Augmentin
Augmentin
Augmentin (Clavulanate/Amoxicillin)Structure
Active substance - Amoxicillin+Clavulanate acid.
Pharmacological action
Antibacterial a wide spectrum. Blocks synthesis covers of microbic cells , inhibits beta-laktamazy. It is active concerning Gram-positive aerobes: Streptococcus pneumoniae, S.pyogenes, S.viridans, S.bovis, Staphylococcus aureus , Enterococcus spp. Gram-negative aerobes: Bordetella pertussis, Brucella spp., Campylobacter jejuni, E.coli, Gardnerella vaginalis, H.influenzae, H.ducreyi, Klebsiella spp., Moraxella catarrhalis, N.gonorrhoeae, N.meningitidis, Pasteurella multocida, Proteus spp., Salmonella spp., Shigella spp. Vibrio cholerae, Yersinia enterocolitica. It is quickly soaked up after introduction inside (food intake does not render influence on absorption). The maximum concentration is reached through 1 h after reception. The maximum concentration in plasma after injections 1,2 g makes 105,4 mg/l and 28,5 mg/l.
Has great volume of distribution - high concentration are found out in liquids and organism tissues . The peak of concentration in organism liquids is observed through 1 h after achievement of peak of plasma concentration. Weakly contacts fibers of plasma. Leaves at a hemodialysis, it is insignificant - at a peritoneal dialysis.
Indications to application
Infectious diseases top (an acute and chronic sinusitis, an acute and chronic average otitis, a retropharyngeal abscess) and the bottom respiratory tracts (an acute and chronic bronchitis, a pneumonia, a pleura empyema); infections of urinary ways (including a cystitis, an urethritis, a pyelonephritis), gynecologic infections (including a salpingitis, a salpingo-oophoritis, an endometritis, septic abortion, a pelviperitonitis); cholic ways (a cholecystitis, a cholangitis), osteal and connecting tissues (including a chronic osteomyelitis), a skin and soft tissues (a phlegmon, a wound fever), dontogenous infections (periodontitis); the infections transferred sexual by (a gonorrhea).
Contraindications
Hypersensitivity; allergic reactions to antibiotics of group of Penicillinums and cephalosporins in the anamnesis; a cholestatic icterus, a hepatitis caused by reception of antibiotics of group of Penicillinums (in the anamnesis); hepatic insufficiency; an infectious mononucleosis, a lymphoid leukosis. Application at pregnancy and feeding by a breast: Probably, if the expected effect of therapy exceeds potential risk for a foetus. For the period of treatment it is necessary to stop thoracal feeding.
Side effect
In most cases by-effects weak and transient, meet from organs GASTROINTESTINAL TRACT is more often: appetite loss, a nausea, vomiting, a diarrhoeia. Development of a superinfection, a stomatitis, a vaginitis is possible; in rare instances - a pseudomembranous colitis with a serious diarrhoeia. There can be allergic reactions: an itch, dermal rashes; at sensitive patients probably development of reactions of immediate hypersensitivity. Extremely seldom transitional rising of level of transaminases in a blood plasma can be observed. There are individual reports on occurrence of a cholestatic icterus, a hepatitis, disturbances of function of a liver.
Interaction
At simultaneous application with Methotrexatum toxicity of Methotrexatum, with Allopyrinolum - frequency of development of an exanthema raises, anticoagulants - extend a prothrombin time. Lowers efficiency of peroral contraceptives. It is necessary to avoid simultaneous application with Disulfiramum. Iit is incompatible with the solutions containing blood, proteins, lipids, a glucose, a dextran, bicarbonate. It is impossible to admix in a syringe. It is incompatible with aminoglycosides.
Overdosage
Symptoms: in most cases the nausea, a diarrhoeia, vomiting, are possible - excitation, a sleeplessness, giddiness, in some cases - convulsive attacks. Data on a lethal outcome or occurrence of by-effects menacing to a life is not available. Treatment: symptomatic, in case of recent reception (less than 4) to remove a preparation from GASTROINTESTINAL TRACT (a gastric lavage, reception of the activated coal for absorption reduction), the hemodialysis is effective.
Special indicatings
With care prescribe to the patients inclined to allergic reactions to cephalosporins and others beta-laktamnye antibiotics (risk of development of two-dimensional sensitivity), with serious disturbances of function of a liver, kidneys (correction of a regimen of dosage is necessary). High concentration give false positive reaction to a glucose in urine at use of Felling's solution.
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