Drops Amoxicillin: malangizo ogwiritsira ntchito

Amoxicillin: malangizo ogwiritsa ntchito ndi kuwunika

Dzina lachi Latin: Amoxicillin

Code ya ATX: J01CA04

Mphamvu yogwira: amoxicillin (amoxicillin)

Wopanga: Biochemist, OJSC (Russia), Dalhimpharm (Russia), Organika, OJSC (Russia), STI-MED-SORB (Russia), Hemofarm (Serbia)

Sinthani mafotokozedwe ndi chithunzi: 11.26.2018

Mitengo muma pharmacies: kuchokera ku ma ruble 30.

Amoxicillin ndi antibacterial mankhwala, semisynthetic penicillin.

Kutulutsa mawonekedwe ndi kapangidwe kake

Mlingo wa Amoxicillin:

mapiritsi: pafupifupi oyera kapena oyera, osalala, osanjikiza ndi chamfer (ma PC 10 kapena ma PC 20. mumatumba, mu bokosi la makatoni a 1, 2, 5, 10, 50 kapena 100, ma PC 24. mitsuko yamagalasi amtundu wakuda, m'matayilo okhala ndi 1 akhoza, ma PC 20. M'matumba kapena ma botolo a polymer, mu bokosi lamatabwa a 1 akhoza kapena botolo),
makapisozi: gelatinous, pa mlingo wa 250 mg - kukula No. 2, wokhala ndi chipewa chobiriwira chakuda komanso choyera ndi chikasu chokwanira, pamtunda wa 500 mg - kukula No. 0, wokhala ndi kapu wofiira ndi thupi lachikasu, mkati mwa makapisozi ndi ufa wonunkhira wokhala ndi utoto kuchokera chikaso choyera mpaka choyera, kupindika kwake ndikololedwa (250 mg aliyense: ma PC 8. M'matumba, pamatumba awiri matuza 2, ma PC 10. mumatumba otupa, pakatundu kakhadi 1 kapena 2 phukusi, 10 kapena 20 ma PC). Mukhoza, mu katoni munyolo umodzi 1 500, ma 500 mg uliwonse: ma PC 8. M'matumba, pamatumba okhala ndi matuza 2, ma PC 8. urnyh chithuza mu phukusi makatoni 1 kapena phukusi 2, 10 ma PC. ku matuza mu bokosi katoni 1, 2, 50 kapena 100 mapaketi)
granules pakamwa kuyimitsidwa: granular ufa kuchokera oyera ndi tinge thunzi mpaka oyera, atasungunuka m'madzi - kuyimitsidwa chikasu ndi fungo la zipatso (40 g aliyense m'mabotolo amdima amdima ali ndi 100 ml, pamakatoni a chikwama 1 mabotolo 1 ndi supuni yoyesera yokhala ndi magawo a 2,5 ml ndi 5 ml).

Piritsi limodzi lili:

yogwira mankhwala: amoxicillin trihydrate (mwa amoxicillin) - 250 mg kapena 500 mg,
othandizira zigawo: wowuma wa mbatata, magnesium stearate, polysorbate-80 (pakati-80), talc.

1 kapisozi muli:

yogwira mankhwala: amoxicillin trihydrate - 286.9 mg kapena 573.9 mg, omwe amafanana ndi 250 mg kapena 500 mg ya amoxicillin,
othandizira: microcrystalline cellulose PH 102, magnesium stearate, titanium dioxide (E171), gelatin.

Kuphatikiza apo, ngati mbali ya chipolopolo:

kukula 2: cap - quinoline chikasu (E104), indigo carmine (E132), mlandu - utoto wachikasu wa utoto (E104),
kukula 0: cap - utoto dzuwa dzuwa chikasu (E110), utoto azorubine (E122), thupi - utoto chitsulo oxide chikasu (E172).

Mu 5 ml ya kuyimitsidwa koyimitsidwa (2 g ya granules) muli:

yogwira mankhwala: amoxicillin trihydrate (mwa mankhwala a amoxicillin) - 250 mg,
othandizira zigawo: sodium saccharrate dihydrate, sucrose, simethicone S184, sodium benzoate, guar chingamu, sodium citrate dihydrate, kununkhira kwa sitiroberi, kununkhira kwa rasipiberi, kununkhira kwa kukoma kosangalatsa.

Mankhwala

Amoxicillin ndi penicillin wopanga, mankhwala ochepetsa mphamvu ya bakiteriya omwe ali ndi antibacterial bactericidal acid. Limagwirira ntchito chifukwa cha mphamvu ya amoxicillin kuyambitsa bakiteriya latch, inhibiting transpeptidase ndi kusokoneza kaphatikizidwe kamapulogalamu a cell a khoma la peptidoglycan panthawi yogawa komanso kukula.

Zabwino za grram-gramu komanso zopanda gramu zimawonetsa chidwi cha mankhwalawo.

Amoxicillin amagwira mabakiteriya otsatirawa:

mabakiteriya olimbitsa aerobic: Corynebacterium speciales (spp.), Staphylococcus spp. (kupatula ngati tizilombo ta "penicillinase"), Bacillus anthracis, Listeria monocytogene, Enterococcus faecalis, Streptococcus spp. (kuphatikizapo Streptococcus pneumoniae),
aerobic gram-negative bacteria: Brucella spp., Bordetella pertussis, Shigella spp., Escherichia coli, Klebsiella spp., Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus influenzae, Salmonella spp.
Ena: Leptospira spp., Clostridium spp., Borrelia burgdorferi, Helicobacter pylori.

Ma microorganic omwe amatulutsa penicillinase ndi ma beta-lactamase ena samvera chidwi ndi mankhwalawa, chifukwa beta-lactamases imawononga amoxicillin.

Pharmacokinetics

Pambuyo pakukonzekera kwamlomo, amoxicillin imathamanga ndipo imatsala pang'ono kukwana (93%). Mafuta samakhudzidwa ndimankhwala omwe amapezeka pakanthawi kochepa, mankhwalawa samawonongeka m'malo a acid pamimba. Kuzindikira kwakukulu kumachitika pambuyo pa maola 1-2 ndipo kumakhala 0,0015-0.003 mg / ml pambuyo pa mlingo wa 125 mg ndi 0.0035-0.005 mg / ml pambuyo pa mlingo wa 250 mg. Zotsatira zamankhwala zimayamba kukula mu 1 / 4-1 / maola awiri ndipo zimatha maola 8.

Ili ndi buku lalikulu logawa. Mlingo wa ndende umachulukana molingana ndi mlingo wa mankhwalawo. Miyoyo yambiri ya amoxicillin imapezeka m'madzi amadzimadzi am'madzi, ma pleural ndi peritoneal, sputum, bronchial secretions, mapapu ndi mafupa, matumbo a mucosa, mkodzo, gland ya prostate, ziwalo zoberekera za amayi, minofu ya adipose, madzimadzi amkati a pakhungu, komanso matuza a pakhungu. Imalowetsa fetal minofu, ndimagwira ntchito bwino kwa chiwindi - mu ndulu ya ndulu, momwe zake zimatha kupitilira kuchuluka kwa plasma ndi 2-5 nthawi. Kubisala kwa purulent kwa bronchi sikumagawidwa bwino. Mukamagwiritsa ntchito pa nthawi ya pakati, zam amoillillin m'matumbo amtundu wa umbilical ndi amniotic fluid ndi 25-30% ya ndende ya plasma ya thupi la mkazi.

Ndi mkaka wa m'mawere, kachakudya kakang'ono kamachotsedwa. Chotchinga magazi muubongo sichingagonjetsedwe bwino, kugwiritsidwa ntchito kwa madzi mu ubongo pogwiritsa ntchito amoxicillin pochizira meningitis (kutupa kwa meninges) sikupitilira 20%.

Kumangiriza kwa mapuloteni a plasma - 17%.

Zimapangidwa mosakwanira voliyumu ndikupanga ma metabolites osagwira.

Hafu ya moyo (T_1/2) ndi maola 1-1. 50-70% imachotsedwa kudzera mu impso osasinthika. Mwa izi, mwa kusefedwa kwa glomerular - 20%, tubular excretion - 80%. 10-20% imachotsedwa m'matumbo.

T_1/2 vuto laimpso kuwonongeka ndi creatinine chilolezo (CC) cha 15 ml / mphindi kapena kuchepera, limakwera mpaka maola 8.5.

Ndi hemodialysis, amoxicillin imachotsedwa.

Zizindikiro zogwiritsidwa ntchito

Malinga ndi malangizo, Amoxicillin akuwonetsedwa zochizira matenda opatsirana komanso otupa oyambitsidwa ndi tizilombo tating'onoting'ono:

kupuma thirakiti matenda - pachimake bronchitis, kuchuluka kwa chifuwa, bronchopneumonia, ziphuphu zakumaso,
matenda a ziwalo za ENT - sinusitis, tonsillitis, pharyngitis, pachimake otitis media,
matenda a pakhungu ndi minyewa yofewa - dermatoses yachiwiri yomwe amayamba kudwala, erysipelas, impetigo,
matenda a genitourinary dongosolo - cystitis, pyelonephritis, urethritis, gonorrhea,
matenda a gynecological - endometritis, cervicitis,
matenda a m'mimba - typhoid fever, paratyphoid fever, shigellosis (kamwazi), salmonellosis, nsomba ya salmonella,
zilonda zam'mimba ndi duodenum (monga gawo la mankhwala osakanikirana),
matenda am'mimba - enterocolitis, peritonitis, cholecystitis, cholangitis,
Meningococcal matenda,
listeriosis (mitundu yovuta komanso yotsika),
leptospirosis,
Borreliosis (matenda a Lyme)
sepsis
endocarditis (kupewa pa nthawi ya mano ndi zina.

Contraindication

kulephera kwa chiwindi
Mphumu ya bronchial,
hay fever
lymphocytic leukemia
matenda mononucleosis,
colitis chifukwa chotenga maantibayotiki (kuphatikizapo mbiri ya zamankhwala),
yoyamwitsa
Hypersensitivity a beta-lactam maantibayotiki, kuphatikizapo penicillin, cephalosporins, carbapenems,
tsankho limodzi ndi zigawo zikuluzikulu za mankhwala.

Zowonjezera zina zokhudzana ndi mitundu ina ya amoxicillin:

mapiritsi: Matenda omwenso ali ndi vuto lachipatala (kuphatikiza mbiri yakale)
makapisozi: atopic dermatitis, mbiri ya matenda am'mimba thirakiti, zaka mpaka zaka 5,
granules: glucose-galactose malabsorption syndrome, sucrose (isomaltase) kuchepa, fructose tsankho, atopic dermatitis, mbiri ya matenda am'mimba.

Mochenjera, tikulimbikitsidwa kuti Amoxicillin ayenera kulembedwa kwa odwala omwe amalephera kupweteka kwa impso, mbiri yakutuluka magazi, yomwe imakonda kukula kwa thupi lawo siligwirizana (kuphatikizapo mbiri yakale), panthawi yapakati.

Kuphatikiza apo, muyenera kusamala mukamagwiritsa ntchito mapiritsi pochiza odwala omwe ali ndi mbiri ya matenda am'mimba.

Zotsatira zoyipa

Kuchokera kumimba dongosolo: kuphwanya malingaliro a kukoma, kusanza, kusanza, kutsegula m'mimba, matenda am'mimba, matenda am'mimba, glossitis, chiwindi matenda, kuwonjezeka kwa hepatitis transaminases, cholestatic jaundice, pachimake cytolytic hepatitis,
Kuchokera kwamanjenje: kusowa tulo, kukhumudwa, kupweteka mutu, kuda nkhawa, kusokoneza, chizungulire, ataxia, kusintha kwa machitidwe, zotumphukira za m'mimba, kupsinjika, magwiridwe antchito.
matupi awo sagwirizana zochita: malungo, urticaria, ankatenthetsa wa khungu, rhinitis, conjunctivitis, erythema, eosinophilia, angioneurotic edema, kupweteka m'malo olumikizirana mafupa, exfoliative dermatitis, Stevens - Johnson poliformnaya (multiforme) erythema, matupi awo sagwirizana vasculitis, anaphylactic zochita mantha ofanana matenda a seramu
magawo a labotale: neutropenia, leukopenia, agranulocytosis, kuchepa magazi, thrombocytopenic purpura,
Kuchokera kwamikodzo dongosolo: crystalluria, interstitial nephritis,
ena: tachycardia, kupuma movutikira, maliseche candidiasis, mphamvu zapamwamba (nthawi zambiri pochiza matenda opatsirana kapena odwala omwe ali ndi kuchepa kwamthupi).

Kuphatikiza apo, ndizotheka kukulitsa zovuta zotsatirazi zomwe zidanenedwa mutatenga mitundu ina ya Amoxicillin:

mapiritsi: matupi awo sagwirizana pakhungu pakhungu, kuyabwa, poizoni wa khungu, kudziwika pustulosis, hepatic cholestasis, eosinophilia,
makapisozi: kamwa youma, lilime laubweya wakuda, makulidwe a khungu ndi mucous, kuwonjezeka kwa nthawi ya prothrombin ndi nthawi yophatikizana ndi magazi, madontho a enamel ya dzino ku chikasu, bulauni kapena imvi,
malankhulidwe: "tsitsi lakuda", kupindika kwa mano enamel, hemolytic anemia, pachimake kwambiri pustulosis.

Malangizo apadera

Kukhazikitsidwa kwa Amoxicillin ndikotheka pokhapokha palibe chidziwitso cha wodwalayo chomwe chimayambitsa matenda a beta-lactam (kuphatikizapo penicillins, cephalosporins). Mwa zolinga za prophylactic, kayendedwe ka munthawi yomweyo antihistamines akuwonetsedwa.

Mukamagwiritsa ntchito njira zakulera za pakamwa za estrogen, azimayi ayenera kulangizidwa kuti agwiritse ntchito njira zoletsa zamkati mwa mankhwala ndi amoxicillin.

Ndi concomitant anticoagulant mankhwala, kuwunika kuyenera kuthandizidwa kuti achepetse kuchepetsa kwake.

Kugwiritsa ntchito maantibayotiki sikuthandiza mankhwalawa opatsirana pogonana.

Amoxicillin sayenera kutumikiridwa pochiza matenda opatsirana mononucleosis chifukwa choopsa chotupa cha erythematous pakhungu ndikukulitsa Zizindikiro za matendawa.

Sitikulimbikitsidwa kugwiritsa ntchito njira zamkamwa za amoxicillin pochiza odwala omwe ali ndi matenda am'mimba, omwe amaphatikizidwa ndi kupukusana kosalekeza kapena kusanza.

Ngati kutsekula m'mimba kumachitika mukamamwa amoxicillin, mutha kugwiritsa ntchito mankhwala othandizira okhala ndi kaolin kapena attapulgite, kupewa kumwa mankhwala omwe amayamba kuyenda m'mimba.

Ngati muli ndi matenda otseguka m'mimba ndimadzimadzi, chopondapo chamadzimadzi chamtundu wamtundu wobiriwira komanso fungo losakanikirana, kuphatikizapo kuphatikizika kwa magazi limodzi ndi kutentha thupi komanso kupweteka kwambiri pamimba, muyenera kufunsa dokotala. Zizindikirozi zitha kuwonetsa kuperewera kwa maantibayotiki mu mawonekedwe a matenda a clostridiosis pseudomembranous colitis.

Mimba komanso kuyamwa

Panthawi ya bere, kugwiritsa ntchito Amoxicillin kumatheka pokhapokha ngati njira yochizira yomwe mayi akuyembekezeredwa, idapitilira zomwe zingawopseze mwana wosabadwayo.

Kugwiritsa ntchito mankhwalawa pa mkaka wa m`mawere ndi contraindicated. Ngati kuli kofunikira kupangira amoxicillin, yoyamwitsa iyenera kutha.

Mu vuto laimpso

Mochenjera, Amoxicillin ayenera kugwiritsidwa ntchito pochiza odwala omwe amalephera impso.

Mitundu yofananira yamapiritsi ndi granules imagwiritsidwa ntchito kwa odwala omwe ali ndi CC pamtunda wa 40 ml / min, makapisozi omwe ali ndi CC yopitilira 30 ml / min.

A kwambiri aimpso kuwonongeka, kusintha kwa mankhwala kumafunika. Amapangidwa poganizira CC pochepetsa mlingo umodzi kapena kukulitsa nthawi pakati pa Mlingo wa Amoxicillin.

Ndi CC 15-40 ml / mphindi, mulingo woyenera umaperekedwa, koma nthawi yolingana ndi kuchuluka imawonjezeredwa mpaka maola 12, ndi CC yochepera 10 ml / min, mlingo uyenera kuchepetsedwa ndi 15-50%.

Mlingo wapamwamba tsiku lililonse wa Amoxicillin mu anuria ndi 2000 mg.

Ngati ana amisala akuwonongeka kwa ana omwe ali ndi CC yopitilira 30 ml / mphindi, sayenera kukonzanso mlingo. Ndi CC ya 10-30 ml / min, ana amapatsidwa 2/3 ya mankhwalawa, ndikukulitsa nthawi pakati Mlingo mpaka maola 12. Mwa ana omwe ali ndi CC osakwana 10 ml / mphindi, pafupipafupi makonzedwe a mankhwalawa ndi 1 nthawi patsiku, kapena amawapatsa 1/3 ya ana omwe amakhala mlingo.

Kuyanjana kwa mankhwala osokoneza bongo

Ndi munthawi yomweyo kugwiritsa ntchito amoxicillin:

ascorbic acid: imapangitsa kuwonjezeka kwa kuchuluka kwa mankhwala,
aminoglycosides, maantacid okhala, mankhwala osokoneza bongo, glucosamine: amathandizira kuchepetsa komanso kuchepetsa mayamwidwe,
ethanol: amachepetsa mayamwidwe amo amoillillin,
digoxin: imakulitsa mayamwidwe,
phenenecid, phenylbutazone, oxyphenbutazone, indomethacin, acetylsalicylic acid: amachititsa kuchuluka kwa amoxicillin m'madzi a m'magazi, ndikuchepetsa kuchotsedwa kwawo,
methotrexate: chiopsezo chokhala ndi poizoni wa methotrexate ukuwonjezeka,
anticoagulants ndi mankhwala osokoneza bongo pa kagayidwe kamene para-aminobenzoic acid amapangidwira: motsutsana ndi kuchepa kwa kapangidwe ka vitamini K ndi prothrombin index chifukwa cha kuponderezedwa kwa microflora yamatumbo ndi amoxicillin, chiopsezo chotulutsa magazi kwambiri.
allopurinol: imawonjezera chiopsezo chotenga khungu lawo siligwirizana,
kulera kwapakamwa: kubwezeretsanso kwa estrogens m'matumbo amachepetsa, komwe kumayambitsa kuchepa kwa mphamvu yakulera,
mabakiteriya atizilombo toyambitsa matenda (cycloserine, vancomycin, aminoglycosides, cephalosporins, rifampicin): timayambitsa zotsatira za antibacterial.
mankhwala a bacteriostatic (sulfonamides, macrolides, lincosamides, chloramphenicol, tetracyclines): amathandizira kufooka kwa bactericidal zotsatira za amoxicillin,
metronidazole: antibacterial ntchito ya amoxicillin imachuluka.

Analogi ya Amoxicillin ndi awa: mapiritsi - Amoxicillin Sandoz, Ecobol, Flemoxin Solutab, Ospamox, makapisozi - Hiconcil, Amosin, Ampiok, Hikontsil, Ampicillin Trihydrate.