Momwe mungagwiritsire ntchito Amoxiclav 312?

Ufa woyimitsidwa pakamwa, 156.25 mg / 5 ml ndi 312.5 mg / 5 ml

5 ml ya kuyimitsidwa (kipimo 1 cha pipette) chili

ntchito: amoxicillin monga amoxicillin trihydrate 125 mg, clavulanic acid monga potaziyamu clavulanate 31.25 mg (wa mulingo wa 156.25 mg / 5 ml) kapena amoxicillin ngati amoxicillin trihydrate 250 mg, clavulanic acid ngati potaziyamu clavulanate 62,5 mg (wa Mlingo 312,5 mg / 5 ml)

obwera: anhydrous citric acid, anhydrous sodium citrate, microcrystalline cellulose, sodium carboxymethyl cellulose, xanthan chingamu, anhydrous colloidal silicon dioxide, silicon dioxide, Strawberry flavour (pa mulingo wa 156.25 mg / 5 ml), Wild Cherry flavor (kwa Mlingo wa 31,5 mg. / 5 ml), sodium benzoate, sodium saccharin, mannitol.

Crystalline ufa kuchokera kuzoyera mpaka zachikaso zopepuka.

Kuyimitsidwa mokonzekereratu ndi kuyimitsidwa kokhazikika kuyambira pafupi yoyera mpaka chikaso.

Mankhwala

Pharmacokinetics

Amoxicillin ndi clavulanic acid amasungunuka kwathunthu mu madzi amchere pH ya thupi. Zonsezi ndizoyamwa bwino pakamwa. Mulingo woyenera kumwa amoxicillin / clavulanic acid mukadzayamba kudya. Pambuyo pakamwa, bioavailability wa amoxicillin ndi clavulanic acid pafupifupi 70%. Mphamvu ya kuchuluka kwa mankhwalawa mu plasma ya zigawo zonse ziwiri ndi zofanana. Pazambiri za seramu ndizodziwikiratu zimafikira ola limodzi pambuyo pa kukhazikitsa.

Mphamvu ya amoxicillin ndi clavulanic acid mu seramu ya magazi mukamamwa mankhwala a amoxicillin / clavulanic acid ndi ofanana ndi omwe amadziwika ndi pakamwa pokhapokha ngati gawo limodzi la amoxicillin ndi clavulanic acid.

Pafupifupi 25% ya kuchuluka kwathunthu kwa clavulanic acid ndi 18% ya amoxicillin amamangiriza mapuloteni a plasma. Kuchuluka kwa magawa pakamwa pakumwa mankhwala pafupifupi 0.3-0.4 l / kg wa amoxicillin ndi 0,2 l / kg wa clavulanic acid.

Pambuyo pokonzanso mtsempha wamagazi, onse amoxicillin ndi clavulanic acid adapezeka mu chikhodzodzo, mafinya am'mimbamo, khungu, mafuta, minofu yamatumbo, zotumphukira ndi zotumphukira, bile ndi mafinya. Amoxicillin amalowa bwino mu madzi a cerebrospinal.

Amoxicillin ndi clavulanic acid amawoloka placental zotchinga. Zinthu zonsezi zimadutsanso mkaka wa mawere.

Amoxicillin amachotsekera pang'ono mu mkodzo wofanana ndi penicillic acid wofanana ndi 10 - 25% ya mlingo woyambirira. Clavulanic acid imapangidwa m'thupi ndi kuponyera mkodzo ndi ndowe, komanso mpweya wa mpweya wothira mpweya.

Kuchulukitsa kwapakati theka la moyo wa amoxicillin / clavulanic acid ndi pafupifupi ola limodzi, ndipo kuvomerezeka kokwanira pafupifupi 25 l / h. Pafupifupi 60-70% ya amoxicillin ndi 40-65% ya clavulanic acid amachotsedwa mu mkodzo mkati mwa maola 6 atatha kumwa kamodzi pa mapiritsi a amoxicillin / clavulanic acid. Pa maphunziro osiyanasiyana, zidapezeka kuti 50-85% ya amoxicillin ndi 27-60% ya clavulanic acid amachotsedwa mkodzo mkati mwa maola 24. Kuchuluka kwacrosulanic acid kumachotsedwa pakatha maola 2 mutatha ntchito.

Kugwiritsa ntchito pamodzi kwa phenenecid kumachepetsa kutulutsidwa kwa amoxicillin, koma mankhwalawa samakhudza kutuluka kwa clavulanic acid kudzera mu impso.

Hafu ya moyo wa amoxicillin imakhala yofanana mwa ana a zaka zitatu mpaka ziwiri, komanso mwa ana achikulire ndi akulu. Popereka mankhwala kwa ana aang'ono kwambiri (kuphatikiza ana akhanda) m'milungu yoyamba ya moyo, mankhwalawa sayenera kuperekedwa kawiri patsiku, omwe amalumikizidwa ndi kusakhazikika kwa njira ya impso kwa ana. Chifukwa chakuti okalamba omwe ali ndi vutoli amatha kuvutika ndi vuto la impso, mankhwalawa ayenera kuyikidwa mosamala ku gulu la odwala, koma ngati kuli kotheka, kuyang'anira ntchito yaimpso kuyenera kuchitika.

Chilolezo chonse cha amoxicillin / clavulanic acid m'madzi am'magazi amachepetsa mwachindunji kuchepa kwa impso. Kuchepa kwa chilolezo cha amoxicillin kumanenedweratu poyerekeza ndi clavulanic acid, chifukwa kuchuluka kwa amoxicillin kumathandizidwa kudzera mu impso. Chifukwa chake, popereka mankhwala kwa odwala omwe amalephera aimpso, kusintha kwa mankhwalawa ndikofunikira kuti muchepetse kuchuluka kwa amoxicillin ndikukhalabe wofunikira clavulanic acid.

Popereka mankhwala kwa odwala omwe ali ndi vuto la chiwindi, muyenera kusamala posankha mlingo ndikuwonetsetsa ntchito ya chiwindi.

Mankhwala

Amoxicillin ndi mankhwala osokoneza bongo opangidwa kuchokera ku gulu la penicillin (beta-lactam antibiotic) yomwe imalepheretsa ma enzymes amodzi (omwe nthawi zambiri amatchedwa ma penicillin-binding protein) omwe amaphatikizidwa ndi biosynthesis ya peptidoglycan, yomwe ndi gawo lofunikira kwambiri la khoma la bakiteriya. Kuletsa kwa peptidoglycan synthesis kumayambitsa kufooka kwa khungu la cell, nthawi zambiri kumatsatiridwa ndi lysis l cell ndi cell cell.

Amoxicillin amawonongeka ndi beta-lactamases opangidwa ndi mabakiteriya osagwira, chifukwa chake zochitika za amoxicillin zokha sizimakhala ndi tizilombo tating'onoting'ono timene timatulutsa michere.

Clavulanic acid ndi beta-lactam mwapangidwe kogwirizana ndi penicillin. Imalepheretsa ma beta-lactamase, potero kuletsa kuyatsidwa kwa amoxicillin ndikukulitsa zochitika zake. Clavulanic acid yokha ilibe mphamvu yokhudza antibacterial.

Kuchulukitsa nthawi yopitilira muyeso wosachepera (T> IPC) imawerengedwa kuti ndiyo yofunika kwambiri pakuwonetsa mphamvu ya amoxicillin.

Njira ziwiri zomwe zingalimbane ndi amoxicillin ndi clavulanic acid ndi:

inactivation ndi bacteria beta-lactamases omwe saponderezedwa ndi clavulanic acid, kuphatikiza makalasi B, C ndi D.

kusintha kwa mapuloteni omangira penicillin, omwe amachepetsa kuyanjana kwa antibacterial wothandizila ku pathogen yomwe akufuna.

Kusakhudzidwa kwa mabakiteriya kapena njira ya pampu ya efflux (kayendedwe ka zinthu) kumatha kuyambitsa kapena kupitiliza kulimbana ndi mabakiteriya, makamaka mabakiteriya osavomerezeka.

Mfundo za MIC zokhala amoillillin / clavulanic acid ndizomwe zimatsimikiziridwa ndi Komiti ya European for Testing of Antimicrobial Sensitivity (EUCAST).

Kutulutsa mafomu ndi kapangidwe kake

Mlingo wa mankhwalawa mwanjira yowoneka ndi ufa woyera womwe umapangidwira kukonzekera kuyimitsidwa. Kuphatikizidwa kwa 250 mg ya amoxicillin trihydrate (kapena 500 mg) ndi 62 mg ya clavulanic acid mu mawonekedwe a mchere wa potaziyamu (125 mg) amagwiritsidwa ntchito ngati mankhwala ena. Kupititsa patsogolo kuthandizira komanso kupititsa patsogolo phindu la bioavailability, zinthu zomwe zimagwiritsidwa ntchito zimaphatikizidwa ndi izi:

• silika wamatumbo oyaka,
• Zithunzi Cherry
• benzoate, carboxycellulose ndi sodium saccharin,
• cellcrystalline mapadi,
• xanthan chingamu,
• mannitol.

Wothandizira antimicrobial amagwiritsidwa ntchito pamaso pa matenda opatsirana.

Mankhwalawa ali m'mbale zamagalasi. Mukapaka ufa ndi madzi owiritsa, kuyimitsidwa kumatha kumapezeka, komwe kumakhala kosakanikirana ndi oyera kapena oyera achikasu.

Zotsatira za pharmacological

Maantibayotiki amagwira mabakiteriya, kupha tizilombo toyambitsa matenda. Magwiridwe ochitapo kanthu amatengera mphamvu ya mankhwala oopsa a amoxicillin, gawo lochititsa chidwi kuchokera ku gulu la penicillin. Beta-lactam wothandizila linalake ndipo tikulephera ndi michere ntchito ya zinthu zomwe zimayambitsa kapangidwe ka peptidoglycan. Izi ndizofunikira pakulumikizana kwachilengedwe ndikulimbikitsa nembanemba wa pathogen yopatsirana. Ikawonongedwa, chipolopolo chakunja chimafinya, ndipo bakiteriya amafa mothandizidwa ndi zosmotic.

Nthawi yomweyo, amoxicillin satha kugwira ntchito polimbana ndi tizilombo tosiyanasiyana tomwe timapanga beta-lactamases. Ma Enzymes amawononga anti-synthetic antiotic, kotero mchere wa potaziyamu wa clavulanic acid unawonjezeredwa ku mankhwala kuti atetezeke. Imalepheretsa zochitika za beta-lactamases, pomwe amoxicillin amayambitsa kufa kwa mabakiteriya. Chifukwa cha kuphatikiza uku, antibacterial agent ali ndi chiwonetsero chokwanira.

Pharmacokinetics

Mukamagwiritsa ntchito kuyimitsidwa pakamwa, ziwalo zonse zogwira ntchito zimamasulidwa mothandizidwa ndi esterases m'matumbo ndipo zimayikiridwa kukhoma la matumbo ochepa. Akalowa m'magazi, semisynthetic penicillin ndi beta-lactam amafika pazofunikira kwambiri za seramu mkati mwa ola limodzi. Zinthu zonsezi sizigwirizana ndi mapuloteni a plasma. Ndi albin, mitundu yovuta imangokhala 18-20% ya zinthu zomwe zimagwira.

Akalowa m'magazi, semisynthetic penicillin ndi beta-lactam amafika pazofunikira kwambiri za seramu mkati mwa ola limodzi.

Amoxicillin amakumana ndi biotransformation mu hepatocytes pamlingo wocheperapo kuposa clavulanic acid. Zinthu zofunikirazi zimachotseredwa kudzera mu impso kudzera mu kusefera kwa mawonekedwe ake oyambirira. Chiwonetsero china cha clavulanate chimachoka m'thupi momwe amapangira michere yokhala ndi ndowe. Kutha kwa theka-moyo kumapangitsa pafupifupi mphindi 60-90.

Zizindikiro zogwiritsidwa ntchito

Mankhwalawa amagwiritsidwa ntchito ngati matenda a bakiteriya omwe amayambitsidwa ndi kukula kosalamulirika kwa tizilombo toyambitsa matenda:

• matenda a chapamwamba kupuma thirakiti ndi ziwalo ENT: pharyngeal abscess, kutupa kwa paranasal ndi paranasal sinuses, otitis media, tonsillitis, sinusitis,
• matenda a m'mapapo ndi bronchi (chibayo, bronchitis),
• matenda a mabala otseguka, kuwonongeka kwa minofu ya mafupa (osteomyelitis), matenda a minofu yofewa,
• matenda a mano (alveolitis),
• kuwonongeka kwa mabakiteriya am'mimba komanso chikhodzodzo,
• matenda azamatenda komanso matenda opatsirana pogonana (chinzonono ndi chlamydia).

Mankhwala amaloledwa kugwiritsidwa ntchito poletsa zovuta za postoperative zodziwika ndi kukhalapo kwa matenda, kapena zochizira ziphuphu zomwe zimayambitsidwa ndi kukula kwa staphylococcus.