa ntchito ya pharmacological. Clavulanic acid imapangidwa mozama kwambiri, ndikupanga 1-amino-4 hydroxy-butan-2-one ndi 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid, ndipo imachotsedwa kudzera m'matumbo am'mimba , ndi mkodzo, komanso ndi mpweya wotuluka mu mawonekedwe a mpweya woipa.

    Amoxicillin amachotseredwa makamaka kudzera mu impso, pomwe clavulanic acid imadziwika ndi aimpso komanso makina owonjezera mphamvu. Pafupifupi 45-65% ya clavulanic acid ndi 60-70% ya amoxicillin amachotsedwa mu mkodzo nthawi yoyamba ya 6 atatenga piritsi limodzi la 500 mg / 125 mg kapena 250 mg / 125 mg kapena atabayidwa jakisoni imodzi ya Augmentin pa mlingo wa 500 mg / 100 mg kapena 1000 mg / 200 mg. Kupanga munthawi yomweyo kwa phenenecid kumalepheretsa kuwonetsa kwa amoxicillin, koma sikukhudza kuwonongeka kwa clavulanic acid.

    Zizindikiro zogwiritsidwa ntchito

    Malinga ndi malangizo, Augmentin amatchulidwa kuti apatsidwe matenda oyambitsidwa ndi bakiteriya omwe amayang'anira maantibayotiki:

    • matenda a pakhungu, minofu yofewa,
    • matenda kupuma thirakiti: bronchitis, logi bronchopneumonia, kupuma, zotupa zam'mapapo,
    • matenda a genitourinary dongosolo: cystitis, urethritis, pyelonephritis, mimba sepsis, syphilis, chinzonono, matenda a ziwalo za m'chiuno,
    • matenda a mafupa ndi mafupa: osteomyelitis,
    • matenda a odontogenic: periodontitis, odontogenic maxillary sinusitis, mano akulu
    • matenda akuwuka ngati zovuta pambuyo pa opaleshoni: peritonitis.

    Contraindication

    • Hypersensitivity kuti clavulanic acid, amoxicillin, ena mwa mankhwala ndi beta-lactam mankhwala (cephalosporins, penicillin) mu anamnesis,
    • m'mbuyomu jaundice kapena chiwindi kukomoka mukamagwiritsa ntchito mankhwala osakanikirana a clavulanic acid okhala ndi amoxicillin m'mbiri
    • impso mkhutu ntchito (ufa pakukonzekera kuyimitsidwa kwa pakamwa makonzedwe a 200 mg / 28,5 mg ndi 400 mg / 57 mg, mapiritsi 875 mg / 125 mg),
    • phenylketonuria (ufa wa kuyimitsidwa kwamlomo).

    Contraindication ku Augmentin kwa ana: mapiritsi - mpaka zaka 12 ndi kulemera kwa thupi osakwana 40 makilogalamu, ufa wopuma pakamwa 400 mg / 57 mg ndi 200 mg / 28,5 mg - mpaka miyezi itatu.

    Ngati chiwindi chayamba kugwira ntchito, Augmentin ayenera kumwedwa mosamala.

    Panthawi yoyembekezera komanso yoyamwitsa, kusankha kwa kugwiritsa ntchito mankhwalawa kumachitika ndi adokotala.

    Malangizo ogwiritsira ntchito Augmentin: njira ndi mlingo

    Augmentin asanaikidwe, tikulimbikitsidwa kumayesedwa kuti tidziwe momwe microflora yapangidwira matendawa. Kenako, dokotalayo akhazikitsa njira yolingirira zaka za wodwalayo, kulemera kwake, ntchito ya impso, komanso kuopsa kwa matendawo.

    Njira yochepetsetsa yothandizira ndi masiku 5, nthawi yayitali yodzichiritsa popanda kusintha matendawa ndi milungu iwiri. Imwani mankhwala kumayambiriro kwa chakudya.

    Ngati ndi kotheka, nthawi yoyamba yomwe mankhwalawa amathandizidwa ndi makolo, ndiye kuti akutsegulidwa pakamwa.

    Mlingo woyenera mukamamwa mapiritsi a Augmentin a ana opitirira zaka 12 ndi akulu:

    • vuto la matenda ofatsa pang'ono: piritsi limodzi (250 mg + 125 mg) katatu patsiku,
    • matenda oopsa kapena opweteka kwambiri: piritsi limodzi (500 mg + 125 mg) katatu patsiku kapena piritsi limodzi (875 mg + 125 mg) kawiri pa tsiku.

    Chofunika: Mapiritsi awiri a 250 mg / 125 mg siofanana ndi piritsi limodzi la 500 mg / 125 mg.

    Mlingo woyenera mukamayimitsidwa Augmentin:

    • ana opitirira zaka 12 ndi akulu: 11 ml ya kuyimitsidwa kwa 400 mg / 57 mg / 5 ml kawiri pa tsiku (lolingana ndi piritsi 1 la 875 mg + 125 mg),
    • ana kuyambira miyezi itatu mpaka zaka 12 (masekeli mpaka 40 makilogalamu): mlingo wa tsiku ndi tsiku umatsimikizika potengera kulemera kwa thupi ndi msinkhu (ml kwa kuyimitsidwa, kapena mg / kg / tsiku). Mtengo wowerengedwa uyenera kugawidwa pazidutswa zitatu ndi gawo la maola 8 (kuyimitsidwa kwa 125 mg / 31.25 mg / 5 ml), kapena Mlingo 2 (kuyimitsidwa kwa 400 mg / 57 mg / 5 ml kapena 200 mg / 28,5 mg / 5 ml) pakapita maola 12. Kwa kuyimitsidwa kwa 125 mg / 31.25 mg / 5 ml, Mlingo wotsika - 20 mg / kg / tsiku, mlingo waukulu wa ** - 40 mg / kg / tsiku. Kwa kuyimitsidwa kwa 400 mg / 57 mg / 5 ml ndi 200 mg / 28,5 mg / 5 ml, Mlingo wotsika ndi 25 mg / kg / tsiku, Mlingo waukulu ndi 45 mg / kg / tsiku.

    * Mlingo wochepa umagwiritsidwa ntchito pochiza matendawa komanso matenda a minofu yofewa ndi khungu.

    ** Mlingo wofunikira umafunikira mankhwalawa a sinusitis, atitis media, matenda a mafupa ndi mafupa, kwamkodzo komanso kupuma.

    Mlingo woyenera wa Augmentin mu njira yothetsera mtsempha wama mtsempha (iv):

    • Ana opitirira zaka 12 ndi akulu: 1000 mg / 200 mg katatu patsiku (maola 8 aliwonse), atatenga matenda oopsa, nthawi yochepetsera jakisoni itha kuchepetsedwa mpaka maola 4-6,
    • ana kuyambira miyezi itatu kufika zaka 12: katatu patsiku pamlingo wa 50 mg / 5 mg / kg kapena 25 mg / 5 mg / kg kutengera ndi zovuta za matendawa, nthawi pakati pa jakisoni ndi maola 8,
    • ana osakwana zaka 3 miyezi: ndi thupi lolemera kuposa 4 kg - 25 mg / 5 mg / kg kapena 50 mg / 5 mg / kg maola 8 aliwonse, ndi thupi lolemera zosakwana 4 kg - 25 mg / 5 mg / kg maola 12 aliwonse.

    Augmentin amayenera kumwedwa mosamala pa mankhwala omwe adokotala adawalamulira, kuwonetsetsa kuti apatsidwa mlingo.

    Zotsatira zoyipa

    Kugwiritsa ntchito Augmentin nthawi zina kumatha kuyambitsa zotsatirazi (makamaka zofatsa komanso zazifupi):

    • hematopoietic dongosolo: thrombocytopenia, leukopenia (kuphatikizapo neutropenia), hemolytic anemia ndi agranulocytosis (kusintha), kuchuluka kwa prothrombin index ndi nthawi ya magazi,
    • chitetezo chamthupi: matupi awo sagwirizana ndi anaphylaxis, angioedema, matenda ofanana ndi seramu matenda, Stevens-Johnson syndrome, Matupi a vasculitis, poyizoni epermatosis, oxous exfoliative dermatitis, pachimake kwambiri pantulosis. Augmentin iyenera kusiyidwa ngati mtundu wina wa khungu ulipo.
    • mawonekedwe a pakhungu: zotupa, urticaria, erythema multiforme,
    • dongosolo lamkati lamanjenje: kuchepa thupi ndi kugwedezeka (kusinthika), kupweteka mutu, chizungulire,
    • chiwindi: cholestatic jaundice, hepatitis, kuchuluka kwapakati pa ACT ndi / kapena ALT (izi zoyipa zimachitika pakubala kapena pambuyo pake, makamaka mwa odwala okalamba komanso mwa abambo (omwe amakhala ndi chithandizo chachitali), mwa ana - kawirikawiri, ndipo ali zosinthika)
    • kwamikodzo dongosolo: crystalluria, interstitial nephritis.

    Nthawi zambiri, kugwiritsa ntchito Augmentin kumatha kuyambitsa matenda otsegula m'mimba mwa akulu ndi ana, nseru, kusanza, dyspepsia (zovuta zam'mimba izi zitha kuchepetsedwa ngati mumwa mankhwala ndikudya).

    Nthawi zina, mwa ana omwe atenga kuyimitsidwa kwa Augmentin, mtundu wa chovala chapamwamba cha enamel ya mano amatha kusintha.

    Mphamvu yachilengedwe yokhudzana ndi mankhwala nthawi zambiri imayambitsa matenda a mucous membrane, nthawi zina amatha kuyambitsa hemorrhagic ndi pseudomembranous colitis.

    Mankhwala

    Mankhwala
    Njira yamachitidwe
    Amoxicillin ndi penicillin wopanga-piritsi (beta-lacgamotic) yemwe amaletsa ma enzyme amodzi kapena angapo (omwe amadziwika kuti mapuloteni omanga penicillin) pa biosynthesis ya bacterius peptidoglycan, womwe ndi gawo lolumikizana la khoma la bakiteriya. Kuletsa kwa peptidoglycan kaphatikizidwe kumayambitsa kuwonda kwa khungu la maselo, komwe pambuyo pake kumayambitsa lysis ndi kufa kwa cell.
    Amoxicillin amawonongeka ndi beta-lactamases opangidwa ndi mabakiteriya osagwira, chifukwa chake zochita za amoxicillin palokha siziphatikiza ma tizilombo omwe amapanga ma enzymes awa.
    Clavulanic acid ndi beta-lactamase inhibitor mogwirizana ndi penicillins. Clavulanic acid imalepheretsa ma enzymes ena a beta-lactamase, potero imalepheretsa mphamvu ya amoxicillin. Clavulanic acid yokhayo sikuwonetsa kwambiri antibacterial.
    Ubale wa pharmacokinetics / pharmacodynamics
    Choyimira chachikulu chodziwikitsa kugwira ntchito kwa amoxicillin ndi nthawi yochulukirapo pazocheperako zoletsa zina (T> IPC).
    Kukana mapangidwe limagwirira
    Pali njira ziwiri zazikulu zopangira kukana kwa amoxicillin / clavulanic acid:
    • Kukhazikika kwa iwo a beta-lactamase omwe sanalepheretsedwe ndi clavulanic acid, kuphatikizapo beta-lactamases yamakalasi B, C ndi D.
    • Zosintha zamapuloteni omanga ma penicillin, zomwe zimapangitsa kuchepa kwa mgwirizano wa antibacterial pazomwe akuchita.
    Kuphatikiza apo, kusintha kwa kupendekera kwa chipolopolo cha tizilombo, komanso kufotokozera kwa mapampu a efflux, kumatha kuyambitsa kapena kuthandizira pakukula kwa bakiteriya, makamaka mabakiteriya osagwiritsa ntchito gramu.
    Kutengeka kwa mabakiteriya azamankhwala kumasiyana mosiyanasiyana ndi dera komanso nthawi. Ndikofunika kuti muzisamala ndi zidziwitso zakumudzi zam'deralo, makamaka pankhani yothandizira matenda oopsa. Akatswiri ayenera kufunsidwa ngati deta yakumaloko ikukayikira kuchuluka kwa mankhwalawa pochiza matenda ena ake.
    Tizilombo tating'onoting'ono tomwe timayambira
    Aerobic gram zabwino tizilombo:
    Enterococcus faecalis, Gardnerella vaginalis, Staphylococcus aureus, methicillin-sens *, coagulase-negative staphylococci (wodwala wa methicillin), Streptococcus agalactiae, Streptococcus pneumoniae1,Streptococcus pyogene ndi ena beta hemolytic streptococci, gulu Streptococcus viridans.
    Aerobic gram-hasi tizilombo:
    Capnocytophaga spp., Eikenella corrodens, Haemophilus influenzae 2, Moraxella catarrhalis, Pasteurella multocida
    Ma tizilombo a Anaerobic:
    Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp.
    Ma microorganism omwe anakwanitsa kupewa
    Aerobic gram zabwino tizilombo:
    Enterococcus faecium **
    Aerobic gram-hasi tizilombo:
    Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris
    Tizilombo toyambitsa mwachilengedwe
    Aerobic gram-hasi tizilombo tating'onoting'ono
    Acinetobacter sp., Citrobacter freundii, Enterobacter sp., Legionella pneumophila, Morganella morganii, Providencia spp., Pseudomonas sp., Serratia sp., Stenotrophomonas maltoph.ilia
    Tizilombo tina tosiyanasiyana
    Chlamydophilia pneumoniae, Chlamodophila psittaci, Coxiella burnetti, Mycoplasma pneumoniae.
    * Ma staphylococci onse okhala ndi methicillin amagwirizana ndi amoxicillin / clavulanic acid. "Kuzindikira kwachilengedwe kwachilengedwe pakakhala kuti palibe njira yolimbirana yomwe idatengedwa.
    1 Drug Augmentin, ufa woyimitsidwa pakamwa, 200 mg / 28,5 mg mu 5 ml ndi 400 mg / 57 mg mu 5 ml, wosayenera mankhwalawa opatsirana ndi penicillin omwe amalimbana ndi chibayo cha Streptococcus pneumoniae (onani. magawo "Mlingo ndi Ulamuliridwe" ndi "Njira zopewera").
    M'mayiko ena a EU, zovuta zoperewera zimanenedwa pafupipafupi kupitirira 10%.
    Pharmacokinetics
    Zogulitsa
    Amoxicillin ndi clavulanic acid ndizosungunuka kwathunthu muzinthu zamadzimadzi ndi pH ya thupi. Zinthu zonsezi zimatengedwa mwachangu komanso bwino kuchokera m'matumbo am'mimba (GIT) pambuyo pakamwa. Mafuta a yogwira zinthu ndi mulingo woyenera kumwa mankhwala kumayambiriro kwa chakudya. Pambuyo pakamwa, bioavailability wa amoxicillin ndi clavulanic acid ndi 70%. Ma paracokinetic magawo awiri onsewa ndi ofanana, nthawi yoti afike pazowonjezera za plasma concentration (Tmax) ili pafupifupi ola limodzi.
    Pansipa pali zotsatira za pharmacokinetic za kafukufuku womwe mapiritsi a amoxicillin / clavulanic acid (mlingo 875 mg / 125 mg) amatengedwa ndi odzipereka athanzi kawiri patsiku pamimba yopanda kanthu.

    Mtengo wapakati wa magawo a pharmacokinetic (± kupatuka mwanjira wamba)

    AUC (0-244) (μg x h / ml)

    Amoxicillin / clavulanic acid 875 mg / 125 mg

    Amoxicillin / clavulanic acid 875 mg / 125 mg

    Bongo

    Ndi mankhwala osokoneza bongo a Augmentin, kuphwanya kayendedwe kazinthu zamagetsi zamagetsi ndi zizindikiro zoyipa zam'mimba zitha kuwonedwa. Pali malipoti a kakulidwe ka amoxicillin crystalluria, komwe nthawi zina kunapangitsa kulephera kwa impso. Odwala omwe ali ndi vuto la impso, komanso ena omwe amamwa mankhwalawa muyezo, amatha kugwidwa.

    Kuyimitsa zinthu zoyipa zomwe zimagwirizana ndi kugwira ntchito kwa m'mimba, chithandizo cha mankhwala chimayikidwa, pakusankha komwe kuyenera kuyang'aniridwa mwapadera kuti matenda akhale ndi mulingo wamadzi. Clavulanic acid ndi amoxicillin amatha kuchotsedwa mu kayendedwe kazinthu mwa njira ya hemodialysis.

    Kafukufuku woyembekezeredwa kumalo opezeka ndi toxology omwe ana 51 adachitapo kanthu adatsimikiza kuti kuperekera kwa amoxicillin mu mlingo wosaposa 250 mg / kg sikunachititse kukula kwa matenda ofunika kwambiri a bongo ndipo sikunafunikire kuti pakhale thovu.

    Pambuyo pokonzekera kulowetsedwa kwa amoxicillin mu waukulu Mlingo, imatha kukhala chikhodzodzo mu ma catheters, kotero kuti mawonekedwe awo amayenera kuwunikidwa pafupipafupi.

    Malangizo apadera

    Pa chithandizo cha Augmentin, ndikofunikira kuti mupange mbiri yakale yatsatanetsatane mwatsatanetsatane kuti mudziwe ngati panali zochitika zina za hypersensitivity za cephalosporins, penicillin kapena allergen ena.

    Zochitika zazikuluzikulu za anaphylactoid, nthawi zina zakupha, zanenedwapo nthawi zina. Makamaka chiwopsezo chachikulu chotere cha odwala omwe ali ndi mbiri ya hypersensitivity kwa penicillin. Ngati matendawo apezeka, chithandizo cha Augmentin chiyenera kuyimitsidwa nthawi yomweyo; woopsa, adrenaline ayenera kutumikiridwa nthawi yomweyo. Pangakhale kufunika kwa mankhwala a oxygen, kuphatikizira kwa glucocorticosteroids, kuonetsetsa kuti patuluka mpweya, kuphatikizapo kulowetsamo.

    Ndi kugwiritsidwa ntchito kwa nthawi yayitali kwa Augmentin, chiopsezo cha kubereka kwambiri kwa tizilombo ting'onoting'ono tosakhudzidwa ndi icho chikukula.

    Mimba komanso kuyamwa

    Zotsatira za maphunziro a ntchito yobereka mu nyama yokhala ndi makulidwe a Parementin ndi pakamwa a Augmentin zimatsimikizira kusakhalapo kwa teratogenic zotsatira zoyambitsidwa ndi mankhwalawa. Kafukufuku amodzi, omwe adachitika mwa odwala omwe ali ndi vuto losakhazikika lamankhwala, akuti prophylactic mankhwala omwe ali ndi antiotic antiotic amatha kuonjezera chiopsezo cha necrotizing enterocolitis mu akhanda. Chifukwa chake, Augmentin iyenera kugwiritsidwa ntchito pokhapokha ngati phindu la chithandizo cha mayiyo limaposa kwambiri zovuta zomwe zingachitike pa mwana wosabadwayo.

    Kukhazikitsidwa kwa Augmentin panthawi yotsekera ndikuloledwa. Komabe, ngati ana akukhala ndi zovuta (candidiasis ya mucous membrane wamkamwa, kutsekula m'mimba, kuchuluka kwa chidwi), tikulimbikitsidwa kusiya kuyamwitsa.

    Gwiritsani ntchito paubwana

    Kukhazikitsidwa kwa Augmentin kwa ana kumaloledwa malinga ndi zomwe zikuwonetsedwa pazotsatira:

    • ufa pakukonzekera kuyimitsidwa koyendetsa pakamwa ndi ufa pakukonzekera njira yothetsera utsogoleri wa iv - kuyambira pobadwa,
    • mapiritsi okhala ndi filimu - kuyambira zaka 12.

    Ndi mkhutu aimpso ntchito

    Odwala omwe ali ndi vuto la impso, kusintha kwa mankhwalawa kumadalira kuchuluka kwa achire a amoxicillin ndipo amachokera ku clearinine chilolezo (CC).

    Mukamamwa ndi odwala achikulire omwe ali ndi CC yoposa 30 ml / min, mapiritsi a Augmentin omwe ali ndi mlingo wa 500 mg / 125 mg kapena 250 mg / 125 mg, komanso kuyimitsidwa ndi mlingo wa 125 mg / 31.25 mg mu 5 ml, palibe chifukwa choti musinthe mlingo. Ngati mtengo wa QC uli kuyambira 10 mpaka 30 ml / mphindi, odwala akulimbikitsidwa kuti atenge piritsi limodzi la 500 mg / 125 mg kapena piritsi limodzi la 250 mg / 125 mg (kwa matenda ofatsa pang'ono) kawiri pa tsiku kapena 20 ml ya kuyimitsidwa kwa 125 mg / 31.25 mg mu 5 ml 2 pa tsiku.

    Ndi mtengo wa CC wochepera 10 ml / min, Augmentin amagwiritsidwa ntchito pa mlingo wa 1 piritsi 500 mg / 125 mg kapena piritsi limodzi 250 mg / 125 mg (kwa matenda ofatsa pang'ono) 1 nthawi patsiku kapena 20 ml ya kuyimitsidwa kwa 125 mg / 31.25 mg mu 5 ml kamodzi patsiku.

    Mapiritsi a 875 mg / 125 mg amangoperekedwa kwa odwala omwe CC yawo imadutsa 30 ml / min; chifukwa chake, kusintha kwa mlingo sikofunikira. Nthawi zambiri, utsogoleri wa Augmentin umalimbikitsidwa.

    Mukamagwiritsidwa ntchito kwa achikulire ndi ana opitirira zaka 12 kapena akulemera kuposa 40 makilogalamu omwe ali ndi hemodialysis, muyezo wa Augmentin ndi piritsi limodzi 500 mg / 125 mg (mapiritsi awiri 250 mg / 125 mg) kamodzi pa maola 24 kapena 20 ml Kuyimitsidwa 125 mg / 31.25 mg 1 nthawi patsiku.

    Panthawi ya dialysis, komanso kumapeto kwake, wodwala amalandira piritsi limodzi (1 piritsi), lomwe limakupatsani mwayi wothandizira kuchepa kwa ndende ya clavulanic acid ndi amoxicillin mu seramu yamagazi.

    Kuyanjana kwa mankhwala osokoneza bongo

    Mankhwala a probenecid ndi ofanana nawo (phenylbutazone, diuretics, NSAIDs) amachepetsa katulutsidwe ka tubular wa amoxicillin. Ndi munthawi yomweyo makonzedwe ali osavomerezeka, chifukwa amatha kumayendera limodzi ndi kulimbikira komanso kuwonjezeka kwa ndende ya amoxicillin m'magazi (pomwe impso excretion ya clavulanic acid sikuchepetsa).

    Zakudya za Augmentin zimatha kuthana ndi vuto la kulera kwapakamwa, kuchepetsa kutha kwake (wodwalayo ayenera kudziwa za izi).

    Augmentin mu mawonekedwe a yankho la jakisoni sangasakanikirane ndi aminoglycoside maantivitamini omwewo mu syringe yomweyo, chifukwa pamenepa amasiya kuchita. Ndizosavomerezeka kusakaniza ndi mayankho a kulowetsedwa okhala ndi dextran, dextrose ndi sodium bicarbonate. Osasakanikirana ndi zinthu zamagazi, ndi njira zina zama protein (protein hydrolysates), ndi ma lipid emulsions a intravenous (iv) makonzedwe.

    Maantibiotic omwe ali ndi zinthu zomwezi: Amoxiclav, Arlet, Clamosar, Bactoclav, Verklav, Liklav, Panclav, Rapiklav, Ranklav, Medoklav, Flemoklav Solutab, Ekoklav, Fibell.

    Zofanizira za Augmentin ndi makina amachitidwe, mankhwala am'magulu amodzi a mankhwala: Ampiok, Ampisid, Libakcil, Oxamp, Oxampicin, Oxamsar, Sulbacin, Sultasin, Santaz, etc.

    Migwirizano ndi machitidwe osungidwa

    Sungani pamatenthedwe mpaka 25 ° C pamalo owuma patali ndi ana.

    • mapiritsi okhala ndi amoxicillin a 875 mg ndi 250 mg - zaka 2,
    • mapiritsi a amoxicillin 500 mg - zaka 3,
    • ufa wowonjezera njira yothetsera mtsempha wama khosi - zaka 2,
    • ufa w kuyimitsidwa mwa mawonekedwe osagwirizana - zaka 2,
    • kuyimitsidwa mokonzekera (kutentha mkati mwa 2-8 ° C) - masiku 7.

    Ndemanga za Augmentin

    Odwala amasiyira ndemanga zabwino za Augmentin mwanjira ya mapiritsi ndi kuyimitsidwa kwa ana, kuzidziwitsa kuti ndi ogwira ntchito komanso odalirika. Muyezo wapakati wama mankhwalawa m'mapulogalamu apadera ndi 4.3-4.5 mwa mfundo 5. Amayi ambiri amakhala ndi chidwi ndi kuyimitsidwa kwake, chifukwa amakulolani mwachangu komanso moyenera kuthana ndimatenda a ana pafupipafupi ngati tonsillitis kapena bronchitis. Kuphatikiza apo, kuyimitsidwako kumakhala ndi kukoma kosangalatsa, chifukwa chomwe ana amawakonda kwambiri.

    Komanso, mwayi wa Augmentin amatengedwa kuti ndi mwayi wakugwiritsira ntchito kwake kwa amayi apakati, makamaka mu trimesters II ndi III. Madotolo ati nthawi imeneyi kuti ichitike bwino pa chithandizo ichi ndikofunika kwambiri kuti muwone momwe mulondola ndi kutsatiridwa.

    Mtengo wa Augmentin m'masitolo ogulitsa mankhwala

    Mtengo wapakati wa Augmentin mu mawonekedwe apiritsi: mlingo 875 mg / 125 mg - 355-388 rubles. pa paketi 14 pcs., mlingo wa 500 mg / 125 mg - 305-421 rubles. pa paketi 14 pcs., Mlingo wa 250 mg / 125 mg - 250-266 rubles. pa paketi 20 ma PC.

    Mutha kugula ufa wokonzekera kuyimitsidwa kwa pakamwa ndi Mlingo wa 125 mg / 31.25 mg mu 5 ml kwa ma ruble 134-158, mlingo wa 200 mg / 28,5 mg mu 5 ml kwa ma ruble 147-162, ndi mlingo wa 400 mg / 57 mg mu 5 ml - kwa ma ruble 250-277.

    Powonjezera pakukonzekera njira yothandizira mtsempha wama mtsempha pakali pano palibe.

    Kusiya Ndemanga Yanu

    https://pobedidijabetes.org

    Posts Popular

    pobedidijabetes.org © Copyright 2024. All Rights Reserved. | Matenda Atsoka!