flashC Oral pharmaco Flashcards
(121 cards)
1
Q
Oxacillin (Oxacilina Vitrofarma -Colombia)
disease : staphylococcal infections
A
capsules 500mg Oxacillin every 6 hours for at least 14 days
Rp / Oxacillin capsules 0.5g
no : LVI
Ds : internal once every 6 hours for 14 days
2
Q
Oxacillin ((Oxacilina Vitrofarma -Colombia))
Disease : moderate desease
A
capsules 500mg Oxacillin once every 6 hours until disappearance of symptoms, Continue at least 48 hours after the disappearance
Rp / Oxacillin capsules 0.5g
No (Depends on how long she will tell us, you have to add 8 because keep going 48 hours after disappearance)
Ds : internal once every 6 hours until disappearance of symptoms, Continue at least 48 hours after the disappearance
3
Q
Oxacillin (Oxacilina Vitrofarma -Colombia)
For children less than 40 kg children for exemple 40 kg for mild infection
A
40kg child with mild infection = 50mg * 40 = 2000 mg / 4 = 500 mg per day
For a severale infection you double the final dose so 1000 mg per day
capsules 500mg Oxacillin once every 6 hours ( depends on how long she is gonna tell us)
Rp / Oxacillin capsules 0.5g
no 4 * X
ds :capsules 500mg Oxacillin once every 6 hours ( depends on how long she is gonna tell us)
4
Q
oxacillin used in ? (diseases)
A
• treatment of staphylococcal infections;
• nfections of the skin and soft tissues (dermatitis, furunculosis, phlegms, mastitis, infected wounds and burns);
• ENT infections (external otites); dental abscesses;
• infections of the urogenital tract due to penicillin-secretory staphylococcus
• osteomyelitis, staphylococcal enterocolitis
- In the case of endocarditis or staphylococcal septicaemia, parenteral treatment should be used.
5
Q
AMPICILLIN respiratory infection and urinary infection
+ dose for child 35kg
+ serious desease
A
caspule AMPICILLIN 250 mg 2 every 6 hours for (depends on how long she tells us)
RP / AMPICILLIN capsule 0.25g
No 2 * X
ds : internal caspule AMPICILLIN 250 mg 2 every 6 hours (depends on how long she tells us)
For child = 35 * 50 =1750 mg —> 1750 / 4 = 430 mg every 6 hours
in serious diseases 4g/day so 1000 mg / 4 caps every 6 hours
6
Q
ampicillin used in ?
A
- genitourinary
- biliary
- Digestive
- caused by sesible germs: meningitis with Haemophilus influenzae, pneumococcus or meningococcus,
- respiratory bacterial infections (bronchitis, pneumonia), sinusitis, otitis
- urinary infections with Escherichia coli, Proteus
- acute gastroenteritis with salmonella, typhoid fever, bacterial dysentery
- whooping cough, septicaemia, endocarditis
- VERY WELL SUPPORTED BY PREGNANT WOMEN AND INFANTS!!
7
Q
AUGMENTIN tablets
A
(for mild infection for adult) 625 mg tablets augmentin twice a day (depends on how long she tells us)
Rp /Tablet augmentin 0.625 g
No : 2 * X
ds : internal 625 mg tablets augmentin twice a day (depends on how long she tells us)
For severe infection : 1 g tablet * 2/Day (Twice day)
Dental infection : 625mg twice day for 5 days (No : X)
Children between 3 months-1 year( 9kgs) : 9 * 25 =225 mg per day 7
Children over 6 years (18-40 kg): 5 ml Augmentin suspension 312 mg / 5 ml 3 times a day
8
Q
augmentin is used in ?
A
- Mixed infections with microorganisms sensitive to Amoxicillinum, or beta-lactamase-producing
• Infections of the upper respiratory tract, caused by pneumococcus, S.pyogenes, H. Influenzae
sinusitis
otitis media
• Infections of the lower respiratory tract, caused by pneumococcus, H. Influenzae
acute and chronic bronchitis
bronchopneumonia
• Genitourinary tract infections
cystitis, urethritis - E.Coli
gonorrhea
• Skin infections- Staphylococcus aureus, S. pyogenes.
• Dental infections - alveolodental abscess.
9
Q
Cefuroxime
A
Zinnat tablets 250 mg cefuroxime twice a day for xxx time
Rp : cefuroxime 0.25 g
No : 2* Xxxxxxx
ds internal Zinnat tablets 250 mg cefuroxime twice a day for xxxxx time
(500 mg per day for all the desease execpt in bacterial pneumopathies)
in bacterial pneumopathies: 1000 mg a day —> 4 caps a day of 250 mg
10
Q
cefuroxime is used on ?
A
- Infections of the lower respiratory tract : • acute and chronic bronchitis • pneumonia - Infections of the upper respiratory tract: • otitis media • Sinusitis • tonsillitis • pharyngitis. - Infections of the genitourinary tract: • • cystitis • • urethritis • • gonococcal urethritis • • cervicitis.. - Infections of the skin and soft tissues: • Furunculosis • Pilodermitis • Impetigo - - Meningitis produced by: • H. Influentzae • neumococcus • Meninggogic
11
Q
ERYTHROMYCIN
A
( Gonococcal urethritis) tablet form 200mg erythromycin 2 and half tablets twice a day for 14 days
Rp : erythromycin tablet 0.2g
no : LXX
Rp : internal tablet form 200mg erythromycin 2 and half tablets twice a day for 14 days
(For adult) : internal Suspended powder for oral use 1,5g/Day 30 min before meal
(In severe infections) : internal suspended powder 4g/Day, taken in 4doses
12
Q
ERYTHROMYCIN is used in ?
A
PENICILLIN ALLERGIC PATIENTS !! •Bronchitis • Diphtheria • neonatal conjunctivitis • Mycoplasma pneumonia, Chlamydia trachomatis in infants •pertussis • legionnaires' disease • sinusitis • otitis media • pharyngitis
13
Q
GENTAMYCIN gentamicinum
A
FOR ADULT 70 KGD A 2ml vial contains 40mg of gentamicin 2 mg per kg = 140 mg per day in 3 doses
In the case of microorganisms with sensitivity moderate or in the case where there is seen an improvement in the clinical rapid , dose daily is to increase at 3 mg / kg body
In case of serious infections , up to 5 ml / kg body / day can be administered distributed in 3-4 doses
- Duration of treatment : 3 to 7 (10) days .
14
Q
gentamicyn is used for ?
A
Infections of tract Respiratory
Bronchitis
pneumonia
- Infections of ways urogenital:
Pyelonephritis
Cystitis
urethral
prostatitis
- infection with gonococcus including those caused by species resistant to penicillin and other antibiotics
- Severe eye infections
- Treatment of infections in after burns serious
- Septicemia
- due to its action , it is very effective in fighting in- hospital infections = nosocomial
- it is indicated and in the case of patients with renal impairment light with disease of neuromuscular (eg. Disease Parkinson’s disease) but also in the elderly .
15
Q
clarithromycinum Claritromicina
A
250 mg film-coated tablets, 500 mg
Therapeutic schemes:
- Triple therapy (7-14 days): 500 mg Clarithromycin twice daily in combination with Lansoprazole 30 mg twice daily and Amoxicillin 1000 mg twice daily for 7-14 days.
- Triple therapy (7 days): Clarithromycin 500 mg twice daily in combination with Lansoprazole 30 mg twice daily and Metronidazole 400 mg twice daily for 7 days.
- Triple therapy (7 days): 500 mg Clarithromycin twice daily in combination with Omeprazole 40 mg once daily and Amoxicillin 1000 mg twice daily or Metronidazole 400 mg twice daily for 7 days.
- Triple therapy (10 days): 500 mg Clarithromycin twice daily in combination with Amoxicillin 1000 mg twice daily and Omeprazole 20 mg once daily for 10 days.
- Dual therapy (14 days): the usual dose is 500 mg Clarithromycin 3 times a day for 14 days. Clarithromycin should be given in combination with Omeprazole 40 mg orally once daily. Omeprazole 40 mg once daily for 28 days was used in the pivotal study. Omeprazole 40 mg once daily for 14 days was used in supportive studies.
16
Q
CLARITROMICINA IS USED FOR ?
A
- nasopharyngeal infections: o amigadalite or pharyngitis o of the paranasal sinuses - lower respiratory tract infections: or acute / chronic bronchitis o atypical pneumonia - skin infections: the impetigo the erysipelas a boil a folliculitis - Helicobacter Pylori eradication treatment
17
Q
doxycyclinum Doxiciclina
A
CAPSULEs of 100mg of doxiciclina, 2 capsules first day and after 1 caps per day (depend until when)
Rp : capsules of doxicicline 0.1g
no 1 * X +2
Ds : internal CAPSULEs of 100mg of doxiciclina, 2 capsules first day and after 1 caps per day (depend until when)
(serious infection ) : 200 mg every day
(for child) : 1st day 4mgweight, after it’s 2 mgweight
(Acute gonococcal infections in women) : 2x100mg per day until healing
(Primary sancre, secondary syphilis) : 300mg per day for 10 days
(Primary sancre, secondary syphilis) : 2x100mg per day for 7 days
18
Q
doxiciclina is used for ?
A
- Respiratory tract infections:
o antibiotic of choice in acute episodes of chronic bronchitis caused by:
pneumococcus
Streptococci
Haemophilus influenzae - Infections of the urogenital apparatus
a first choice antibiotic in Chlamydia infections
an alternative to penicillin treatment in infections caused by:
gonococci
Treponema pallidum - Infections of the digestive system:
o Cholera
a Whipple disease - Eye, skin and soft tissue infections
- Numerous strains of staphylococcus are resistant to Tetracycline
19
Q
metronidazolum Metronidazol
A
Oral tablets containing metronidazole 250 mg 3 (morning, afternoon, evening) TABLETS PER DAY DUNRING 7 DAYS
Rp : tablets metronidazole 0.25 g
No : XXI
Ds internal Oral tablets containing metronidazole 250 mg 3 (morning, afternoon, evening) TABLETS PER DAY DUNRING 7 DAYS
20
Q
metronidazolum Metronidazol is used for ?
A
Therapeutic indications
- Vaginal and urethral tricomoniasis
- liver dysentery
- Amebic liver abscesses
- anaerobic infections.
21
Q
Norfloxacinum
A
22
Q
Norfloxacinum
Form of presentation:
A
- Nolicin 400 mg: 400 mg film-coated tablets; box x 2 blisters. x 10 cpr.
- Norflox: Sol. oft / auric. 0.3%; ct. x 1fl. x 5 ml
- Norphloxacin: cps. 400 mg; ct x 1 fl. x 10 cps
23
Q
Norfloxacinum
Therapeutic action:
A
New-generation, broad-spectrum antibacterial fluoroquinolone; bactericidal by inhibiting bacterial DNA gyrase.
24
Q
Norfloxacinum Directions:
A
Complicated and uncomplicated urinary tract infections
• Gastroenteritis
• Endocervical and urethral gonococcal infection
• Prostate
25
Norfloxacinum Contraindications:
- hypersensitivity to norfloxacin
- tendinopathy caused by fluoroquinolones
- Child
- Task
- lactation
26
Norfloxacinum Precautions:
* At high doses (1200 and 1600 mg) and in case of alkaline urine (pH> 7) crystalluria was observed. Although no crystalluria was observed after the usual doses (400 mg twice a day in adults), adequate hydration should be provided to maintain a urinary flow of 1200-1500 ml / day.
* Caution in patients with a stroke and a history of severe cerebrovascular disease. during treatment. tendinitis can occur very rarely, which can progress to tendon rupture, especially of the Achilles tendon.
* Avoid sun or UV exposure. during treatment. long-lasting and / or in the case of nosocomial infections, resistant strains can be selected, especially between staphylococcus and pseudomonas.
* Caution in patients with myasthenia gravis, in those with a history of seizures or in the presence of factors that predispose to seizures.
27
Norfloxacinum SIDE EFFECTS :
- Retrosternal burns
- Abdominal pain and cramps
- Nausea
- Diarrhea
- Anorexia
- Pancreatitis (rare)
- Itching
- Photosensitization
- Exfoliative dermatitis
- Polymorphic erythema
- Stevens-Johnson syndrome
- Myalgias and / or convulsive arthralgias
- Mental confusion
- Hallucinations
- Headache
- Sleepiness
- Insomnia
- Depression
- Anxiety or nervousness
- Irritability
- Increased uremia and serum creatinine
- Increased transaminases, bilirubin and alkaline phosphatase
28
Norfloxacinum Administration method
• Adults: Gonococcal urethritis 800 mg in a single dose
- in prostatitis usually 400 mg every 12 hours for 28 days.
- in uncomplicated urinary tract infections 400 mg every 12 hours for 3 days.
- in case of complicated urinary tract infections, 400 mg every 12 hours, for 10-21 days. - in bacterial gastroenteritis 400 mg every 8-12 hours, for 5 days.
- In case of IR, for a Cl creatinine <30 ml / min - 400 mg once / day. It is administered on an empty stomach (one hour before or 2 hours after a meal).
29
Scobutil Form of presentation
- Tablets containing butylscopolamine bromide 10 mg (flac. With 20 pcs.);
- Suppositories containing butylscopolamine 10 mg or 7.5 mg (box of 6 pcs.);
- Ampoules of 1 ml aqueous solution for injection containing 10 mg butylscopolamine bromide (box of 10 pcs.).
30
scobutil Therapeutic Action
Digestive and genitourinary antispasmodic by parasympatholytic action and weak ganglioplegia; gastric antisecretory. intestinal absorption is poor and the duration of action is relatively short. The product is metabolized by the liver; a small amount is excreted unchanged in the urine. It does not cross the blood-brain barrier or the placenta.
31
scobutil Indications
- Intestinal, biliary, urethral colic,
- Painful spastic phenomena of the cavitary organs (pyloric or cardiac spasm),
- Gastroduodenal ulcer,
- Mucomembrane colitis;
- Dysmenorrhea;
- Sludge retention;
- For hypotonic duodenography and differential radiological diagnosis between functional spasms and organic stenosis
- .Secondary spastic disorders of the digestive tract, related to tubes or probes, also spasms that appeared during catheterizations, after bladder surgery,
- Prostate
- Cholecyst.
32
scobutil Contraindications
- Glaucoma,
- Prostate adenoma with urinary retention,
- Ileus paralytic,
- Megacolon,
- Mechanical obstruction in the digestive tract,
- Hiatal hernia with esophageal reflux,
- A supraventricular tachyarrhythmias;
- Caution in severe ischemic heart disease and in patients with marked hyperthyroidism.
- Caution when combined with quinidine, amantadine, tricyclic antidepressants (increases the risk of side effects).
33
scobutil Side effects
* Dry mouth
* Vision disorders
* Tachycardia
* Constipation
* Difficulty urinating (especially at high doses).
34
scobutil Administration method
Adults: 1-2 tablets 3-4 times / day.
• Children 4-10 years: 1/2 tablet 1-3 times / day.
In severe biliary or nephrotic colic: 1 vial of Scobutyl compound is injected very slowly intravenously. In cases where intravenous administration is not possible, the drug may be injected deep intramuscularly, in no case subcutaneously, due to possible phenomena of local intolerance. After removal of acute spastic phenomena by parenteral administration, treatment can be continued with suppositories.
1 suppository contains 1 g of algocalmin and 0.01 g of scobutyl
35
Adrenaline PRESENTATION FORMS:
- Tablets
- Injectible solution: ampoules of 1 ml injectible solution containing Epinephrine 1mg(package of 100 ampoules)
- Solution for internal use containing Epinephrine 1 mg/ml or 20 drops (20ml vial)
36
adrenaline THERAPEUTIC ACTION:
- Vasoconstriction in:
o skin territory
o mucous
o Splahnic territory
- vasodilation in:
o skeletal muscles territory
o cerebral territory
o coronary territory
- the heart is stimulated by direct action;
- stimulation is accompanied by increased myocardial oxygen consumption
- low doses of adrenaline: vasodilating action
- high doses, injected IV: vasoconstrictor action
- blood pressure rises sharply
- bronchodilation
- relaxation of digestive smooth muscles (except sphincters)
- relaxes the bladder (but contracts the bladder sphincter)
- relaxes the myometrium
- mydriasis by contraction of the radius muscle of the iris
- Increased blood sugar
- Increase in oxidative metabolism
- Increases ACTH secretion
37
adrenaline PHARMACOKINTEIC PROPERTIES:
- subcutaneous administration is followed by relatively slow absorption (3-5 minutes) due to local vasoconstriction.
- absorption is much faster in the case of MI
- rapidly inactivated in the body, especially in the liver
- it is excreted in the urine as inactive metabolites.
38
adrenaline indication
- The main indication is anaphylactic shock
- preferably injected IV, in the first minutes after the onset of the anaphylactic accident
- treatment of asthma attack in subcutaneous injections
- local: sometimes used for decongestant and antihemorrhagic purposes. It is added in small quantities, in the solution of Procaine or Lidocaine in order to prolong the local action of the anesthetic (decreases the absorption by vasoconstriction)
39
adrenaline CONTRAINDICATIONS:
- high blood pressure
- myocardial disease
- ischemic heart disease
- tachycardia
- atherosclerosis
- chronic pulmonary heart disease
- hyperthyroidism
- prostate adenoma
- severe kidney failure
- contraindications are relative in emergency conditions, which are life threatening
- sympathomimetics are considered doping substances (prohibited in athletes)
- caution when combined with atropine under anesthesia
40
adrenaline ADVERSE EFFECTS:
- toxic potential
- weakness
- faint
- brutal hypertension
- stroke
- ventricular fibrillation
- sometimes local ischemia due to excessive vasoconstriction.
41
adrenaline DRUG INTERACTIONS
- Do not administer during anesthesia with Cyclopropane and Halothane (severe arrhythmias)
- caution when combined with atropine under anesthesia
- Quinine is an antagonist of epinephrine
- Incompatibilities in solution:
o atropine
o Carbenicillin
o Cephalothin
o Chloramphenicol hemisuccinate
o Sodium Meticillin
o sodium and potassium benzylpenicillin
o hydrochloric tetracycline
o Vitamin C
- Co-administration of beta-blockers may cause severe hypertension and bradycardia
- Co-administration of alpha-blockers may decrease the intensity of the constricting effect of Epinephrine
42
adrenaline dosage
- subcutaneous injections 0.25-0.5 mg at a time (use 1% solution, officinal)
- IV is indicated less often - it is injected slowly, diluted 0.3-0.5 mg (with great caution).
- In anaphylactic shock, slow IV 0.1-0.5 mg (0.1-0.5 ml from the ampoule), diluted with 10 ml isotonic saline
- If not possible:
o 1/2-1 ampoule 0,5-1 mg is injected intramusculary
o Is administered perlingually 1mg-20drops of the solution for internal use or a vial possibly repeated after 1-15 minutes
- If not possible, inject the same dose into the heart cavity
- In cardiac syncope slow IV 0,5-1mg(1/2-1 ampoule)
- In asthma, subcuntaneous injections 0,3 mg (0,3 ml vial), possibly repeated every 20 minutes (maximum 2-3 doses)
- In local applications, as a hemostatic, in 1/1000000-1/2000 solution
- Associated with local anesthetics, in 1/200.000-1/20.000 solution
43
NYSTATIN presentation form :
- Folding cardboard box with 2/150 blisters of 10 tablets coated 500 000 IU
- Nistatin powder :Flacs containing 6 g powder containing 2,400,000 IU nistatin, 1 ml of suspension contains 120,000 IU.
44
nystatine therapeutic action :
- interfere with the permeability of the cell membrane of sensitive fungi
- Acts mainly on - Candida
- Aspergillus
- Cryptococcus neoformans
- Histoplasma capsulatum
45
nystatine Therapeutic indications :
Superficial candidiasis: - mucous membranes (oral, gastrointestinal, vaginal)
- skin
- The suspension is administere - Oral : important oro-pharyngeal lesions
- a local on the skin and mucous membranes
46
nystatine contraindication
specific allergy
47
nystatine Adverse reactions :
- Greatand and vomit
- Diarrhea
- irritation at local or intravaginal application
48
nystatine posology
- In adults, doses of 4,000,000- 6,000,000 IU/day, divided into 3-4 intakes
- Children> 6 years : 1,000,000-4,000,000 IU./day divided into 3-4 sockets
- Adm between meals is recommended, avoiding association with food
- The suspension is prepared by placing in the powder bottle with 2 vials of distilled water (20ml)
- shake the vial vigorously for 2-3 minutes
- a suspension of 120,000 IU is obtained
- Ready-made suspension is used for 4-6 days
- shake the vial vigorously before each use
- In vaginal infections, it is administered 2 times a day 100 000-200 000 IU, in local buffering.
49
Diazepam FORM OF PREZENTION:
- tablets containing Diazepam 2 mg/ 10 mg (jar of 30 pcs)
| - vials, solution for injection: vials of 2 ml injectable solution containing Diazepam 10 mg (box of 5 pcs)
50
diazepam THERAPEUTIC ACTION:
- sedative effect
- anticonvulsant
- skeletal muscle relaxant
- weak hypnotic effects
- the effect is fast
- it decreases anxiety and mental tension
- it reduces tension in schizophrenic patients
- it produces a peaceful sleep
- it appears in the blood a few hours after administration
- it reaches the maximum concentration after 2 hours
- it crosses the placental barrier
- it appears in lactate secretion
- it is metabolized in the liver
51
diazepam PHARMACOKINETIC PROPERTIES:
- it is quickly absorbed from the intestine
- it binds to plasma proteins in a large proportion (98%)
- it crosses the blood-brain barrier and the placenta
- it is excreted in breast milk.
- T1 / 2 is between 32 and 47 hours.
- Diazepam is metabolized in the liver
- urinary excretion
52
diazepam THERAPEUTIC INDICATIONS:
- anxiety
- neurosis
- in states of mental tension
- treatments for depression or psychosis
- treatment of skeletal muscle spasms and their pain associated with rheumatoid arthritis, in fractures
- adjuvant to epileptics
53
diazepam
| CONTRAINDICATIONS+ PRECAUTIONS:
- Patients taking Diazepam should not drive, work on dangerous machines or perform actions that require mental and physical coordination.
- do not drink alcohol during treatment with Diazepam.
54
diazepam SIDE EFFECTS:
- fatigue
- drowsiness
- Ataxia
- headache
- confusion
- depression
- blurred vision
- hypotension
- urinating difficulty
- libido difficulty
- may develop alcohol-barbiturate addiction
- IV: may cause apnea and/ or cardiac syncope
55
diazepam dosage
- The usual dose is 4-40mg/ day, the dose should be adjusted according to the disease and case
- ORAL or IV / IM injection
- ORAL: for adults and older children 2/5/10 mg / 1-2x / day
- Elderly 2 mg / 1-2x / day
- Slow IM / IV in adults and older children 2-20mg
- Tetanus: 200-400 mg / day
- mild anxiety: it will be taken 3 times / day 2 mg
- severe anxiety, various psychotic disorders: it will be taken 5-15mg 3 times / day
- In muscle spasms 5-15 m/ day distributed in 3 doses
- In the elderly it is recommended to give half of the adult dose
- Children will be administered approximately 0.5 mg/ kilogram/ day divided into 3-4 doses
56
ACC acetylcysteinum Form of presentation:
- 200mg capsules (original packaging with 20, 50, 100 capsules)
- 200mg effervescent tablets: Original packs of 10 or 20 effervescent tablets.
- Powder for oral solution -20 sachets x 3g
57
ACC acetylcysteinum composition :
```
- one capsule contains:
or acetylcysteine
or mannitol
a stearic acid
or dye
- effervescent cmp:
or acetylcysteine
an ascorbic acid
or lactose
or mannitol
or saccharin sodium
```
58
ACC acetylcysteinum Therapeutic action:
- expectorant
59
ACC acetylcysteinum Directions:
- diseases of the respiratory tract accompanied by abundant secretions of the mucous membranes
- acute and chronic bronchitis
- laryngitis
- sinusitis
- purulent otitis media
60
ACC acetylcysteinum Contraindications:
- not used in children under 2 years
- patients with lactose intolerance
- not indicated in case of hypersensitivity to Acetylcysteine
- not used in pregnancy and lactation
- may have a vasodilating effect
61
ACC acetylcysteinum side effect
stomatitis
- headache
- Itching
- Hives
- suffocation
- hypersensitivity
- pyrosis
62
ACC acetylcysteinum Administration method:
- In acute illness:
o in children aged 6-14 years twice a day with an effervescent tablet of ACC 200 (corresponding to 2x200 mg)
o for adults 3 times a day an effervescent tablet of ACC 200 (corresponding to 3 x 200 mg)
- In chronic diseases:
o in adults twice daily with an effervescent tablet of ACC 200 (corresponding to 2x 200 mg)
- In cystic fibrosis
o in children over 6 years of age 3 times a day an effervescent tablet of ACC 200 (corresponding to 3 x 200 mg).
- The effervescent tablets are administered dissolved in 1/2 glass of water.
- The duration of treatment will be determined according to the clinical picture
- In acute conditions, the duration of treatment is generally between 5-7 days
- In cystic fibrosis, a longer treatment will be done, in order to obtain the best effect. In chronic conditions, the doctor determines the duration of treatment.
63
Hidrocortizon hemisuccinat
| Pharmaceutical presentation:
- Vials of 5 ml solution containing Hydrocortisone hemisuccinate 25 mg, dissolved in one ml glycerinformol
- cans with 1 ampoule of Hydrocortisone and 1 ampoule often containing aqueous sodium bicarbonate solution
- boxes of 100 vials of 5 ml: 50 ampoules (clear glass) with active ingredient (solution A) and 50 ampoules (brown glass) with solvent (solution B)
64
HYDROCORTIZON HEMISUCCINATE Therapeutic action:
- Soluble hydrocortisone ester
- Actions:
o Anti-inflammatory
o Decongestant
o Antihypertensive
o Bronchodilators
a hepatic and antitoxic rotor
o intense and relatively fast [the effect develops after 2 hours of injection and lasts 8-12 hours]
65
HYDROCORTIZON HEMISUCCINATE Directions:
```
- severe infectious conditions:
o severe infections resistant to treatment, collapse or involvement of vital organs:
tuberculous or pneumococcal meningitis
Bacterial endocarditis
viral hepatitis
Infectious mononucleosis
transfusion error
severe allergic shock
acute collagenosis
Toxic pulmonary edema
Cerebral edema
transplant rejection crises
Acute adrenal insufficiency - Addisonian seizures or after adrenal alchemy
```
66
HYDROCORTIZON HEMISUCCINATE side effect
- it is possible the appearance of signs of adrenal and antehypophyseal depletion
- Excessive intravenous injection of high doses may cause cardiovascular collapse
67
HYDROCORTIZON HEMISUCCINATE Contraindications:
- Gastro-duodenal ulcer
- acute psychosis
- diabetic ketoacidosis
- IC
- Diabetic hypertension
- HTA
- TB
- infections with neurotropic viruses [area, chickenpox, corneal herpes],
- in infections it is mandatory to combine specific antibiotics or chemotherapeutics.
- Sol. added to glucose solutions can be used for up to 4 hours
- added to the blood can be used for up to 2 hours
- in case of treatment with insulin or heparin the doses should be increased
- Glucocorticoids are on the list of doping substances [banned in athletes]
68
HYDROCORTIZON HEMISUCCINATE Administration method:
- Doses range from 0.100 to 0.500 g
- In anaphylactic shock: 1 g of preparation within a few minutes, then 0.500 g every 6-8 hours, for 3-5 days if needed
- In children, doses lower than 0.25g / 24h are used
- IV, in slow injection [a few minutes] or IV infusion (500-1000 ml of 5% glucose in water or isotonic chlorosodium solution is added to the solution, possibly to the same amount of saline)
- in adults 100 mg-l g Hydrocortisone, repeating, as needed, at 8-hour intervals, no more than 2-3 days
- in children, 5-20 mg / kilobody for one dose
- Mix the 2 ampoules, possibly dilute
69
Aspirin Pharmaceutical presentation:
- bottle with 30 compartiments of 0,100 g.
| - lamineted paper strips with 20 compartiments of 0,500g
70
aspirin Therapeutic action:
- analgesic
- anti-inflammatory
- antipyretic
- antiplatelet agent
71
aspirin indication :
```
-Curative in:
• Moderate pain:
o Headache
o Neuralgia
o Myalgia
o Arthralgia
o Postoperative algee
• Fever
• Inflammatory conditions
-prophylactic for the prevention of arterial and venous thrombosis
```
72
aspirin Contraindications:
-product hypersensitivity
-active gastrointestinal disorders:
• Gastritis
• Gastric or duodenal ulcer
-severe liver and kidney disease
-deficit of G-6-PD
-hemorrhagic diathesis (hemophilia hypoprothrombinemia)
-children under one year
73
aspirin side effect :
-Disorders may occur:
• Gastrointestinal
o Heartburn
o Pirozis
-product hypersensitivity(skin rash, bronchospasm)
-favors the tendency to hemorrhages
-Reye’s syndrome in children whith chickenpox or the flu
74
aspirin Administration method:
-per bone, preferably after meals or with an anti acid
-it’s recommended to crush the tablets before administration
-Adults:
o As an analgesic and antipyretic: 10-15 mg/kgc (300-900 mg) at 4-6 hours
o As an anti-inflammatory: 20-40mg/kgc at 12 hours
o As an antiplatelet agent: 0,5g at 2 days
-Children:
o as an analgesic and antipyretic:50-65 mg/kg body/24 hours divided in 4 to 6 rounds
o as an anti-inflammatory: 120-140 mg/kg body/day 2-3 days then 100 mg/body kg/day for the next 4-7 days.
75
paracetamolum Acetaminofen - Paracetamol PRESENTATION FORMS:
- Tablets containing Paracetamol 500 mg/ 100 mg
- rectal suppositories containing Paracetamol 250 mg and 125 mg. – boxes of 6 suppositories
- Paracetamol 100/200 Berlin-Chemie- soil for internal use 5 ml soil (1 teaspoon measure) contains 120/200 mg Paracetamol – bottle with 60 ml solution/ 100 ml solution
76
paracetamolum Acetaminofen - Paracetamol TERAPEUTIC ACTION:
- Analgesic and antipyretic with moderate intensity action, similar to Fenacetin.
77
paracetamolum Acetaminofen - Paracetamol TERAPEUTIC INDICATIONS:
- headache
- dental pain
- Neuralgia
- Myalgia
- febrile states
78
paracetamolum Acetaminofen - Paracetamol Contraindications:
- Specific allergy
- liver failure
- Serious IR
- caution during pregnancy, especially in the first trimester
79
paracetamolum Acetaminofen - Paracetamol ADVERSE REACTIONS:
- is less toxic than Fenacetin
- allergic rash
- Thrombocytopenia
- anemia
- Agranulocytosis
- kidney damage
- hepatic necrosis (at toxic doses)
80
paracetamolum Acetaminofen - Paracetamol MEDICAL INTERACTIONS
- Decrease the effect and increase the hepatotoxicity of paracetamol:
o Barbiturates
o Alcohol
o Carbamazepine
o Hidantoine
o Rifampycin
o Rifabutin
o Diflunisal
o Sulfinpirazone
- Hypoprothrombinemia: Warfarin
- Bone marrow suppression: Zidovudine
81
paracetamolum Acetaminofen - Paracetamol Posology:
- In adults and children over 12 years of age:
a regular dose is 500 mg every 6-8 hours
o a minimum interval of 4 hours between sockets will be observed
o Do not exceed the maximum dose of 1g/take and 4g/ 24 hours
o For long-term treatment, the maximum dose/day is reduced to 2.5 g
o For higher doses the treatment will be performed under strict medical supervision.
o Children between 6 and 12 years: 250-500 mg at 6-8 hours
o Children between 3 and 6 years: 125-250 mg at 6-8 hours.
- Paracetamol sinus:
o Adults: 3-6 tablets/day, divided into 3 sockets (morning, noon and evening)
o Do not take more than 6 tablets/day and 2 tablets/take
o Children between 5-10 years: 1-2 tablets/day (depending on age)
o Do not exceed the maximum dose of 2 tablets/day
o between 10-15 years: 2-3 tablets/day (depending on age)
o Do not take more than 3 tablets/day
o In children, no more than 1 tablet should be given at a time
o Tablets are taken half an hour before meals.
- Paracetamol 100:
o children 1-6 years: 1-2 tablets (after age)
o Children over 6 years: 2-4 tablets (after age)
o The dose may be repeated, if necessary, 4 times a day.
- Paracetmol 125, 250 suppositories:
o children 6-12 months: 1/2 suppository of 125 mg, 3 times a day
o children 1-3 years: a suppository of 125 mg, 3 times a day
o children 3-7 years: a suppository of 250 mg 1-2 times/day
o children 7-15 years: a suppository of 250 mg 1-3 times/day
o It is preferable that the duration of treatment does not exceed 10 days.
- Paracetamol 120/200 Berlin-Chemie, solution for internal use:
o is administered with the 5 ml measuring spoon or the 5 ml graduated lid.
o The dose administered is dependent on the patient's age and weight, generally 10 - 15 mg/kg body Paracetamol once, up to 50 mg/kg body as the total daily dose
o Children under 6 months will be given in 3 - 4 fractional doses 70 - 100 mg (daily dose max. 350 mg)
o Children under 1 year 3 - 4 times /day 100 - 150 mg, max. 500 mg /day
o Children under 3 years of age 3 - 4 times a day 150 - 200 mg (max. 750 mg/day)
o Children under 6 years of age 3 - 4 times /day 200 - 300 mg (max. 1 000 mg /day)
o Children under 9 years of age 3 - 4 times/day 300 - 500 mg (max. 1,500 mg /day)
o Children under 12 years of age 3 - 4 times 400 - 600 mg (max. 2 000 mg/day).
o In adolescents over 12 years of age 3 - 4 times /day 500 - 1 000 mg (max. 4 g/day)
o Patients with liver or kidney failure or in the case of Gilbert syndrome the doses will be decreased.
82
Algocalmin PRESENTATION FORMS:
- Tube with 10 tablets
- Tablets containing Metamizol sodium 500 mg
- Boxes with 6 suppositories for children
- suppositories containing Metamizol sodium 1 g for 300 mg
- boxes with 5 ampoules of 2ml/5 ml
- ampoules of 2 ml/ 5ml injectable aqueous solution containing Metamizol sodium 1 g
83
Algocalmin TERAPEUTIC ACTION:
- analgesic
- Antipyretic
- anti-inflammatory
- weak antispastic
84
Algocalmin TERAPEUTIC INDICATIONS:
- headache
- Neuralgia
- lumbago
- rheumatic joint and muscle pain
- postoperative pain
- febrile states
- colic (renal, ureteral)
85
Algocalmin Contraindications:
- Absolute:
an allergic history to Pirazolone
hypersensitivity to NSAID
a history of agranulocytosis in Pirazolidine derivatives
a hepatic porphyria
a congenital deficiency of 6-phosphate-dehydrogenase glucozo
o kidney disease
- Relative:
an asthma
o frequent upper respiratory tract infections
a common rhinitis and rhinosinusitis
an intolerance to other analgesics, with a cross-allergy possible
86
Algocalmin ADVERSE REACTIONS:
- Hematological: agranulocytosis, leukopenia, anemia or thrombopenia.
- erythema, pruritus
- renal failure
- interstitial nephropathy manifested by:
oliguria
an anuria
a proteinuria
- Asthma attacks in patients with cross allergy with Aspirin
- red staining of the urine
87
Algocalmin precaution :
- Avoid use during the first 3 months of pregnancy
- may be administered during lactation.
- If fever persists or occurs after taking Metamizol or if ulcerative lesions occur in the oral cavity, immediately discontinue treatment
88
Algocalmin Posology:
- Adults: 1-2 tablets 1-2 times/day or 2-5 ml 1-2 times /day
o in slow/ iM Iv injections
o 1-3 suppositories for adults /day
- Children: 1 -2 tablets, by age or 1-3 suppositories for children /day
89
CEFALEXIN Form of presentation:
- Box x 1 bottle of powder for 60ml suspension
- 500 mg capsules
- 250 mg capsules
- Keflex 250 mg: Oral suspension 5 ml
- Keflex 125mg: 5ml oral suspension
- Keflex 100 mg drops for pediatric use: 1ml solution
90
CEFALEXIN Therapeutic action
- Inhibits bacterial wall synthesis
- Bacteria that divide quickly are more susceptible to the action of Cefalexin
- The spectrum of action includes:
CG +: staphylococci, hemolytic alpha and beta streptococci, pneumococcus
BG-: E.coli, Klebsiella, Proteus, Salmonella, Shigella
CG-: Neisseria
- Resistant germs:
Methicillin-resistant Staphylococcus aureus,
Methicillin-resistant Streptococcus epidermidis,
Haemophyllus influenzae (most strains),
91
cefalexin Pharmacokinetic properties:
- Rapidly absorbed after oral adm
- digestive absorption
- ensures the achievement of plasma levels comparable to those obtained by IM administration
- Absorption is fast and total in the duodenum
- The presence of food is delayed, but does not diminish absorption
- has good diffusion in tissues and organs.
- CSF diffusion is poor
- It crosses the placenta and is excreted in small amounts in breast milk
- It is not metabolized in the body
- Excretion occurs mostly by the kidneys (glomerular filtration and tubular secretion), in active form
- Biliary excretion is very weak
92
cefalexin Indications
- Otitis media caused by:
Pneumococcus
Haemophilus influenzae
Staphylococci
- Infections of the lower respiratory tract
Pneumococcus
Haemophilus influenza
Staphylococci
- Infections of the upper respiratory tract, including pharyngitis and angina - S. pyogenes
- effective in:
acute and chronic urinary tract infections
Skin and soft tissue infections caused by Staphylococcus aureus and S. pyogenes
Sinusitis
Gonococcal urethritis
- There is currently insufficient evidence to establish the efficacy of cephalexin in the prophylaxis of RAA
and bacterial endocarditis
93
cefalexin Contraindications
- Hypersensitivity to Cephalosporins
- It is avoided during breastfeeding and the first months of pregnancy
- Prudence in IR
- In combination with aminoglycoside antibiotics or highly active diuretics (furosemide), monitoring of renal function is recommended.
- Precaution: Penicillin-sensitive patients
94
cefalexin Side effects :
- Adults: the dose varies between 1-4 / day
o Usually: 1-2 g / day in doses from 4-6h;
o Maximum dose 4g / day
o If doses> 4g are required, parenteral administration should be considered
- Children: 25 - 50mg / kg body / day divided into 8 -12 hours;
o Dose max4g / day
- Elderly: the same dose as in adults if the patient has no kidney damage
95
cefaclor FORMS OF PRESENTATION:
- Ceclor 250 mg: capsules, each equivalent to 250 mg (0.68 mmol) cefaclor.
- Ceclor 500 mg: capsules, each equivalent of 500 mg (1.36 mmol) cefaclor.
- Ceclor 125 mg: granules, to obtain 60 ml, 75 ml, respectively 100 ml of suspension, each 5 ml equivalent
to 125 mg (0.34 mmol) of cefaclor.
- Ceclor 187 mg: granules, to obtain 50 ml / 100 ml suspension, each 5 ml equivalent to 187 mg (0.51
mmol) cefaclor.
- Ceclor 250 mg: granules, to obtain 60 ml / 75 ml / 100 ml suspension, each 5 ml equivalent to 250 mg
(0.68 mmol) cefaclor.
- Ceclor 375 mg: granules, to obtain 50 ml, respectively 100 ml of suspension, each 5 ml equivalent of 375
mg (1.00 mmol) cefaclor.
- Ceclor 125 mg: chewable tablets, each equivalent to 125 mg (0.34 mmol) cefaclor. Ceclor 250 mg:
chewable tablets, each equivalent to 250 mg (0.68 mmol) cefaclor.
96
cefaclor THERAPEUTIC ACTION
- is wider in generation II than in cephalosporins in generation I
- more resistant to beta-lactamases
- more active on BG-
- more active on:
• staphylococci
• Proteins
• Enterobacter
- Haemophilus Influentzae strains secreting beta-lactamases are sensitive
- active in vitro against the following organisms:
o alpha and beta-hemolytic streptococci
o Staphylococci
o Streptococcus pyogenes
o Escherichia coli
- is not active against:
o Pseudomonas
o methicillin-resistant staphylococci
o most strains of enterococci
97
cefaclor PHARMACOKINETIC PROPERTIES:
- well absorbed after oral administration before a meal
- Total absorption remains unchanged in the presence of food; but peak plasma levels are reduced by
almost half, and peak levels are delayed.
- After pre-meal administration of 250 mg, 500 mg, and 1 g, respectively, maximum plasma concentrations
of 7, 13, and 23 mg / l, respectively, were obtained in 30 to 60 minutes.
- The serum half-life is 0.6 to 0.9 hours
- Probenecid significantly prolongs the half-life.
- In patients with reduced renal function, the half-life of serum is slightly prolonged.
- In patients whose kidney function is completely absent, the half-life of intact molecules is 2.3 to 2.8 hours.
- Hemodialysis shortens the half-life by 25-30%.
- is 50% bound to plasma proteins.
- The drug is rapidly excreted by the kidneys; up to 85% is present unchanged in the urine after about 8
hours, mostly in 2 hours. During these 8 hours, the maximum urine concentrations, after administration of doses of 250 mg, 500 mg and 1 g were approximately 600, 900 and 1 900 mg / l, respectively.
- Small amounts of Cefaclor have been detected in breast milk after a dose of 500 mg
98
cefaclor THERAPEUTIC INDICATIONS:
- Otitis media caused by:
Pneumococcus
Haemophilus influenzae
Staphylococci
- Infections of the lower respiratory tract
Pneumococcus
Haemophilus influenzae
Staphylococci
- Infections of the upper respiratory tract, including pharyngitis and angina - S. pyogenes
- has been shown to be effective in:
acute and chronic urinary tract infections
Skin and soft tissue infections caused by Staphylococcus aureus and S. pyogenes
Sinusitis
Gonococcal urethritis
- Urinary tract infections with E.Coli
99
cefaclor
| CONTRAINDICATIONS AND PRECAUTIONS:
- Hypersensitivity to Cephalosporins, Penicillins or other drugs.
- Prior to the introduction of Cefaclor therapy, careful consideration should be given to the presence of
- If this product is to be administered to patients sensitive to Penicillin, care must be taken because cases of
anaphylactic shock have been reported after administration of beta-lactam antibiotics to hypersensitive patients.
- The drug should be administered with great care in patients with known allergic episodes.
- Pseudomembranous colitis has been reported with most broad-spectrum antibiotics.
100
cefaclor side effects
- Diarrhea, nausea and vomiting
- Hives and itching
- morbiliform eruptions
- less common:
o Stevens-Johnson syndrome
o anaphylactic shock
o toxic necrotic epidermolysis
o cases of thrombocytopenia
o a slight increase in the ASAT and ALAT tests
o a transient hepatitis
o a gallbladder jaundice
- thrombocytopenia
- polymorphic erythema
101
cefaclor DOSAGE:
o Orally
o Adults: The usual dose is 250 mg every 8 hours. The total daily dose should not exceed 4 g / day.
o Children: The usual recommended daily dose is 20 mg / kg body weight / day divided into doses
administered at 8 hours. In case of more serious infections, otitis media, sinusitis and infections caused by less susceptible organisms, 40 mg / kg body / day in divided doses is recommended, up to a maximum of 1 g / day.
102
Tetracycline Form of presentation
Blisters with 10 250mg capsules
| - Capsules containing 250 mg tetracycline in the form of hydrochloride.
103
tetracycline Therapeutic action
Broad-spectrum antibiotic, bacteriostatic.
- The spectrum shall comprise:
```
• G- and G+ germs
• rickettsial
• spirochete
• actinomycetes
• some protozoa
• some large viruses
- The action is reduced compared to:
o Treponema
o Leptospire
o mycobacteria
o Different strains of proteus or Pseudomonas are usually resistant.
```
104
tetracycline Pharmacokinetic properties
Bioavailability after oral administration is around 77%
- Administration in this way of a dose of 500 mg achieves in 1-2 h a plasma concentration ranging between 2.5 and 3.5 mcg / ml
- These values are higher than CMI for sensitive bacteria
- Foods, especially dairy products, as well as preparations containing calcium, magnesium and fiber significantly reduce absorption
- The average half- life of biological attraction is 10.6 h
- Tetracycline is 65% bound to plasma proteins .
- Diffuses very well in most tissues and biological fluids
- Very high concentrations are reached in the urine and bile
- It diffuses in the CSF only in a small proportion
- It accumulates in
o reticuloendothelial tissue
o bones
o dentine
o tooth enamel
- Stool elimination represents 20-50%, and urinary elimination 30-60% of the oral dose.
105
tetracycline Therapeutic indications
- Infections of the upper and lower respiratory tract:
o acute episodes of chronic bronchitis
o interstitial pneumonia caused by Chlamydia / Mycoplasma
o sinusitis
- Urogenital infections:
o urethritis with Mycoplasma or Chlamydia
o adnexitis
o gonorrhea
o syphilis (if the patient is hypersensitive to Penicillin )
- Bile duct infections:
o Cholecystitis
- Infections of the gastrointestinal tract:
o Cholera
o Whipple's disease
- Severe forms of acne vulgaris
- Tetracycline Ointment :
o Prophylactic, in superficial skin lesions likely to be infected with pyogenic germs
o Therapeutically, in superficial skin infections, with germs sensitive to Tetracycline
106
tetracycline Contraindications
- Allergy to T etracycline
- Severe liver function disorders
- Kidney failure
107
tetracycline side effects
- Nausea
- epigastric discomfort
- diarrhea
- The appearance of tetracycline-resistant germs in the intestine causes severe diarrhea
- Photosensitization
- Allergic manifestations occur very rarely
108
tetracycline dosage
- preferably after meals
- with a small amount of fluids
- Adult : 2-4g / day distributed in equal doses at 6h
- Children> 7 years : 25-50mg / kg body weight distributed in doses at 6 hours
109
omeran Form of presentation
Operated capsules. Cardboard folding box containing 2 blisters of 10 capsules each.
110
omeran indication
```
o Evolutionary duodenal ulcer
o Evolutionary gastric ulcer
o Reflux esophagitis
or Zollinger-Ellison Syndrome
o It is also indicated as a preventive treatment in case of recurrence in reflux esophagitis and in gastric and duodenal ulcer difficult to control.
```
111
omeran contraindication
Hypersensitivity to omeprazole.
112
omeran side effects
Omeprazole is generally well tolerated. Diarrhea, headache, nausea, bloating, constipation, rash, photosensitivity may occur. Haematological disorders have been reported: anemia, neutropenia, pancytopenia, thrombocytopenia. These manifestations are transient and of moderate intensity.
Precautions for administration: In case of gastric ulcer, it is recommended to check the benignity of the lesions before starting the treatment. As with other gastric antisecretory drugs, omeprazole promotes the growth of intragastric bacteria by reducing the volume and acidity of gastric juice, especially in the case of long-term treatments. In children, the efficacy and tolerability of the drug have not been studied.
113
omeran adminitration methods
• Adults: - Duodenal ulcer: 20 mg / day (one dose) for 2 weeks. If the cure is not complete, the treatment can be extended by 2 weeks. If it is an ulcer refractory to other treatments, 40 mg / day (in a single dose) can be used for 4 weeks. In case of relapses, the same treatment regimens can be applied again.
- Gastric ulcer: 20 mg / day for 4 weeks. If it does not heal, additional treatment is recommended for another 4 weeks. In case of relapses, the same treatment scheme is applied. In those with gastric ulcer refractory to other treatments: 40 mg / day for 8 weeks.
- Reflux esophagitis: 20 mg / day for 4 weeks. Additional treatment, if necessary, 4 weeks.
- Refractory esophagitis at other treatments: 40 mg / day, 8 weeks. Recurrence: the treatment schedule is repeated. Maintenance treatment: In patients with recurrent reflux esophagitis, relapses of 20 mg omeprazole / day with a duration of treatment of up to 6 years can be prevented. /day. In refractory cases cured by omeprazole (40 mg / day) preventive treatment of 20 mg / day may be insufficient. The dose may be increased to 40 mg (single daily dose). Zollinger-Ellison Syndrome: Treatment is individualized; its duration depends on the clinical manifestations. Patients with severe forms who do not respond to other therapeutic methods have been successfully treated (in 90% of cases) with doses ranging from 20 to 120 mg / day. For a dose above 80 mg / day, the daily dose should be divided into two doses.
• Children: No clinical experience is required to establish an adequate dosage. In case of renal or hepatic impairment, no dose adjustment is required in the elderly.
114
Ciprofloxacine Form of presentation :
- Boxes with 5 ampoules/10 ampoules of colourless glass provided with breaking ring for infusion solution
- 10 ml vial (Concentrated for infusion solution) contains 100 mg ciprofloxacine => 100mg/ 10 ml
- Tablets coated 250/ 500 mg (boxes with 10-20 tablets coated)
- Concentrate for infusion solution
- Tablets coated 250/ 500 mg (boxes with 10-20 tablets coated)
- CIPROFLOXACINA 100 mg/10 ml (Concentrate for infusion solution)
- CIPROFLOXACINA ARENA 250 mg (COMPR)
- CIPROFLOXACINA INFOMED 2mg/dl (Infusion solution)
- CIPROFLOXACINA ARENA 500/750/100 mg (Filmed tablets)
- CIPROFLOXACINA OZONE 250mg (filmed tablet)
- CIPROFLOXACINA CLARIS 2mg/ml (infusion solution)
115
Ciprofloxacine Therapeutic action
* ANTIBACTERIAL CHINOLONE FLUOROCHINOLONE
* Fluoroquinolone with strong bactericidal action and wide spectrum of action.
* The bactericidal action is due to disturbance of the synthesis of DNA bacteria by inhibition of DNA gyrase (topoisomerase), the enzyme that catalyzes the condensation of double helical strands of DNA during division, so that they fit into the cell.
* preventing superspiration (which follows the breakdown of DNA chains ) makes it impossible for normal chromosomes and plasmids to segregate , causing division to stop and death of sensitive microorganisms .
116
Ciprofloxacine Pharmacokinetic properties
- Maximum blood C% is reached 60-90 minutes after ingestion
- The half-life is between 3 and 5 hours.
- present in large numbers at the site of infection
117
ciprofloxacine Therapeutic indications
respiratory infections
- ENT infections
- kidney infection, urogenital them
- pelvic infections
- bone and joint infections
- abdominal infections
- skin and soft tissue infections
- septicemia with BG-
- prophylactic in patients with depressed immune system
- infectious diarrhea caused by enterotoxic strains of E. coli
118
ciprofloxacine Contraindication :
- hypersensitivity to Ciprofloxacin, to other Chinolones or to any of the excipients of the product
- pregnancy and lactation
- history of tendinopathy in F luoroquinolone.
- Ciprofloxacine may cause stimulation of the central nervous system manifested by
o umlaut
o asthenia
o photophobia
o confusion
o very rarely hallucinations or convulsions
- using Ciprofloxacine may cause crystalluria, if urine has a pH alkaline.
- and consequently it is necessary an adequate hydration and avoiding the alkalization of the urine .
- the daily dose should not be exceeded.
- in patients with impaired renal function it may be necessary to adjust the dose.
- Treatment with Ciprofloxacin is not recommended in children during the growing period , except in exceptional cases of serious infections with germs resistant to other antibiotics .
119
ciprofloxacine Side effects:
```
Digestive:
o Nausea
o diarrhea
o vomiting
o abdominal pain
o flatulence
- Neurological:
o Dizziness
o DISORDERS
o Fatigue
o Confusion
o very rarely drunk
o in isolated cases psychotic reactions
o taste and smell disorders
o visual disturbances
o temporary hearing impairment
o intracranial hypertension
o worsening of myasthenia gravis symptoms
```
120
ciprofloxacine Drug interactions
Concomitant administration with Theophylline => increase the plasma concentration of Theophylline.
- Association with Cyclosporine => transient increase in creatinineemia.
- The association with Warfarin enhances the anticoagulant action of Warfarin, with hemorrhagic risk. In this case it is necessary to monitor the prothrombin time and the INR.
121
ciprofloxacine Dosage ; Method of administration :
- Ciprofloxacine 100 mg / 10 ml : IV infusion for 30-60 minutes in C% = 1-2 mg / ml, in isotonic saline or glucose 5% solution
- It is not recommended to mix infusion concentrate for the soil with other medicines
- It is impossible to continue the treatment for another 3 days after the disappearance of the fever or clinical symptoms
- The duration of treatment depends on the severity of the disease and the clinical and bacteriological evolution.
- It is important to continue treatment for another 3 days after the disappearance of fever or clinical symptoms
- 500 mg tablets: single, daily dose; about 7-14 days;
- Normal kidney function:
o The usual dose is 200 mg / 2-3x / day
o In severe infections: adm up to 400 mg / 2-3x / day
o It can be used with other antibiotics depending on the result of the antibiogram
- IR:
o Creatinine clearance 31-60 ml / min or creatinine clearance 124-168μmol / l: one dose or 2 doses are allowed, the maximum dose being 800mg / day
o Creatinine clearance <30 ml / min or creatinine> 169μmol / l => maximum recommended dose of 400mg / day in a single dose
- Children and adolescents: 20-30mg / kg / body / day divided into 2 doses, depending on the severity of the infection
- The duration of treatment should not exceed 14 days;
