Saukad da Amoxicillin: umarnin don amfani

Amoxicillin: umarnin don amfani da bita

Sunan Latin: Amoxicillin

Lambar ATX: J01CA04

Aiki mai aiki: amoxicillin (amoxicillin)

Mai samarwa: Biochemist, OJSC (Russia), Dalhimpharm (Russia), Organka, OJSC (Russia), STI-MED-SORB (Russia), Hemofarm (Serbia)

Bayanin sabuntawa da hoto: 11.26.2018

Farashin kuɗi a cikin kantin magani: daga 30 rubles.

Amoxicillin magani ne na kwayan cuta, maganin farji na jini.

Formaddamar da tsari da abun da ke ciki

Sashi siffofin Amoxicillin:

Allunan: kusan fararen fari ne ko fari, silin-silin, tare da layin rarrabawa da ɗakuna (kwalaye 10 ko guda 20 a cikin blisters, a cikin kwali na kwali na 1, 2, 5, 10, 50 ko 100 fakiti, 24 inji mai kwakwalwa. Gilashin launuka mai duhu, a cikin kwali na kwarjin 1 na iya, kwamfutoci 20. cikin gwangwani na polymer ko kwalabe, a cikin kwali na kwali na 1 can ko kwalban),
capsules: gelatinous, a wani adadin na 250 MG - girman No. 2, tare da filayen kore mai duhu da fari tare da rawaya mai launin shuɗi, a ƙimar 500 MG - girman No. 0, tare da jan hula da jikin rawaya, a cikin capsules babban foda ne mai launi tare da launi daga haske mai launin rawaya zuwa fari, an yarda clumping dinsa (250 mg kowane: guda 8 a cikin blisters, a cikin kwali na kwali 2, komputa 10 cikin blisters, a cikin kwali na 1 ko 2 fakiti, fakiti 10 ko 20. a cikin wata, a cikin wani kwali 1 aya, 500 M kowace: 8 inji mai kwakwalwa a cikin blisters, a cikin wani kwali dam na 2 blisters, 8 inji mai kwakwalwa a cikin con urnyh bororo a kwali kunshin 1 ko fure 2, 10 inji mai kwakwalwa. a blisters a kartani akwatin 1, 2, 50 ko 100 fakitoci)
granules don dakatarwa da baki: giram mai launi daga fari tare da launin shuɗi zuwa fari, bayan narke cikin ruwa - dakatarwar launin shuɗi tare da ƙamshi mai ɗanɗano (40 g kowane a cikin gilashin gilashi mai duhu tare da ƙarfin 100 ml, a cikin kwali na kwali 1 kwalban a saiti tare da cokali mai aunawa tare da rabo na 2.5 ml da 5 ml).

Kwamfutar hannu 1 ya ƙunshi:

abu mai aiki: amoxicillin trihydrate (cikin sharuddan amoxicillin) - 250 MG ko 500 MG,
abubuwan taimako: sitaci dankalin turawa, sittin magnesium, polysorbate-80 (tween-80), talc.

Kaya 1 ta ƙunshi:

abu mai aiki: amoxicillin trihydrate - 286.9 mg ko 573.9 mg, wanda ya yi daidai da abun da ke ciki na 250 mg ko 500 mg na amoxicillin,
abubuwan taimako: microcrystalline cellulose PH 102, magnesium stearate, titanium dioxide (E171), gelatin.

Bugu da ƙari, a zaman wani ɓangare na kwaskwarimar kwanshin:

girman 2: hula - fenti mai launin shuɗi (E104), indigo carmine (E132), shari'ar - quinoline mai launin shuɗi (E104),
girman 0: hula - fenti na faɗuwar rana rawaya (E110), fenti azorubine (E122), jiki - baƙin ƙarfe mai ruwan baƙin ƙarfe mai haske (E172).

A cikin 5 ml na ƙarar da aka gama (2 g na granules) ya ƙunshi:

abu mai aiki: amoxicillin trihydrate (cikin sharuddan amoxicillin) - 250 MG,
abubuwan taimako: sodium saccharinate dihydrate, sucrose, simethicone S184, sodium benzoate, guar gum, sodium citrate dihydrate, Strawberry flavour, dandano rasberi, ɗanye mai ɗanɗano abin sha'awa.

Pharmacodynamics

Amoxicillin wani nau'in maganin penicillin ne na kwala-kwala, mai kashe kwayoyin cuta mai lalata kwayoyin cuta tare da rawar jiki iri-iri. Hanyar aiwatarwa shine saboda iyawar amoxicillin don haifar da ƙarar ƙwayar cuta, hana transpeptidase da rushe rikicewar furotin da ke nuna jikin bango na peptidoglycan a lokacin rarrabuwa da haɓaka.

Gram-tabbatacce da kuma na gram-korau microorganisms nuna ji da kai ga miyagun ƙwayoyi.

Amoxicillin yana aiki a cikin ƙwayoyin masu zuwa:

kwayoyin aerobic gram-tabbatattun ƙwayoyin cuta: Corynebacterium bayanai (spp.), Staphylococcus spp. (sai dai wani nau'in dake samarda penicillinase), Bacillus anthracis, Listeria monocytogenes, Enterococcus faecalis, Streptococcus spp. (gami da cutar huda ciki da waje),
kwayoyin aerobic gram-korau: Brucella spp., Bordetella pertussis, Shigella spp., Escherichia coli, Klebsiella spp., Neisseria meningitidis, Neisseria gonorrhoeae, Haemophilus mura, Salmonella spp., Vibrio cholerae, Proteus mioterabella, kariya
Sauran: Leptospira spp., Clostridium spp., Borrelia burgdorferi, Helicobacter pylori.

Kwayoyin cuta masu haifar da penicillinase da sauran beta-lactamases ba su kula da maganin ba, tunda beta-lactamases suna lalata amoxicillin.

Pharmacokinetics

Bayan gudanar da maganin baka, amoxicillin yana saurin girma kuma kusan gabaɗaya (93%) yana sha. Ba a magance fitowar kayan abinci ta hanyar cin abinci lokaci guda, ba a lalata magungunan a cikin yanayin acidic na ciki ba. Matsakaicin mafi girman hankali an kai shi bayan sa'o'i 1-2 kuma ya zama 0.0015-0.003 mg / ml bayan kashi na 125 mg da 0.0035-0.005 mg / ml bayan kashi 250 na mg. Tasirin asibiti ya fara haɓaka cikin 1 / 4-1 / 2 hours kuma yana ɗaukar 8 hours.

Yana da babban rarraba rarraba. Matsayin maida hankali yana ƙaruwa gwargwadon yawan maganin. Ana samun babban haɗarin amoxicillin a cikin ƙwayar plasma, cututtukan jijiyoyin jiki da na ciki, hanji, ƙwarin hanji, ƙwanƙwasa da kasusuwa, mucosa na hanji, fitsari, glandar prostate, gabobin mata, tsotsin nama na tsopose, ƙwayar kunne na tsakiya, da kuma fitsarin fata. Ya ratsa cikin fitsarin mahaifa, tare da aikin hanta na al'ada - zuwa cikin mafitsara, inda abin da ke ciki zai iya wuce yawan ƙwayar cutar ta plasma sau 2-4. Ana rarraba rarrabewar ƙwayar baƙin ciki a cikin talauci. Lokacin amfani dashi yayin daukar ciki, abubuwan da ke tattare da amoxycillin a cikin tasoshin mara igiyar ruwa da ruwan amniotic shine kashi 25-30 na yawan hankalin mace a cikin jini.

Tare da madara mai nono, an ɗan rage adadin. An shawo kan shinge na kwakwalwa-mai rauni, maida hankali ne cikin ruwa na cerebrospinal lokacin amfani da amoxicillin don maganin cututtukan meningitis (kumburi da meninges) bai wuce 20% ba.

Haɗawa ga furotin plasma - 17%.

An metabolized a cikin ƙarancin girma tare da samuwar metabolites marasa aiki.

Rabin rayuwa (T_1/2) shine awa 1-1.5. 50-70% an kewaya ta ta hanyar kodan bai canzawa ba. Daga cikin waɗannan, ta hanyar haɗaɗɗiyar dunƙule - 20%, tubular excretion - 80%. 10-20% yana toshewa cikin hanjin.

T_1/2 idan akwai matsala game da aiki na keɓaɓɓen aiki tare da keɓantaccen keɓantaccen ɗaukar hoto (CC) na 15 ml / min ko lessasa, yana ƙaruwa zuwa 8.5 hours.

Tare da maganin hemodialysis, an cire amoxicillin.

Alamu don amfani

Dangane da umarnin, ana nuna Amoxicillin don magance cututtukan da ke haifar da kumburi da ke haifar da ƙwayoyin cuta mai saurin kamuwa:

cututtuka na numfashi - m mashahuri, wuce gona da iri na mashako, mashako, huhu, ciwon huhu,
cututtuka na gabobin ENT - sinusitis, tonsillitis, pharyngitis, m otitis media,
cututtuka na fata da taushi kyallen takarda - biyu da suka kamu da cutar dermatoses, erysipelas, impetigo,
cututtuka na tsarin cututtukan ƙwayar cuta - cystitis, pyelonephritis, urethritis, gonorrhea,
cututtukan cututtukan mahaifa - endometritis, cervicitis,
cututtukan hanji - zazzabin zazzabin cizon sauro, zazzabin paratyphoid, zazzabin shigellosis (dysentery), salmonellosis, motar salmonella,
peptic na ciki na ciki da duodenum (a matsayin wani ɓangare na haɗin maganin jiyya),
cututtuka na ciki - enterocolitis, peritonitis, cholecystitis, cholangitis,
meningococcal kamuwa da cuta,
listeriosis (m da latent siffofin),
leptospirosis,
Borreliosis (cutar Lyme)
sepsis
endocarditis (rigakafin yayin hakori da sauran ƙananan ayyukan tiyata).

Contraindications

gazawar hanta
asma,
hay zazzabi
cututtukan cututtukan ƙwayar cutar hanji
na kowa mononucleosis,
colitis saboda shan maganin rigakafi (gami da tarihin likita),
nono
hypersensitivity ga beta-lactam maganin rigakafi, gami da penicillins, cephalosporins, carbapenems,
mutum haƙuri zuwa ga abubuwan da miyagun ƙwayoyi.

Contraarin ƙarin contraindications na wasu nau'ikan amoxicillin:

Allunan: cututtukan rashin lafiyan (haɗe da tarihin likita), shekaru har zuwa shekaru 10 tare da nauyin jikin ƙasa da kilo 40,
capsules: atopic dermatitis, tarihin cututtukan gastrointestinal, shekaru har zuwa shekaru 5,
granules: glucose-galactose malabsorption syndrome, karancin sucrose (isomaltase), rashin jituwa na fructose, atopic dermatitis, tarihin cututtukan gastrointestinal.

Tare da taka tsantsan, an ba da shawarar cewa an tsara Amoxicillin ga marasa lafiya da gazawar koda, tarihin zubar jini, daɗaɗɗen haɓakar halayen ƙwayoyin cuta (ciki har da tarihin), yayin daukar ciki.

Bugu da kari, yakamata a yi taka tsantsan yayin amfani da allunan don kula da marasa lafiya da tarihin cututtukan cututtukan gastrointestinal.

Side effects

daga tsarin narkewa: cin zarafin tsinkaye, tashin zuciya, vomiting, dysbiosis, zawo, stomatitis, pseudomembranous colitis, ƙwanƙwasa, aikin hanta mai rauni, haɓaka ayyukan ƙwaƙwalwar hepatic matsakaici, cholestatic jaundice, m hepatitis cytolytic,
daga tsarin juyayi: rashin bacci, tashin hankali, ciwon kai, damuwa, damuwa, rikicewa, damuwa, ataxia, canjin hali, neuropathy na gefe, rashin damuwa, halayen shakatawa,
rashin lafiyan halayen: zazzabi, urticaria, flushing na fata, rhinitis, conjunctivitis, erythema, eosinophilia, angioneurotic edema, zafi a cikin gidajen abinci, exfoliative dermatitis, Stevens - Johnson poliformnaya (multiforme) erythema, rashin lafiyan vasculitis, anaphylactic buga halayen kama magani cuta
sigogi na dakin gwaje-gwaje: neutropenia, leukopenia, agranulocytosis, anemia, thrombocytopenic purpura,
daga urinary tsarin: crystalluria, interstitial nephritis,
wasu: tachycardia, karancin numfashi, candidiasis na farji, superinfection (mafi yawan lokuta a cikin maganin cututtukan cututtukan fata ko a cikin marasa lafiya da rage yawan juriya).

Bugu da ƙari, yana yiwuwa haɓaka sakamako masu biyo baya waɗanda aka ruwaito lokacin ɗaukar wasu nau'ikan Amoxicillin:

Allunan: rashin lafiyan halayen a cikin nau'i na fata fatar, itching, mai guba epidermal necrolysis, na kowa exanthematous pustulosis, hepatic cholestasis, eosinophilia,
maganin capsules: bushe baki, baki mai launin gashi, candidiasis na fata da membranes na mucous, karuwa a cikin prothrombin da lokacin coagulation jini, toshewar hakori mai launin shuɗi, launin ruwan kasa ko launin toka,
granules: “baki mai gashi”, haɓakar haƙoran haƙoran haƙora, haemolytic anemia, matattarar ƙwayar cuta mai haɓakawa.

Umarni na musamman

Wa'adin na Amoxicillin zai yiwu ne kawai idan babu wata alama a cikin cikakken tarihin mai haƙuri na rashin lafiyar rashin lafiyar ƙwayoyin beta-lactam (ciki har da penicillins, cephalosporins). Don dalilai na prophylactic, gudanar da aikin maganin antihistamines na lokaci daya.

Lokacin amfani da maganin hana daukar ciki na kwayar cutar estrogen, yakamata a shawarci mata da suyi amfani da hanyoyin shawo kan hana haifuwa yayin jiyya tare da amoxicillin.

Tare da conticitagula anticoagulant far, la'akari ya kamata a ba da damar yiwuwar rage yawan su.

Yin amfani da maganin rigakafi ba shi da tasiri don lura da cututtukan da ke haifar da ƙwayar cutar huhu.

Bai kamata a sanya maganin amoxicillin don magance cututtukan mononucleosis ba saboda haɗarin haɓakar fata na erythematous da ƙari yanayin alamun cutar.

An ba da shawarar yin amfani da nau'ikan amoxicillin don maganin marasa lafiya da cututtuka na hanji, wanda ke tare da ci gaba da zawo ko amai.

Idan zawo mai laushi yana faruwa yayin shan amoxicillin, zaku iya amfani da abubuwan antidiarrheal waɗanda ke ɗauke da kaolin ko attapulgite, ku guji shan kwayoyi waɗanda ke rage jinkirin motsin hanji.

Idan zazzabin zazzabin cizon sauro tare da ruwa, maban mage na launin kore da ƙamshi mai ƙamshi, gami da haɗuwa da jini wanda zazzabi ya kamu da zazzabi da zafin ciki, yakamata a nemi likita nan da nan. Wadannan bayyanar cututtuka na iya nuna matsala mai rikitarwa ta hanyar maganin rigakafi a cikin haɓakar ci gaban ƙwaƙwalwar ƙwaƙwalwar ƙwayar cuta ta mahaifa.

Haihuwa da lactation

A lokacin haihuwar haihuwa, yin amfani da Amoxicillin zai yiwu ne kawai idan ana tsammanin tasirin warkewar cutar ga mahaifiyar, a cewar likitan, ya wuce yuwuwar barazanar tayin.

Yin amfani da miyagun ƙwayoyi yayin lactation an contraindicated. Idan ya zama dole don rubanya amoxicillin, ya kamata a daina shayar da jarirai.

Tare da nakasa aiki na koda

Tare da taka tsantsan, ya kamata a yi amfani da Amoxicillin don kula da marasa lafiya da gazawar renal.

Ana amfani da tsari na yau da kullun don alluna da granules a cikin marasa lafiya tare da CC sama da 40 ml / min, don capsules tare da CC mafi girma fiye da 30 ml / min.

A cikin rauni mai girma na koda, ana buƙatar daidaita sashi. An ƙirƙira shi yana yin la'akari da CC ta hanyar rage guda ɗaya ko ƙara tazara tsakanin allurai na Amoxicillin.

Tare da CC 15-40 ml / min, ana tsara adadin da aka saba, amma ana yin tazara tsakanin allurai zuwa awa 12, tare da CC ƙasa da 10 ml / min, yakamata a rage kashi 15 zuwa 15%.

Matsakaicin adadin yau da kullun na Amoxicillin a cikin ƙwayar cuta shine 2000 mg.

Game da lalacewa aiki na yara a cikin yara tare da CC fiye da 30 ml / min, ba a buƙatar gyaran jigilar sashi ba. Tare da CC na 10-30 ml / min, ana wajabta yara 2/3 na kashi na yau da kullun, suna ƙaruwa tazara tsakanin allurai har zuwa awa 12. A cikin yara da ke da CC kasa da 10 ml / min, mitar kulawa da miyagun ƙwayoyi shine lokaci 1 a rana, ko kuma an sanya su 1/3 na kashi na al'ada na yara.

Hulɗa da ƙwayoyi

Tare da amfani da amoxicillin na lokaci daya:

ascorbic acid: yana haifar da haɓaka a cikin matakin sha daga ƙwayoyi,
aminoglycosides, antacids, laxatives, glucosamine: taimaka rage gudu da rage sha,
ethanol: yana rage yawan narkewar amoxicillin,
digoxin: yana kara yawanshi,
probenecid, phenylbutazone, oxyphenbutazone, indomethacin, acetylsalicylic acid: haifar da karuwa a cikin yawan amoxicillin a cikin jini, yana rage jinkirin sa,
methotrexate: hadarin haɓakar sakamakon cutar guba yana ƙaruwa,
kai tsaye anticoagulants da kwayoyi a lokacin metabolism wanda para-aminobenzoic acid aka kafa: a bango na raguwa a cikin kwayar bitamin K da prothrombin index saboda lalata ƙwaƙwalwar microflora na hanji ta amoxicillin, haɗarin zubar jini yana ƙaruwa,
allopurinol: yana ƙara haɗarin haɓakar halayen fata na fata,
maganin hana haihuwa: sake dawo da maganin estrogens a cikin hanji ya ragu, wanda hakan ke haifar da raguwar tasirin hana haihuwa,
kwayoyin rigakafin ƙwayoyin cuta (cycloserine, vancomycin, aminoglycosides, cephalosporins, rifampicin): suna haifar da tasirin maganin ƙwayoyin cuta,
kwayoyi masu kashe kwayoyin cuta (sulfonamides, macrolides, lincosamides, chloramphenicol, tetracyclines): suna taimakawa ga raunana sakamakon kwayar cuta ta amoxicillin,
metronidazole: aikin ƙwayoyin ƙwayoyin cuta na amoxicillin yana ƙaruwa.

Amoxicillin analogues sune: allunan - Amoxicillin Sandoz, Ecobol, Flemoxin Solutab, Ospamox, capsules - Hiconcil, Amosin, Ampioks, Hikontsil, Ampicillin Trihydrate.