Levaquin
Levaquin (Levofloxacin)Pharmacology
Pharmacological action - antibacterial a wide spectrum, bactericidal. Possesses a wide spectrum of action.
It is effective concerning the microorganisms steady against aminoglycosides, macroleads and other antibiotics (including to Penicillinum).
Pharmacokinetics
After intake quickly also it is completely soaked up, absolute bioavailability of tablets of 500 mg and 750 mg makes 99 %. Cmax it is reached through 1-2 h. At simultaneous reception with nutrition time of achievement Cmax (on 1) is slightly enlarged and slightly decreases Cmax ().
The average volume of distribution makes 74-112 l after unitary and repeated introductions of doses of 500 mg and 750 mg. It is widely distributed in organism tissues, well gets into a tissue of lungs (concentration in lungs in 2-5 times above concentration in plasma). In vitro in a range of the concentration corresponding to clinical value (1-10 mkg/ml), linkage with fibers of plasma (mainly with albumins) makes 24-38 % and does not depend on concentration of Levaquin.
The pharmacokinetics of Levaquin does not depend on an age, sex and race of the patient.
The pharmacokinetics of Levaquin at children is not studied.
Contraindications
Hypersensitivity
Restrictions
Age till 18 years (safety and efficiency of application are not defined).
Levaquin is not defined in thoracal milk, it is possible to assume, that Levaquin can get into thoracal milk of feeding women and to cause serious collateral reactions in children who are on thoracal feeding. Feeding women should stop either thoracal feeding, or reception of Levaquin (considering the importance of a medicine for mother).
Side effects
In clinical researches following by-effects were surveyed as possibly bound to reception Levaquin : a nausea (1,3 %), a diarrhoeia (1 %), a vaginitis (0,7 %), an abdominal pain (0,4 %), a meteorism (0,4 %), a dermal itch (0,4 %), giddiness (0,3 %), a dyspepsia (0,3 %), an eruption (0,3 %), a genital candidiasis (0,2 %), taste disturbance (0,2 %), vomiting (0,2 %), a constipation (0,1 %), a fungoid infection (0,1 %), an itch in the field of genitals (0,1 %), a headache (0,1 %), the milkwoman (0,1 %), nervousness (0,1 %), an erythematic eruption (0,1 %), an urticaria (0,1 %).
Overdosage
Treatment of an acute overdosage: a gastric lavage, adequate hydration. It is not deduced by a dialysis, the specific antidote does not exist.
Way of application and dose
Inside, i.v. Inside: regardless to food intake, 250-500 mg of 1 times a day. I.v.: driply slowly 250-750 mg everyone 24 h (of 250-500 mg enter a dose during 60 mines, 750 mg - during 90 mines). The subsequent transition to peroral reception in the same dose is possible.
Duration of treatment depends on indications to application.
It is necessary to mean possibility of development of a pseudomembranous colitis if the patient has a diarrhoeia against reception of anti-infectives. Treatment by anti-infectives leads to modification of normal flora of a thick intestine and can lead to the strengthened growth of clostridiums. If the diagnosis "a pseudomembranous colitis" is established, it is necessary to cancel Levaquin and to begin corresponding treatment.
In clinical researches phototoxic reactions are noted less than at 0,1 % of the patients receiving Levaquin.
Careful monitoring of level of a glucose in blood at these patients Is recommended. If against Levaquin hypoglycemic reaction develops, it is necessary immediately to cancel Levaquin and to begin corresponding therapy.
As well as reception of any strong antimicrobic preparation, the periodic estimation of functions of systems of an organism, including renal, hepatic, hemopoietic is expedient.
The patient should be warned:
- About expediency of plentiful drink;
- About that Levaquin can cause neurologic by-effects (for example, giddiness of various degree of expression), in this connection the patient should know, how it reacts on Levaquin before being engaged in the activity demanding speed of reaction and bound to raised concentration of attention;
- During treatment it is necessary to avoid a strong solar or artificial ultra-violet irradiation; at occurrence of phototoxic reactions (for example,) it is necessary for dermal eruption to stop treatment.
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