The semi synthetic penicillin, it is bactericidal and has a wide range of activities. Penalized peptidoglycan synthesis (reference polymer cell wall) between the division and growth, causing lysis of the bacteria. It is active against aerobic gram-positive bacteria: Staphylococcus spp. (except for strains producing penicillinase), Streptococcus spp. and aerobic gram-negative organisms: Neisseria gonorrhoeae, Neisseria meningitidis, Escherichia coli, Shigella spp, Salmonella spp, Klebsiella spp… The strains producing penicillinase, resistant to the action of proviron for women.
Pharmacokinetics: Absorption – a fast, high (93%), food intake has no effect on the absorption is not destroyed in the acid environment of the stomach. When administered at a dose of 125 and 250 mg maximum concentration – 1.5-3 and 3.5-5 ug / ml, respectively. . The time to maximum concentration after oral administration – 1-2 hours has an extensive volume of distribution: in high concentrations detected in plasma, sputum, bronchial secretions (bronchial secretions in purulent allocation weak), pleural and peritoneal fluid, urine, content of skin blisters, tissue lung, intestinal mucosa, female genital organs, prostate gland, middle ear fluid (if inflammation), bone, adipose tissue, gallbladder (normal liver), fetal tissues. With increasing doses of 2-fold concentration is also increased by 2 times.The concentration in the bile exceeding the plasma concentration of 2-4 fold. The amniotic fluid and umbilical cord vessels proviron for women concentration – 25-30% of the plasma level-term pregnant women. Poorly penetrates the blood-brain barrier, inflammation of the meninges concentration in cerebrospinal fluid – approximately 20% of the level in plasma. Connection with the plasma protein-17%. Partially metabolized to form inactive metabolites. . The half-life -1-1.5 hours Write 50-70% kidneys unchanged (by tubular secretion – 80%, and glomerular filtration rate – 20%), liver -10-20%. The small amount is excreted in breast milk. proviron for women is removed by hemodialysis.
Bacterial infections caused by susceptible pathogens: lower respiratory tract infections (bronchitis, pneumonia), and upper respiratory tract (sinusitis, pharyngitis, tonsillitis, acute otitis media), urogenital system (pyelonephritis, pyelitis, cystitis, urethritis, gonorrhea, endometritis, cervicitis), gastrointestinal tract (cholangitis, cholecystitis, dysentery, salmonellosis, salmonella carrier), skin and soft tissue infections (erysipelas, impetigo, secondarily infected dermatoses), leptospirosis, listeriosis, Lyme disease (Lyme disease), endocarditis (prophylaxis).
Hypersensitivity (including to other penicillins, cephalosporins, carbapenems), children under 3 years (for a given dosage form).
allergic diseases (including history), gastrointestinal disease in history (especially colitis, associated with the use of antibiotics), kidney failure, severe liver dysfunction, pregnancy, lactation, infectious mononucleosis, lymphatic leukemia.
Pregnancy and lactation
Use of the drug during pregnancy is possible only when the intended benefits to the mother outweighs the potential risk to the fetus. If necessary, the appointment during lactation should stop breastfeeding.
Dosage and administration
. Inside, before or after meals
for adults and children over 10 years (with a body weight over 40 kg) appoint 0.5 g 3 times a day; in severe infections – 0.75-1 g 3 times a day. Children aged 5-10 years appoint 0.25 g three times a day;under 5 years old – administered as a suspension. The course of treatment 5-12 days depending on the type and severity of the disease. In acute uncomplicated gonorrhea appoint 3 g single dose; the treatment of women recommended to repeat this dose intake.
In acute infectious diseases of the gastrointestinal tract (paratyphoid fever, typhoid fever), and biliary tract, gynecological infectious diseases of adults -1.5-2 g 3 times a day or 1-1.5 g 4 times . day
at leptospirosis adults – 0.5-0.75 g 4 times a day for 6-12 days.
when salmonellonositelstve adults – 1.5-2 g 3 times daily for 2-4 weeks.
For the prevention of endocarditis with small surgical interventions for adults – 3 -4 g for 1 h prior to the procedure. If necessary, repeat the dose administered 8-9 hours Children dose reduced by 2 times..
In patients with impaired renal function at creatinine clearance (CC) 15-40 ml / min interval between doses increased to 12 hours; with CC less than 10 ml / min the dose is reduced by 15-50%; with anuria – the maximum dose of 2 g / day.
Side effects : Allergic reactions: possible urticaria, skin flushing, erythematous rash, angioedema, rhinitis, conjunctivitis; rarely – fever, arthralgia, eosinophilia, exfoliative dermatitis, erythema multiforme exudative (including Stevens-Johnson syndrome); reactions similar to serum sickness; in rare cases – anaphylactic shock. On the part of the gastrointestinal tract: goiter, change in taste, nausea, vomiting, diarrhea, stomatitis, glossitis, a moderate increase in activity of “liver” transaminases, rarely – pseudomembranous enterocolitis. From the nervous system: agitation, anxiety , insomnia, ataxia, confusion, behavioral changes, depression, peripheral neuropathy, headache, dizziness, epileptic reactions. Laboratory findings: leukopenia, neutropenia, thrombocytopenic purpura, anemia. Other: shortness of breath, tachycardia, interstitial nephritis, candidiasis of the vagina, superinfection (especially in patients with chronic diseases or low resistance of the body).
Symptoms: nausea, vomiting, diarrhea, disruption of water and electrolyte balance (as a result of vomiting and diarrhea). Treatment: gastric lavage, activated charcoal, saline laxatives, medicines for maintaining fluid and electrolyte balance; hemodialysis.
Interaction with other medicinal products
Antacids, glucosamine, laxatives, drugs, food, aminoglycosides slow down and reduce absorption; . ascorbic acid increases the absorption of
bactericidal antibiotics (including aminoglycosides, cephalosporins, vancomycin, rifampicin) have a synergistic effect; . bacteriostatic drugs (macrolides, chloramphenicol, lincosamides, tetracyclines, sulfonamides) – antagonistic
Improves the effectiveness of indirect anticoagulants (suppressing the intestinal microflora, reduces the synthesis of vitamin K and prothrombin index); estrogensoderzhaschih reduces the effectiveness of oral contraceptives; drugs, which is formed during the metabolism of p-aminobenzoic acid, ethinyl estradiol – the risk of bleeding “breakthrough.” proviron for women reduces clearance and increases the toxicity of methotrexate; enhances the absorption of digoxin.
Diuretics, allopurinol, oxyphenbutazone, phenylbutazone, nonsteroidal anti-inflammatory drugs, and other drugs that block tubular secretion, increase the concentration of proviron for women in the blood.
Allopurinol increases the risk of skin rash.
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In exchange treatment is necessary to monitor the state of the function of the blood, liver and kidneys.
Perhaps the development of superinfection due to growth insensitive to it microflora, which requires a corresponding change in antibiotic therapy.
In appointing the patients with sepsis may develop bacteriolysis reaction (Jarisch-Herxheimer .) (rare)
in patients with hypersensitivity to penicillin, may be cross-allergic reactions to other beta-lactam antibiotics.
in the treatment of mild diarrhea on the background of a course of treatment should be avoided antidiarrhoeal drugs that reduce intestinal motility; You can use kaolin or attapulgitsoderzhaschie antidiarrheals.In severe diarrhea should consult a doctor.
Treatment continues for sure 48-72 hours after the disappearance of clinical signs of disease. With simultaneous use of oral contraceptives and estrogensoderjath proviron for women should be possible to use other or additional contraceptive methods. steroiden kaufen
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