Cipro
Cipro (Ciprofloxacin)Pharmacological action
Antimicrobic broad-spectrum agent. Bactericidal an effect has. Suppresses DNA-girazu and oppresses synthesis of bacteriemic DNA. It is highly active concerning the majority of Gram-negative bacteria: Pseudomonas aeruginosa, Haemophilus influenzae, Escherichia coli, Shigella spp., Salmonella spp., Neisseria meningitidis, N.gonorrhoeae. It is active concerning many strains Staphylococcus spp. (Producing and not producing a penicillinase, Methicillinum-refractory), some strains Enterococcus spp., and also Campylobacter spp., Legionella spp., Mycoplasma spp., Chlamydia spp., Mycobacterium spp. Ciprofloxacin is active concerning the bacteria producing beta-laktamazy.
To ciprofloxacin are refractory Ureaplasma urealyticum, Clostridium difficile, Nocardia asteroides. Action concerning Treponema pallidum is studied insufficiently.
Pharmacokinetics
It is quickly soaked up from GASTROINTESTINAL TRACT. Bioavailability after intake makes 70 %. Food intake slightly influences a ciprofloxacin absorption. Linkage with fibers of plasma makes 20-40 %. It is distributed in tissues and organism liquids. Gets into a spinal liquid. Concentration of ciprofloxacin at uninflammed cerebral covers reach 10 %, at inflamed - to 37 %. Gets through a placenta, it is allocated with thoracal milk. High concentration are reached in bile. It is allocated with urine and bile.
Indications
The infectious-inflammatory diseases caused by microorganisms sensitive to ciprofloxacin, including diseases of respiratory tracts, an abdominal cavity and organs of a small basin, bones, joints, a skin; a hematosepsis; serious infections of ENTs-organs, etc. Treatment of postoperative infections. Preventive maintenance and treatment of infections at patients with the lowered immunity.
For local application: acute and subacute conjunctivitises, blepharites, bacteriemic helcomas, keratites, keratoconjunctivites, chronic dacryocystites, meibomites. Infectious lesions of eyes after traumas or hit of alien bodies. Preoperative preventive maintenance in an ophthalmosurgery.
Dosage regimen
The individual. Inside - on 250mg-750 mg 2 times/days Duration of treatment - from 7-10 days till 4 weeks.
For i.v. introduction a single dose - 200-400 mg, frequency rate of introduction - 2 times/sut; duration of treatment - 1-2 weeks, if necessary and more. The drop introduction within 30 minutes is more preferable
At local application instill on 1-2 drops in the bottom conjunctival bag of the amazed eye everyone 1-4 h.
The maximum doses: for adults at intake a daily dose - 1.5
Side effect
From the alimentary system: a nausea, vomiting, a diarrhoeia, abdominal pains, rising of activity of hepatic transaminases, bilirubin, a pseudomembranous colitis.
From party TSNS: a headache, giddiness, feeling of weariness, dream disorder, dreadful dreamings, hallucinations, syncopes, visual disturbances.
Also crystalluria, a glomerulonephritis, a dysuria, a polyuria, an albuminuria, a hematuria, transitional augmentation of the maintenance in creatinine blood serum.
From hemopoiesis system: an eosinophilia, a leukopenia, a neutropenia, change of quantity of thrombocytes.
The parties of cardiovascular system: a tachycardia, disturbances of a warm rhythm, an arterial hypotension.
Allergic reactions: a dermal itch, an urticaria, a Quincke's edema, Stevens-Johnson's syndrome, arthralgias.
The collateral reactions bound to chemotherapeutic action: a candidiasis.
Local reactions: morbidity, a phlebitis (at i.v. introduction). At application of eye drops in some cases easy morbidity and a conjunctiva hyperemia are possible.
The other: a vasculitis.
Contraindications
Pregnancy, lactemia (thoracal feeding), children's age till 15 years, a hypersensibility to ciprofloxacin.
Pregnancy and lactemia
Ciprofloxacin is contraindicative to application at pregnancy and in a lactemia (thoracal feeding) as in experimental researches it is established, that it causes an arthropathy.
Special indicatings
Correction of a regimen of dosage is required from patients with disturbances of function of kidneys. With care apply at patients of advanced age, at an atherosclerosis of vessels of a brain, disturbances of a cerebral circulation, an epilepsy, a convulsive syndrome of an obscure aetiology.
During treatment patients should receive liquid enough.
In case of a persistent diarrhoeia ciprofloxacin should be cancelled.
At simultaneous i.v. introduction of ciprofloxacin and barbiturates the CARDIAC CONTRACTIONS RATE control, a BP, an electrocardiogram is necessary. In the course of treatment the concentration control in blood of urea, a creatinine, hepatic transaminases is necessary.
In treatment depression of reactionary ability (is possible especially at simultaneous application with alcohol).
Medicinal interaction
At simultaneous application with warfarin the risk of development of a bleeding increases.
Simultaneous reception of ciprofloxacin and Theophyllinum can lead to rising of concentration of Theophyllinum in a blood plasma, at the expense of competitive inhibition in binding sites of cytochrome P450 that leads to augmentation of the period of semideducing of Theophyllinum and ascending of risk of development of the toxic action bound to Theophyllinum.
Simultaneous reception of antacids, and also the preparations containing ions of aluminium, zinc, iron or magnesium, can cause depression of an absorption of ciprofloxacin, therefore an interval between appointment of these preparations should be not less than 4 h.
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