21 December, 2024
    Kev khomob thiab kev tiv thaiv

    Augmentin hmoov: cov lus qhia rau kev siv

    Npe sau npe: P N015030 / 04-131213
    Hom Lub Npe: Augmentin®
    Thoob ntiaj teb uas tsis yog tus tswv lossis cov pab pawg npe: amoxicillin + clavulanic acid.
    Daim ntawv noj tshuaj: Hmoov rau kev ncua rau kev tswj hwm qhov ncauj.

    Cov tshuaj muaj pes tsawg leeg
    Yam tshuaj muaj zog:
    Amoxicillin trihydrate nyob rau hauv cov nqe lus ntawm amoxicillin 125.0 mg, 200.0 mg lossis 400.0 mg hauv 5 ml ntawm kev ncua.
    Poov tshuaj clavulanate nyob rau hauv cov nqe lus ntawm clavulanic acid 31.25 mg, 28.5 mg lossis 57.0 mg hauv 5 ml ntawm kev ncua.
    Cov muaj tswv yim:
    Xanthan ntawm cov pos hniav, aspartame, succinic acid, colloidal silicon dioxide, hypromellose, txiv kab ntxwv tsw 1, txiv kab ntxwv tsw 2, ntxhiab tsw ntxhiab tsw ntxhiab tsw ntxhiab, Lub teeb daj tsw tsw zoo, silicon dioxide.
    Qhov sib piv ntawm cov khoom siv nquag hauv kev ncua

    Dosage form Qhov sib piv ntawm cov nquag ua haujlwm Amoxicillin, mg (hauv daim ntawv ntawm amoxicillin trihydrate) Clavulanic acid, mg (hauv daim ntawv ntawm potassium clavulanate)
    Hmoov rau kev ncua 125 mg / 31.25 mg hauv 5 ml 4: 1 125 31.25
    Hmoov rau kev ncua 200 mg / 28.5 mg hauv 5 ml 7: 1,200 28,5
    Hmoov rau kev npaj qhov kev ncua ntawm 400 mg / 57 mg hauv 5 ml 7: 1 400 57

    Kev piav qhia
    Rau qhov ntau npaum ntawm 125 mg / 31.25 mg nyob rau hauv 5 ml: hmoov ntawm cov xim dawb lossis yuav luag xim dawb, nrog cov yam ntxwv ntawm tus ntxhiab tsw. Thaum diluted, ib qho kev ncua ntawm dawb lossis yuav luag dawb yog tsim. Thaum sawv ntsug, ib qho dej dawb lossis dawb yuav luag nag lossis daus maj mam ua kom qeeb.
    Rau qhov ntau npaum ntawm 200 mg / 28.5 mg hauv 5 ml lossis 400 mg / 57 mg hauv 5 ml: hmoov hmoov dawb lossis yuav luag dawb, nrog tus yam ntxwv tsw. Thaum diluted, ib qho kev ncua ntawm dawb lossis yuav luag dawb yog tsim. Thaum sawv ntsug, ib qho dej dawb lossis dawb yuav luag nag lossis daus maj mam ua kom qeeb.

    Pharmacological pawg: Tshuaj tua kab mob, ib nrab hluavtaws penicillin + beta-lactamase inhibitor.

    ATX Code: J01CR02

    PHARMACOLOGICAL COV CAI

    Cov Tshuaj Hauv Tshuaj
    Mechanism ntawm kev ua
    Amoxicillin yog cov tshuaj tua kab mob ntau tshaj ib nrab hnub nrog kev ua si tiv thaiv ntau yam kab mob gram-positive thiab gram-tsis zoo. Tib lub sijhawm, amoxicillin tiv thaiv kev puas tsuaj los ntawm beta-lactamases, thiab yog li ntawd cov spectrum ntawm kev ua ntawm amoxicillin tsis txuas ntxiv rau cov kab mob me me uas tsim cov enzyme no.
    Clavulanic acid, beta-lactamase inhibitor yam ntxwv ntawm kev siv rau penicillins, muaj peev xwm tsis muaj peev xwm tsis ua haujlwm ntau ntawm beta-lactamases pom muaj nyob rau hauv penicillin thiab cephalosporin resistant microorganisms. Clavulanic acid muaj kev ua tau zoo txaus los tiv thaiv plasmid beta-lactamases, uas feem ntau txiav txim siab qhov tawm tsam ntawm cov kab mob, thiab tsis muaj kev tiv thaiv zoo tiv thaiv cov chromosomal beta-lactamases hom 1, uas tsis yog tshuaj tiv thaiv los ntawm clavulanic acid.
    Muaj cov clavulanic acid nyob hauv kev npaj Augmentin® tiv thaiv amoxicillin los ntawm kev puas tsuaj los ntawm cov enzymes - beta-lactamases, uas tso cai nthuav tawm cov tshuaj tua kab mob ntawm amoxicillin.
    Cov hauv qab no yog hauv kev ua haujlwm hauv vitro ntawm amoxicillin nrog clavulanic acid.
    Cov kab mob feem ntau cuam tshuam rau kev sib xyaw ntawm amoxicillin nrog clavulanic acid
    Gram-zoo aerobes
    Bacillus anthracis
    Enterococcus faecalis
    Listeria monocytogenes
    Nocardia asteroides
    Streptococcus pyogenes1,2
    Tus kab mob Streptococcus agalactiae 1.2
    Streptococcus spp. (lwm beta hemolytic streptococci) 1,2
    Staphylococcus aureus (methicillin rhiab) 1
    Staphylococcus saprophyticus (methicillin rhiab)
    Coagulase-negative staphylococci (rhiab rau methicillin)
    Gram-zoo anaerobes
    Clostridium spp.
    Peptococcus niger
    Peptostreptococcus magnus
    Peptostreptococcus micros
    Peptostreptococcus spp.
    Gram-negative aerobes
    Bordetella mob hnoos qhuav
    Haemophilus influenzae1
    Helicobacter pylori
    Moraxella catarrhalis1
    Neissevia gonorrhoeae
    Pasteurella multocida
    Vibrio mob raws plab
    Gram-negative anaerobes
    Bacteroides fragilis
    Bacteroides spp.
    Capnocytophaga spp.
    Eikenella corrodens
    Fusobacterium nucleatum
    Fusobacterium spp.
    Porphyromonas spp.
    Prevotella spp.
    Lwm yam
    Borrelia burgdorferi
    Leptospira icterohaemorrhagiae
    Treponema pallidum
    Cov kab mob rau cov uas yuav tiv taus cov tshuaj amoxicillin nrog clavulanic acid yog qhov yuav tshwm sim
    Gram-negative aerobes
    Escherichia coli1
    Klebsiella oxytoca
    Klebsiella pneumoniae1
    Klebsiella spp.
    Proteus mirabilis
    Proteus vulgaris
    Proteus spp.
    Salmonella spp.
    Shigella spp.
    Gram-zoo aerobes
    Corynebacterium spp.
    Enterococcus faecium
    Tus kab mob Streptococcus pneumoniae 1.2
    Cov pab pawg Streptococcus Viridans
    Cov kab mob uas ib txwm muaj peev xwm tiv thaiv kev sib txuas ntawm amoxicillin nrog clavulanic acid
    Gram-negative aerobes
    Acinetobacter spp.
    Citrobacter freundii
    Cov kab mob Enterobacter spp.
    Hafnia alvei
    Legionella pneumophila
    Morganella morganii
    Providencia spp.
    Pseudomonas spp.
    Serratia spp.
    Stenotrophomonas maltophilia
    Yersinia enterocolitica
    Lwm yam
    Chlamydia mob ntsws dej
    Chlamydia psittaci
    Chlamydia spp.
    Coxiella burnetii
    Mycoplasma spp.
    1 - rau cov kab mob no, kev soj ntsuam kev tau txais txiaj ntsig ntawm kev sib xyaw ntawm amoxicillin nrog clavulanic acid tau pom hauv cov kev tshawb fawb soj ntsuam.
    2 - hom kab mob ntawm cov kab mob no tsis tsim cov beta-lactamases.
    Kev nkag siab nrog amoxicillin monotherapy qhia zoo ib yam li kev nkag siab zoo rau kev sib xyaw ntawm amoxicillin nrog clavulanic acid.
    Cov Tshuaj Pharmacokinetics
    Xuas
    Ob lub tshuaj sib xyaw ntawm cov tshuaj Augmentin®, amoxicillin thiab clavulanic acid, tau nrawm thiab nrawm los ntawm lub plab zom mov (GIT) tom qab kev tswj hwm qhov ncauj. Qhov nqus ntawm cov khoom nquag ntawm kev npaj ntawm Augmentin is yog qhov zoo tshaj yog tias cov tshuaj no tau noj thaum pib noj mov.
    Cov tshuaj pharmacokinetic ntawm amoxicillin thiab clavulanic acid tau txais hauv kev soj ntsuam kuaj mob tau pom hauv qab no, thaum cov neeg ua haujlwm noj qab haus huv muaj hnub nyoog 2-12 xyoo ntawm lub plab tsis muaj pa coj Augmentin® hmoov rau qhov ncauj ncua, 200 mg / 28.5 mg hauv 5 ml (228 , 5 mg) ntawm ib koob ntawm 45 mg / 6.4 mg / kg ib hnub, faib ua ob zaug.
    Yooj yim pharmacokinetic

    Nquag siv Cmax (mg / l) Tmax (teev) AUC (mg × h / l) T1 / 2 (teev)
    Amoxicillin 11.99 ± 3.28 1.0 (1.0-2.0) 35.2 ± 5.01.22 ± 0.28
    Clavulanic acid 5.49 ± 2.71 1.0 (1.0-2.0) 13.26 ± 5.88 0.99 ± 0.14

    Cov tshuaj pharmacokinetic ntawm amoxicillin thiab clavulanic acid tau txais hauv kev soj ntsuam kuaj mob tau pom hauv qab no thaum cov neeg tuaj yeem noj qab haus huv tau noj ib zaug ntawm Augmentin®, hmoov rau kev tshem tawm qhov ncauj, 400 mg / 57 mg hauv 5 ml (457 mg).
    Yooj yim pharmacokinetic

    Nquag nquag siv Cmax (mg / l) Tmax (teev) AUC (mg × h / l)
    Amoxicillin 6.94 ± 1.24 1.13 (0.75-1.75) 17.29 ± 2.28
    Clavulanic acid 1.10 ± 0.42 1.0 (0.5-1.25) 2.34 ± 0.94

    Cmax - ntau qhov ntshav siab tshaj plaws.
    Tmax - lub sijhawm kom mus txog qhov siab tshaj plaws ntshav plasma.
    AUC yog thaj chaw hauv qab kev cia siab-lub sijhawm nkhaus.
    T1 / 2 - ib nrab-lub neej.
    Kev xa Khoom
    Ib yam li kev sib xyaw ua ke ntawm amoxicillin nrog clavulanic acid, kev kho mob ntau ntawm amoxicillin thiab clavulanic acid muaj nyob hauv ntau cov ntaub so ntswg thiab cov kua dej ua kua (hauv lub plab, ua rau lub plab, cov tawv nqaij, adipose thiab cov leeg nqaij, synovial thiab peritoneal kua, kua tsib, thiab cov kua paug). Cov.
    Amoxicillin thiab clavulanic acid muaj qhov tsis muaj zog ntawm kev cog lus rau cov ntshav protein. Cov kev tshawb fawb pom tau tias kwv yees li 25% ntawm tag nrho cov nyiaj clavulanic acid thiab 18% ntawm amoxicillin hauv ntshav plasma khi rau cov ntshav plasma protein.
    Hauv kev tshawb nrhiav tsiaj, tsis muaj kev txuam ntawm lub Cheebtsam ntawm Augmentin® kev npaj hauv ib qho khoom hauv nruab nrog.
    Amoxicillin, zoo li feem ntau penicillins kis mus rau niam mis. Cov kab ntawm clavulanic acid kuj tseem yuav pom nyob hauv niam cov kua mis. Dhau ntawm qhov muaj peev xwm ntawm kev nkag siab, mob raws plab thiab candidiasis ntawm lub qhov ncauj ua pa ntawm lub qhov ncauj, tsis muaj lwm qhov tsis zoo ntawm amoxicillin thiab clavulanic acid rau kev noj qab haus huv ntawm cov menyuam noj niam mis yog qhov paub.
    Cov kev tshawb fawb tsiaj yug me nyuam tau pom tias amoxicillin thiab clavulanic acid hla qhov chaw teeb meem. Txawm li cas los xij, tsis muaj qhov tshwm sim tsis zoo ntawm tus me nyuam hauv plab.
    Kev zom zaub mov
    10-25% ntawm thawj zaug koob tshuaj amoxicillin yog raug tawm los ntawm lub raum hauv daim ntawv ntawm qhov tsis muaj zog metabolite (penicilloic acid). Clavulanic acid tau dav dav rau 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid thiab 1-amino-4-hydroxybutan-2-ib thiab tau tawm los ntawm lub raum xws li txuas nrog huab cua tas sijhawm hauv daim ntawv cov roj carbon dioxide.
    Chaw Sau Ntawv
    Zoo li lwm yam penicillins, amoxicillin tsuas yog tawm hauv cov raum, thaum clavulanic acid tawm los ntawm ob lub raum thiab ntxiv cov tshuab. Li ntawm 60-70% ntawm amoxicillin thiab kwv yees li 40-65% ntawm clavulanic acid raug tso tawm los ntawm lub raum tsis hloov hauv thawj 6 teev tom qab noj 1 lub tshuaj ntawm 250 mg / 125 mg lossis 1 ntsiav tshuaj ntawm 500 mg / 125 mg. Kev tswj hwm tib lub sijhawm ntawm probenecid qeeb qeeb ua rau qhov tsis pom kev ntawm amoxicillin, tab sis tsis yog clavulanic acid (saib ntu "Kev cuam tshuam nrog lwm cov tshuaj").

    INDICATIONS RAU SIV

    Cov kab mob kis tau los ntawm cov kab mob me me nkag siab rau amoxicillin / clavulanic acid:
    • mob ENT, xws li mob ua mob tonsillitis, mob ntsws, mob otitis, feem ntau tshwm sim los ntawm Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis thiab Streptococcus pyogenes.
    • Cov kab mob ua pa tsawg dua, xws li ua kom mob ntsws ntev, mob ntsws, thiab mob ntsws, feem ntau los ntawm tus kab mob Streptococcus pneumoniae, Haemophilus influenzae, thiab Moraxella catarrhalis.
    • Kab mob Urogenital, xws li mob cystitis, mob urethritis, pyelonephritis, poj niam mob caj dab, feem ntau yog los ntawm hom kab mob Enterobacteriaceae (feem ntau Escherichia coli), Staphylococcus saprophyticus thiab hom kab mob ntawm genus Enterococcus, nrog rau tus kab mob gonorrhea los ntawm Neisseria gonorrhoeae.
    • Kev kis mob ntawm daim tawv nqaij thiab cov nqaij mos, feem ntau tshwm sim los ntawm Staphylococcus aureus, Streptococcus pyogenes, thiab hom ntawm cov genus Bacteroides.
    • Kev kis mob ntawm cov pob txha thiab pob qij txha, xws li osteomyelitis, feem ntau tshwm sim los ntawm Staphylococcus aureus, yog tias muaj kev kho mob ntev yog tsim nyog.

    Kev kis mob tshwm sim los ntawm cov kab mob me me uas nkag rau amoxicillin tuaj yeem kho nrog Augmentin®, vim tias amoxicillin yog ib qho ntawm nws cov khoom xyaw tseem ceeb.

    TXHEEJ TXHEEM RAU SIV

    • Cov tshuaj tiv thaiv tsis haum rau amoxicillin, clavulanic acid, lwm yam tshuaj, tshuaj tiv thaiv beta-lactam (piv txwv li, penicillins, cephalosporins) hauv anamnesis,
    • Cov mob daj ntseg yav dhau los lossis lub siab ua kom lub siab ua haujlwm thaum siv amoxicillin nrog clavulanic acid nyob rau hauv anamnesis,
    • menyuam yaus hnub nyoog txog 3 hlis,
    • kev ua haujlwm tsis zoo hauv lub raum (creatinine tshem tawm tsawg dua 30 ml / min),
    • phenylketonuria.

    DAIM NTAWV THOV KEV TXHAUM CAI THIAB THAUM MUAJ NCUAV QAB ZE QAB ZIB

    Cev xeeb tub
    Hauv kev tshawb fawb ntawm kev ua me nyuam hauv cov tsiaj, qhov ncauj thiab kev tswj hwm ntawm Augmentineral tsis ua rau muaj teebmeem teratogenic.
    Hauv txoj kev tshawb fawb ib zaug hauv cov poj niam nrog lub cev ua ntej lub cev xoos xoos, nws tau pom tias kev siv tshuaj kho mob muaj feem cuam tshuam nrog kev pheej hmoo ntawm necrotizing enterocolitis hauv cov menyuam mos yug tshiab. Zoo li txhua yam tshuaj, Augmentin® tsis pom zoo rau siv thaum cev xeeb tub, tshwj tsis yog muaj kev cia siab rau tus niam tshaj qhov muaj feem yuav ua rau muaj menyuam hauv plab.
    Lub sijhawm pub mis niam
    Cov tshuaj Augmentin® tuaj yeem siv thaum pub mis. Dhau ntawm qhov muaj peev xwm ntawm kev nkag siab, mob raws plab, lossis candidiasis ntawm lub qhov ncauj cov leeg ua kab mob cuam tshuam nrog kev nkag mus ntawm cov nyiaj ntawm cov khoom xyaw tseem ceeb ntawm cov tshuaj no rau cov niam mis, tsis muaj lwm yam kev tsis zoo tshwm sim hauv cov menyuam mos lub mis. Thaum muaj qhov tshwm sim tsis zoo hauv cov menyuam yaus noj niam mis, kev pub mis niam yuav tsum tsis tsum.

    KHAWV KOOB THIAB KEV COB QHIA

    Txog kev tswj hwm qhov ncauj.
    Cov tshuaj noj rau lub cev yog tsim tshwj xeeb raws lub hnub nyoog, lub cev qhov hnyav, lub raum kev ua haujlwm ntawm tus neeg mob, nrog rau qhov mob hnyav heev.
    Txhawm rau kom txo qis lub plab zom mov tsis zoo thiab ua kom zoo dua ntawm kev nqus, cov tshuaj yuav tsum tau noj thaum pib noj mov.
    Qhov kawm tsawg kawg ntawm cov tshuaj tua kab mob kev kho mob yog 5 hnub.
    Txoj kev kho yuav tsum tsis txhob txuas ntxiv ntev dua 14 hnub yam tsis muaj tshuaj xyuas qhov xwm txheej kho mob.
    Yog tias tsim nyog, nws muaj peev xwm los ua cov kev kho mob ib qib dhau ib zaug (thawj kev tswj hwm kev coj noj coj ua hauv Augmentin® hauv kev siv tshuaj yog hmoov rau kev npaj cov tshuaj rau kev tswj hwm nrog kev hloov mus tom qab Augmentin® hauv kev kho mob qhov ncauj).
    Cov neeg loj thiab menyuam yaus hnub nyoog 12 xyoos thiab laus dua lossis hnyav 40 kg lossis ntau dua
    Nws raug nquahu kom siv lwm cov tshuaj ntawm Augmentin® lossis 11 ml ntawm kev ncua ntawm kev ncua ntawm 400 mg / 57 mg hauv 5 ml, uas yog sib npaug rau 1 ntsiav tshuaj ntawm Augmentin®, 875 mg / 125 mg.
    Cov menyuam hnub nyoog 3 hlis txog 12 xyoos nrog lub cev hnyav dua li 40 kg
    Kev xam qhov koob tshuaj yog nqa tawm raws li lub hnub nyoog thiab lub cev qhov hnyav, qhia hauv mg / kg lub cev qhov hnyav ib hnub lossis milliliters ntawm kev ncua. Qhov koob tshuaj txhua hnub tau muab faib ua 2 koob tshuaj txhua 12 teev. Cov tshuaj pom zoo ntau npaum li cas thiab kev tswj hwm pes tsawg zaus raug nthuav tawm hauv cov kab hauv qab no.
    Augmentin® kev noj tshuaj lub rooj noj mov (kev suav tshuaj rau amoxicillin)

    Ncua Sijhawm 7: 1 (200 mg / 28.5 mg hauv 5 ml lossis 400 mg / 57 mg hauv 5 ml) hauv 2 koob tshuaj txhua 12 teev
    Kev txhaj tshuaj qis 25 mg / kg / hnub
    Kev txhaj tshuaj ntau npaum li cas 45 mg / kg / hnub

    Kev txhaj tshuaj qis ntawm Augmentin® raug pom zoo rau kev kho mob ntawm daim tawv nqaij thiab cov nqaij mos, nrog rau cov mob tonsillitis.
    Kev txhaj tshuaj siab ntawm Augmentin High tau pom zoo rau kev kho mob ntawm cov kab mob xws li otitis media, sinusitis, kis mob qis qis ntawm txoj hlab ntsws thiab mob txeeb zig, mob pob txha thiab pob qij txha.
    Rau Augmentin® nrog qhov sib piv ntawm amoxicillin rau clavulanic acid 7: 1, muaj cov ntaub ntawv tsis txaus ntseeg tau pom zoo kom pom zoo kom siv cov koob tshuaj ntau dua 45 mg / kg / hnub hauv 2 faib rau cov menyuam hauv cov hnub nyoog 2 xyoos.
    Cov menyuam txij thaum yug mus txog 3 hlis
    Kev siv kev ncua uas muaj qhov sib piv ntawm amoxicillin rau clavulanic acid 7: 1 (200 mg / 28.5 mg hauv 5 ml thiab 400 mg / 57 mg hauv 5 ml) yog contraindicated hauv cov neeg no.
    Cov menyuam yug ua ntej
    Tsis muaj cov lus qhia hais txog qhov muab tshuaj.
    Cov pab pawg neeg tshwj xeeb
    Cov neeg laus cov neeg mob
    Yuav tsum tsis txhob kho cov tshuaj ntau npaum li cas; tib cov tshuaj muab tshuaj zoo ib yam li cov neeg laus. Hauv cov neeg mob laus uas lub raum lub raum tsis ua haujlwm, cov koob tshuaj uas tsim nyog rau cov neeg laus uas lub raum tsis ua haujlwm.
    Cov neeg mob uas lub raum tsis ua hauj lwm zoo
    A 7: 1 ncua kev kawm (200 mg / 28.5 mg hauv 5 ml lossis 400 mg / 57 mg hauv 5 ml) yuav tsum tsuas yog siv rau cov neeg mob uas muaj creatinine tshem ntau tshaj 30 ml / min, tsis tas yuav tsum kho ntau npaum li cas.
    Feem ntau, yog tias ua tau, kev kho mob rau cov niam txiv yuav tsum yog qhov zoo dua.
    Cov neeg mob uas muaj lub siab ua haujlwm tsis zoo
    Txoj kev kho yog nqa tawm nrog ceev faj, daim siab ua haujlwm tseem raug saib xyuas tsis tu ncua.
    Tsis muaj cov ntaub ntawv txaus los hloov lub tswv yim hloov cov koob tshuaj hauv cov neeg mob zoo li no.
    Tus txheej txheem ntawm kev npaj ntawm qhov raug ncua
    Qhov kev ncua yog npaj tam sim ua ntej siv thawj zaug.
    Kwv yees li 40 ml ntawm cov dej rhaub kom txias rau chav sov yuav tsum tau ntxiv rau lub raj mis hmoov, tom qab ntawd kaw lub raj mis nrog lub hau thiab co kom txog thaum cov hmoov yaj tag, cia lub raj mis sawv ntsug li 5 feeb kom ntseeg tau tias kev ua kom tiav. Tom qab ntawd ntxiv dej rau lub cim rau ntawm lub raj mis thiab co lub raj mis dua. Hauv tag nrho, kwv yees li 64 ml ntawm dej yog xav tau los npaj qhov kev ncua.
    Lub raj mis yuav tsum tau co kom zoo ua ntej txhua qhov kev siv. Txhawm rau kom raug qhov tseeb ntawm cov tshuaj, siv lub ntsuas ntsuas lossis cov koob txhaj tshuaj, uas yuav tsum tau ntxuav nrog dej zoo tom qab siv txhua zaus.Tom qab kev nrawm, qhov kev ncua yuav tsum khaws cia tsis pub dhau 7 hnub hauv lub tub yees, tab sis tsis khov.
    Rau cov menyuam muaj hnub nyoog qis dua 2 xyoos, qhov ntsuas ntsuas ib zaug ntawm kev ncua kev ncua ntawm cov tshuaj Augmentin® tuaj yeem tov nrog dej hauv qhov sib piv ntawm 1: 1.

    Tso tawm daim ntawv thiab muaj pes tsawg leeg

    Cov tshuaj tua kab mob muaj nyob rau hauv cov ntawv hauv qab no:

    • zaj duab xis-cov ntsiav tshuaj: oval, dawb lossis yuav luag dawb, ntawm qhov tawg - ntawm dawb-daj mus yuav luag dawb hauv 250 mg txhua (250 + 125): nrog cov ntawv sau rau ntawm ib sab ntawm AUGMENTIN ntsiav tshuaj (hauv cov hlwv ntawm 10 pcs., hauv thawv ntim 2 blisters), 500 mg txhua (500 + 125): nrog ntawv sau ntxiv “АС” thiab qhov phom sij rau ntawm ib sab (hauv cov hlwv ntawm 7 lossis 10 pcs., nyob hauv ib pob 2 lub hlwv), 875 mg (875 + 125 ): nrog cov tsiaj ntawv "A" thiab "C" ntawm ob sab ntawm lub ntsiav tshuaj thiab qhov kev pheej hmoo ntawm qhov pheej hmoo ntawm ib sab (hauv cov hlwv ntawm 7 pcs., hauv daim npav ntawm 2 daim duab),
    • hmoov rau kev ncua rau kev tswj hwm ntawm qhov ncauj: dawb lossis yuav luag dawb, nrog tus yam ntxwv tsis hnov ​​tsw, thaum diluted, kev ncua (dawb lossis yuav luag dawb) tau txais nyob rau hauv uas muaj cov ntaub ntawv dej nag thaum so (hauv iav fwj, 1 lub raj mis nrog lub hau ntsuas hauv lub thawv ntawv) ,
    • hmoov rau kev daws rau kev tswj hwm kev ua haujlwm: los ntawm dawb mus rau yuav luag dawb (hauv ib pob ntawm cov duab los qhia 10 fwj).

    Augmentin siv kev sib xyaw ntawm clavulanic acid (nyob rau hauv daim ntawv ntawm cov ntsev potassium) thiab amoxicillin (hauv cov tshuaj sodium ntsev) yog cov tshuaj yeeb dej caw.

    1 ntsiav tshuaj muaj:

    • cov tshuaj nquag: clavulanic acid - 125 mg, amoxicillin (raws li trihydrate) - 250, 500 lossis 875 mg,
    • kev zam: sodium carboxymethyl hmoov txhuv nplej siab, colloidal silicon dioxide, magnesium stearate, microcrystalline cellulose.

    Cov sib xyaw ua ke ntawm cov zaj duab xis txheej ntawm cov ntsiav tshuaj suav nrog: hypromellose, hypromellose (5cP), macrogol 6000, macrogol 4000, dimethicone, titanium dioxide.

    5 ml ntawm qhov raug tshem tawm npaj rau kev tswj hwm qhov ncauj muaj:

    • cov tshuaj yeeb dej caw sib piv ntawm amoxicillin (hauv daim ntawv ntawm trihydrate) rau clavulanic acid (hauv kev tsim cov ntsev potassium): 125 mg / 31.25 mg, 200 mg / 28.5 mg, 400 mg / 57 mg,
    • kev zam: hypromellose, xanthan ntawm cov pos hniav, succinic acid, aspartame, colloidal silicon dioxide, flavings (txiv kab ntxwv 1, txiv kab ntxwv 2, raspberry, "Bright molasses"), silicon dioxide.

    1 vial (1200 mg) ntawm cov tshuaj tov dej muaj cov tshuaj nquag:

    • amoxicillin (nyob rau hauv daim ntawv ntawm sodium ntsev) - 1000 mg,
    • clavulanic acid (nyob rau hauv daim ntawv ntawm cov poov tshuaj ntsev) - 200 mg.

    Cov Tshuaj Hauv Tshuaj

    Amoxicillin yog tshuaj tua kab mob uas muaj peev xwm tiv thaiv ntau yam kab mob uas muaj ntau yam-tsis zoo thiab gram-zoo. Txawm li cas los xij, amoxicillin tiv thaiv kev puas tsuaj los ntawm β-lactamases; yog li ntawd, nws cov kev ua haujlwm spectrum tsis ntev rau cov kab mob ua cov enzyme no.

    Clavulanic acid muaj cov qauv zoo ib yam li penicillins thiab yog ib qho inhibitor ntawm β-lactamases, uas piav qhia txog nws lub peev xwm tsis muaj peev xwm ua rau ntau hom β-lactamases, uas nyob hauv cov kab mob me me uas qhia tias tawm tsam cephalosporins thiab penicillins. Qhov kev tiv thaiv zoo no ua rau plasmid β-lactamases, feem ntau muab cov kab mob tiv thaiv kab mob, thiab tsis zoo tiv thaiv hom 1 chromosomal l-lactamases uas tsis raug clavulanic acid inhibition.

    Cov kab ke ntawm clavulanic acid nyob rau hauv kev sib xyaw ntawm Augmentin tso cai rau koj los tiv thaiv amoxicillin los ntawm kev puas tsuaj los ntawm cov enzymes - β-lactamases, uas ua kom paub tseeb tias nthuav tawm ntawm cov tshuaj tua kab mob ntawm cov tshuaj yeeb dej caw.

    Hauv cov tshuaj vitro, cov kab mob hauv qab no yog nkag rau kev sib xyaw ntawm amoxicillin nrog clavulanic acid:

    • gram-negative aerobes: Vibrio cholerae, Bordetella pertussis, Pasteurella multocida, Haemophilus influenzae, Neisseria gonorrhoeae, Moraxella catarrhalis, Helicobacter pylori,
    • Gram-positive aerobes: coagulase-negative staphylococci (mob rhiab rau methicillin), Staphylococcus saprophyticus (qhia qhov tsis hnov ​​mob rau methicillin), Staphylococcus aureus (qhia kev nkag siab rau methicillin), Bacillus anthracisal, Streptocococcus ag. (lwm yam β-hemolytic streptococci), Streptococcus pyogenes, Enterococcus faecalis, Nocardia asteroides, Listeria monocytogenes,
    • gram-negative anaerobes: Prevotella spp., Bacteroides fragilis, Bacteroides spp., Porphyromonas spp., Fusobacterium spp., Fusobacterium nucleatum, Eikenella corrodens, Capnocytophaga spp.,
    • gram-positive anaerobes: Peptostreptococcus spp., Peptostreptococcus magnus, Peptostreptococcus micros, Peptostreptococcus niger, Clostridium spp.,
    • Lwm tus: Treponema pallidum, Leptospira icterohaemorrhagiae, Borrelia burgdorferi.

    Cov kab mob me me hauv qab no yog tsiag ntawv los ntawm kev ua kom tiv taus cov tshuaj amoxicillin nrog clavulanic acid:

    • gram-positive aerobes: streptococci ntawm pawg Viridans, Corynebacterium spp., Streptococcus pneumoniae (hom kab mob no tsis tsim β-lactamases, thiab cov tshuaj kho tau txais txiaj ntsig los ntawm kev tshawb fawb soj ntsuam), Enterococcus faecium,
    • gram-negative aerobes: Shigella spp., Escherichia coli, Salmonella spp., Klebsiella spp., Klebsiella pneumoniae, Klebsiella oxytoca, Proteus spp., Proteus vulgaris, Proteus vulgaris, Proteus vulgaris.

    Cov kab mob hauv qab no yog tshuaj tiv thaiv kab mob, uas suav nrog amoxicillin thiab clavulanic acid:

    • gram-negative aerobes: Yersinia enterocolitica, Acinetobacter spp., Stenotrophomonas maltophilia, Citrobacter freundii, Serratia spp., Enterobacter spp., Pseudomonas spp., Hafnia alvei, Providencia spp., Morganella morganii, Legionella pneum.
    • lwm yam: Coxiella burnetii, Chlamydia psittaci, Chlamydia mob ntsws, Chlamydia spp., Mycoplasma spp.

    Cov kev nkag siab ntawm cov kab mob rau amoxicillin monotherapy qhia qhov zoo sib xws mus rau kev sib xyaw ntawm amoxicillin nrog clavulanic acid.

    Cov Tshuaj Pharmacokinetics

    Clavulanic acid thiab amoxicillin tau nrawm thiab yuav luag 100% nqus tau los ntawm lub plab zom mov (GIT) thaum noj ntawm qhov ncauj. Qhov kev nqus ntawm cov khoom siv nquag ntawm Augmentin raug suav tias yog qhov zoo dua thaum cov tshuaj nkag mus rau hauv lub cev thaum pib noj mov.

    Kev siv ntawm kev ncua rau kev tswj hwm ntawm qhov ncauj tau kawm hauv kev sim tshuaj uas cov neeg ua haujlwm pab dawb noj qab haus huv hnub nyoog 2 txog 12 xyoos koom nrog. Lawv coj Augmentin hauv tshuaj ntau npaum li 125 mg / 31.25 mg 5 ml ntawm ib plab khoob hauv 3 koob tshuaj, muab ib koob tshuaj amoxicillin thiab clavulanic acid txhua hnub ntawm 40 thiab 10 mg / kg, feem. Raws li qhov txiaj ntsig ntawm kev sim, cov kev ntsuas hauv qab no pharmacokinetic tau txais:

    • clavulanic acid: qhov siab tshaj plaws ntawm 2.7 ± 1.6 mg / ml, lub sijhawm nce mus txog cov ntsiab lus plasma ntau tshaj plaws ntawm 1.6 teev (thaj tsam 1-2 teev), AUC 5.5 ± 3.1 mg × h / ml, tshem tawm ib nrab-lub neej ntawm 0.94 ± 0.05 teev,
    • amoxicillin: qhov siab tshaj plaws 7.3 ± 1.7 mg / ml, lub sijhawm kom ncav cuag cov ntshav siab tshaj plaws 2.1 teev (thaj tsam 1.2–3 teev), AUC 18.6 ± 2.6 mg × h / ml Qhov kev tshem tawm ib nrab-lub neej ntawm 1.0 ± 0.33 teev.

    Kev tshawb fawb sib piv ntawm cov yam ntxwv ntawm lub pharmacokinetics ntawm Augmentin kuj tau nqa tawm thaum noj nws nyob rau hauv daim ntawv ntawm cov ntsiav tshuaj, zaj duab xis-ntsiav tshuaj ntsiav tshuaj (ntawm lub plab khoob). Cov txiaj ntsig ntawm kev txiav txim siab qhov pharmacokinetic tsis nyob ntawm kev ua kom tau ntawm Augmentin, clavulanic acid thiab amoxicillin nyob rau hauv ntau yam tshuaj muaj raws li nram no:

    • ib Augmentin ntsiav tshuaj nrog qhov ntau npaum ntawm 250 mg / 125 mg: rau amoxicillin - qhov siab tshaj plaws ntawm 3.7 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plasma concentration ntawm 1.1 teev, AUC (thaj chaw hauv qab nkhaus "concentration - sijhawm") 10.9 mg h / ml ib nrab-neej (T1/2) 1 teev. Rau cov clavulanic acid, qhov siab tshaj plaws yog 2.2 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws hauv cov ntshav ntshav yog 1.2 teev, AUC 6.2 mg × h / ml, T1/2 - 1.2 teev
    • ob lub Augmentin ntsiav tshuaj nrog qhov ntau dua ntawm 250 mg / 125 mg: rau amoxicillin - qhov siab tshaj plaws ntawm 5.8 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plasma concentration ntawm 1.5 teev, AUC 20.9 mg × h / ml, T1/2 - 1.3 teev. Rau cov clavulanic acid, qhov siab tshaj yog 4.1 mg / L, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plahaum yog 1.3 teev, AUC 11.8 mg × h / ml, T1/2 - 1 teev
    • ib Augmentin ntsiav tshuaj nrog qhov koob tshuaj 500 mg / 125 mg: rau amoxicillin - qhov siab tshaj plaws ntawm 6.5 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plasma concentration ntawm 1.5 teev, AUC 23.2 mg × h / ml, T1/2 - 1.3 teev. Rau cov clavulanic acid, qhov siab tshaj yog 2.8 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws nyob rau hauv cov ntshav ntshav yog 1.3 teev, AUC 7.3 mg × h / ml, T1/2 - 0.8 teev
    • amoxicillin cais ntawm ib koob ntawm 500 mg: qhov siab tshaj plaws 6.5 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plasma concentration 1.3 teev, AUC 19.5 mg × h / ml, T1/2 - 1.1 teev
    • clavulanic acid ib leeg ntawm koob tshuaj 125 mg: qhov siab tshaj plaws 3.4 mg / l, lub sijhawm nce mus txog qhov siab tshaj plaws ntshav plasma 0.9 teev, AUC 7.8 mg × h / ml, T1/2 - 0.7 teev.

    Lub pharmacokinetics ntawm cov tshuaj kuj tseem tau tshawb xyuas nrog kev saib xyuas ntawm cov leeg ntshav ntawm Augmentin rau cov neeg tuaj noj qab haus huv zoo. Raws li qhov tshwm sim, cov tshuaj pharmacokinetic hauv qab no tau txais nyob ntawm qhov koob tshuaj:

    • ntau npaum 1000 mg / 200 mg: rau amoxicillin - qhov siab tshaj plaws ntawm 105.4 μg / ml, T1/2 - 0.9 teev, AUC 76.3 mg × h / ml, tawm hauv cov zis hauv thawj 6 teev tom qab kev tswj hwm ntawm 77.4% ntawm cov tshuaj nquag. Rau cov clavulanic acid, qhov siab tshaj plaws yog 28.5 μg / ml, T1/2 – 0.9 teev, AUC 27.9 mg × h / ml, tawm hauv cov zis thaum thawj 6 teev tom qab kev tswj hwm ntawm 63.8% ntawm cov tshuaj nquag,
    • ntau npaum li 500 mg / 100 mg: rau amoxicillin - qhov siab tshaj plaws ntawm 32.2 μg / ml, T1/2 - 1.07 teev, AUC 25.5 mg × h / ml, tawm hauv cov zis thaum thawj 6 teev tom qab kev tswj hwm ntawm 66.5% ntawm cov tshuaj nquag. Rau cov clavulanic acid, qhov siab tshaj plaws yog 10.5 μg / ml, T1/2 - 1.12 teev, AUC 9.2 mg × h / ml, tawm hauv cov zis hauv thawj 6 teev tom qab kev tswj hwm ntawm 46% ntawm cov tshuaj nquag.

    Ob qho tib si thaum noj ntawm qhov ncauj thiab tso ntshav, clavulanic acid thiab amoxicillin hauv kev kho mob ntau yam tau txiav txim siab nyob rau hauv cov kua dej interstitial thiab ntau cov ntaub so ntswg (hauv cov nqaij hauv lub plab, adipose thiab cov leeg nqaij, tawv nqaij, zais zis, purulent paug, bile, peritoneal thiab synovial. kua).

    Ob lub cev sib xyaw ntawm Augmentin qaug zog khi rau cov ntshav protein. Cov txiaj ntsig kev tshawb fawb qhia tau hais tias qib ntawm kev khi ntawm amoxicillin rau cov plasma protein yog kwv yees li 18%, thiab clavulanic acid - 25%. Kev sim tsiaj tsis tau lees tias cov kev txuam nrog cov tshuaj nquag hauv cov nruab nrog cev.

    Amoxicillin kis mus rau niam mis, uas tseem txiav txim siab clavulanic acid nyob rau hauv cov ntsiab lus ntau ntau. Qhov tshwm sim tsis zoo ntawm cov tshuaj no rau kev noj qab haus huv ntawm cov me nyuam noj niam mis, ntxiv rau txoj kev loj hlob ntawm candidiasis ntawm cov nqaij mos ntawm lub qhov ncauj ntawm lub qhov ncauj, raws plab thiab qhov kev pheej hmoo ntawm kev hnov ​​mob, tsis tau txheeb xyuas.

    Kev kawm txog kev ua haujlwm ntawm kev ua me nyuam hauv tsiaj thaum siv amoxicillin nrog clavulanic acid qhia tau hais tias cov khoom xyaw nquag ntawm Augmentin hla qhov chaw tiv thaiv tsis zoo, tab sis tsis txhob muaj qhov tsis zoo ntawm tus me nyuam hauv plab.

    Txij li 10 txog 25% ntawm cov koob tshuaj amoxicillin raug tso tawm hauv cov zis hauv daim ntawv ntawm penicilloic acid, ib qho tshuaj metabolite uas tsis muaj cov tshuaj pharmacological. Clavulanic acid muaj ntau qhov kev tiv thaiv, ua rau 1-amino-4 hydroxy-butan-2-ib thiab 2,5-dihydro-4- (2-hydroxyethyl) -5-oxo-1H-pyrrole-3-carboxylic acid, thiab tawm los ntawm txoj hnyuv plab. , nrog tso zis, thiab tseem nrog ua pa tawm ntawm cov pa roj carbon dioxide.

    Amoxicillin tsuas yog tawm hauv lub raum, thaum clavulanic acid yog tus kheej los ntawm ob lub raum thiab ib qho kev txuas ntxiv. Kwv yees li 45-65% ntawm clavulanic acid thiab li 60-70% ntawm amoxicillin raug tso tawm tsis hloov hauv cov zis thaum thawj 6 teev tom qab noj 1 ntsiav tshuaj 500mg / 125 mg lossis 250 mg / 125 mg lossis tom qab ib koob txhaj tshuaj ntawm Augmentin ntawm koob tshuaj 500 mg / 100 mg lossis 1000 mg / 200 mg. Kev tswj hwm tib lub sij hawm ntawm probenecid inhibits qhov excretion ntawm amoxicillin, tab sis tsis cuam tshuam qhov cuam tshuam ntawm clavulanic acid.

    Kev ntsuas rau siv

    Raws li cov lus qhia, Augmentin yog tshuaj rau cov kab mob kis tau los ntawm cov kab mob me me uas nkag siab rau cov tshuaj tua kab mob:

    • kis ntawm daim tawv nqaij, cov nqaij mos,
    • mob ntsws ua pa: ntsws mob ntsws, lobar bronchopneumonia, empyema, mob ntsws ua paug,
    • kis kab mob ntawm cov kab mob genitourinary: cystitis, mob rwj, pyelonephritis, rho menyuam sepsis, mob syphilis, mob ncauj lus, kis mob rau cov kabmob hauv lub plab pelvic,
    • kis kab mob ntawm cov pob txha thiab pob qij txha: txha oselomyelitis,
    • cov mob hu ua odontogenic: mob qog, kab mob hu ua perontogenic maxillary sinusitis, mob hniav heev,
    • kev kis mob tshwm sim los ntawm cov kev mob tshwm sim tom qab kev phais: mob rau daim tawv.

    Cov Yuav Tsum Muaj

    • cov tshuaj tiv thaiv kab mob rau clavulanic acid, amoxicillin, lwm yam tshuaj thiab cov tshuaj tua kab mob beta-lactam (cephalosporins, penicillins) hauv anamnesis,
    • cov teeb meem yav dhau los ntawm jaundice lossis daim siab ua haujlwm thaum siv sib xyaw ntawm clavulanic acid nrog amoxicillin hauv keeb kwm
    • lub raum tsis ua haujlwm (hmoov rau qhov kev npaj ncua ntawm kev ncua ntawm qhov ncauj 200 mg / 28.5 mg thiab 400 mg / 57 mg, ntsiav tshuaj 875 mg / 125 mg),
    • phenylketonuria (hmoov rau kev tshem tawm hauv qhov ncauj).

    Cov Tshuaj Tiv Thaiv kom tsis haum rau Augmentin rau menyuam yaus: ntsiav tshuaj - txog 12 xyoos thiab lub cev hnyav dua 40 kg, hmoov rau kev tshem tawm qhov ncauj 400 mg / 57 mg thiab 200 mg / 28,5 mg - txog 3 hlis.

    Thaum lub cev ua haujlwm tsis zoo, Augmentin yuav tsum ua nrog ceev faj.

    Thaum cev xeeb tub thiab pub niam mis, kev txiav txim siab txog qhov xav tau ntawm kev siv tshuaj yog los ntawm cov kws kho mob koom nrog.

    Cov lus qhia rau kev siv Augmentin: txoj kev thiab ntau npaum li cas

    Ua ntej lub sij hawm teem tseg ntawm Augmentin, nws raug nquahu kom kuaj xyuas kom paub qhov rhiab ntawm microflora uas ua rau muaj mob rau cov tshuaj tua kab mob no. Tom ntej no, kws kho mob teeb tsa cov tshuaj ntau npaum li cas mus rau hauv tus account tus neeg mob lub hnub nyoog, hnyav, lub raum kev ua haujlwm, thiab qhov mob hnyav heev.

    Txoj kev kho mob yam tsawg kawg nkaus yog 5 hnub, kev kho mob siab tshaj plaws yam tsis kho cov teeb meem hauv tsev kho mob yog 2 lub lis piam. Siv cov tshuaj thaum pib noj mov.

    Yog tias tsim nyog, thawj zaug tshuaj yog muab tshuaj rau niam txiv, ces kev tswj hwm ntawm qhov ncauj tuaj yeem raug kho.

    Cov koob tshuaj pom zoo thaum noj cov tshuaj Augmentin rau cov menyuam yaus hnub nyoog dhau 12 xyoos thiab cov laus:

    • Thaum kis mob sib khuav ntawm me mus rau mob hnyav: 1 ntsiav tshuaj (250 mg + 125 mg) 3 zaug hauv ib hnub,
    • rau kev mob hnyav lossis mob nyhav: 1 ntsiav tshuaj (500 mg + 125 mg) 3 zaug hauv ib hnub lossis 1 ntsiav tshuaj (875 mg + 125 mg) 2 zaug ib hnub.

    Tseem Ceeb: 2 ntsiav tshuaj ntawm 250 mg / 125 mg tsis sib npaug rau 1 ntsiav tshuaj ntawm 500 mg / 125 mg.

    Cov koob tshuaj pom zoo thaum noj Augmentin:

    • cov menyuam yaus hnub nyoog dhau 12 xyoos thiab laus: 11 ml ntawm kev ncua ntawm 400 mg / 57 mg / 5 ml 2 zaug hauv ib hnub (sib xyaw rau 1 ntsiav tshuaj ntawm 875 mg + 125 mg),
    • cov menyuam muaj 3 hlis txog 12 xyoos (hnyav txog 40 kg): koob tshuaj txhua hnub yog txiav txim siab raws qhov hnyav ntawm lub cev thiab hnub nyoog (hauv ml rau kev ncua, lossis mg / kg / hnub). Tus nqi suav yuav tsum muab faib ua 3 koob nrog 8-teev sib nrug (rau kev ncua 125 mg / 31.25 mg / 5 ml), lossis 2 koob tshuaj (rau ncua 400 mg / 57 mg / 5 ml lossis 200 mg / 28.5 mg) / 5 ml) ntawm 12-teev sib nrug. Rau qhov ncua tawm 125 mg / 31.25 mg / 5 ml, qis * koob - 20 mg / kg / hnub, siab ** koob - 40 mg / kg / hnub. Rau kev ncua ntawm 400 mg / 57 mg / 5 ml thiab 200 mg / 28.5 mg / 5 ml, koob tshuaj tsawg yog 25 mg / kg / hnub, koob tshuaj ntau yog 45 mg / kg / hnub.

    * Kev siv tshuaj tsawg kawg yog siv rau hauv kev kho mob ntawm cov mob tonsillitis thiab mob ntawm cov nqaij mos thiab tawv nqaij.

    ** Yuav tsum tau txhaj ntau dua rau hauv kev kho mob ntawm qhov ntswg, mob otitis, mob ntawm cov pob qij txha thiab pob txha, tso zis thiab mob ntsws.

    Pom zoo koob tshuaj ntawm Augmentin ua ib txoj kev hais daws rau kev tswj hwm (iv):

    • cov menyuam hnub nyoog dhau 12 xyoos thiab cov laus: 1000 mg / 200 mg 3 zaug hauv ib hnub (txhua 8 teev), nrog rau kis mob hnyav, lub sijhawm nruab nrab ntawm kev txhaj tshuaj tuaj yeem txo mus rau 4-6 teev,
    • cov menyuam yaus los ntawm 3 hlis txog 12 xyoos: 3 zaug hauv ib hnub ntawm tus nqi ntawm 50 mg / 5 mg / kg lossis 25 mg / 5 mg / kg nyob ntawm qhov mob hnyav, lub sijhawm luv ntawm kev txhaj tshuaj yog 8 teev,
    • cov menyuam yaus hnub nyoog qis dua 3 hlis: nrog lub cev qhov hnyav tshaj 4 kg - 25 mg / 5 mg / kg lossis 50 mg / 5 mg / kg txhua 8 teev, nrog lub cev qhov hnyav tsawg dua 4 kg - 25 mg / 5 mg / kg txhua 12 teev.

    Augmentin yuav tsum noj kom nruj ntawm cov koob tshuaj uas kws kho mob tau hais tseg, soj ntsuam cov tshuaj noj kom ntau.

    Sab sij huam

    Kev siv cov Augmentin tsis tshua muaj tshwm sim tuaj yeem ua rau cov kev mob tshwm sim hauv qab no (feem ntau me me thiab dhau mus):

    • hematopoietic system: thrombocytopenia, leukopenia (suav nrog neutropenia), hemolytic anemia thiab agranulocytosis (thim rov qab), kev nce prothrombin index thiab lub sijhawm los ntshav,
    • kev tiv thaiv kab mob: kev tsis haum tshuaj nyob rau hauv daim ntawv ntawm anaphylaxis, angioedema, ib qho tsos mob zoo ib yam li kev mob ntshav siab, Stevens-Johnson syndrome, kev tsis haum vasculitis, tshuaj lom rau daim tawv nqaij tsis haum, ua rau lub cev ua kom tawv nqaij dermatitis, mob ua kom zoo txaus rau qhov mob ua paug. Augmentin yuav tsum tsis ua mus ntxiv yog hais tias muaj ib qho ua xua dermatitis,
    • cov tawv nqaij ua kom zoo nkauj: tawm pob, urticaria, erythema multiforme,
    • lub hauv nruab nrab hauv lub paj hlwb: hyperactivity thiab convulsions (thim rov qab), mob taub hau, kiv taub hau,
    • mob siab: cholestatic mob daj ntseg, kab mob siab, qhov nruab nrab nce ntawm ACT thiab / lossis theem ALT (cov kev mob tshwm sim no tshwm sim thaum kho lossis tam sim ntawd, feem ntau yog rau cov neeg laus thiab cov txiv neej (nrog kev kho mob ntev), hauv cov menyuam yaus - tsis tshua muaj, thiab yog) thim rov qab)
    • cov kab mob zis: crystalluria, interstitial nephritis.

    Ntau zaus, kev siv cov Augmentin tuaj yeem ua rau mob plab zom mov hauv cov neeg laus thiab menyuam yaus, xeev siab, ntuav, dyspepsia (cov kev cuam tshuam ntawm lub plab no yuav txo qis yog tias koj siv cov tshuaj nrog zaub mov noj).

    Qee zaum, hauv cov menyuam yaus uas tau coj Augmentin kev ncua, xim ntawm lub tsho tiv no sab saum toj ntawm cov txha hniav laus yuav hloov.

    Cov kab mob microbiological ntawm cov tshuaj feem ntau ua rau mob hnyuv plab ntawm lub hauv plab, nyob rau qee qhov tsis tshua muaj neeg muaj peev xwm ua rau mob hemorrhagic thiab pseudomembranous colitis.

    Cov chaw muag tshuaj

    Cov Tshuaj Hauv Tshuaj
    Mechanism ntawm kev ua
    Amoxicillin yog ib qho hluavtaws penicillin (beta-lacgam tshuaj tua kab mob) uas tiv thaiv ib lossis ntau ntau tus kabmob (paub tias yog penicillin-khi cov protein) thaum lub sijhawm biosynthesis ntawm cov kab mob peptidoglycan, uas yog kev sib koom ua ke ntawm cov kab mob ntawm tes. Kev txwv tsis pub peptidoglycan hluavtaws ua rau ua rau cov xovtooj ntawm tes xoob, uas tom qab ntawd ua rau lysis thiab cell tuag.
    Amoxicillin raug pov tseg los ntawm beta-lactamases ua los ntawm cov kab mob tawm tsam, thiab yog li ntawd kev ua si spectrum ntawm amoxicillin nws tus kheej tsis suav nrog cov kab mob me me uas tsim cov enzymes no.
    Clavulanic acid yog beta-lactamase inhibitor yam ntxwv ntawm kev mob rau penicillins. Clavulanic acid thaiv qhov kev txiav txim ntawm qee yam enzymes beta-lactamase, thiaj li tiv thaiv qhov ua tsis tau ntawm amoxicillin. Clavulanic acid ib leeg tsis muaj qhov ua kom zoo rau kev siv tshuaj tua kab mob tseem ceeb.
    Cov kev sib raug zoo ntawm pharmacokinetics / pharmacodynamics
    Lub hauv paus tseem ceeb los txiav txim siab qhov kev ua haujlwm ntawm amoxicillin yog lub sijhawm uas dhau los ntawm qhov kev txwv qis tshaj plaws (T> IPC).
    Kuj tsim mechanism
    Nws muaj ob lub ntsiab tseem ceeb rau kev tsim cov kev tiv thaiv rau amoxicillin / clavulanic acid:
    • Kev tsis ua haujlwm los ntawm cov beta-lactamases uas tsis raug txwv los ntawm clavulanic acid, suav nrog beta-lactamases ntawm cov chav B, C thiab D.
    • Cov kev hloov pauv ntawm cov kab mob sib txuas rau penicillin, uas ua rau txo qis ntawm kev sib raug zoo ntawm tus neeg sawv cev tiv thaiv kab mob rau lub hom phiaj ntawm kev ua no.
    Tsis tas li ntawd, kev hloov pauv ntawm qhov permeability ntawm lub plhaub ntawm cov kab mob me, nrog rau kev qhia ntawm efflux twj, tuaj yeem ua rau lossis txhawb kev txhim kho ntawm cov kab mob tiv thaiv, tshwj xeeb tshaj yog cov kab mob gram-tsis zoo.
    Cov kab mob sib xyaw nrog cov tshuaj tua kab mob sib txawv los ntawm thaj av thiab sijhawm. Nws raug nquahu kom coj mus rau hauv cov ntaub ntawv hauv cheeb tsam rhiab heev, tshwj xeeb tshaj yog thaum nws los txog rau kev kho mob ntawm kev mob hnyav. Cov kws tshaj lij yuav tsum tau sab laj yog tias cov ntaub ntawv tiv thaiv hauv zos nug txog qhov ua haujlwm ntawm cov tshuaj hauv kev kho qee yam mob.
    Cov kab mob ntxim nyiam
    Aerobic gram-cov kab mob zoo:
    Enterococcus faecalis, Gardnerella qhov chaw mos, Staphylococcus aureus, methicillin-sensitive *, coagulase-negative staphylococci (methicillin-rhiab), Qhatreptococcus agalactiae, Tus kab mob Streptococcus pneumoniae1,Cov kab mob Streptococcus pyogenes thiab lwm yam beta hemolytic streptococci, pab pawg Streptococcus viridans.
    Aerobic gram-tsis zoo kab mob:
    Capnocytophaga spp., Eikenella corrodens, Haemophilus influenzae 2, Moraxella catarrhalis, Pasteurella multocida
    Cov kab mob Anaerobic:
    Bacteroides fragilis, Fusobacterium nucleatum, Prevotella spp.
    Cov kab mob uas kis tau tiv taus yog qhov ua tau
    Aerobic gram-cov kab mob zoo:
    Enterococcus faecium **
    Aerobic gram-tsis zoo kab mob:
    Escherichia coli, Klebsiella oxytoca, Klebsiella pneumoniae, Proteus mirabilis, Proteus vulgaris
    Ib txwm tiv taus cov kab mob me
    Aerobic gram-cov kab mob tsis zoo
    Acinetobacter sp., Citrobacter freundii, Enterobacter sp., Legionella pneumophila, Morganella morganii, Providencia spp., Pseudomonas sp., Serratia sp., Stenotrophomonas maltophilia
    Lwm yam kab mob me
    Chlamydophilia mob ntsws, Chlamodophila psittaci, Coxiella burnetti, Mycoplasma pneumoniae.
    * Txhua qhov methicillin-resistant staphylococci tiv taus amoxicillin / clavulanic acid. "Ntuj me me rhiab heev thaum tsis muaj ib qho yuav kis tau cov tshuab.
    1 Tshuaj Augmentin, hmoov rau kev tshem tawm ntawm qhov ncauj, 200 mg / 28.5 mg hauv 5 ml thiab 400 mg / 57 mg hauv 5 ml, tsis tsim nyog rau kev kho mob ntawm penicillin-resistant kis ntawm Streptococcus pneumoniae (saib ntu "Ntu thiab Tswj Xyuas" thiab "Kev Ceeb Toom").
    2 Hauv qee lub tebchaws EU, cov kab mob uas tau txo qis qis tau qhia nrog ntau zaus ntau dua 10%.
    Cov Tshuaj Pharmacokinetics
    Xuas
    Amoxicillin thiab clavulanic acid yog ua kom tiav nyob rau hauv kev daws teeb meem nrog physiological pH. Ob lub Cheebtsam tau nrawm thiab zoo rau lub plab zom mov (GIT) tom qab kev tswj hwm ntawm qhov ncauj. Kev tshem tawm ntawm cov tshuaj nquag yog qhov zoo dua hauv kev noj tshuaj thaum pib noj mov. Tom qab kev tswj hwm ntawm qhov ncauj, lub bioavailability ntawm amoxicillin thiab clavulanic acid yog 70%. Cov tshuaj pharmacokinetic ntawm ob lub cev sib xyaw ua ke zoo sib xws, lub sijhawm mus txog qhov siab tshaj plaws ntshav plasma concentration (Tmax) yog kwv yees li 1 teev.
    Hauv qab no yog cov txiaj ntsig pharmacokinetic ntawm txoj kev tshawb fawb uas amoxicillin / clavulanic acid ntsiav tshuaj (noj ntau npaum 875 mg / 125 mg) tau noj los ntawm cov neeg ua haujlwm pab noj qab haus huv 2 zaug ib hnub twg ntawm lub plab khoob.

    Tus nqi nruab nrab ntawm cov chaw muag tshuaj tsis sib haum (dev tus qauv sib txawv)

    AUC (0-244) (μg x h / ml)

    Amoxicillin / clavulanic acid 875 mg / 125 mg

    Amoxicillin / clavulanic acid 875 mg / 125 mg

    Noj ntau dhau

    Nyob rau hauv rooj plaub ntawm kev noj tshuaj ntau dhau ntawm Augmentin, kev ntxhov siab hauv cov dej-electrolyte sib npaug thiab cov tsos mob tsis zoo los ntawm lub plab zom mov tuaj yeem pom. Muaj cov ntaub ntawv qhia txog kev txhim kho amoxicillin crystalluria, uas qee qhov kev ua rau kev loj hlob ntawm lub raum tsis ua haujlwm. Cov neeg muaj lub raum tsis ua hauj lwm zoo, nrog rau cov neeg uas noj cov tshuaj hauv qhov siab, yuav ua rau chua leeg.

    Txhawm rau kom tsis txhob muaj qhov tshwm sim tsis zoo cuam tshuam nrog kev ua haujlwm ntawm lub plab zom mov, kev kho mob raws kev kho mob yog tus kws kho mob, nyob rau hauv kev xaiv qhov twg tshwj xeeb yuav tsum tau them rau qhov ib txwm ua dej-electrolyte sib npaug. Clavulanic acid thiab amoxicillin tuaj yeem tshem tawm ntawm cov kev mob system los ntawm cov txheej txheem hemodialysis.

    Kev kawm paub yav tom ntej ntawm lub chaw toxicology nyob rau hauv uas 51 cov menyuam koom tau lees tias kev tswj hwm ntawm amoxicillin nyob rau hauv ib koob tshuaj tsis ntau tshaj 250 mg / kg tsis tau ua rau txoj kev loj hlob ntawm cov tsos mob tseem ceeb ntawm kev noj tshuaj ntau dhau thiab tsis tas yuav mob plab.

    Tom qab tso cov tshuaj amoxicillin nyob rau hauv cov koob tshuaj tseem ceeb, nws tuaj yeem tsim ib qho nag lossis daus ntawm txoj kev tso zis, yog li lawv txoj kev thaj yeeb yuav tsum kuaj xyuas tsis tu ncua.

    Cov lus qhia tshwj xeeb

    Thaum lub sij hawm Augmentin txoj kev kho, nws yog qhov yuav tsum tau ua ntej sau ib qho keeb kwm kev kho mob kom paub tseeb seb puas muaj yav dhau los ua kom tsis haum mob cephalosporins, penicillins lossis lwm yam kev ua xua.

    Muaj kev phiv tshuaj anaphylactoid, qee zaum kuj ua rau neeg tuag taus, muaj qee kis. Tshwj xeeb yog qhov kev pheej hmoo siab ntawm cov xwm txheej zoo li no hauv cov neeg mob uas muaj keeb kwm mob siab rau penicillins. Yog tias muaj qhov tsis haum tshwm sim, Augmentin kev kho mob yuav tsum nres tam sim ntawd; hauv qhov xwm txheej loj, adrenaline yuav tsum tau siv tam sim ntawd. Tej zaum yuav xav tau kev kho mob oxygen, kev tswj hwm kev noj qab haus huv ntawm glucocorticosteroids, kom ntseeg tau txog kev ua pa ntawm cov hlab pa, suav nrog kev nkag siab.

    Nrog rau kev siv Augmentin ntev ntev, qhov kev pheej hmoo ntawm kev yug me nyuam ntau dhau ntawm cov kab mob tsis haum rau nws nce.

    Cev xeeb tub thiab lactation

    Cov txiaj ntsig ntawm kev tshawb fawb ntawm kev ua tub rog hauv cov tsiaj nrog kev tswj hwm ntawm ncauj thiab lub qhov ncauj ntawm Augmentin paub meej tias tsis muaj teratogenic cuam tshuam los ntawm cov tshuaj. Ib txoj kev tshawb fawb nkaus xwb, uas tau ua hauv cov neeg mob uas ua ntej ntawm lub qog ua kom puas, qhia tias kev kho mob nrog cov tshuaj tiv thaiv kab mob no tuaj yeem ua rau muaj kev pheej hmoo ntau ntxiv ntawm necrotizing enterocolitis hauv cov menyuam mos. Yog li, Augmentin yuav tsum tsuas yog siv rau hauv cov xwm txheej uas muaj txiaj ntsig zoo ntawm kev kho mob rau leej niam ntau tshaj qhov ua tau qhov tsis zoo ntawm tus me nyuam hauv plab.

    Lub sijhawm teem rau Augmentin thaum lub sijhawm lactation raug tso cai. Txawm li cas los xij, yog tias cov menyuam yaus muaj qhov tsis zoo (ua mob rau lub plab ntawm lub qhov ncauj ntawm lub qhov ncauj ntawm lub qhov ncauj, raws plab, nce ntxiv), nws raug nquahu kom tsis pub niam mis.

    Siv rau thaum yau

    Lub sij hawm teem tseg ntawm Augmentin rau cov menyuam yaus raug tso cai raws li cov kev qhia uas ua tau raws li kev noj tshuaj:

    • hmoov rau kev npaj ib qho kev ncua rau kev tswj hwm qhov ncauj thiab hmoov rau kev npaj ntawm kev daws rau iv kev tswj hwm - txij thaum yug los,
    • zaj duab xis-coated ntsiav tshuaj - los ntawm 12 xyoos.

    Thaum tsis ua haujlwm lub raum

    Hauv cov neeg mob uas lub raum tsis ua haujlwm, kev kho kom haum raws li kev kho mob ntau tshaj plaws ntawm amoxicillin thiab yog raws li kev tsim cov tshuaj muaj kabmob (CC).

    Thaum noj los ntawm cov neeg mob loj hauv CC ntau dua 30 ml / min, Augmentin ntsiav tshuaj nrog 500 mg / 125 mg lossis 250 mg / 125 mg, nrog rau kev ncua nrog kev siv tshuaj ntau npaum li 125 mg / 31.25 mg hauv 5 ml, tsis tas yuav siv tshuaj kho. Yog tias tus nqi QC yog los ntawm 10 txog 30 ml / min, cov neeg mob raug nquahu kom noj 1 ntsiav tshuaj 500 mg / 125 mg lossis 1 ntsiav tshuaj ntawm 250 mg / 125 mg (rau mob me rau mob me) 2 zaug hauv ib hnub lossis 20 ml ntawm kev ncua ntawm 125 mg / 31,25 mg nyob rau hauv 5 ml 2 zaug ib hnub.

    Nrog tus nqi CC tsawg dua 10 ml / min, Augmentin siv nyob rau hauv koob tshuaj 1 ntsiav tshuaj 500 mg / 125 mg lossis 1 ntsiav tshuaj 250 mg / 125 mg (rau mob me rau mob me) 1 zaug ib hnub lossis 20 ml ntawm ncua kev kawm ntawm 125 mg / 31.25 mg nyob rau hauv 5 ml ib zaug ib hnub.

    875 mg / 125 mg ntsiav tshuaj tsuas yog kho rau cov neeg mob uas CC ntau dua 30 ml / min; yog li ntawd, kev kho tshuaj tsis tas yuav tsum tau. Feem ntau, niam txiv kev tswj hwm ntawm Augmentin raug pom zoo.

    Thaum siv rau cov neeg laus thiab menyuam yaus hnub nyoog 12 xyoos lossis hnyav dua 40 kg uas nyob rau ntawm hemodialysis, koob tshuaj Augmentin yog 1 ntsiav tshuaj 500 mg / 125 mg (2 ntsiav tshuaj 250 mg / 125 mg) ib zaug hauv 24 teev lossis 20 ml Ncua Sijhawm 125 mg / 31.25 mg 1 zaug nyob rau ib hnub.

    Thaum lub sijhawm raug lim ntshav, zoo li ntawm nws qhov kawg, tus neeg mob tau txais ib qho ntxiv ib ntsiav tshuaj (1 koob), uas tso cai rau koj kom them nyiaj rau qhov kev poob qis hauv cov concentration ntawm clavulanic acid thiab amoxicillin hauv cov ntshav cov ntshav.

    Yeeb tshuaj sib cuam tshuam

    Probenecid thiab cov tshuaj zoo sib xws (phenylbutazone, diuretics, NSAIDs) txo cov tubular ua ke ntawm amoxicillin. Kev tswj hwm tib lub sij hawm tsis pom zoo, vim tias nws tuaj yeem nrog kev tawm tsam thiab kev nce ntxiv ntawm cov tshuaj amoxicillin hauv cov ntshav (thaum lub raum ua haujlwm ntawm clavulanic acid tsis qeeb).

    Kev ua kom tau Augmentin tuaj yeem cuam tshuam cov nyhuv ntawm qhov ncauj tawm tsam, txo lawv cov txiaj ntsig (tus neeg mob yuav tsum paub txog qhov no).

    Augmentin nyob rau hauv kev daws teeb meem rau kev txhaj tshuaj tsis tuaj yeem sib xyaw nrog cov tshuaj tiv thaiv aminoglycoside hauv tib lub koob txhaj, vim tias qhov no lawv poob lawv cov haujlwm. Nws kuj tseem tsis tuaj yeem tov nrog cov kev daws teeb meem uas muaj dextran, dextrose thiab sodium bicarbonate. Tsis txhob sib xyaw nrog cov khoom ntshav, nrog rau lwm cov kev daws teeb meem protein (protein hydrolysates), nrog lipid emulsions rau kev tso ntshav (iv) kev tswj hwm.

    Cov tshuaj tua kab mob nrog tib yam sib xyaw ua ke: Amoxiclav, Arlet, Clamosar, Bactoclav, Verklav, Liklav, Panclav, Rapiklav, Ranklav, Medoklav, Flemoklav Solutab, Ekoklav, Fibell.

    Augmentin kev sib piv los ntawm cov txheej txheem ntawm kev ua, tshuaj ntawm ib pawg kws tshuaj: Ampioks, Ampisid, Libakcil, Oxamp, Oxampicin, Oxamsar, Sulbacin, Sultasin, Santaz, thiab lwm yam.

    Cov lus thiab cov xwm txheej ntawm kev cia

    Muab cia rau qhov kub thiab txias siab txog 25 ° C hauv qhov chaw qhuav kom tsis muaj menyuam yaus.

    • ntsiav tshuaj nrog amoxicillin cov ntsiab lus ntawm 875 mg thiab 250 mg - 2 xyoos,
    • ntsiav tshuaj nrog amoxicillin 500 mg - 3 xyoos,
    • hmoov rau kev daws rau cov thawj coj ua dej num - 2 xyoos,
    • hmoov rau kev ncua hauv daim ntawv tsis qhib - 2 xyoos,
    • npaj raug ncua (ntawm qhov kub thiab txias li ntawm 2-8 ° C) - 7 hnub.

    Kev txheeb xyuas txog Augmentin

    Cov neeg mob tawm feem ntau qhov kev tshuaj xyuas zoo txog Augmentin ua rau cov ntsiav tshuaj thiab ncua kev kawm rau cov menyuam yaus, coj tus yam ntxwv ua tau zoo thiab ntseeg tau. Qhov ntsuas tshuaj nruab nrab hauv kev sib tham tshwj xeeb yog 4,3-4,5 ntawm 5 lub ntsiab lus. Ntau tus niam mob siab rau qhov kev ncua, vim nws cia koj sai thiab muaj peev xwm tiv taus cov kab mob xws li menyuam yaus xws li tonsillitis lossis mob ntsws. Ib qho ntxiv, kev ncua tsis pub muaj qab ntxiag, vim cov menyuam yaus nyiam nws.

    Tsis tas li, qhov zoo dua ntawm Augmentin raug suav hais tias yog qhov ua tau ntawm nws siv nyob rau hauv cov poj niam cev xeeb tub, mas nyob hauv II thiab III trimesters. Cov kws kho mob tau hais tias lub sijhawm no rau kev kho kom zoo nws yog qhov tseem ceeb heev uas yuav tau soj ntsuam qhov tseeb ntawm kev noj tshuaj thiab ua raws txhua qhov kev pom zoo.

    Tus nqi ntawm Augmentin hauv chaw muag tshuaj

    Tus nqi nruab nrab ntawm Augmentin hauv ntsiav tshuaj daim ntawv: ntau npaum 875 mg / 125 mg - 355-388 rubles. ib pob ntawm 14 pcs., noj tshuaj 500 mg / 125 mg - 305-421 rubles. rau ib pob ntawm 14 pcs., ntau npaum li 250 mg / 125 mg - 250-266 rubles. ib pob 20 pcs.

    Koj tuaj yeem yuav cov hmoov rau qhov kev npaj tawm ntawm qhov ncauj ncua nrog qhov ntau npaum ntawm 125 mg / 31.25 mg hauv 5 ml rau txog 134-158 rubles, ntau npaum ntawm 200 mg / 28.5 mg hauv 5 ml rau 147-162 rubles, thiab ntau npaum li ntawm 400 mg / 57 mg hauv 5 ml - rau 250–276 rubles.

    Hmoov rau qhov kev npaj ntawm ib qho kev daws rau kev tswj hwm dej tam sim no tsis muaj.

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